WorldWideScience

Sample records for providing greater access

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

    Directory of Open Access Journals (Sweden)

    Diana K. Wakimoto

    2014-03-01

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

  2. Accessibility of district health nursing services in the Greater ...

    African Journals Online (AJOL)

    There was no doubt that the health services were culturally accessible in the sense that no complaints of racial discrimination were indicated. The clients did not have any problems to be nursed by health care providers of any cultural background. The issue of functional accessibility needs urgent attention to be in line with ...

  3. Accessibility of MOOCs: Understanding the Provider Perspective

    Science.gov (United States)

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

    2016-01-01

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

  4. 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

  5. JSTOR: Providing New Access to Old Research

    OpenAIRE

    K.M. Guthrie

    1998-01-01

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

  6. Demonstrate provider accessibility with desktop and online services.

    Science.gov (United States)

    2001-10-01

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

  7. Providing Access to Electronic Information Resources in Further Education

    Science.gov (United States)

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

    2004-01-01

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

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

    OpenAIRE

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

    2017-01-01

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

  9. 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

  10. 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…

  11. 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.

  12. Greater access to fast-food outlets is associated with poorer bone health in young children.

    Science.gov (United States)

    Vogel, C; Parsons, C; Godfrey, K; Robinson, S; Harvey, N C; Inskip, H; Cooper, C; Baird, J

    2016-03-01

    A healthy diet positively influences childhood bone health, but how the food environment relates to bone development is unknown. Greater neighbourhood access to fast-food outlets was associated with lower bone mass among infants, while greater access to healthy speciality stores was associated with higher bone mass at 4 years. Identifying factors that contribute to optimal childhood bone development could help pinpoint strategies to improve long-term bone health. A healthy diet positively influences bone health from before birth and during childhood. This study addressed a gap in the literature by examining the relationship between residential neighbourhood food environment and bone mass in infants and children. One thousand one hundred and seven children participating in the Southampton Women's Survey, UK, underwent measurement of bone mineral density (BMD) and bone mineral content (BMC) at birth and 4 and/or 6 years by dual-energy X-ray absorptiometry (DXA). Cross-sectional observational data describing food outlets within the boundary of each participant's neighbourhood were used to derive three measures of the food environment: the counts of fast-food outlets, healthy speciality stores and supermarkets. Neighbourhood exposure to fast-food outlets was associated with lower BMD in infancy (β = -0.23 (z-score): 95% CI -0.38, -0.08) and lower BMC after adjustment for bone area and confounding variables (β = -0.17 (z-score): 95% CI -0.32, -0.02). Increasing neighbourhood exposure to healthy speciality stores was associated with higher BMD at 4 and 6 years (β = 0.16(z-score): 95% CI 0.00, 0.32 and β = 0.13(z-score): 95% CI -0.01, 0.26 respectively). The relationship with BMC after adjustment for bone area and confounding variables was statistically significant at 4 years, but not at 6 years. The neighbourhood food environment that pregnant mothers and young children are exposed may affect bone development during early childhood. If confirmed in

  13. Internet access and investment incentives for broadband service providers

    OpenAIRE

    Baranes, Edmond; Poudou, Jean-Christophe

    2011-01-01

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

  14. Process of care and assistance quality to women in labor with greater access to social goods

    Directory of Open Access Journals (Sweden)

    Adriana Cristina D’Ornelas

    2009-09-01

    Full Text Available Objective: This study aimed at analyzing the process of care and the quality of vaginal delivery assistance in women with greater access to social goods, in a large private hospital in São Paulo, comparing the delivery room with delivery suites. Methods: Cross-sectional and retrospective study, using random sampling of 395 medical charts. Rresults: In the delivery room, labor lasted two hours with the use of oxytocin (56.3%, double-block anesthesia (76.3% and right mediolateral episiotomy (67.7%. At the delivery suites, duration of labor was over ten hours (27.1%, the use of prostaglandin (8.6%, anesthesia by double block technique (61.4%, no anesthesia in 10%, midline episiotomy in 48.6%. Gestational age over 37 weeks (92.3%, birth weight of 3 kg or more (71.4% and 93.5% were referred to the normal nursery. Cconclusion: The results indicated good quality of care during hospitalization and development of delivery, both in the delivery room and in the delivery suites.

  15. Every even number greater than 2 is the sum of two primes provided Riemann hypothesis holds

    OpenAIRE

    Sabihi, Ahmad

    2016-01-01

    We solve Goldbach's conjecture for all the evens greater than 2. This solution is based upon the proof of Sabihi's first and second conjectures (my own conjectures on Goldbach's one) and Riemann Hypothesis is supposed to be correct. Our essential method goes through compleax integral analysis. The first conjecture states that $L(N(k))-D(N(k))\\geq K(N(k),m)\\geq 2$ and $N(k)\\geq 120$, but since the proof can be exhaustive for special case $N(k)=n$, we therefore prove it in such a case. The seco...

  16. Care decision making of frontline providers of maternal and newborn health services in the greater Accra region of Ghana.

    Directory of Open Access Journals (Sweden)

    Ebenezer Oduro-Mensah

    Full Text Available OBJECTIVES: To explore the "how" and "why" of care decision making by frontline providers of maternal and newborn services in the Greater Accra region of Ghana and determine appropriate interventions needed to support its quality and related maternal and neonatal outcomes. METHODS: A cross sectional and descriptive mixed method study involving a desk review of maternal and newborn care protocols and guidelines availability, focus group discussions and administration of a structured questionnaire and observational checklist to frontline providers of maternal and newborn care. RESULTS: Tacit knowledge or 'mind lines' was an important primary approach to care decision making. When available, protocols and guidelines were used as decision making aids, especially when they were simple handy tools and in situations where providers were not sure what their next step in management had to be. Expert opinion and peer consultation were also used through face to face discussions, phone calls, text messages, and occasional emails depending on the urgency and communication medium access. Health system constraints such as availability of staff, essential medicines, supplies and equipment; management issues (including leadership and interpersonal relations among staff, and barriers to referral were important influences in decision making. Frontline health providers welcomed the idea of interventions to support clinical decision making and made several proposals towards the development of such an intervention. They felt such an intervention ought to be multi-faceted to impact the multiple influences simultaneously. Effective interventions would also need to address immediate challenges as well as more long-term challenges influencing decision-making. CONCLUSION: Supporting frontline worker clinical decision making for maternal and newborn services is an important but neglected aspect of improved quality of care towards attainment of MDG 4 & 5. A multi

  17. Increasing Access to Dental and Medical Care by Allowing Greater Flexibility in Scope of Practice.

    Science.gov (United States)

    Manski, Richard J; Hoffmann, Diane; Rowthorn, Virginia

    2015-09-01

    In recent years, advocates for increasing access to medical and oral health care have argued for expanding the scope of practice of dentists and physicians. Although this idea may have merit, significant legal and other barriers stand in the way of allowing dentists to do more primary health care, physicians to do more oral health care, and both professions to collaborate. State practice acts, standards of care, and professional school curricula all support the historical separation between the 2 professions. Current laws do not contemplate working across professional boundaries, leaving providers who try vulnerable to legal penalties. Here we examine the legal, regulatory, and training barriers to dental and medical professionals performing services outside their traditional scope of practice.

  18. Health-Needs Assessment for West African Immigrants in Greater Providence, RI.

    Science.gov (United States)

    Adu-Boahene, Akosua Boadiwaa; Laws, Michael Barton; Dapaah-Afriyie, Kwame

    2017-01-06

    African immigrants in the United States may experience barriers to health-care access and effectiveness. This mixed-methods study used paper-based surveys of people (N=101) in the target population from Nigeria, Ghana, and Liberia, recruited through convenience and snowball sampling. Semi-structured interviews were conducted with 3 clergy members who pastor churches with large Nigerian, Ghanaian, and Liberian populations, respectively; and five physicians and a clinical pharmacist who serve African immigrants. Length of stay in the United States was associated with the health status of refugee children. Undocumented immigration status was associated with lack of health insurance. Cardiovascular diseases, uterine fibroids and stress-related disorders were the most prevalent reported conditions. Regardless of English fluency, many immigrants are unfamiliar with medical terminology. African immigrants in the state of Rhode Island need more health education and resources to navigate the US health-care system. [Full article available at http://rimed.org/rimedicaljournal-2017-01.asp].

  19. Providing Internet Access to High-Resolution Mars Images

    Science.gov (United States)

    Plesea, Lucian

    2008-01-01

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

  20. Providing Internet Access to High-Resolution Lunar Images

    Science.gov (United States)

    Plesea, Lucian

    2008-01-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

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

    Science.gov (United States)

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

    2013-04-01

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

  3. Enclosed nests may provide greater thermal than nest predation benefits compared with open nests across latitudes

    Science.gov (United States)

    Martin, Thomas E.; Boyce, Andy J.; Fierro-Calderon, Karolina; Mitchell, Adam E.; Armstad, Connor E.; Mouton, James C.; Bin Soudi, Evertius E.

    2017-01-01

    Nest structure is thought to provide benefits that have fitness consequences for several taxa. Traditionally, reduced nest predation has been considered the primary benefit underlying evolution of nest structure, whereas thermal benefits have been considered a secondary or even non-existent factor. Yet, the relative roles of these factors on nest structures remain largely unexplored.Enclosed nests have a constructed or natural roof connected to sides that allow a restricted opening or tube entrance that provides cover in all directions except the entrance, whereas open nests are cups or platforms that are open above. We show that construction of enclosed nests is more common among songbirds (Passeriformes) in tropical and southern hemisphere regions than in north temperate regions. This geographic pattern may reflect selection from predation risk, under long-standing assumptions that nest predation rates are higher in southern regions and that enclosed nests reduce predation risk compared with open cup nests. We therefore compared nest predation rates between enclosed vs. open nests in 114 songbird species that do not nest in tree holes among five communities of coexisting birds, and for 205 non-hole-nesting species from the literature, across northern temperate, tropical, and southern hemisphere regions.Among coexisting species, enclosed nests had lower nest predation rates than open nests in two south temperate sites, but not in either of two tropical sites or a north temperate site. Nest predation did not differ between nest types at any latitude based on literature data. Among 319 species from both our field studies and the literature, enclosed nests did not show consistent benefits of reduced predation and, in fact, predation was not consistently higher in the tropics, contrary to long-standing perspectives.Thermal benefits of enclosed nests were indicated based on three indirect results. First, species that built enclosed nests were smaller than species using

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

    Science.gov (United States)

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

    2016-07-01

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

  5. Open Access Papers Have a Greater Citation Advantage in the Author-Pays Model

    Directory of Open Access Journals (Sweden)

    Elaine Sullo

    2016-03-01

    Full Text Available Objective – To investigate the citation performance of open access (OA and toll access (TA papers published in author-pays open access journals. Design – Longitudinal citation analysis. Setting – Publications in Springer and Elsevier’s author-pays open access journals. Subjects – 633 journals published using the author-pays model. This model encompasses both journals where the article processing charge (APC is required and journals in which authors can request open access and voluntarily pay APCs for accepted manuscripts. Methods – The authors identified APC funded journals (journals funded by mandatory author processing charges as well as those where authors voluntarily paid a fee in order to have their articles openly accessible from both Springer and Elsevier, and analyzed papers published in these journals from 2007 to 2011. The authors excluded journals that adopted the APC model later than 2007. To identify Springer titles, the authors created a search strategy to identify open access articles in SpringerLink. A total of 576 journals were identified and double checked in the Sherpa-Romeo database (a database of copyright and open access self-archiving policies of academic journals to verify their open access policies. The authors then downloaded the journal content using SpringerLink, and using Springer Author-Mapper, separated out the open access articles from the toll access articles. In order to identify the Elsevier APC funded journals, the authors referred to “Open Access Journal Directory: A-Z,” which contained 35 OA journals (p. 584. Once the authors consulted “Sponsored articles” issued by Elsevier and verified titles in Sherpa-Romeo, they identified 57 journals that fit the “author-pays” model. The bibliographic information was downloaded and OA articles were separated from TA articles. The authors confirmed that all journals were indeed OA publications by downloading the full-text from off-campus locations

  6. Barriers to electronic access and delivery of educational information in resource constrained public schools: a case of Greater Tubatse Municipality

    CSIR Research Space (South Africa)

    Pholotho, T

    2016-05-01

    Full Text Available Information and Communication Technologies (ICTs) are capable of expanding access to quality education, educational resources and provide teachers with new skills. Nevertheless, a majority of rural public schools have limited ICTs, mainly due...

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

    DEFF Research Database (Denmark)

    Helle, Tina; Brandt, Åse; Iwarsson, Susanne

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

  8. Underimmunization in Ohio's Amish: parental fears are a greater obstacle than access to care.

    Science.gov (United States)

    Wenger, Olivia K; McManus, Mark D; Bower, John R; Langkamp, Diane L

    2011-07-01

    Holmes County, Ohio, one of the largest Amish communities in the world, has persistently low immunization rates. Studies of other Amish communities have revealed that parents do not immunize their children because of lack of access to immunizations. Our study explored reasons that Amish parents in the previously uninvestigated Holmes County population exempt themselves from immunizations. In January 2007, questionnaires for assessing attitudes regarding immunizations were mailed to a random sampling of 1000 Amish parents in Holmes County. Thirty-seven percent of the parents responded. Among the 359 respondents, 68% stated that all of their children had received at least 1 immunization, and 17% reported that some of their children had received at least 1 immunization. Only 14% of the parents reported that none of their children had received immunizations. Eighty-six percent of the parents who completely exempted their children from vaccines stated that the main reason they do not vaccinate their children is concern over adverse effects. Many parents indicated that they allow their children to receive only some vaccines because of concern about the way certain vaccines are produced. The reasons that Amish parents resist immunizations mirror reasons that non-Amish parents resist immunizations. Even in America's closed religious communities, the major barrier to vaccination is concern over adverse effects of vaccinations. If 85% of Amish parents surveyed accept some immunizations, they are a dynamic group that may be influenced to accept preventative care. Underimmunization in the Amish population must be approached with emphasis on changing parental perceptions of vaccines in addition to ensuring access to vaccines. Copyright © 2011 by the American Academy of Pediatrics.

  9. Improving quality in a national intestinal failure unit: greater efficiency, improved access and reduced mortality.

    Science.gov (United States)

    Donaldson, Emma; Taylor, Michael; Abraham, Arun; Carlson, Gordon; Fletcher, Olivia; Varden, Jacqui; Teubner, Antje; Lal, Simon

    2015-07-01

    In 2010, there was a significant waiting list for admission to the intestinal failure unit (IFU) at the Salford Royal National Health Service (NHS) Foundation Trust. There had been a steady increase in the number of new patients referred to the IFU (89 patients 2005; 152 patients 2012) and the number of established patients requiring home parenteral nutrition (HPN) (135 patients 2005; 206 patients 2012) over the last decade. The impact of the resulting long waiting list for these complex patients was that patient deaths occurred in those awaiting admission. Continuous improvement methodology using the model for improvement and sequential plan-do-study-act cycles. Salford Royal NHS Foundation Trust IFU; a large NHS teaching hospital in Northwest England. The primary outcome measures were inpatient length of stay and time spent on waiting list prior to admission. A continuous improvement programme, supported by a project manager. There has been a 21% reduction in average length of stay on the IFU from 55.7 to 44.0 days and a reduction of 72% in the average length of time new patients spent on the waiting list for admission from 65.7 to 18.5 days. These changes were associated with concomitant reduction in 30-day readmission rate from 12.1% to 4.5% and early suggestions of reduced inpatient and waiting list mortality. It is possible to improve the efficiency of a large national service for complex patients using quality improvement methodology, resulting in improved access and reduced waiting list mortality.

  10. 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

  11. 48 CFR 552.238-70 - Identification of Electronic Office Equipment Providing Accessibility for the Handicapped.

    Science.gov (United States)

    2010-10-01

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

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

    Science.gov (United States)

    Grace, Del Marjorie

    2014-01-01

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

  13. Race and the Metropolitan Origins Of Postsecondary Access to Four Year Colleges: The Case of Greater Boston

    OpenAIRE

    Berger, Joseph B.; Smith, Suzanne M.; Coelen, Stephen P.

    2004-01-01

    The Metro Boston Equity Initiative is devoted to analyzing race relations and racial equity issues not simply in the city of Boston, but across the entire metropolitan region. Although greater Boston still has a large white majority and suburban sectors with very little diversity, immigration of Latinos and Asians is driving the region’s growth, and much of this population increase is taking place well outside of the city limits. Changing patterns of school enrollment provide a good sense of ...

  14. Better, Sooner, More Convenient? The reality of pursuing greater integration between primary and secondary healthcare providers in New Zealand.

    Science.gov (United States)

    Lovelock, Kirsten; Martin, Greg; Gauld, Robin; MacRae, Jayden

    2017-01-01

    This article focuses on the results of evaluations of two business plans developed in response to a policy initiative which aimed to achieve greater integration between primary and secondary health providers in New Zealand. We employ the Consolidated Framework for Implementation Research to inform our analysis. The Better, Sooner, More Convenient policy programme involved the development of business plans and, within each business plan, a range of areas of focus and associated work-streams. The evaluations employed a mixed method multi-level case study design, involving qualitative face-to-face interviews with front-line staff, clinicians and management in two districts, one in the North Island and the other in the South Island, and an analysis of routine data tracked ambulatory sensitive hospitalisations and emergency department presentations. Two postal surveys were conducted, one focussing on the patient care experiences of integration and care co-ordination and the second focussing on the perspectives of health professionals in primary and secondary settings in both districts. Both evaluations revealed non-significant changes in ambulatory sensitive hospitalisations and emergency department presentation rates and slow uneven progress with areas of focus and their associated work-streams. Our evaluations revealed a range of implementation issues, the barriers and facilitators to greater integration of healthcare services and the implications for those who were responsible for putting policy into practice. The business plans were shown to be overly ambitious and compromised by the size and scope of the business plans; dysfunctional governance arrangements and associated accountability issues; organisational inability to implement change quickly with appropriate and timely funding support; an absence of organisational structural change allowing parity with the policy objectives; barriers that were encountered because of inadequate attention to organisational

  15. 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…

  16. Doctors and nurses on wards with greater access to clinical dietitians have better focus on clinical nutrition.

    Science.gov (United States)

    Thoresen, L; Rothenberg, E; Beck, A M; Irtun, Ø

    2008-06-01

    According to the Council of Europe, clinical dietitians should assume a more central role in nutritional support. The aim of this study was to assess the opinions among doctors, nurses and clinical dietitians regarding the use of clinical dietitians' expertise in the hospital units and, further, to assess whether the presence of clinical dietitians in hospital departments influenced doctors and nurses focus on clinical nutrition. A questionnaire about the use of clinical nutrition was mailed to 6000 doctors and 6000 nurses working in hospital units where undernutrition is documented to be common, as well as to 678 clinical dietitians working in Scandinavian hospitals. The response rate of clinical dietitians, nurses and doctors were 53%, 46% and 29%, respectively. Nurses and doctors who saw clinical dietitians often found it less difficult to identify undernourished patients and found that insight into the importance of adequate nutrition was better than those who saw clinical dietitians seldom. Clinical nutrition had a higher priority in units with frequent visits by clinical dietitians. The present study shows that doctors and nurses on wards with greater access to clinical dietitians had better focus on clinical nutrition.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Howard Ratner

    2014-03-01

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

  19. 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

  20. Scaling cost-sharing to wages: how employers can reduce health spending and provide greater economic security.

    Science.gov (United States)

    Robertson, Christopher T

    2014-01-01

    In the employer-sponsored insurance market that covers most Americans; many workers are "underinsured." The evidence shows onerous out-of-pocket payments causing them to forgo needed care, miss work, and fall into bankruptcies and foreclosures. Nonetheless, many higher-paid workers are "overinsured": the evidence shows that in this domain, surplus insurance stimulates spending and price inflation without improving health. Employers can solve these problems together by scaling cost-sharing to wages. This reform would make insurance better protect against risk and guarantee access to care, while maintaining or even reducing insurance premiums. Yet, there are legal obstacles to scaled cost-sharing. The group-based nature of employer health insurance, reinforced by federal law, makes it difficult for scaling to be achieved through individual choices. The Affordable Care Act's (ACA) "essential coverage" mandate also caps cost-sharing even for wealthy workers that need no such cap. Additionally, there is a tax distortion in favor of highly paid workers purchasing healthcare through insurance rather than out-of-pocket. These problems are all surmountable. In particular, the ACA has expanded the applicability of an unenforced employee-benefits rule that prohibits "discrimination" in favor of highly compensated workers. A novel analysis shows that this statute gives the Internal Revenue Service the authority to require scaling and to thereby eliminate the current inequities and inefficiencies caused by the tax distortion. The promise is smarter insurance for over 150 million Americans.

  1. 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.

  2. 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.

  3. 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.

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

    Science.gov (United States)

    Jantz, Ronald C.

    2000-01-01

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

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

    Science.gov (United States)

    Ragains, Patrick

    2004-01-01

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

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

    Science.gov (United States)

    Garrison, Brian Wade

    2013-01-01

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

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

    Science.gov (United States)

    Keenan, Thomas P.; Trotter, David Mitchell

    1999-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Whelan, Gene; Pelton, Mitch A.

    2007-08-09

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

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

    Directory of Open Access Journals (Sweden)

    Eliana Wulandari

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

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

    Science.gov (United States)

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

    2017-01-01

    Analysing farmer knowledge of the requirements of finance providers can provide valuable insights to policy makers about ways to improve farmers’ access to finance. This study compares farmer knowledge of the requirements to obtain finance with the actual requirements set by different finance provider types, and investigates the relation between demographic and socioeconomic factors and farmer knowledge of finance requirements. We use a structured questionnaire to collect data from a sample of finance providers and farmers in Java Island, Indonesia. We find that the most important requirements to acquire finance vary among different finance provider types. We also find that farmers generally have little knowledge of the requirements, which are important to each type of finance provider. Awareness campaigns are needed to increase farmer knowledge of the diversity of requirements among the finance provider types. PMID:28877174

  11. 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.

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

    Science.gov (United States)

    Akkary, Ehab; Olgers, Forrest

    2014-11-01

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

  13. 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.

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

    Science.gov (United States)

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

    2017-04-17

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

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

    Directory of Open Access Journals (Sweden)

    Lindsay E. Wright

    2014-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Riggs Elisha

    2012-05-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  18. False security or greater social inclusion? Exploring perceptions of CCTV use in public and private spaces accessed by the homeless.

    Science.gov (United States)

    Huey, Laura

    2010-03-01

    It has been well documented that owing to the vulnerability inherent in their situation and status, the homeless experience high rates of harassment and criminal victimization. And yet, the question of whether CCTV surveillance of public and private spaces - so frequently viewed by the middle classes as a positive source of potential security - might also be viewed by the homeless in similar ways. Within the present paper, I address this issue by considering the possibility that CCTV might be seen by some homeless men and women as offering: a) a measure of enhanced security for those living in the streets and in shelters, and; b) to the extent that security is conceived of as a social good, the receipt of which marks one as a citizen of the state, a means by which they can be reconstituted as something more than 'lesser citizens'. To test these ideas, I rely on data from interviews conducted with homeless service users, service providers for the homeless, and police personnel in three cities. What is revealed is a mixed set of beliefs as to the relative security and meaning of CCTV.

  19. 41 CFR 102-79.95 - Who is responsible for the costs associated with providing access to antenna sites?

    Science.gov (United States)

    2010-07-01

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

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

    Science.gov (United States)

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

    2004-05-01

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

  1. Open Access Articles Have a Greater Research Impact Than Articles Not Freely Available, A review of: Antelman, Kristin. “Do Open-Access Articles Have a Greater Research Impact?” College & Research Libraries 65.5 (Sep. 2004: 372-82.

    Directory of Open Access Journals (Sweden)

    Suzanne P. Lewis

    2006-09-01

    Full Text Available Objective – To ascertain whether open access articles have a greater research impact than articles not freely available, as measured by citations in the ISI Web of Science database. Design – Analysis of mean citation rates of a sample population of journal articles across four disciplines. Setting – Journal literature across the disciplines of philosophy, political science, mathematics, and electrical and electronic engineering. Subjects – A sample of 2,017 articles across the four disciplines published between 2001 and 2002 (for political science, mathematics, and electrical and electronic engineering and between 1999 and 2000 (for philosophy. Methods – A systematic presample of articles for each of the disciplines was taken to calculate the necessary sample sizes. Based on this calculation, articles were sourced from ten leading journals in each discipline. The leading journals in political science, mathematics, and electrical and electronic engineering were defined by ISI’s Journal Citation Reports for 2002. The ten leading philosophy journals were selected using a combination of other methods. Once the sample population had been identified, each article title and the number of citations to each article (in the ISI Web of Science database were recorded. Then the article title was searched in Google and if any freely available full text version was found, the article was classified as open access. The mean citation rate for open access and non‐open access articles in each discipline was identified, and the percentage difference between the means was calculated. Main results – The four disciplines represented a range of open access uptake: 17% of articles in philosophy were open access, 29% in political science, 37% in electrical and electronic engineering, and 69% in mathematics. There was a significant difference in the mean citation rates for open access articles and non‐open access articles in all four disciplines. The

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2013-12-01

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

  4. Vaginally delivered tenofovir disoproxil fumarate provides greater protection than tenofovir against genital herpes in a murine model of efficacy and safety.

    Science.gov (United States)

    Nixon, Briana; Jandl, Thomas; Teller, Ryan S; Taneva, Ekaterina; Wang, Yanhua; Nagaraja, Umadevi; Kiser, Patrick F; Herold, Betsy C

    2014-01-01

    Increased susceptibility to genital herpes in medroxyprogesterone-treated mice may provide a surrogate of increased HIV risk and a preclinical biomarker of topical preexposure prophylaxis safety. We evaluated tenofovir disoproxil fumarate (TDF) in this murine model because an intravaginal ring eluting this drug is being advanced into clinical trials. To avoid the complications of surgically inserting a ring, hydroxyethylcellulose (HEC)-stable formulations of TDF were prepared. One week of twice-daily 0.3% TDF gel was well tolerated and did not result in any increase in HSV-2 susceptibility but protected mice from herpes simplex virus 2 (HSV-2) disease compared to mice treated with the HEC placebo gel. No significant increase in inflammatory cytokines or chemokines in vaginal washes or change in cytokine, chemokine, or mitochondrial gene expression in RNA extracted from genital tract tissue was detected. To further evaluate efficacy, mice were treated with gel once daily beginning 12 h prior to high-dose HSV-2 challenge or 2 h before and after viral challenge (BAT24 dosing). The 0.3% TDF gel provided significant protection compared to the HEC gel following either daily (in 9/10 versus 1/10 mice, P < 0.01) or BAT24 (in 14/20 versus 4/20 mice, P < 0.01) dosing. In contrast, 1% tenofovir (TFV) gel protected only 4/10 mice treated with either regimen. Significant protection was also observed with daily 0.03% TDF compared to HEC. Protection was associated with greater murine cellular permeability of radiolabeled TDF than of TFV. Together, these findings suggest that TDF is safe, may provide substantially greater protection against HSV than TFV, and support the further clinical development of a TDF ring.

  5. 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.

  6. 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.

  7. 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

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

    Science.gov (United States)

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

    2016-12-01

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

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

    Science.gov (United States)

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

    2014-11-01

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

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

    Science.gov (United States)

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

    2013-08-30

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

  11. Canagliflozin provides greater attainment of both HbA1c and body weight reduction versus sitagliptin in patients with type 2 diabetes.

    Science.gov (United States)

    Schernthaner, Guntram; Lavalle-González, Fernando J; Davidson, Jaime A; Jodon, Holly; Vijapurkar, Ujjwala; Qiu, Rong; Canovatchel, William

    2016-11-01

    To evaluate the proportion of patients with type 2 diabetes mellitus (T2DM) achieving reductions in both glycated hemoglobin (HbA1c) and body weight with canagliflozin, a sodium glucose co-transporter 2 inhibitor, versus sitagliptin over 52 weeks. Data were pooled from two, randomized, Phase 3 studies of canagliflozin 100 and 300 mg versus sitagliptin 100 mg as add-on to metformin, and canagliflozin 300 mg versus sitagliptin 100 mg as add-on to metformin plus sulfonylurea (N = 1856). The composite end points of change from baseline in both HbA1c body weight body weight reduction ≥5% at Week 52 were evaluated. Safety was assessed based on adverse event reports. Canagliflozin provided reductions in HbA1c and body weight over 52 weeks versus sitagliptin. A greater proportion of patients had both HbA1c and body weight reductions with canagliflozin 100 and 300 mg versus sitagliptin 100 mg (67.7%, 72.6%, and 44.1%, respectively). Among patients with HbA1c and body weight reductions, more patients achieved the composite end point of HbA1c body weight reduction ≥5% with canagliflozin 100 and 300 mg versus sitagliptin 100 mg (18.9%, 18.3%, and 5.7%, respectively). Canagliflozin was generally well tolerated. A greater proportion of patients with T2DM achieved reductions in both HbA1c and body weight, and more patients with HbA1c and body weight reductions achieved HbA1c body weight reduction ≥5% with canagliflozin versus sitagliptin over 52 weeks. www.ClinicalTrials.gov identifiers are NCT01106677; NCT01137812.

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

    Science.gov (United States)

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

    2015-10-01

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

  13. 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

  14. Greater access to healthy food outlets in the home and school environment is associated with better dietary quality in young children.

    Science.gov (United States)

    Barrett, Millie; Crozier, Sarah; Lewis, Daniel; Godfrey, Keith; Robinson, Sian; Cooper, Cyrus; Inskip, Hazel; Baird, Janis; Vogel, Christina

    2017-12-01

    To explore associations between dietary quality and access to different types of food outlets around both home and school in primary school-aged children. Cross-sectional observational study. Hampshire, UK. Children (n 1173) in the Southampton Women's Survey underwent dietary assessment at age 6 years by FFQ and a standardised diet quality score was calculated. An activity space around each child's home and school was created using ArcGIS. Cross-sectional observational food outlet data were overlaid to derive four food environment measures: counts of supermarkets, healthy specialty stores (e.g. greengrocers), fast-food outlets and total number of outlets, and a relative measure representing healthy outlets (supermarkets and specialty stores) as a proportion of total retail and fast-food outlets. In univariate multilevel linear regression analyses, better diet score was associated with exposure to greater number of healthy specialty stores (β=0·025 sd/store: 95 % CI 0·007, 0·044) and greater exposure to healthy outlets relative to all outlets in children's activity spaces (β=0·068 sd/10 % increase in healthy outlets as a proportion of total outlets, 95 % CI 0·018, 0·117). After adjustment for mothers' educational qualification and level of home neighbourhood deprivation, the relationship between diet and healthy specialty stores remained robust (P=0·002) while the relationship with the relative measure weakened (P=0·095). Greater exposure to supermarkets and fast-food outlets was associated with better diet only in the adjusted models (P=0·017 and P=0·014, respectively). The results strengthen the argument for local authorities to increase the number of healthy food outlets to which young children are exposed.

  15. Dual Blockade of HER-2 Provides a Greater Magnitude of Benefit in Patients With Hormone-Negative Versus Hormone-Positive Breast Cancer.

    Science.gov (United States)

    Abramovitz, Mark; Williams, Casey; Loibl, Sibylle; Leyland-Jones, Brian

    2016-12-01

    The dual small molecule tyrosine kinase inhibitor lapatinib blocks both human epidermal growth factor receptor (HER-1) and human epidermal growth factor receptor 2 (HER-2) tyrosine kinase activity by binding reversibly to the ATP-binding site of the receptor's intracellular domain. Lapatinib, in combination with capecitabine, has been approved in 2007 for the treatment of patients with advanced HER-2 + breast cancer upon progressive disease following standard chemotherapy. Approval was also extended to the treatment of postmenopausal women with advanced hormone receptor (HR)-positive and HER-2-positive breast cancer in 2010. More recently, clinical trials that have investigated the efficacy of dual HER-2 blockade in both the metastatic and neoadjuvant breast cancer settings. For example, in 2013 the European Medicines Agency approved the combination of lapatinib and trastuzumab in HER-2 + /HR - patients. We review the efficacy results from dual HER-2 blockade studies and present new post hoc analysis efficacy data according to HR status. We show that dual blockade of HER-2 appears to provide a greater magnitude of benefit in the HR - versus the HR + subgroup of patients. Finally, we examine the potential of molecularly subtyping HER-2 + tumors using the PAM50 test as a predictor of response to treatment with the combination of trastuzumab and lapatinib. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. 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.

  17. 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.

  18. 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.

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

    Science.gov (United States)

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

    2010-10-01

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

  20. Greater London.

    Science.gov (United States)

    1985-05-01

    Greater London, composed of 14 inner boroughs and 19 outer ones, covers 1,579 square kilometers and has a population density of 77.9 persons per hectare. From 1971-1981, Greater London decreased in population by 10%, declining from 7.45 million to 6.71 million. All outer boroughs and 13 inner boroughs lost population in the 1970s; only the historic financial and business center--the City of London--showed a population increase. 48% of the population is male and somewhat over 60% of the total population is between 16 and pensionable age. Inner London includes more 25-44 year olds than Outer London. In Greater London 18% of the population was born in foreign countries, with almost a quarter of Inner London's residents being foreign born. Men (15%) and women (16%) in Inner London and men (16%) and women (13%) in Outer London are likely to have more education than other Britons. Somewhat more working women are found in Greater London than in the rest of Great Britain, with the highest percentage in the City of London. 34% of British households include children under age 16, but only 29% of Greater London's households include children. Only 10% of the City of London's households have children, and 1/4 of mothers work, as compared to 13% for all of Britain. A majority of Greater London households have either no car or only 1 car since public transportation and walking to work are convenient. Greater London households declined by 5% to 2.5 million in 1981, with average household size declining from 2.8 to 2.6 persons; 26% are single-person households (55% of these are pensioners). As in the rest of Britain, more people are buying homes and renting them from local authorities. 1/3 of Greater London residents live in publicly owned housing. Some lifestyle variations exist between Greater London residents and other Britons in terms of household consumption, but these differences are not as great as geographic differences in the US, and Greater London demographic data may be

  1. 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.

  2. 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.

  3. 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

  4. 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…

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

    Raimondo, Barbara

    2013-01-01

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

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

    Science.gov (United States)

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

    2009-08-07

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

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

    Science.gov (United States)

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

    2015-03-01

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

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

    Science.gov (United States)

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

    2012-08-01

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

  10. 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.

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

    Science.gov (United States)

    Baker, Laurence C; Chan, Jia

    2007-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Hamid Reza Chamanzari

    2015-10-01

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

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

    Science.gov (United States)

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

    2013-09-01

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

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

    Science.gov (United States)

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

    2017-08-01

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

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

    CSIR Research Space (South Africa)

    Green, Cheri A

    2012-10-01

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

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

    Science.gov (United States)

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

    2010-11-01

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

  17. 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.

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

    Science.gov (United States)

    Young, Jeffrey R.

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jenny Hill

    2014-08-01

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

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

    Science.gov (United States)

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

    2014-06-11

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

  1. Discovery of a Prefusion Respiratory Syncytial Virus F-Specific Monoclonal Antibody That Provides Greater In Vivo Protection than the Murine Precursor of Palivizumab.

    Science.gov (United States)

    Zhao, Min; Zheng, Zi-Zheng; Chen, Man; Modjarrad, Kayvon; Zhang, Wei; Zhan, Lu-Ting; Cao, Jian-Li; Sun, Yong-Peng; McLellan, Jason S; Graham, Barney S; Xia, Ning-Shao

    2017-08-01

    Palivizumab, a humanized murine monoclonal antibody that recognizes antigenic site II on both the prefusion (pre-F) and postfusion (post-F) conformations of the respiratory syncytial virus (RSV) F glycoprotein, is the only prophylactic agent approved for use for the treatment of RSV infection. However, its relatively low neutralizing potency and high cost have limited its use to a restricted population of infants at high risk of severe disease. Previously, we isolated a high-potency neutralizing antibody, 5C4, that specifically recognizes antigenic site Ø at the apex of the pre-F protein trimer. We compared in vitro and in vivo the potency and protective efficacy of 5C4 and the murine precursor of palivizumab, antibody 1129. Both antibodies were synthesized on identical murine backbones as either an IgG1 or IgG2a subclass and evaluated for binding to multiple F protein conformations, in vitro inhibition of RSV infection and propagation, and protective efficacy in mice. Although 1129 and 5C4 had similar pre-F protein binding affinities, the 5C4 neutralizing activity was nearly 50-fold greater than that of 1129 in vitro In BALB/c mice, 5C4 reduced the peak titers of RSV 1,000-fold more than 1129 did in both the upper and lower respiratory tracts. These data indicate that antibodies specific for antigenic site Ø are more efficacious at preventing RSV infection than antibodies specific for antigenic site II. Our data also suggest that site Ø-specific antibodies may be useful for the prevention or treatment of RSV infection and support the use of the pre-F protein as a vaccine antigen.IMPORTANCE There is no vaccine yet available to prevent RSV infection. The use of the licensed antibody palivizumab, which recognizes site II on both the pre-F and post-F proteins, is restricted to prophylaxis in neonates at high risk of severe RSV disease. Recommendations for using passive immunization in the general population or for therapy in immunocompromised persons with

  2. 48 CFR 1837.203-70 - Providing contractors access to sensitive information.

    Science.gov (United States)

    2010-10-01

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

  3. 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

  4. 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.

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

    OpenAIRE

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2017-07-01

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

  8. 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

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

    Science.gov (United States)

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

    2017-01-17

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

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

    Science.gov (United States)

    Sullivan, Catherine H

    2009-09-01

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

  11. Older leaves of lettuce (Lactuca spp.) support higher levels of Salmonella enterica ser. Senftenberg attachment and show greater variation between plant accessions than do younger leaves.

    Science.gov (United States)

    Hunter, Paul J; Shaw, Robert K; Berger, Cedric N; Frankel, Gad; Pink, David; Hand, Paul

    2015-06-01

    Salmonella can bind to the leaves of salad crops including lettuce and survive for commercially relevant periods. Previous studies have shown that younger leaves are more susceptible to colonization than older leaves and that colonization levels are dependent on both the bacterial serovar and the lettuce cultivar. In this study, we investigated the ability of two Lactuca sativa cultivars (Saladin and Iceberg) and an accession of wild lettuce (L. serriola) to support attachment of Salmonella enterica serovar Senftenberg, to the first and fifth to sixth true leaves and the associations between cultivar-dependent variation in plant leaf surface characteristics and bacterial attachment. Attachment levels were higher on older leaves than on the younger ones and these differences were associated with leaf vein and stomatal densities, leaf surface hydrophobicity and leaf surface soluble protein concentrations. Vein density and leaf surface hydrophobicity were also associated with cultivar-specific differences in Salmonella attachment, although the latter was only observed in the older leaves and was also associated with level of epicuticular wax. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

    Science.gov (United States)

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

    2012-10-01

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

  13. Next-generation genomic shotgun sequencing indicates greater genetic variability in the mitochondria of Hypophthalmichthys molitrix relative to H. nobilis from the Mississippi River, USA and provides tools for research and detection

    Science.gov (United States)

    Miller, John J; Eackles, Michael S.; Stauffer, Jay R; King, Timothy L.

    2015-01-01

    We characterized variation within the mitochondrial genomes of the invasive silver carp (Hypophthalmichthys molitrix) and bighead carp (H. nobilis) from the Mississippi River drainage by mapping our Next-Generation sequences to their publicly available genomes. Variant detection resulted in 338 single-nucleotide polymorphisms for H. molitrix and 39 for H. nobilis. The much greater genetic variation in H. molitrix mitochondria relative to H. nobilis may be indicative of a greater North American female effective population size of the former. When variation was quantified by gene, many tRNA loci appear to have little or no variability based on our results whereas protein-coding regions were more frequently polymorphic. These results provide biologists with additional regions of DNA to be used as markers to study the invasion dynamics of these species.

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    Erica Lessem

    2015-03-01

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

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

    Science.gov (United States)

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

    2014-06-07

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

  17. 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

  18. 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.

  19. 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

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

    Science.gov (United States)

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

    2015-01-01

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

  1. 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

  2. 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.

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-05-09

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

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

    Science.gov (United States)

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

  7. 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

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

    Science.gov (United States)

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

    2017-02-02

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

  9. Public Funding and Budgetary Challenges To Providing Universal Access To Primary Education in Sub-Saharan Africa

    Science.gov (United States)

    Omwami, Edith Mukudi; Keller, Edmond J.

    2010-02-01

    Budgetary capacity that would allow for the public funding of the provision of universal access to primary education is lacking in many sub-Saharan economies. National revenues significantly lag behind the overall economic productivity measure of GDP. Analysis of data derived from UNESCO and UNDP for 2004 shows that governments in the region spend far less in US dollars per unit cost on primary education than do developed countries. Increasing the unit cost of education in order to enable a government to guarantee universal primary education would take away resources from other tiers of the education system in many countries in the region. The alternative is to universalise access, despite existing budget allocation constraints, and thereby further compound the problems of poor infrastructure and limited human resource capacity that continue to compromise education quality in sub-Saharan Africa.

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

    Science.gov (United States)

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

    2017-11-01

    Advanced trauma life support (ATLS) is the international standard of care and forms the basis of trauma training in South Africa. Previous local studies demonstrated a low completion rate among junior doctors (JD). This study was designed to determine the reasons and identify possible barriers of JDs to accessing the ATLS course at a major university hospital. This was a prospective study utilising a structured survey that included all JDs who were undertaking their internship training. A total of 105 JDs completed the survey. Sixty-two percent were female (65/105) and the mean age was 25 years. Forty-eight percent (50/105) of all JDs were post graduate year 1 (PGY 1) and the remaining 52% were post graduate year 2 (PGY 2) JDs. Sixty-two percent (65/105) of all respondents had completed their mandatory rotation in surgery. The reasons for non-attendance of ATLS were: unable to secure a place on course (52%), unable to afford course fee (18%), permission for attendance not granted (14%), unable to obtain study leave (10%) and lack of interest (5%). Subgroup analysis comparing the reasons for PGY1s vs PGY2s demonstrated that not being able to secure a place on course was more common among PGY2s [19% vs 33%, p ATLS training is difficulty in accessing the course due to oversubscription, financial reasons, followed by difficulty in obtaining professional development leave due to staff shortage. There is an urgent need to improve access to the ATLS training course for JDs in our environment.

  11. 20 CFR 652.207 - How does a State meet the requirement for universal access to services provided under the Act?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false How does a State meet the requirement for universal access to services provided under the Act? 652.207 Section 652.207 Employees' Benefits EMPLOYMENT... Act, on a Statewide basis through: (i) Self-service; (ii) Facilitated self-help service; and (iii...

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

    Science.gov (United States)

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

    2013-12-01

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

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

    Science.gov (United States)

    Miller, Kate

    2008-01-01

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

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

    Science.gov (United States)

    Glenngård, Anna H; Anell, Anders

    2017-09-15

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  18. 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

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

    Science.gov (United States)

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

    2018-01-25

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

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

    Science.gov (United States)

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

    2015-03-27

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

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

    Science.gov (United States)

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

    2017-11-28

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

  2. 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.

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

    Science.gov (United States)

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

    2012-04-01

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

  4. [Does ultraclean air in the operating room provide greater safety?].

    Science.gov (United States)

    van Tiel, Frank H; Buiting, Anton G; Meessen, Nico E L; Voss, Andreas; Vos, Margreet C

    2010-01-01

    The Dutch quality control plan for climatisation of the operating room (OR), which was published in 2005, describes the management and maintenance of the air conditioning system. This management plan proposes a standard for air quality in class 1 ORs. This has been adopted by the Dutch Orthopaedic Society, but not by other surgical societies. The British study which underlies the proposed norm for air quality in class 1 ORs, a study on the infection preventive effect of ultraclean air, dates from 1982 and is inadequately controlled for prophylactic use of antibiotics. Antibiotic prophylaxis in itself already reduces the number of surgical site infections.-More recent studies fail to show an infection preventive effect of ultraclean air in the OR. The Dutch Working Party for Infection Prevention (WIP) ought to take the initiative, together with the medical Scientific Societies and the Society of Infection Prevention and Control in the health care setting (VHIG), to establish enforceable norms for microbiological air quality and to set criteria as to which types of operations are allowed to be performed in which class of OR.

  5. [Does ultraclean air in the operating room provide greater safety?].

    NARCIS (Netherlands)

    Tiel, F.H. van; Buiting, A.G.M.; Meessen, N.E.L.; Voss, A.; Vos, M.C.

    2010-01-01

    The Dutch quality control plan for climatisation of the operating room (OR), which was published in 2005, describes the management and maintenance of the air conditioning system. This management plan proposes a standard for air quality in class 1 ORs. This has been adopted by the Dutch Orthopaedic

  6. 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

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

    Science.gov (United States)

    Giles Iii, James T

    2016-01-01

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

  8. Autism, Art, and Accessibility to Theater.

    Science.gov (United States)

    Corbett, Blythe A

    2016-12-01

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

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

    Science.gov (United States)

    Edmonds, Leslie; And Others

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

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

    Science.gov (United States)

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

    2015-10-01

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

  11. Greater retention in care among adolescents on antiretroviral treatment accessing "Teen Club" an adolescent-centred differentiated care model compared with standard of care: a nested case-control study at a tertiary referral hospital in Malawi.

    Science.gov (United States)

    MacKenzie, Rachel K; van Lettow, Monique; Gondwe, Chrissie; Nyirongo, James; Singano, Victor; Banda, Victor; Thaulo, Edith; Beyene, Teferi; Agarwal, Mansi; McKenney, Allyson; Hrapcak, Susan; Garone, Daniela; Sodhi, Sumeet K; Chan, Adrienne K

    2017-11-01

    There are numerous barriers to the care and support of adolescents living with HIV (ALHIV) that makes this population particularly vulnerable to attrition from care, poor adherence and virological failure. In 2010, a Teen Club was established in Zomba Central Hospital (ZCH), Malawi, a tertiary referral HIV clinic. Teen Club provides ALHIV on antiretroviral treatment (ART) with dedicated clinic time, sexual and reproductive health education, peer mentorship, ART refill and support for positive living and treatment adherence. The purpose of this study was to evaluate whether attending Teen Club improves retention in ART care. We conducted a nested case-control study with stratified selection, using programmatic data from 2004 to 2015. Cases (ALHIV not retained in care) and controls (ALHIV retained in care) were matched by ART initiation age group. Patient records were reviewed retrospectively and subjects were followed starting in March 2010, the month in which Teen Club was opened. Follow-up ended at the time patients were no longer considered retained in care or on 31 December 2015. Cases and controls were drawn from a study population of 617 ALHIV. Of those, 302 (48.9%) participated in at least two Teen Club sessions. From the study population, 135 (non-retained) cases and 405 (retained) controls were selected. In multivariable analyses, Teen Club exposure, age at the time of selection and year of ART initiation were independently associated with attrition. ALHIV with no Teen Club exposure were less likely to be retained than those with Teen Club exposure (adjusted odds ratio (aOR) 0.27; 95% CI 0.16, 0.45) when adjusted for sex, ART initiation age, current age, reason for ART initiation and year of ART initiation. ALHIV in the age group 15 to 19 were more likely to have attrition from care than ALHIV in the age group 10 to 14 years of age (aOR 2.14; 95% CI 1.12, 4.11). This study contributes to the limited evidence evaluating the effectiveness of service delivery

  12. 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.

  13. 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.

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

    Science.gov (United States)

    Cohen, Leonard A

    2009-07-01

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

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

    CSIR Research Space (South Africa)

    Green, Cheri A

    2012-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Dillip Angel

    2010-06-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  18. 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...

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

    Science.gov (United States)

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

    2017-04-01

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

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

    Science.gov (United States)

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

    2017-04-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Adriano Senatore

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

  4. Editorial Greater international exposure for African range and forage ...

    African Journals Online (AJOL)

    Password, Remember me, or Register. DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription or Fee Access. Editorial Greater international exposure for African range and forage science. Susi Vetter. Abstract. Click on the link to view the editorial. African Journal of Range & Forage Science 2009, ...

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

    Directory of Open Access Journals (Sweden)

    Fabrizio Celli

    2015-05-01

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

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

    Science.gov (United States)

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

    2018-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Yuenyong Nilsiam

    2016-11-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2017-10-17

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

  10. 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.

  11. Technology for People, Not Disabilities: Ensuring Access and Inclusion

    Science.gov (United States)

    Foley, Alan; Ferri, Beth A.

    2012-01-01

    The potential of technology to connect people and provide access to education, commerce, employment and entertainment has never been greater or more rapidly changing. Communication technologies and new media promise to "revolutionize our lives" by breaking down barriers and expanding access for disabled people. Yet, it is also true that technology…

  12. Greater Somalia, the never-ending dream?

    DEFF Research Database (Denmark)

    Zoppi, Marco

    2015-01-01

    This paper provides an historical analysis of the concept of Greater Somalia, the nationalist project that advocates the political union of all Somali-speaking people, including those inhabiting areas in current Djibouti, Ethiopia and Kenya. The Somali territorial unification project of “lost ter...

  13. 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.

  14. Health equity and migrants in the Greater Mekong Subregion.

    Science.gov (United States)

    McMichael, Celia; Healy, Judith

    2017-01-01

    Migrant health is receiving increasing international attention, reflecting recognition of the health inequities experienced among many migrant populations and the need for health systems to adapt to diverse migrant populations. In the Greater Mekong Subregion (GMS) there is increasing migration associated with uneven economic integration and growth, socio-economic vulnerabilities, and disparities between countries. There has been limited progress, however, in improving migrant access to health services in the Subregion. This paper examines the health needs, access barriers, and policy responses to cross-border migrants in five GMS countries. A review of published literature and research was conducted on migrant health and health service access in Cambodia, Lao People's Democratic Republic, Myanmar, Thailand, and Viet Nam, as well as analysis of current migration trends and universal health coverage (UHC) indicators in the Subregion. The review included different migrant types: i.e. migrant workers, irregular migrants, victims of trafficking, refugees and asylum seekers, and casual cross-border migrants. There is substantial diversity in the capacity of GMS health systems to address migrant populations. Thailand has sought to enhance migrant health coverage, including development of migrant health policies/programs, bilateral migrant worker agreements, and migrant health insurance schemes; Viet Nam provides health protection for emigrant workers. Overall, however, access to good quality health care remains weak for many citizens in GMS countries let alone migrants. Migrant workers - and irregular migrants in particular - face elevated health risks yet are not adequately covered and incur high out-of-pocket (OOP) payments for health services. UHC implies equity: UHC is only achieved when everyone has the opportunity to access and use good-quality health care. Efforts to achieve UHC in the GMS require deliberate policy decisions to include migrants. The emergence of

  15. Bus transport in Greater Manchester

    DEFF Research Database (Denmark)

    Sørensen, Claus Hedegaard; Gudmundsson, Henrik

    is that ‘organisation matters’ and that the reforms may have changed significantly the institutional conditions for the implementation of sustainable transport policies and easures. We have focused the research on public transport in larger cities and how their organisation has changed due to the reforms. At the NECTAR......, and will be elaborated by the time of the NECTAR workshop in May: • Deregulation and privatisation have not changed negative trends in modal split in Greater Manchester, but likely made it worse at least compared to London. • Deregulation and privatisation have worsened conditions for a greening of the bus fleets...

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

    Science.gov (United States)

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

    2018-03-01

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

  17. 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

  18. Institutional Change for Improving Accessibility in the Design and Delivery of Distance Learning--The Role of Faculty Accessibility Specialists at the Open University

    Science.gov (United States)

    Slater, Rachel; Pearson, Victoria K.; Warren, James P.; Forbes, Tina

    2015-01-01

    The Open University (OU) has an established infrastructure for supporting disabled students. Historically, the thrust of this has focused on providing accessible adjustments post-production. In 2012, the OU implemented securing greater accessibility (SeGA) to raise awareness and bring about an institutional change to curriculum design so that the…

  19. 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

  20. 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

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

    Science.gov (United States)

    2017-08-14

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

  2. 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...

  3. 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.

  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. Open Access publishing in physics gains momentum

    CERN Multimedia

    2006-01-01

    The first meeting of European particle physics funding agencies took place on 3 November at CERN to establish a consortium for Open Access publishing in particle physics, SCOAP3 (Sponsoring Consortium for Open Access Publishing in Particle Physics). Open Access could transform the academic publishing world, with a great impact on research. The traditional model of research publication is funded through reader subscriptions. Open Access will turn this model on its head by changing the funding structure of research results, without increasing the overall cost of publishing. Instead of demanding payment from readers, publications will be distributed free of charge, financed by funding agencies via laboratories and the authors. This new concept will bring greater benefits and broaden opportunities for researchers and funding agencies by providing unrestricted distribution of the results of publicly funded research. The meeting marked a positive step forward, with international support from laboratories, fundin...

  6. 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…

  7. ICT Access and Usage in Higher Education in South Africa | IDRC ...

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

    The assumption underlying information and communication technology (ICT) in higher education policy is that increased access to ICT leads to greater use of ICT. Baseline data gathered for the first time in 2004 and 2007 provides an urgently needed foundation to an understanding of access and use in higher education in ...

  8. ICT Access and Usage in Higher Education in South Africa | CRDI ...

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

    The assumption underlying information and communication technology (ICT) in higher education policy is that increased access to ICT leads to greater use of ICT. Baseline data gathered for the first time in 2004 and 2007 provides an urgently needed foundation to an understanding of access and use in higher education in ...

  9. 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.

  10. Metropolitan Access Network

    Directory of Open Access Journals (Sweden)

    Slavko Šarić

    2003-11-01

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

  11. Enhancing Independent Internet Access for Individuals with Mental Retardation through Use of a Specialized Web Browser: A Pilot Study.

    Science.gov (United States)

    Davies, Daniel K.; Stock, Steven E.; Wehmeyer, Michael L.

    2001-01-01

    In this study, a prototype web browser, called Web Trek, that utilizes multimedia to provide access for individuals with cognitive disabilities was developed and pilot-tested with 12 adults with mental retardation. The Web Trek browser provided greater independence in accessing the Internet compared to Internet Explorer. (Contains references.)…

  12. Mobile Applications for Mental Health Providers.

    Science.gov (United States)

    Morganstein, Joshua

    2016-01-01

    Mobile devices such as smartphones and tablets have fundamentally changed the ways in which we interact with information. Far more than communication devices, smartphones and tablets are now indispensable tools in the pocket of healthcare providers. Mobile mental health applications (apps) provide instant access to up-to-date information on prevention, assessment and treatment. Self-help apps allow patients to take greater ownership of their own health and well-being. The past decade has seen an extraordinarily rapid proliferation of mobile medical apps. Though thousands of apps now exist, the challenge for healthcare providers and consumers alike has become sorting through mobile apps for those which provide accurate content delivered in the most user-friendly format. This article will review six mobile apps that can assist healthcare providers and consumers interested in enhancing mental health.

  13. Ontology Based Access Control

    Directory of Open Access Journals (Sweden)

    Özgü CAN

    2010-02-01

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

  14. 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

  15. A review of the Cercyon Leach (Coleoptera, Hydrophilidae, Sphaeridiinae of the Greater Antilles

    Directory of Open Access Journals (Sweden)

    Emmanuel Arriaga-Varela

    2017-06-01

    Full Text Available The representatives of the genus Cercyon Leach occurring in the Greater Antilles are reviewed. Ten species are recorded, of which five are described here as new: C. gimmeli sp. n. (Dominican Republic, C. armatipenis sp. n. (Dominican Republic, C. taino sp. n. (Dominican Republic, C. sklodowskae sp. n. (Jamaica and C. spiniventris sp. n. (Dominican Republic. Diagnoses and detailed distributional data are also provided for C. floridanus Horn, 1890 (distributed in southeastern United States of America and Cayman Islands, C. insularis Chevrolat, 1863 (endemic to the Antilles C. praetextatus (Say, 1825 (widely distributed in the New World incl. Greater Antilles, C. quisquilius (Linnaeus, 1761 (an adventive species of Paleartic origin and C. nigriceps (Marshall, 1802 (an adventive species probably of Oriental origin. Cercyon armatipenis, C. gimmeli, C. taino form a group of closely related species only distinguishable by male genitalia and DNA sequences. A key to the Great Antillean Cercyon is provided and important diagnostic characters are illustrated. The larvae of C. insularis and C. taino were associated with adults using COI barcode sequences, illustrated and diagnosed. Full occurrence data, additional images and COI barcode sequences were submitted to open access on-line depositories in an effort to provide access to complete data.

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

    Science.gov (United States)

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

    2014-12-01

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

  17. 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

  18. Access to modern contraception.

    Science.gov (United States)

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

    2006-06-01

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

  19. Management plan for Midcontinent greater white-fronted geese

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of this plan is to provide guidelines for management decisions affecting the Midcontinent Population of Greater White-fronted Geese (Anser albifrons...

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

    Science.gov (United States)

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

    2012-01-01

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

  1. 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....

  2. 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.

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

    Science.gov (United States)

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

    2011-11-01

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

  4. Access Nets: Modeling Access to Physical Spaces

    Science.gov (United States)

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

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

  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. Access 3

    Science.gov (United States)

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

    2017-08-07

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

  7. THE GREATER CANE RATS (THRYONOMIS SWINDERIANUS,

    African Journals Online (AJOL)

    2017-01-12

    Jan 12, 2017 ... ABSTRACT. The adrenal glands of domesticated greater cane rats (Thryonomys swinderianus), were studied using histological and ultrastructural techniques. A total of seven (7) adult male greater cane rats, aged from 10-14 months, with an average weight of 1.89 kg (range: 1.6 -2.2 kg) were used in this ...

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

    Directory of Open Access Journals (Sweden)

    Lauren Zakarin Safier

    2017-01-01

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

  9. Accessing the Microform Publication.

    Science.gov (United States)

    Schindler, Stan

    1985-01-01

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

  10. Public Access Report.

    Science.gov (United States)

    Anshien, Carol M.; And Others

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

  11. 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

  12. Formal Mediation and Negotiation Training, Providing Greater Skills for Commanders in Bosnia

    National Research Council Canada - National Science Library

    McConnell, G

    1999-01-01

    .... However, the training is not optimized for the environment that they will encounter. The Bosnia environment requires battalion and brigade commanders to possess and utilize mediation and negotiation skills...

  13. Culture rather than genes provides greater scope for the evolution of large-scale human prosociality

    OpenAIRE

    Bell, Adrian V; Peter J Richerson; McElreath, Richard

    2009-01-01

    Whether competition among large groups played an important role in human social evolution is dependent on how variation, whether cultural or genetic, is maintained between groups. Comparisons between genetic and cultural differentiation between neighboring groups show how natural selection on large groups is more plausible on cultural rather than genetic variation.

  14. Anti-predator meshing may provide greater protection for sea turtle nests than predator removal.

    Directory of Open Access Journals (Sweden)

    Julie M O'Connor

    Full Text Available The problem of how to protect sea turtle nests from terrestrial predators is of worldwide concern. On Queensland's southern Sunshine Coast, depredation of turtle nests by the introduced European red fox (Vulpes vulpes has been recorded as the primary terrestrial cause of egg and hatchling mortality. We investigated the impact of foxes on the nests of the loggerhead turtle (Caretta caretta and occasional green turtle (Chelonia mydas over ten nesting seasons. Meshing of nests with fox exclusion devices (FEDs was undertaken in all years accompanied by lethal fox control in the first five-year period, but not in the second five-year period. Lethal fox control was undertaken in the study area from 2005 to February 2010, but foxes still breached 27% (range19-52% of turtle nests. In the second five-year period, despite the absence of lethal fox control, the average percentage of nests breached was less than 3% (range 0-4%. Comparison of clutch depredation rates in the two five-year periods demonstrated that continuous nest meshing may be more effective than lethal fox control in mitigating the impact of foxes on turtle nests. In the absence of unlimited resources available for the eradication of exotic predators, the use of FEDs and the support and resourcing of a dedicated volunteer base can be considered an effective turtle conservation tool on some beaches.

  15. Anti-predator meshing may provide greater protection for sea turtle nests than predator removal

    Science.gov (United States)

    O’Connor, Julie M.; Limpus, Colin J.; Hofmeister, Kate M.; Allen, Benjamin L.; Burnett, Scott E.

    2017-01-01

    The problem of how to protect sea turtle nests from terrestrial predators is of worldwide concern. On Queensland’s southern Sunshine Coast, depredation of turtle nests by the introduced European red fox (Vulpes vulpes) has been recorded as the primary terrestrial cause of egg and hatchling mortality. We investigated the impact of foxes on the nests of the loggerhead turtle (Caretta caretta) and occasional green turtle (Chelonia mydas) over ten nesting seasons. Meshing of nests with fox exclusion devices (FEDs) was undertaken in all years accompanied by lethal fox control in the first five-year period, but not in the second five-year period. Lethal fox control was undertaken in the study area from 2005 to February 2010, but foxes still breached 27% (range19–52%) of turtle nests. In the second five-year period, despite the absence of lethal fox control, the average percentage of nests breached was less than 3% (range 0–4%). Comparison of clutch depredation rates in the two five-year periods demonstrated that continuous nest meshing may be more effective than lethal fox control in mitigating the impact of foxes on turtle nests. In the absence of unlimited resources available for the eradication of exotic predators, the use of FEDs and the support and resourcing of a dedicated volunteer base can be considered an effective turtle conservation tool on some beaches. PMID:28187181

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

    Science.gov (United States)

    Zakarin Safier, Lauren; Sauer, Mark V

    2017-03-08

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

  17. ANATOMICAL VARIATIONS OF THE GREATER PALATINE NERVE IN THE GREATER PALATINE CANAL.

    Science.gov (United States)

    Hafeez, Najmus Sahar; Ganapathy, Sugantha; Sondekoppam, Rakesh; Johnson, Marjorie; Merrifield, Peter; Galil, Khadry A

    2015-01-01

    The greater palatine nerve and the greater palatine canal are common sites for maxillary anesthesia during dental and maxillo-facial procedures. The greater palatine nerve is thought to course as a single trunk through the greater palatine canal, branching after its exit from the greater palatine foramen. We describe intra-canalicular branching variations of the greater palatine nerve found in 8 of 20 embalmed dissection specimens. Such variation is previously unreported in the literature. We characterize the variations in branching pattern and discuss the possible implications for clinical practice.

  18. 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…

  19. Setting the Greater Mekong Subregion - Development Analysis ...

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

    ... in 1997-98, its primary goal is to foster a greater understanding of development issues and equip its member institutes and researchers with expertise, skills, and knowledge using a peer-to-peer approach. ... It will allow GMS-DAN to continue to contribute leadership and expertise to development research in the region.

  20. Greater Sao Paulo Newer Library Automation.

    Science.gov (United States)

    McLean, Dulce Didio

    1991-01-01

    This followup to a 1981 study presents descriptions of automated projects or activities in academic, public, and special libraries or information centers in the Greater Sao Paulo region that developed from 1981 through 1987. It is noted that an overall increase in the level of automation since 1981 has been observed. (four references) (Author/MAB)

  1. 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

  2. The Open Access Divide

    Directory of Open Access Journals (Sweden)

    Jingfeng Xia

    2013-10-01

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

  3. Accessing memory

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-09-26

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

  4. Hygrophoraceae of the Greater Antilles : Hygrocybe subgenus Hygrocybe

    Science.gov (United States)

    Sharon A. Cantrell; D. Jean Lodge

    2000-01-01

    A key to six taxa of Hygrocybe, subgenus Hygrocybe, sections Chlorophanae and Hygrocybe is provided. One species is new and four species are reported for the first time from the Greater Antilles. The new species is H. chimaeroderma (section Chlarophanae). Hygrocybe acutoconica, H. calyptriformis and H. incolor (section Hygrocybe) are reported for the first time, and...

  5. Providing Contraception to Adolescents.

    Science.gov (United States)

    Raidoo, Shandhini; Kaneshiro, Bliss

    2015-12-01

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

  6. 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...

  7. Rural New Zealand health professionals' perceived barriers to greater use of the internet for learning.

    Science.gov (United States)

    Janes, Ron; Arroll, Bruce; Buetow, Stephen; Coster, Gregor; McCormick, Ross; Hague, Iain

    2005-01-01

    The purpose of this research was to investigate rural North Island (New Zealand) health professionals' attitudes and perceived barriers to using the internet for ongoing professional learning. A cross-sectional postal survey of all rural North Island GPs, practice nurses and pharmacists was conducted in mid-2003. The questionnaire contained both quantitative and qualitative questions. The transcripts from two open questions requiring written answers were analysed for emergent themes, which are reported here. The first open question asked: 'Do you have any comments on the questionnaire, learning, computers or the Internet?' The second open question asked those who had taken a distance-learning course using the internet to list positive and negative aspects of their course, and suggest improvements. Out of 735 rural North Island health professionals surveyed, 430 returned useable questionnaires (a response rate of 59%). Of these, 137 answered the question asking for comments on learning, computers and the internet. Twenty-eight individuals who had completed a distance-learning course using the internet, provided written responses to the second question. Multiple barriers to greater use of the internet were identified. They included lack of access to computers, poor availability of broadband (fast) internet access, lack of IT skills/knowledge, lack of time, concerns about IT costs and database security, difficulty finding quality information, lack of time, energy or motivation to learn new skills, competing priorities (eg family), and a preference for learning modalities which include more social interaction. Individuals also stated that rural health professionals needed to engage the technology, because it provided rapid, flexible access from home or work to a significant health information resource, and would save money and travelling time to urban-based education. In mid-2003, there were multiple barriers to rural North Island health professionals making greater

  8. The Bipartisan Patient Protection Act: greater liability on managed care plans.

    Science.gov (United States)

    Mayers, Urura W

    2003-01-01

    Mrs. Mayers' article notes the substantial differences that exist between the Senate and the House of Representatives' version of the Bipartisan Patient Protection Act of 2001. While observing the remedies made available to participants, beneficiaries, or enrollees under both bills, she shows that the Senate bill places greater liability on managed care plans because it favors consumer protection, while the House of Representatives' bill does not. In order to develop an understanding of why an act of this nature is needed, Mrs. Mayers provides a brief historical overview of how managed care entities developed. She also examines the Employee Retirement Income Security Act ("ERISA") and proposes amendments to them. She concludes her article by raising an even deeper concern, and that is: what happens to individuals without access to health care coverage.

  9. Holocene peatland initiation in the Greater Everglades

    Science.gov (United States)

    Dekker, Stefan; de Boer, Hugo; Dermody, Brian; Wagner-Cremer, Friederike; Wassen, Martin; Eppinga, Maarten

    2015-04-01

    The mechanisms involved in the initiation and development of the Greater Everglades peatland ecosystems in South Florida (USA) remain a topic of discussion. In this study, we present an overview of basal ages of peat deposits in South Florida, which shows two major episodes of peatland initiation between 7.0-4.5 kyr and 3.5-2.0 kyr. Our analysis of regional climate proxy datasets led to three alternative hypotheses that may explain the timing and duration of these two peatland initiation episodes: (1) decreased drainage due to relative sea level (RSL) rise during the Holocene (2) gradual increase in precipitation throughout the Holocene, and (3) a combination of increasing precipitation, rising RSL and oscillations in the climate system. We test whether these three hypotheses can explain the pattern of initiation and development of the Greater Everglades peatlands using models that simulate the non-linear processes involved in peat production and decomposition in combination with the local drainage conditions of Southern Florida. The model results suggest that RSL-rise alone cannot predict the onset of peat initiation in the Greater Everglades using our model setup. The model also implies that the climate was wet enough for peat development also during the early Holocene. The first two hypothesized mechanisms in combination with climate oscillations may explain the onset of peat accumulation at 8.2 kyr BP. The two-phased character of peat land initiation may be explained by the spatial distribution of local drainage conditions. As peatland development is highly non-linear, our model uncovers a mechanistic way how peats can suddenly shift from a dry high equilibrium to a wet low equilibrium resulting in lake formation as observed in paleo-ecological studies in the Greater Everglades.

  10. 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

  11. 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...

  12. 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...

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

    Science.gov (United States)

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

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

  14. Interspecific hybridization between greater kudu and nyala.

    Science.gov (United States)

    Dalton, Desiré L; Tordiffe, Adrian; Luther, Ilse; Duran, Assumpta; van Wyk, Anna M; Brettschneider, Helene; Oosthuizen, Almero; Modiba, Catherine; Kotzé, Antoinette

    2014-06-01

    Hybridization of wildlife species, even in the absence of introgression, is of concern due to wasted reproductive effort and a reduction in productivity. In this study we detail an accidental mating between a female nyala (Tragelaphus angasii) and a male greater kudu (T. strepsiceros). The hybrid was phenotypically nyala and was identified as such based on mitochondrial DNA. Further genetic analysis based on nine microsatellite markers, chromosome number and chromosome morphology however, confirmed its status as an F1 hybrid. Results obtained from a reproductive potential assessment indicated that this animal does not have the potential to breed successfully and can be considered as sterile.

  15. Greater body mass index is related to greater self-identified cold tolerance and greater insensible body mass loss.

    Science.gov (United States)

    Jung, Dahee; Kim, Dami; Park, Joonhee; Lee, Joo Young

    2016-08-22

    Insensible body mass loss (IBL) from the human body continuously occurs, which is an important component in body heat exchange. The purpose of this study was to examine the relevance of IBL to anthropometric characteristics and self-identified thermal tolerance. A total of 289 healthy young Korean males were chosen and sorted into the following three groups: heat tolerable only (HTO, N = 79), cold tolerable only (CTO, N = 104), neither heat nor cold tolerable (NHC, N = 106). They weighed before and after a 30-min rest under lightly clothed condition at an air temperature of 23 ± 1 °C with a relative humidity 55 ± 5 %RH. (1) The IBL of 289 males had a mean of 90 ± 75 g h(-1) (48 ± 40 g h(-1) m(-2)); (2) No significant difference in IBL among the three groups were found; (3) Significant differences in body weight and body mass index (BMI) among three groups were found (P body surface area (P = 0.059); (4) CTO was approximately 4.1 kg heavier in body weight (P body surface area. For healthy young males within normal anthropometric ranges in Korea, IBL was positively related to BMI, and individuals with greater BMI showed greater self-identified cold tolerance, but no direct relationship was found between IBL and self-identified cold tolerance. This suggests that body physique (e.g., BMI) could be an explanatory factor between insensible body heat loss and subjective cognition on cold tolerance.

  16. 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

  17. Commercial sector can improve access.

    Science.gov (United States)

    Finger, W R

    1998-01-01

    This article discusses the improved accessibility to family planning (FP) services made possible by expanding services among private physicians and through social marketing in developing countries. Encouraging private sector (PS) FP is a way to ease the caseload of public FP facilities and creating the potential for attracting more lower-income clients. Few developing countries have a "viable commercial market" for contraceptives. Commercial success depends upon a secure supply of FP supplies, well-trained providers, and consumer demand. Consumers want affordable, high-quality, and convenient services. Governments must ensure that regulations do not hamper PS programs. Public and private programs should not compete in ways that are counterproductive. The commercial sector includes private physicians, clinics, pharmacies, or hospitals without public subsidies. Public funding might be used to encourage PS distribution, especially condoms and messages about HIV and sexually transmitted disease prevention. Messages may target specific audiences and promote an appealing logo and packaging. SOMARC in Turkey promotes a network of commercial health care facilities that offer high quality FP at affordable prices. The model includes provider training, quality of care monitoring, marketing, a hotline, posted prices, and prices set by consumer affordability surveys. This model is being tried in both Nepal and the Philippines. Commercial marketing has been successful in Latin America, North Africa, and the Middle East. Commercial expansion and survival is dependent upon the satisfaction of consumer preferences for convenience, greater access, better confidentiality, and quality. Examples from Zimbabwe and Romania are used to show strategies for training private providers. Private providers will become involved, for instance, by offering targeted training programs.

  18. Hemodialysis access procedures

    Science.gov (United States)

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

  19. Access to the city

    DEFF Research Database (Denmark)

    Andreasen, Manja Hoppe; Møller-Jensen, Lasse

    2017-01-01

    by the urban transport system. The paper draws upon qualitative interviews with residents in the periphery as well as recently collected travel speed data and offers a unique combination of testimony with GIS-based modelling of overall accessibility. A central finding is the overall importance of regular......This paper is concerned with access to the city for urban residents living in the periphery of Dar es Salaam, Tanzania. The paper presents an analysis of the mobility practices of residents and investigates the mobility constraints they experience in relation to the limited accessibility provided...... mobility and access to the city for residents in the periphery. Regular mobility is an ingrained part of residents' livelihood strategies. The majority of households rely on one or more members regularly travelling to central parts of the city in relation to their livelihood activities. The analysis...

  20. From Web accessibility to Web adaptability.

    Science.gov (United States)

    Kelly, Brian; Nevile, Liddy; Sloan, David; Fanou, Sotiris; Ellison, Ruth; Herrod, Lisa

    2009-07-01

    This article asserts that current approaches to enhance the accessibility of Web resources fail to provide a solid foundation for the development of a robust and future-proofed framework. In particular, they fail to take advantage of new technologies and technological practices. The article introduces a framework for Web adaptability, which encourages the development of Web-based services that can be resilient to the diversity of uses of such services, the target audience, available resources, technical innovations, organisational policies and relevant definitions of 'accessibility'. The article refers to a series of author-focussed approaches to accessibility through which the authors and others have struggled to find ways to promote accessibility for people with disabilities. These approaches depend upon the resource author's determination of the anticipated users' needs and their provision. Through approaches labelled as 1.0, 2.0 and 3.0, the authors have widened their focus to account for contexts and individual differences in target audiences. Now, the authors want to recognise the role of users in determining their engagement with resources (including services). To distinguish this new approach, the term 'adaptability' has been used to replace 'accessibility'; new definitions of accessibility have been adopted, and the authors have reviewed their previous work to clarify how it is relevant to the new approach. Accessibility 1.0 is here characterised as a technical approach in which authors are told how to construct resources for a broadly defined audience. This is known as universal design. Accessibility 2.0 was introduced to point to the need to account for the context in which resources would be used, to help overcome inadequacies identified in the purely technical approach. Accessibility 3.0 moved the focus on users from a homogenised universal definition to recognition of the idiosyncratic needs and preferences of individuals and to cater for them. All of

  1. The case of Iranian immigrants in the greater Toronto area: a qualitative study.

    Science.gov (United States)

    Dastjerdi, Mahdieh

    2012-02-27

    Iranians comprise an immigrant group that has a very different cultural background from that of the mainstream Canadian population and speaks a language other than English or French; in this case mainly Farsi (Persian). Although Iranian immigrants in Toronto receive a high proportion of care from Farsi-speaking family physicians and health care providers than physicians who cannot speak Farsi, they are still not satisfied with the provided services. The purpose of this study was to identify the obstacles and issues Iranian immigrants faced in accessing health care services as seen through the eyes of Iranian health care professionals/providers and social workers working in Greater Toronto Area, Canada. Narrative inquiry was used to capture and understand the obstacles this immigrant population faces when accessing health care services, through the lens of fifty Iranian health care professionals/providers and social workers. Thirty three health care professionals and five social workers were interviewed. To capture the essence of issues, individual interviews were followed by three focus groups consisting of three health care professionals and one social worker in each group. Three major themes emerged from the study: language barrier and the lack of knowledge of Canadian health care services/systems; lack of trust in Canadian health care services due to financial limitations and fear of disclosure; and somatization and needs for psychological supports. Iranians may not be satisfied with the Canadian health care services due to a lack of knowledge of the system, as well as cultural differences when seeking care, such as fear of disclosure, discrimination, and mistrust of primary care. To attain equitable, adequate, and effective access to health care services, immigrants need to be educated and informed about the Canadian health care system and services it provides. It would be of great benefit to this population to hold workshops on health topics, and mental health

  2. The case of Iranian immigrants in the greater Toronto area: a qualitative study

    Directory of Open Access Journals (Sweden)

    Dastjerdi Mahdieh

    2012-02-01

    Full Text Available Abstract Introduction Iranians comprise an immigrant group that has a very different cultural background from that of the mainstream Canadian population and speaks a language other than English or French; in this case mainly Farsi (Persian. Although Iranian immigrants in Toronto receive a high proportion of care from Farsi-speaking family physicians and health care providers than physicians who cannot speak Farsi, they are still not satisfied with the provided services. The purpose of this study was to identify the obstacles and issues Iranian immigrants faced in accessing health care services as seen through the eyes of Iranian health care professionals/providers and social workers working in Greater Toronto Area, Canada. Methods Narrative inquiry was used to capture and understand the obstacles this immigrant population faces when accessing health care services, through the lens of fifty Iranian health care professionals/providers and social workers. Thirty three health care professionals and five social workers were interviewed. To capture the essence of issues, individual interviews were followed by three focus groups consisting of three health care professionals and one social worker in each group. Results Three major themes emerged from the study: language barrier and the lack of knowledge of Canadian health care services/systems; lack of trust in Canadian health care services due to financial limitations and fear of disclosure; and somatization and needs for psychological supports. Conclusion Iranians may not be satisfied with the Canadian health care services due to a lack of knowledge of the system, as well as cultural differences when seeking care, such as fear of disclosure, discrimination, and mistrust of primary care. To attain equitable, adequate, and effective access to health care services, immigrants need to be educated and informed about the Canadian health care system and services it provides. It would be of great benefit to

  3. 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

  4. Network Access Control For Dummies

    CERN Document Server

    Kelley, Jay; Wessels, Denzil

    2009-01-01

    Network access control (NAC) is how you manage network security when your employees, partners, and guests need to access your network using laptops and mobile devices. Network Access Control For Dummies is where you learn how NAC works, how to implement a program, and how to take real-world challenges in stride. You'll learn how to deploy and maintain NAC in your environment, identify and apply NAC standards, and extend NAC for greater network security. Along the way you'll become familiar with what NAC is (and what it isn't) as well as the key business drivers for deploying NAC.Learn the step

  5. Optical Access Networks

    Science.gov (United States)

    Zheng, Jun; Ansari, Nirwan

    2005-01-01

    Call for Papers: Optical Access Networks Guest Editors Jun Zheng, University of Ottawa Nirwan Ansari, New Jersey Institute of Technology Submission Deadline: 1 June 2005 h2>Backgroundh2> With the wide deployment of fiber-optic technology over the past two decades, we have witnessed a tremendous growth of bandwidth capacity in the backbone networks of today's telecommunications infrastructure. However, access networks, which cover the "last-mile" areas and serve numerous residential and small business users, have not been scaled up commensurately. The local subscriber lines for telephone and cable television are still using twisted pairs and coaxial cables. Most residential connections to the Internet are still through dial-up modems operating at a low speed on twisted pairs. As the demand for access bandwidth increases with emerging high-bandwidth applications, such as distance learning, high-definition television (HDTV), and video on demand (VoD), the last-mile access networks have become a bandwidth bottleneck in today's telecommunications infrastructure. To ease this bottleneck, it is imperative to provide sufficient bandwidth capacity in the access networks to open the bottleneck and thus present more opportunities for the provisioning of multiservices. Optical access solutions promise huge bandwidth to service providers and low-cost high-bandwidth services to end users and are therefore widely considered the technology of choice for next-generation access networks. To realize the vision of optical access networks, however, many key issues still need to be addressed, such as network architectures, signaling protocols, and implementation standards. The major challenges lie in the fact that an optical solution must be not only robust, scalable, and flexible, but also implemented at a low cost comparable to that of existing access solutions in order to increase the economic viability of many potential high-bandwidth applications. In recent years, optical access

  6. 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

  7. Greater Green River Basin Production Improvement Project

    Energy Technology Data Exchange (ETDEWEB)

    DeJarnett, B.B.; Lim, F.H.; Calogero, D.

    1997-10-01

    The Greater Green River Basin (GGRB) of Wyoming has produced abundant oil and gas out of multiple reservoirs for over 60 years, and large quantities of gas remain untapped in tight gas sandstone reservoirs. Even though GGRB production has been established in formations from the Paleozoic to the Tertiary, recent activity has focused on several Cretaceous reservoirs. Two of these formations, the Ahnond and the Frontier Formations, have been classified as tight sands and are prolific producers in the GGRB. The formations typically naturally fractured and have been exploited using conventional well technology. In most cases, hydraulic fracture treatments must be performed when completing these wells to to increase gas production rates to economic levels. The objectives of the GGRB production improvement project were to apply the concept of horizontal and directional drilling to the Second Frontier Formation on the western flank of the Rock Springs Uplift and to compare production improvements by drilling, completing, and testing vertical, horizontal and directionally-drilled wellbores at a common site.

  8. Triatoma infestans in Greater Buenos Aires, Argentina

    Directory of Open Access Journals (Sweden)

    P Gajate

    2001-05-01

    Full Text Available The Health Administration Agencies of many municipalities in Greater Buenos Aires (GBA receive frequent reports on triatomines in houses. The aim of this work was to identify and describe the dispersal foci of Triatoma infestans in an urban neighborhood of GBA, and contribute to the knowledge of the epidemiological situation in the region. In June 1998, potentially infested places were entomologically evaluated. T. infestans was only detected in a hen building for egg production, which housed approximately 6,000 birds. A total of 2,930 insects were collected. Density was about 9 triatomines/m². The proportions of fifth instar nymphs and adults were significantly higher than those of the other stages (p<0.001. The number of triatomines collected largely exceeded the highest domestic infestation found in one house from rural endemic areas of Argentina. Though triatomines were negative for Trypanosoma cruzi, they could acquire the parasite by coming in contact with infected people living in GBA. Besides, the numerous and widely distributed places housing hens and chickens, would favor the settlement of the vector. Together, both facts may constitute a risk of parasitic vectorial transmission. It is recommended to intensify systematic activities of vector search and case detection in GBA.

  9. Triatoma infestans in Greater Buenos Aires, Argentina.

    Science.gov (United States)

    Gajate, P; Pietrokovsky, S; Abramo Orrego, L; Pérez, O; Monte, A; Belmonte, J; Wisnivesky-Colli, C

    2001-05-01

    The Health Administration Agencies of many municipalities in Greater Buenos Aires (GBA) receive frequent reports on triatomines in houses. The aim of this work was to identify and describe the dispersal foci of Triatoma infestans in an urban neighborhood of GBA, and contribute to the knowledge of the epidemiological situation in the region. In June 1998, potentially infested places were entomologically evaluated. T. infestans was only detected in a hen building for egg production, which housed approximately 6,000 birds. A total of 2,930 insects were collected. Density was about 9 triatomines/m(2). The proportions of fifth instar nymphs and adults were significantly higher than those of the other stages (pparasite by coming in contact with infected people living in GBA. Besides, the numerous and widely distributed places housing hens and chickens, would favor the settlement of the vector. Together, both facts may constitute a risk of parasitic vectorial transmission. It is recommended to intensify systematic activities of vector search and case detection in GBA.

  10. Assessing access to surgical care in Nepal via a cross-sectional, countrywide survey.

    Science.gov (United States)

    Boeck, Marissa A; Nagarajan, Neeraja; Gupta, Shailvi; Varadaraj, Varshini; Groen, Reinou S; Shrestha, Sunil; Gurung, Susant; Kushner, Adam L; Nwomeh, Benedict; Swaroop, Mamta

    2016-08-01

    Adequate surgical care is lacking in many low- and middle-income countries because of diverse barriers preventing patients from reaching providers. We sought to assess perceived difficulties to accessing surgical care in Nepal using the Surgeons OverSeas Assessment of Surgical Need tool. Fifteen of 75 Nepali districts were selected proportionate to the population, with 1,350 households surveyed. Household heads answered questions regarding access to health facilities, and 2 household members were interviewed for medical history. Continuous and categorical variables were analyzed via Wilcoxon rank sum test and Pearson χ(2) test. Multivariable logistic regressions for independent predictors of care access were performed controlling for age, sex, location, and literacy. Of respondents with a surgical condition (n = 1,342), 650 (48.4%) accessed care and 237 (17.7%) did not. Unadjusted analyses showed greater median travel times to all facilities (P access care versus those who did. Literate respondents were more likely to access care across all facilities and access variables in adjusted models (odds ratio 1.66-1.80, P access care at any facility in all analyses (P access to needed surgical care in Nepal during their lifetimes, with those not accessing health facilities having lower literacy rates and fewer transport resources. Promoting education, outreach programs, and transportation access could lessen barriers but will require further exploration. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Open Access, library and publisher competition, and the evolution of general commerce

    CERN Document Server

    Odlyzko, Andrew

    2013-01-01

    Discussions of the economics of scholarly communication are usually devoted to Open Access, rising journal prices, publisher profits, and boycotts. That ignores what seems a much more important development in this market. Publishers, through the oft-reviled "Big Deal" packages, are providing much greater and more egalitarian access to the journal literature, an approximation to true Open Access. In the process they are also marginalizing libraries, and obtaining a greater share of the resources going into scholarly communication. This is enabling a continuation of publisher profits as well as of what for decades has been called "unsustainable journal price escalation". It is also inhibiting the spread of Open Access, and potentially leading to an oligopoly of publishers controlling distribution through large-scale licensing. The "Big Deal" practices are worth studying for several general reasons. The degree to which publishers succeed in diminishing the role of libraries may be an indicator of the degree and ...

  12. Vascular Access Procedures

    Science.gov (United States)

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

  13. Vascular Access for Hemodialysis

    Science.gov (United States)

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

  14. Limited-Access Heart Surgery

    Science.gov (United States)

    ... perform videoscopic surgery with even greater precision. In robotic-assisted surgery, surgeons make several small incisions in the chest ... As with other kinds of limited-access surgery, robotic-assisted surgery can mean shorter hospital stays and recovery times ...

  15. 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.

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

    Science.gov (United States)

    Mold, Freda; de Lusignan, Simon

    2015-12-04

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

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

    Science.gov (United States)

    Mold, Freda; de Lusignan, Simon

    2015-01-01

    Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems. PMID:26690225

  18. Hailstones across the Greater Sydney Metropolitan Area

    Science.gov (United States)

    Rasuly, A. A.; Cheung, K. K. W.; McBurney, B.

    2014-11-01

    This study addresses the recent climatology of hail occurrence in the Greater Metropolitan Severe Thunderstorm Warning Area (GMSTWA) of New South Wales, Australia, which is a sprawling suburban area, with a population of nearly 4.7 million and one of Australia's largest metropolis. The main objective is to highlight the recent temporal-spatial fluctuations of hailstone frequencies and magnitudes for each of recognized and vastly inhabited Local Government Areas (LGAs). The relevant hail event data from 1989 to 2013 were initially derived from the severe storm archive of Australian Bureau of Meteorology. A climatologically oriented GIS technique was applied in the examining and mapping procedure of all hail events and hail days reported throughout the study area. By applying a specific criterion, all severe hails (defined as 2 cm or more in diameter) were cautiously selected and then imported into the ArcGIS software for relevant analysis. Appropriate data layers were stored in a unique database to allow logical integration of the data directly into some geoprocessing functions, mainly for querying, analyzing and mapping purposes in a model-builder setting. The database includes 357 hailstones with sizes 2-11 cm and occurred in 169 hail days across the region during the past 25 years. The models have established that hailstones are neither temporally nor spatially uniform in magnitude throughout the study area. Temporal analysis indicated that most of hail events occurred predominately in the afternoons with peak time of 1-5 p.m. EST. They were particularly common in spring and summer, and reached maximum frequency in November and December. There was an average of 14.3 events each year, but a significant decreasing trend in terms of hail frequency and associated magnitude in the recent years has been identified. In turn, spatial models also established three main distribution patterns over the study area, which include the Sydney Metropolitan, coastal and pronounced

  19. Expatriate job performance in Greater China: Does age matter?

    DEFF Research Database (Denmark)

    Selmer, Jan; Lauring, Jakob; Feng, Yunxia

    to expatriates in Chinese societies. It is possible that older business expatriates will receive more respect and be treated with more deference in a Chinese cultural context than their apparently younger colleagues. This may have a positive impact on expatriates’ job performance. To empirically test...... this presumption, business expatriates in Greater Chine were targeted by a survey. Controlling for the potential bias of a number of background variables, results indicate that contextual/managerial performance, including general managerial functions applied to the subsidiary in Greater China, had a positive...... association with the age of the expatriates. This finding provides partial affirmative support to the presumption that the age of business expatriates matters in a Chinese cultural context. Implications of this result are discussed in detail....

  20. Educational Access in India. Country Policy Brief

    Science.gov (United States)

    Online Submission, 2009

    2009-01-01

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

  1. Barriers to accessing health care services for West African refugee women living in Western Australia.

    Science.gov (United States)

    Drummond, Peter D; Mizan, Ayse; Brocx, Katie; Wright, Bernadette

    2011-03-01

    Help-seeking pathways and barriers to accessing health care services were surveyed in 51 West African refugee women who had settled recently in Perth, Western Australia, and in 100 Australian women. Shame or fear of what family and friends might think, fear of being judged by the treatment provider, fear of hospitalization, and logistical difficulties were significant impediments to accessing health care services for the refugee women. Surprisingly, barriers often were greater for the more-educated refugee women and strengthened with years of residence in Australia. Strategies to help at-risk women overcome these barriers need to be implemented to ensure appropriate access to health care services.

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

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

    Bob Stanley

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

  3. XCOR AeroSpace: Providing Low Cost Access to Space

    Science.gov (United States)

    2009-02-01

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

  4. 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.

  5. Developing an accessible video player

    Directory of Open Access Journals (Sweden)

    Juan José Rodríguez Soler

    2012-05-01

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

  6. Macroscopic characterisations of Web accessibility

    Science.gov (United States)

    Lopes, Rui; Carriço, Luis

    2010-12-01

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

  7. Racial Disparities In Geographic Access To Primary Care In Philadelphia.

    Science.gov (United States)

    Brown, Elizabeth J; Polsky, Daniel; Barbu, Corentin M; Seymour, Jane W; Grande, David

    2016-08-01

    Primary care is often thought of as the gateway to improved health outcomes and can lead to more efficient use of health care resources. Because of primary care's cardinal importance, adequate access is an important health policy priority. In densely populated urban areas, spatial access to primary care providers across neighborhoods is poorly understood. We examined spatial variation in primary care access in Philadelphia, Pennsylvania. We calculated ratios of adults per primary care provider for each census tract and included buffer zones based on prespecified drive times around each tract. We found that the average ratio was 1,073; the supply of primary care providers varied widely across census tracts, ranging from 105 to 10,321. We identified six areas of Philadelphia that have much lower spatial accessibility to primary care relative to the rest of the city. After adjustment for sociodemographic and insurance characteristics, the odds of being in a low-access area were twenty-eight times greater for census tracts with a high proportion of African Americans than in tracts with a low proportion of African Americans. Project HOPE—The People-to-People Health Foundation, Inc.

  8. 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.

  9. Pilot evaluation of a web-based intervention targeting sexual health service access.

    Science.gov (United States)

    Brown, K E; Newby, K; Caley, M; Danahay, A; Kehal, I

    2016-04-01

    Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among 13-19-year olds are reported. A pre-post questionnaire-based design was used. Matched baseline and follow-up data were identified from 148 respondents aged 13-18 years. Outcome measures were self-reported service access, self-reported intention to access services and beliefs about services and service access identified through needs analysis. Objective service access data provided by local sexual health services were also analyzed. Analysis suggests the intervention had a significant positive effect on psychological barriers to and antecedents of service access among females. Males, who reported greater confidence in service access compared with females, significantly increased service access by time 2 follow-up. Available objective service access data support the assertion that the intervention may have led to increases in service access. There is real promise for this novel digital intervention. Further evaluation is planned as the model is licensed to and rolled out by other local authorities in the United Kingdom. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  10. Internet Medline providers.

    Science.gov (United States)

    Vine, D L; Coady, T R

    1998-01-01

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

  11. Interlibrary loan in primary access libraries: challenging the traditional view

    Science.gov (United States)

    Dudden, Rosalind Farnam; Coldren, Sue; Condon, Joyce Elizabeth; Katsh, Sara; Reiter, Catherine Morton; Roth, Pamela Lynn

    2000-01-01

    Introduction: Primary access libraries serve as the foundation of the National Network of Libraries of Medicine (NN/LM) interlibrary loan (ILL) hierarchy, yet few published reports directly address the important role these libraries play in the ILL system. This may reflect the traditional view that small, primary access libraries are largely users of ILL, rather than important contributors to the effectiveness and efficiency of the national ILL system. Objective: This study was undertaken to test several commonly held beliefs regarding ILL system use by primary access libraries. Hypotheses: Three hypotheses were developed. H1: Colorado and Wyoming primary access libraries comply with the recommended ILL guideline of adhering to a hierarchical structure, emphasizing local borrowing. H2: The closures of two Colorado Council of Medical Librarians (CCML) primary access libraries in 1996 resulted in twenty-three Colorado primary access libraries' borrowing more from their state resource library in 1997. H3: The number of subscriptions held by Colorado and Wyoming primary access libraries is positively correlated with the number of items they loan and negatively correlated with the number of items they borrow. Methods: The hypotheses were tested using the 1992 and 1997 DOCLINE and OCLC data of fifty-four health sciences libraries, including fifty primary access libraries, two state resource libraries, and two general academic libraries in Colorado and Wyoming. The ILL data were obtained electronically and analyzed using Microsoft Word 98, Microsoft Excel 98, and JMP 3.2.2. Results: CCML primary access libraries comply with the recommended guideline to emphasize local borrowing by supplying each other with the majority of their ILLs, instead of overburdening libraries located at higher levels in the ILL hierarchy (H1). The closures of two CCML primary access libraries appear to have affected the entire ILL system, resulting in a greater volume of ILL activity for the

  12. Interlibrary loan in primary access libraries: challenging the traditional view.

    Science.gov (United States)

    Dudden, R F; Coldren, S; Condon, J E; Katsh, S; Reiter, C M; Roth, P L

    2000-10-01

    Primary access libraries serve as the foundation of the National Network of Libraries of Medicine (NN/LM) interlibrary loan (ILL) hierarchy, yet few published reports directly address the important role these libraries play in the ILL system. This may reflect the traditional view that small, primary access libraries are largely users of ILL, rather than important contributors to the effectiveness and efficiency of the national ILL system. This study was undertaken to test several commonly held beliefs regarding ILL system use by primary access libraries. Three hypotheses were developed. HI: Colorado and Wyoming primary access libraries comply with the recommended ILL guideline of adhering to a hierarchical structure, emphasizing local borrowing. H2: The closures of two Colorado Council of Medical Librarians (CCML) primary access libraries in 1996 resulted in twenty-three Colorado primary access libraries' borrowing more from their state resource library in 1997. H3: The number of subscriptions held by Colorado and Wyoming primary access libraries is positively correlated with the number of items they loan and negatively correlated with the number of items they borrow. The hypotheses were tested using the 1992 and 1997 DOCLINE and OCLC data of fifty-four health sciences libraries, including fifty primary access libraries, two state resource libraries, and two general academic libraries in Colorado and Wyoming. The ILL data were obtained electronically and analyzed using Microsoft Word 98, Microsoft Excel 98, and JMP 3.2.2. CCML primary access libraries comply with the recommended guideline to emphasize local borrowing by supplying each other with the majority of their ILLs, instead of overburdening libraries located at higher levels in the ILL hierarchy (H1). The closures of two CCML primary access libraries appear to have affected the entire ILL system, resulting in a greater volume of ILL activity for the state resource library and other DOCLINE libraries higher

  13. Access to care: leveraging dental education.

    Science.gov (United States)

    Bertolami, Charles N; Berne, Robert

    2014-11-01

    If it is not a naïve expectation for dentists who have been beneficiaries of public generosity to share their good fortune with the public that made it possible, there may be a rational basis for enhancing the role of dental education in improving access to oral health care by promoting-but not requiring-a voluntary service commitment after graduation commensurate with the magnitude of the subsidy received. Such an approach would be in accordance with the Institute of Medicine's report Improving Access to Oral Health Care for Vulnerable and Underserved Populations, but without the governmental coercion explicit in the report. A sustainable alternative proposal is made here, offering both greater options to students in the financing of their dental education and greater obligations for those students who accept state subsidies: providing tuition discounts for students of state-supported dental schools based not on past residency status but rather on a future commitment to public service. This arrangement could be good public policy that might also help to create a culture in which dental students are given authentic options as part of a profession-wide ideology of public service. The result could well contribute to improved oral health care for the underserved.

  14. Wheelchair users, access and exclusion in South African higher education.

    Science.gov (United States)

    Chiwandire, Desire; Vincent, Louise

    2017-01-01

    South Africa's Constitution guarantees everyone, including persons with disabilities, the right to education. A variety of laws are in place obliging higher education institutions to provide appropriate physical access to education sites for all. In practice, however, many buildings remain inaccessible to people with physical disabilities. To describe what measures South African universities are taking to make their built environments more accessible to students with diverse types of disabilities, and to assess the adequacy of such measures. We conducted semi-structured in-depth face-to-face interviews with disability unit staff members (DUSMs) based at 10 different public universities in South Africa. Challenges with promoting higher education accessibility for wheelchair users include the preservation and heritage justification for failing to modify older buildings, ad hoc approaches to creating accessible environments and failure to address access to toilets, libraries and transport facilities for wheelchair users. South African universities are still not places where all students are equally able to integrate socially. DUSMs know what ought to be done to make campuses more accessible and welcoming to students with disabilities and should be empowered to play a leading role in sensitising non-disabled members of universities, to create greater awareness of, and appreciation for, the multiple ways in which wheelchair user students continue to be excluded from full participation in university life. South African universities need to adopt a systemic approach to inclusion, which fosters an understanding of inclusion as a fundamental right rather than as a luxury.

  15. Selective access and editing in a database

    Science.gov (United States)

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

    2010-01-01

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

  16. 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.

  17. 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…

  18. Land cover mapping of Greater Mesoamerica using MODIS data

    Science.gov (United States)

    Giri, Chandra; Jenkins, Clinton N.

    2005-01-01

    A new land cover database of Greater Mesoamerica has been prepared using moderate resolution imaging spectroradiometer (MODIS, 500 m resolution) satellite data. Daily surface reflectance MODIS data and a suite of ancillary data were used in preparing the database by employing a decision tree classification approach. The new land cover data are an improvement over traditional advanced very high resolution radiometer (AVHRR) based land cover data in terms of both spatial and thematic details. The dominant land cover type in Greater Mesoamerica is forest (39%), followed by shrubland (30%) and cropland (22%). Country analysis shows forest as the dominant land cover type in Belize (62%), Cost Rica (52%), Guatemala (53%), Honduras (56%), Nicaragua (53%), and Panama (48%), cropland as the dominant land cover type in El Salvador (60.5%), and shrubland as the dominant land cover type in Mexico (37%). A three-step approach was used to assess the quality of the classified land cover data: (i) qualitative assessment provided good insight in identifying and correcting gross errors; (ii) correlation analysis of MODIS- and Landsat-derived land cover data revealed strong positive association for forest (r2 = 0.88), shrubland (r2 = 0.75), and cropland (r2 = 0.97) but weak positive association for grassland (r2 = 0.26); and (iii) an error matrix generated using unseen training data provided an overall accuracy of 77.3% with a Kappa coefficient of 0.73608. Overall, MODIS 500 m data and the methodology used were found to be quite useful for broad-scale land cover mapping of Greater Mesoamerica.

  19. Hemodialysis access -- self care

    Science.gov (United States)

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

  20. Internet Access and Empowerment

    Science.gov (United States)

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

    2003-01-01

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

  1. 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,...

  2. Accessibility, reliability, and usability of neurosurgical resources.

    Science.gov (United States)

    Agarwal, Nitin; Kommana, Sumana S; Hansberry, David R; Kashkoush, Ahmed I; Friedlander, Robert M; Lunsford, L Dade

    2017-04-01

    OBJECTIVE Closing the knowledge gap that exists between patients and health care providers is essential and is facilitated by easy access to patient education materials. Although such information has the potential to be an effective resource, it must be written in a user-friendly and understandable manner, especially when such material pertains to specialized and highly technical fields such as neurological surgery. The authors evaluated the accessibility, usability, and reliability of current educational resources provided by the American Association of Neurological Surgeons (AANS), Healthwise, and the National Institute for Neurological Disorders and Stroke (NINDS). METHODS Online neurosurgical patient education information provided by AANS, Healthwise, and NINDS was evaluated using the LIDA scale, a website quality assessment tool, by medical professionals and nonmedical professionals. A high achieving score is regarded as 90% or greater using the LIDA scale. RESULTS Accessibility scores were 76.7% (AANS), 83.3% (Healthwise), and 75.0% (NINDS). Average usability scores for the AANS, Healthwise, and NINDS were 73.3%, 82.6%, and 82.9%, respectively, when evaluated by medical professionals and 78.5%, 80.7%, and 75.9%, respectively, for nonmedical professionals, respectively. Average reliability scores were 58.5%, 53.3%, 72.6%, respectively, for medical professionals and 70.4%, 66.7%, and 78.5%, respectively, for nonmedical professionals when evaluating the AANS, Healthwise, and NINDS websites. CONCLUSIONS Although organizations like AANS, Healthwise, and NINDS should be commended for their ongoing commitment to provide health care-oriented materials, modification of this material is suggested to improve the patient education value.

  3. Achieving universal access to broadband

    DEFF Research Database (Denmark)

    Falch, Morten; Henten, Anders

    2009-01-01

    The paper discusses appropriate policy measures for achieving universal access to broadband services in Europe. Access can be delivered by means of many different technology solutions described in the paper. This means a greater degree of competition and affects the kind of policy measures...... to be applied. The paper concludes that other policy measure than the classical universal service obligation are in play, and discusses various policy measures taking the Lisbon process as a point of departure. Available policy measures listed in the paper include, universal service obligation, harmonization...

  4. Achieving Universal Access to Broadband

    Directory of Open Access Journals (Sweden)

    Morten FALCH

    2009-01-01

    Full Text Available The paper discusses appropriate policy measures for achieving universal access to broadband services in Europe. Access can be delivered by means of many different technology solutions described in the paper. This means a greater degree of competition and affects the kind of policy measures to be applied. The paper concludes that other policy measure than the classical universal service obligation are in play, and discusses various policy measures taking the Lisbon process as a point of departure. Available policy measures listed in the paper include, universal service obligation, harmonization, demand stimulation, public support for extending the infrastructure, public private partnerships (PPP, and others.

  5. 76 FR 18476 - Improving Communications Services for Native Nations by Promoting Greater Utilization of Spectrum...

    Science.gov (United States)

    2011-04-04

    ... providers have not deployed wired services into Tribal lands and that there are instances where wireless... INFORMATION CONTACT: Wireless Telecommunications Bureau, Auctions and Spectrum Access Division: Stephen... 25 employees. I. Synopsis 1. While competitive market forces have spurred robust wireless...

  6. CONTEXT BASED ANDROID APPLICATIONADMINISTRATIVE ACCESS CONTROL (CBAA–AAC) FOR SMART PHONES

    OpenAIRE

    S. Sharavanan; R.M. Balajee

    2016-01-01

    Android applications in smart phones are generally towards provide greater flexibility and convince for users. Considering the fact that the Android applications are having privilege to access data and resources in mobile after it gets installed (one time permission provided by end user on the time installation), these application may also lead to issues in security for the user data as well as issues relate smart phone with peripheral environment. A practical example for an issue which relat...

  7. Practicing more retrieval routes leads to greater memory retention.

    Science.gov (United States)

    Zheng, Jun; Zhang, Wei; Li, Tongtong; Liu, Zhaomin; Luo, Liang

    2016-09-01

    A wealth of research has shown that retrieval practice plays a significant role in improving memory retention. The current study focused on one simple yet rarely examined question: would repeated retrieval using two different retrieval routes or using the same retrieval route twice lead to greater long-term memory retention? Participants elaborately learned 22 Japanese-Chinese translation word pairs using two different mediators. Half an hour after the initial study phase, the participants completed two retrieval sessions using either one mediator (Tm1Tm1) or two different mediators (Tm1Tm2). On the final test, which was performed 1week after the retrieval practice phase, the participants received only the cue with a request to report the mediator (M1 or M2) followed by the target (Experiment 1) or only the mediator (M1 or M2) with a request to report the target (Experiment 2). The results of Experiment 1 indicated that the participants who practiced under the Tm1Tm2 condition exhibited greater target retention than those who practiced under the Tm1Tm1 condition. This difference in performance was due to the significant disadvantage in mediator retrieval and decoding of the unpracticed mediator under the Tm1Tm1 condition. Although mediators were provided to participants on the final test in Experiment 2, decoding of the unpracticed mediators remained less effective than decoding of the practiced mediators. We conclude that practicing multiple retrieval routes leads to greater memory retention than focusing on a single retrieval route. Thus, increasing retrieval variability during repeated retrieval practice indeed significantly improves long-term retention in a delay test. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Perceptions of the food shopping environment are associated with greater consumption of fruits and vegetables.

    Science.gov (United States)

    Blitstein, Jonathan L; Snider, Jeremy; Evans, W Douglas

    2012-06-01

    The present study examined whether characteristics such as quality, selection and convenience are associated with dietary intake of fruits and vegetables independent of perceived costs in an inner-city, low-income population. Secondary analysis of baseline data from a social marketing intervention designed to change household dietary practices among parents of 3- to 7-year-old children. A community sample drawn from six low-income, primarily minority neighbourhoods in Chicago, IL, USA. From the parent study, 526 respondents completed the baseline survey and were eligible for inclusion. Of this number, 495 provided complete data on sociodemographic characteristics, fruit and vegetable consumption, perceptions of the shopping environment, perceived costs of fruits and vegetables, and food shopping habits. Logistic regression analysis showed that more positive perceptions of the food shopping environment were associated with greater consumption of fruits and vegetables. There was an increase of approximately twofold in the likelihood of consuming three or more fruits and vegetables daily per level of satisfaction ascribed to the shopping environment. This association was independent of perceived cost, store type and sociodemographic characteristics. Our data show that among a generally minority and low-income population, quality, selection and convenience are important determinants of fruit and vegetable consumption. Nutrition promotion campaigns that aim to alter the built environment by increasing access to fruits and vegetables should recognize that simply increasing availability may not yield beneficial change when characteristics of the shopping context are ignored.

  9. Backyard chicken keeping in the Greater London Urban Area: welfare status, biosecurity and disease control issues.

    Science.gov (United States)

    Karabozhilova, I; Wieland, B; Alonso, S; Salonen, L; Häsler, B

    2012-01-01

    1. The aim of the study was to collect baseline data on welfare, biosecurity and diseases of backyard chickens kept in the Greater London Urban Area (GLUA), United Kingdom (UK). 2. A total of 65 backyard chicken flock-keepers were recruited from May to July 2010 through adverts on websites, at City farms, veterinary practices and pet feed stores and surveyed by means of a questionnaire. A total of 30 responses were suitable for analysis. 3. Information on keepers' and flocks' characteristics, housing and husbandry practices and owners' knowledge of health problems in chickens and zoonotic diseases was collected. A welfare assessment protocol was developed and the flocks assessed accordingly. 4. Results showed that chickens were generally provided with living conditions that allowed them to perform their natural behaviours. 5. Most of the flock owners did not comply with the regulations of the Department for Environment, Food and Rural Affairs (Defra) on the feeding of catering waste. 6. Disease prevention measures such as vaccination and biosecurity, including limiting the access of human visitors, wild birds and rodents to the flocks were rare. 7. A lack of avian and zoonotic disease knowledge and awareness among the owners has implications for disease control and highlights the need for improved communication between owners, authorities and veterinarians.

  10. Case-matched study of lesser versus greater curvature approach in laparoscopic Warshaw pancreatectomy.

    Science.gov (United States)

    Müller, Philip C; Müller, Sascha A; Steinemann, Daniel C; Pärli, Michael S; Moltzahn, Felix; Schmid, Stefan W; Z'graggen, Kaspar

    2017-04-01

    In laparoscopic distal pancreatectomy (LapDP), the pancreas is accessed in a greater curvature approach (GCA). The lesser curvature approach (LCA) has been proposed in underweight patients. The study investigated the feasibility of LCA irrespective of the body mass index (BMI). This retrospective study included consecutive patients scheduled to undergo LapDP with the LCA. A matched cohort (1:1) underwent GCA. Spleen preservation was performed using the Warshaw technique. Splenic perfusion was intraoperatively assessed by indocyanine green (ICG) angiography. The LCA with LapDP was successful in 12/15 patients. In 2 cases, LCA had to be converted to GCA and in 1 patient to open surgery. The cohorts were well matched in sex (P = 1.0), age (P = .67), indication (P = 1.0), and median BMI (23.4 kg/m 2 vs 24.8 kg/m 2 , P = .41). Splenic preservation was achieved in 14/15 patients with LCA and 4/15 patients with GCA (P = .33). In all LCA cases, ICG angiography indicated sufficient spleen perfusion. The groups had similar morbidity (P = 1.0) and hospital stay (P = .74). LCA was feasible in 80% irrespective of BMI and provided an excellent field of exposure. ICG angiography was feasible in the Warshaw technique. Its reliability should be evaluated in prospective studies. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Differences in the Professional Satisfaction of General Internists in Academically Affiliated Practices in the Greater-Boston Area

    Science.gov (United States)

    Haas, Jennifer S; Cleary, Paul D; Puopolo, Ann Louise; Burstin, Helen R; Cook, E Francis; Brennan, Troyen A

    1998-01-01

    Managed care has created more professional constraints for general internists. We surveyed 198 general internists at 12 academically affiliated practices in the greater-Boston area to examine professional satisfaction. Overall, these physicians were moderately satisfied (mean of 59.1 on a 100-point scale). Before adjustment, women had lower overall satisfaction than men, as well as poorer satisfaction with the domains of career concerns and patient access. Gender had no independent effect on satisfaction after adjustment for age, income, percentage of time providing direct patient care, work status, and site. Younger physicians also had lower overall satisfaction, and these differences remained after adjustment. Improvements in professional satisfaction may be required to ensure the continued recruitment of young physicians, particularly women, into general internal medicine. PMID:9502374

  12. Access to environmental resources and physical activity levels of adults in Hawaii.

    Science.gov (United States)

    Geller, Karly S; Nigg, Claudio R; Ollberding, Nicholas J; Motl, Robert W; Horwath, Caroline; Dishman, Rodney K

    2015-03-01

    Examine associations between physical activity (PA) and spatial accessibility to environmental PA resources in Hawaii. Metabolic equivalents (METs) of mild, moderate, and strenuous PA were compared for accessibility with environmental PA resources within a population-based sample of Hawaiian adults (n = 381). Multiple linear regression estimated differences in PA levels for residing further from a PA resource or residing in an area with a greater number of resources. No associations were found in the total sample. Analyses within subsamples stratified by ethnicity revealed that greater spatial accessibility to a PA resource was positively associated with strenuous PA among Caucasians (P = .04) but negatively associated with moderate PA among Native Hawaiians (P = .00). The lack of association in the total sample may be a consequence of Hawaii's unique environment. Results of stratified sample analyses are unique, providing groundwork for future examinations within parallel environments and among similar ethnic groups. © 2012 APJPH.

  13. Ecological specialization and morphological diversification in Greater Antillean boas.

    Science.gov (United States)

    Reynolds, R Graham; Collar, David C; Pasachnik, Stesha A; Niemiller, Matthew L; Puente-Rolón, Alberto R; Revell, Liam J

    2016-08-01

    Colonization of islands can dramatically influence the evolutionary trajectories of organisms, with both deterministic and stochastic processes driving adaptation and diversification. Some island colonists evolve extremely large or small body sizes, presumably in response to unique ecological circumstances present on islands. One example of this phenomenon, the Greater Antillean boas, includes both small (evolution. Here, we provide the first comprehensive species phylogeny for this clade combined with morphometric and ecological data to show that small body size evolved repeatedly on separate islands in association with specialization in substrate use. Our results further suggest that microhabitat specialization is linked to increased rates of head shape diversification among specialists. Our findings show that ecological specialization following island colonization promotes morphological diversity through deterministic body size evolution and cranial morphological diversification that is contingent on island- and species-specific factors. © 2016 The Author(s). Evolution © 2016 The Society for the Study of Evolution.

  14. Saccharina genomes provide novel insight into kelp biology.

    Science.gov (United States)

    Ye, Naihao; Zhang, Xiaowen; Miao, Miao; Fan, Xiao; Zheng, Yi; Xu, Dong; Wang, Jinfeng; Zhou, Lin; Wang, Dongsheng; Gao, Yuan; Wang, Yitao; Shi, Wenyu; Ji, Peifeng; Li, Demao; Guan, Zheng; Shao, Changwei; Zhuang, Zhimeng; Gao, Zhengquan; Qi, Ji; Zhao, Fangqing

    2015-04-24

    Seaweeds are essential for marine ecosystems and have immense economic value. Here we present a comprehensive analysis of the draft genome of Saccharina japonica, one of the most economically important seaweeds. The 537-Mb assembled genomic sequence covered 98.5% of the estimated genome, and 18,733 protein-coding genes are predicted and annotated. Gene families related to cell wall synthesis, halogen concentration, development and defence systems were expanded. Functional diversification of the mannuronan C-5-epimerase and haloperoxidase gene families provides insight into the evolutionary adaptation of polysaccharide biosynthesis and iodine antioxidation. Additional sequencing of seven cultivars and nine wild individuals reveal that the genetic diversity within wild populations is greater than among cultivars. All of the cultivars are descendants of a wild S. japonica accession showing limited admixture with S. longissima. This study represents an important advance toward improving yields and economic traits in Saccharina and provides an invaluable resource for plant genome studies.

  15. 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...

  16. Limited access: gender, occupational composition, and flexible work scheduling.

    Science.gov (United States)

    Glauber, Rebecca

    2011-01-01

    The current study draws on national data to explore differences in access to flexible work scheduling by the gender composition of women's and men's occupations. Results show that those who work in integrated occupations are more likely to have access to flexible scheduling. Women and men do not take jobs with lower pay in return for greater access to flexibility. Instead, jobs with higher pay offer greater flexibility. Integrated occupations tend to offer the greatest access to flexible scheduling because of their structural locations. Part-time work is negatively associated with men's access to flexible scheduling but positively associated with women's access. Women have greater flexibility when they work for large establishments, whereas men have greater flexibility when they work for small establishments.

  17. Malaria trends and challenges in the Greater Mekong Subregion.

    Science.gov (United States)

    Delacollette, Charles; D'Souza, Carol; Christophel, Eva; Thimasarn, Krongthong; Abdur, Rashid; Bell, David; Dai, Tran Cong; Gopinath, Deyer; Lu, Shaohong; Mendoza, Raymond; Ortega, Leonard; Rastogi, Rakesh; Tantinimitkul, Chawalit; Ehrenberg, John

    2009-07-01

    This report provides an overview of the epidemiological patterns of malaria in the Greater Mekong Subregion (GMS) from 1998 to 2007, and highlights critical challenges facing national malaria control programs and partners in effort to build on their successes as they move towards malaria pre-elimination and elimination as a programmatic goal. Epidemiological data provided by malaria programs show a drastic decline in malaria deaths and confirmed malaria positive cases over the last 10 years in the GMS. More than half of confirmed malaria cases and deaths recorded in the GMS occur in Myanmar, however, reporting methods and data management are not comparable between countries despite effort made by WHO to harmonize data collection, analysis and reporting among WHO Member States. Malaria is concentrated in forested/forest-fringe areas of the region mainly along international borders providing strong rationale to develop harmonized cross-border pre-elimination programs in conjunction with national efforts. Across the Mekong Region, the declining efficacy of recommended first-line antimalarials, eg artemisinin-based combination therapies (ACTs) against falciparum malaria on the Cambodia-Thailand border, the prevalence of counterfeit and substandard antimalarial drugs, the lack of health services in general and malaria services in particular in remote settings, and the lack of information and services targeting migrants and mobile population present important barriers to reach or maintain malaria pre-elimination programmatic goals. Strengthening networking between research institutions and non-government organizations will increase knowledge-based decision and action.

  18. Pandora's Box? Companion Papers on Motivation, Access and the Media.

    Science.gov (United States)

    Sargant, Naomi; Tuckett, Alan

    These two papers address the challenge of harnessing the most appropriate media technology to help learning and teaching into the next century. "Motivation, Access, and the Media," presents the case for greater access for learners to the various technologies. The paper makes the case for access to be free at the point of use and argues…

  19. Access for success | Coughlan | South African Journal of Higher ...

    African Journals Online (AJOL)

    Debates about access and success are currently vigorous in higher education. There is much greater equity in terms of access but success in higher education continues to be racially patterned and far too few students graduate. This article argues for a more selective approach to access that is driven more deliberately by ...

  20. University Access, Inclusion and Social Justice

    Science.gov (United States)

    Hlalele, D.; Alexander, G.

    2012-01-01

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

  1. Freedom of the Press vs. Public Access.

    Science.gov (United States)

    Schmidt, Benno C., Jr.

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

  2. Greater patient confidence yields greater functional outcomes after primary total shoulder arthroplasty.

    Science.gov (United States)

    Styron, Joseph F; Higuera, Carlos A; Strnad, Greg; Iannotti, Joseph P

    2015-08-01

    Patient satisfaction is increasingly being tied to reimbursement rates, and patient satisfaction is often associated with improving functionality and decreasing disability postoperatively. This study sought to determine if a total shoulder arthroplasty patient's preoperative confidence in his or her ability to attain the level of activity desired would influence postoperative functional scores. Patients undergoing a primary total shoulder arthroplasty at a single institution were asked to complete a preoperative questionnaire with multiple items including baseline symptom severity measures and their confidence in reaching their level of desired functionality postoperatively (scored 0-10). Patients then completed an identical postoperative questionnaire at their follow-up visits. Associations between the patient's confidence in attaining treatment goals and functional outcomes was established by multiple linear regression models that were adjusted for gender, age, body mass index, baseline 12-Item Short Form Health Survey mental component scores, college education, smoking status, baseline functional scores, and length of follow-up. Patients had a high level of confidence that their outcome would match their expectations, with an average score of 7.8 (range, 0-10; 28.4% reported a full 10/10 confidence). For every 1-point increase in confidence, patients experienced an average increase in their function score of 2.7 points (P = .039) and improvement in their pain score of 2.0 (P = .033) according to the Penn Shoulder Score. There was no significant association with the patient's 12-Item Short Form Health Survey score postoperatively. Patients with greater preoperative confidence actually have significantly better postoperative functional outcomes than their less confident peers even with adjustment for other known risk factors. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  3. VT Limited Access Highways

    Data.gov (United States)

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

  4. Database Access Through Java Technologies

    OpenAIRE

    Nicolae MERCIOIU; Ion LUNGU

    2010-01-01

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

  5. Public Access and Use of Health Research: An Exploratory Study of the National Institutes of Health (NIH) Public Access Policy Using Interviews and Surveys of Health Personnel

    Science.gov (United States)

    Willinsky, John; Maggio, Lauren

    2011-01-01

    The results provide grounds for expecting the NIH Public Access Policy to have a positive impact on EBP and health care more generally given that between a quarter and a third of participants in this study (1) frequently accessed research literature, (2) expressed an interest in having greater access, and (3) were aware of the policy and expect it to have an impact on their accessing research literature in the future. Results also indicate the value of promoting a greater awareness of the NIH policy, providing training and education in the location and use of the literature, and continuing improvements in the organization of biomedical research for health personnel use. PMID:22106169

  6. Is greater patient choice consistent with equity? The case of the English NHS.

    Science.gov (United States)

    Dixon, Anna; Le Grand, Julian

    2006-07-01

    There are substantial inequities within the current National Health Service (NHS), with people in lower socioeconomic groups (SEGs) using a wide range of services less relative to their needs than people in higher SEGs. These inequities are likely to arise due to factors on both the demand and the supply side of the system. On the demand side, they could arise from differences in patients' beliefs, knowledge, costs, resources and capabilities. On the supply side, professional beliefs and attitudes, and risk selection or cream-skimming by providers may result in inequities. This paper discusses whether these factors are at play within the English NHS and analyses whether current policy to extend patient choice of provider is likely to reduce or increase these inequities. It shows that extending patient choice may leave unchanged inequity due to differences in health beliefs (because choice does not affect these directly), increase inequity due to unequal resources (because patients may have to travel further), and decrease inequity due to unequal capabilities (because the poor will have access to a new and, for them a more effective, source of leverage over health service professionals). On the supply side, there will be little change. The paper then discusses policy options for dealing with factors that contribute to greater inequity on the demand side. It proposes a package of supported choice whereby individuals from lower SEGs would receive assistance in making choices, including an identified key worker to act as patient care adviser and help with transport costs. The paper concludes that policies for extending patient choice can enhance equity--so long as they are properly designed.

  7. Greater learnability is not sufficient to produce cultural universals.

    Science.gov (United States)

    Rafferty, Anna N; Griffiths, Thomas L; Ettlinger, Marc

    2013-10-01

    Looking across human societies reveals regularities in the languages that people speak and the concepts that they use. One explanation that has been proposed for these "cultural universals" is differences in the ease with which people learn particular languages and concepts. A difference in learnability means that languages and concepts possessing a particular property are more likely to be accurately transmitted from one generation of learners to the next. Intuitively, this difference could allow languages and concepts that are more learnable to become more prevalent after multiple generations of cultural transmission. If this is the case, the prevalence of languages and concepts with particular properties can be explained simply by demonstrating empirically that they are more learnable. We evaluate this argument using mathematical analysis and behavioral experiments. Specifically, we provide two counter-examples that show how greater learnability need not result in a property becoming prevalent. First, more learnable languages and concepts can nonetheless be less likely to be produced spontaneously as a result of transmission failures. We simulated cultural transmission in the laboratory to show that this can occur for memory of distinctive items: these items are more likely to be remembered, but not generated spontaneously once they have been forgotten. Second, when there are many languages or concepts that lack the more learnable property, sheer numbers can swamp the benefit produced by greater learnability. We demonstrate this using a second series of experiments involving artificial language learning. Both of these counter-examples show that simply finding a learnability bias experimentally is not sufficient to explain why a particular property is prevalent in the languages or concepts used in human societies: explanations for cultural universals based on cultural transmission need to consider the full set of hypotheses a learner could entertain and all of

  8. Gender differences in commuting behavior: Women's greater sensitivity

    Energy Technology Data Exchange (ETDEWEB)

    Olmo Sanchez, M.I.; Maeso Gonzalez, E.

    2016-07-01

    Women's greater sensitivity to changes in their environment is one of the most distinguishing features between both genders. This article raises women's greater sensitivity to the different variables which influence their commuting modal choice. In order to do this, gender gaps detected in the choice of means of transport in commuting trips with respect to the decision factors such as age, education level, driver's license, private transport access; location, household size and net income, are quantified.The results show a greater female sensitivity to the different variables that affect their modal choice, which helps to better understand the different mobility patterns and it is useful for planning measures favoring sustainable mobility policies and equity. (Author)

  9. Alternate Access to Care: A Cross Sectional Survey of Low Acuity Emergency Department Patients.

    Science.gov (United States)

    MacKay, Jacqueline; Atkinson, Paul; Palmer, Erin; Fraser, Jacqueline; Vaillancourt, Elise; Howlett, Michael; Stoica, George; Powell, Maria

    2017-06-23

    Introduction Patients with low-acuity (Canadian Triage and Acuity Scale level IV and V) complaints use the emergency department (ED) to access care. This has often been attributed to lack of a primary care provider. However, simply being registered with a primary care provider may not prevent low acuity ED presentation. There is some evidence that a lack of timely access to primary care may contribute to low acuity ED presentations. The Wait Time Alliance, a group of Canadian physicians and their respective professional associations, has recently set a benchmark of same day access to family doctors. It is unclear if this benchmark has been achieved in all jurisdictions.  Methods We performed linked cross sectional surveys to quantify the number of people presenting to the ED for nonurgent problems who felt unable to access primary care. Primary care practices were also surveyed to assess access using the metric of time to third next available appointment.  Results In the patient survey, 381 of 580 patients consented to participate. Of the 89 patients who met eligibility criteria, 100% completed the survey. 32 (35.9%) reported that the wait to see their primary care provider was "too long". 45 (50.5%) patients did not contact their primary care provider's office prior to ED presentation. 45 of 72 physician surveys were returned; a response rate of 62.5%. Most (77%) physicians estimated their wait time for a standard appointment to be greater than 48 hours. The mean calculated time to third next available appointment in the region was 6.6 (95% CI 4.6-8.7) days. Conclusions Approximately half of low acuity patients do not attempt to access their primary care provider prior to ED presentation. The benchmark of same day access to primary care has not been achieved in many practices in our region. Further education regarding primary care access would likely be beneficial to both patients and providers.

  10. Social conditions and self-management are more powerful determinants of health than access to care.

    Science.gov (United States)

    Pincus, T; Esther, R; DeWalt, D A; Callahan, L F

    1998-09-01

    Professional organizations advocate universal access to medical care as a primary approach to improving health in the population. Access to medical services is critical to outcomes of acute processes managed in an inpatient hospital, the setting of most medical education, research, and training, but seems to be limited in its capacity to affect outcomes of outpatient care, the setting of most medical activities. Persistent and widening disparities in health according to socioeconomic status provide evidence of limitations of access to care. First, job classification, a measure of socioeconomic status, was a better predictor of cardiovascular death than cholesterol level, blood pressure, and smoking combined in employed London civil servants with universal access to the National Health Service. Second, disparities in health according to socioeconomic status widened between 1970 and 1980 in the United Kingdom despite universal access (similar trends were seen in the United States). Third, in the United States, noncompletion of high school is a greater risk factor than biological factors for development of many diseases, an association that is explained only in part by age, ethnicity, sex, or smoking status. Fourth, level of formal education predicted cardiovascular mortality better than random assignment to active drug or placebo over 3 years in a clinical trial that provides optimal access to care. Increased recognition of limitations of universal access by physicians and their professional societies may enhance efforts to improve the health of the population.

  11. Enstore with Chimera namespace provider

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-01-01

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

  12. Not "Pulling up the Ladder": Women Who Organize Conference Symposia Provide Greater Opportunities for Women to Speak at Conservation Conferences.

    Directory of Open Access Journals (Sweden)

    Stephanie Sardelis

    Full Text Available The scientific community faces numerous challenges in achieving gender equality among its participants. One method of highlighting the contributions made by female scientists is through their selection as featured speakers in symposia held at the conferences of professional societies. Because they are specially invited, symposia speakers obtain a prestigious platform from which to display their scientific research, which can elevate the recognition of female scientists. We investigated the number of female symposium speakers in two professional societies (the Society of Conservation Biology (SCB from 1999 to 2015, and the American Society of Ichthyologists and Herpetologists (ASIH from 2005 to 2015, in relation to the number of female symposium organizers. Overall, we found that 36.4% of symposia organizers and 31.7% of symposia speakers were women at the Society of Conservation Biology conferences, while 19.1% of organizers and 28% of speakers were women at the American Society of Ichthyologists and Herpetologists conferences. For each additional female organizer at the SCB and ASIH conferences, there was an average increase of 95% and 70% female speakers, respectively. As such, we found a significant positive relationship between the number of women organizing a symposium and the number of women speaking in that symposium. We did not, however, find a significant increase in the number of women speakers or organizers per symposium over time at either conference, suggesting a need for revitalized efforts to diversify our scientific societies. To further those ends, we suggest facilitating gender equality in professional societies by removing barriers to participation, including assisting with travel, making conferences child-friendly, and developing thorough, mandatory Codes of Conduct for all conferences.

  13. Not "Pulling up the Ladder": Women Who Organize Conference Symposia Provide Greater Opportunities for Women to Speak at Conservation Conferences.

    Science.gov (United States)

    Sardelis, Stephanie; Drew, Joshua A

    2016-01-01

    The scientific community faces numerous challenges in achieving gender equality among its participants. One method of highlighting the contributions made by female scientists is through their selection as featured speakers in symposia held at the conferences of professional societies. Because they are specially invited, symposia speakers obtain a prestigious platform from which to display their scientific research, which can elevate the recognition of female scientists. We investigated the number of female symposium speakers in two professional societies (the Society of Conservation Biology (SCB) from 1999 to 2015, and the American Society of Ichthyologists and Herpetologists (ASIH) from 2005 to 2015), in relation to the number of female symposium organizers. Overall, we found that 36.4% of symposia organizers and 31.7% of symposia speakers were women at the Society of Conservation Biology conferences, while 19.1% of organizers and 28% of speakers were women at the American Society of Ichthyologists and Herpetologists conferences. For each additional female organizer at the SCB and ASIH conferences, there was an average increase of 95% and 70% female speakers, respectively. As such, we found a significant positive relationship between the number of women organizing a symposium and the number of women speaking in that symposium. We did not, however, find a significant increase in the number of women speakers or organizers per symposium over time at either conference, suggesting a need for revitalized efforts to diversify our scientific societies. To further those ends, we suggest facilitating gender equality in professional societies by removing barriers to participation, including assisting with travel, making conferences child-friendly, and developing thorough, mandatory Codes of Conduct for all conferences.

  14. Open access in Australia: an odyssey of sorts?

    Directory of Open Access Journals (Sweden)

    Colin Steele

    2013-11-01

    Full Text Available Scholarly communication change and open access (OA initiatives in Australia have followed an Odyssean path in the last decade. The stop-start nature of early initiatives demonstrates that institutional leadership is essential for the successful deposit of academic content in an institutional repository. Similarly, OA policies from the two Australian Research Councils were delayed for nearly a decade, partly due to publisher pressure and bureaucratic conservatism. More successful has been the development of full, or hybrid, open access university e-presses. These presses, usually embedded in the scholarly infrastructure of the university, provide monographic models for wider global consideration. Australian universities are now reflecting, partly through recent Research Council edicts and monitoring global OA developments, greater awareness of the need for action in scholarly communication change.

  15. State-level employment, accessibility and rurality

    Directory of Open Access Journals (Sweden)

    Casey Abington

    2014-09-01

    Full Text Available Employment and economic growth in rural areas as a policy issue has been recently highlighted by the federal government. In August 2011, the White House released a report entitled “Jobs and Economic Security for Rural America”. While the document listed various programs and policies that have reportedly benefited rural America, it also stated that rural communities are still facing many challenges. For example, many rural communities have lower incomes and higher poverty rates than more urban areas. One possible reason for rural communities being at a disadvantage compared to urban areas involves transportation, especially in terms of journey to work. Thus, one can ask how employment rates vary with accessibility, as measured by journey to work times, as well as location (rural versus urban. Using 2007 state level data, OLS analysis is used to examine the relationship between employment rates and journey to work times and rurality. The analysis confirms that employment rates decrease with increased journey to work times. However, measures of rurality were only marginally significant and the negative coefficient on each measure indicates that employment rates decrease with greater urbanization. Improving accessibility between (very rural and larger areas might improve employment opportunities. Although weighing the benefits of such (reduced unemployment against the costs of providing better highways or public transit might lead to a different conclusion.

  16. 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...

  17. 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...

  18. CERN Access Cards and Access Authorisations

    CERN Multimedia

    2003-01-01

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

  19. Common Badging and Access Control System (CBACS)

    Science.gov (United States)

    Dischinger, Portia

    2005-01-01

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

  20. Status on disposal of greater-than-Class C

    Energy Technology Data Exchange (ETDEWEB)

    Plummer, T.L.

    1995-12-31

    The Department of Energy (DOE) has developed a plan for the management and disposal of commercially generated greater-than-Class C (GTCC) low-level radioactive waste. The Low-Level Radioactive Waste Policy Amendments Act of 1985 made DOE responsible for disposal of GTCC waste. The act requires that GTCC waste be disposed in a Nuclear Regulatory Commission (NRC)-licensed facility. The NRC has amended 10 CFR 61 to express a preference for geologic disposal of GTCC waste. Based on reassessment studies, legislative guidance, and stakeholder involvement, a revised plan has been formulated to provide for total management of GTCC waste. The plan has four major thrusts: (1) plan for GTCC waste storage at the generator site until disposal is available, (2) establish storage for GTCC sealed sources posing health and safety risk to the public, (3) facilitate storage for other GTCC waste posing health and safety risk to the public, and (4) plan for co-disposal of GTCC waste in a geologic disposal site with similar waste types. The revised plan focuses on applying available resources to near- and long-term needs.

  1. Greater future global warming inferred from Earth's recent energy budget.

    Science.gov (United States)

    Brown, Patrick T; Caldeira, Ken

    2017-12-06

    Climate models provide the principal means of projecting global warming over the remainder of the twenty-first century but modelled estimates of warming vary by a factor of approximately two even under the same radiative forcing scenarios. Across-model relationships between currently observable attributes of the climate system and the simulated magnitude of future warming have the potential to inform projections. Here we show that robust across-model relationships exist between the global spatial patterns of several fundamental attributes of Earth's top-of-atmosphere energy budget and the magnitude of projected global warming. When we constrain the model projections with observations, we obtain greater means and narrower ranges of future global warming across the major radiative forcing scenarios, in general. In particular, we find that the observationally informed warming projection for the end of the twenty-first century for the steepest radiative forcing scenario is about 15 per cent warmer (+0.5 degrees Celsius) with a reduction of about a third in the two-standard-deviation spread (-1.2 degrees Celsius) relative to the raw model projections reported by the Intergovernmental Panel on Climate Change. Our results suggest that achieving any given global temperature stabilization target will require steeper greenhouse gas emissions reductions than previously calculated.

  2. Distribution of grizzly bears in the Greater Yellowstone Ecosystem, 2004

    Science.gov (United States)

    Schwartz, C.C.; Haroldson, M.A.; Gunther, K.; Moody, D.

    2006-01-01

    The US Fish and Wildlife Service (USFWS) proposed delisting the Yellowstone grizzly bear (Ursus arctos horribilis) in November 2005. Part of that process required knowledge of the most current distribution of the species. Here, we update an earlier estimate of occupied range (1990–2000) with data through 2004. We used kernel estimators to develop distribution maps of occupied habitats based on initial sightings of unduplicated females (n = 481) with cubs of the year, locations of radiomarked bears (n = 170), and spatially unique locations of conflicts, confrontations, and mortalities (n = 1,075). Although each data set was constrained by potential sampling bias, together they provided insight into areas in the Greater Yellowstone Ecosystem (GYE) currently occupied by grizzly bears. The current distribution of 37,258 km2 (1990–2004) extends beyond the distribution map generated with data from 1990–2000 (34,416 km2 ). Range expansion is particularly evident in parts of the Caribou–Targhee National Forest in Idaho and north of Spanish Peaks on the Gallatin National Forest in Montana.

  3. Vocal communication in adult greater horseshoe bats, Rhinolophus ferrumequinum.

    Science.gov (United States)

    Ma, Jie; Kobayasi, Kohta; Zhang, Shuyi; Metzner, Walter

    2006-05-01

    Whereas echolocation in horseshoe bats is well studied, virtually nothing is known about characteristics and function of their communication calls. Therefore, the communication calls produced by a group of captive adult greater horseshoe bats were recorded during various social interactions in a free-flight facility. Analysis revealed that this species exhibited an amazingly rich repertoire of vocalizations varying in numerous spectro-temporal aspects. Calls were classified into 17 syllable types (ten simple syllables and seven composites). Syllables were combined into six types of simple phrases and four combination phrases. The majority of syllables had durations of more than 100 ms with multiple harmonics and fundamental frequencies usually above 20 kHz, although some of them were also audible to humans. Preliminary behavioral observations indicated that many calls were emitted during direct interaction with and in response to social calls from conspecifics without requiring physical contact. Some echolocation-like vocalizations also appeared to clearly serve a communication role. These results not only shed light upon a so far widely neglected aspect of horseshoe bat vocalizations, but also provide the basis for future studies on the neural control of the production of communicative vocalizations in contrast to the production of echolocation pulse sequences.

  4. Integration core exercises elicit greater muscle activation than isolation exercises.

    Science.gov (United States)

    Gottschall, Jinger S; Mills, Jackie; Hastings, Bryce

    2013-03-01

    The American College of Sports Medicine and the United States Department of Health and Human Services advocate core training as a means to improve stability, reduce injury, and maintain mobility. There are countless exercises that target the primary core trunk muscles (abdominal and lumbar) with the aim of providing these benefits. However, it is unknown as to which exercises elicit the greatest activation thereby maximizing functional gains and peak performance. Thus, our purpose was to determine whether integration core exercises that require activation of the distal trunk muscles (deltoid and gluteal) elicit greater activation of primary trunk muscles in comparison with isolation core exercises that only require activation of the proximal trunk muscles. Twenty participants, 10 men and 10 women, completed 16 randomly assigned exercises (e.g., crunch, upper body extension, and hover variations). We measured muscle activity with surface electromyography of the anterior deltoid, rectus abdominus, external abdominal oblique, lumbar erector spinae, thoracic erector spinae, and gluteus maximus. Our results indicate that the activation of the abdominal and lumbar muscles was the greatest during the exercises that required deltoid and gluteal recruitment. In conclusion, when completing the core strength guidelines, an integrated routine that incorporates the activation of distal trunk musculature would be optimal in terms of maximizing strength, improving endurance, enhancing stability, reducing injury, and maintaining mobility.

  5. The Shifting Climate Portfolio of the Greater Yellowstone Area.

    Directory of Open Access Journals (Sweden)

    Adam J Sepulveda

    Full Text Available Knowledge of climatic variability at small spatial extents (< 50 km is needed to assess vulnerabilities of biological reserves to climate change. We used empirical and modeled weather station data to test if climate change has increased the synchrony of surface air temperatures among 50 sites within the Greater Yellowstone Area (GYA of the interior western United States. This important biological reserve is the largest protected area in the Lower 48 states and provides critical habitat for some of the world's most iconic wildlife. We focused our analyses on temporal shifts and shape changes in the annual distributions of seasonal minimum and maximum air temperatures among valley-bottom and higher elevation sites from 1948-2012. We documented consistent patterns of warming since 1948 at all 50 sites, with the most pronounced changes occurring during the Winter and Summer when minimum and maximum temperature distributions increased. These shifts indicate more hot temperatures and less cold temperatures would be expected across the GYA. Though the shifting statistical distributions indicate warming, little change in the shape of the temperature distributions across sites since 1948 suggest the GYA has maintained a diverse portfolio of temperatures within a year. Spatial heterogeneity in temperatures is likely maintained by the GYA's physiographic complexity and its large size, which encompasses multiple climate zones that respond differently to synoptic drivers. Having a diverse portfolio of temperatures may help biological reserves spread the extinction risk posed by climate change.

  6. ACHIEVEMENTS OF HIGHER EDUCATION SYSTEM IN GREATER EAST ASIA

    Directory of Open Access Journals (Sweden)

    S. I. Lunev

    2016-01-01

    Full Text Available The article discusses the importance of higher education institutions in the forming and development of scientific knowledge in the big emerging powers of Asia. It is noted that recently, thepositions of the leading Asian universities have become very much stronger (it is confi rmed by the world rating due to the radical education reforms (trajectories were very close to each other that were carried out by the countries of Greater East Asia during the last 25 years. The special programs on the comprehensive development of education were accepted, and its funding was perceived not just as a necessary public expenditure, but as investments to provide the economy with a highly skilled workforce and well-educated professionals. The drastic changes in models of education management are of particular signifi cance. The autonomy of educational institutions can be very high on local level. It is necessary to point out the private sector, which has a crucial signifi cance for Taiwan, South Korea, Japan and China. Exactly universities began playing a major role in scientifi c research in these states. International cooperation in the fi eld of education is also of great importance as it particularly promotes the formation of a cluster of people interested in the development of their own country in an international context.

  7. Wise Detections of Known QSOS at Redshifts Greater Than Six

    Science.gov (United States)

    Blain, Andrew W.; Assef, Roberto; Stern, Daniel; Tsai, Chao-Wei; Eisenhardt, Peter; Bridge, Carrie; Benford, Dominic; Jarrett, Tom; Cutri, Roc; Petty, Sara; hide

    2013-01-01

    We present WISE All-Sky mid-infrared (IR) survey detections of 55 % (17/31) of the known QSOs at z greater than 6 from a range of surveys: the SDSS, the CFHT-LS, FIRST, Spitzer and UK1DSS. The WISE catalog thus provides a substantial increase in tiie quantity of IR data available for these sources: 17 are detected in the WISE Wl (3.4 micrometer) band, 16 in W2 (4.6 micrometers), 3 in W3 (12 micrometers) and 0 in W4 (22micrometers). This is particularly important with Spitzer in its warm-mission phase and no faint follow-up capability at wavelengths longwards of 5 micrometers until the launch of JWST. WISE thus provides a useful tool for understanding QSOs found in forthcoming large-area optical/IR sky surveys, using PanSTARRS, SkyMapper, VISTA, DES and LSST. The rest-UV properties of the WISE-detected and the WISE-non-detected samples differ: the detections have brighter i/z-band magnitudes and redder rest-UV colors. This suggests thai a more aggressive hunt for very-high-redshift QSOs, by combining WISE Wl and W2 data with red observed optical colors could be effective at least, for a subset of dusty candidate QSOs. Stacking the WISE images of the WISE-non-detected QSOs indicates that they are on average significantly fainter than the WISE-detccted examples, and are thus not narrowly missing detection in the WISE catalog. The WISE-catalog detection of three of our sample in the W3 band indicates that their mid-ID flux can be detected individually, although there is no stacked W3 detection of sources detected in Wl but not. W3. Stacking analyses of WISE data for large AGN samples will be a useful tool, and high-redshifl. QSOs of all types will be easy targets for JWST.

  8. Surgical anatomy of greater occipital nerve and its relation to ...

    African Journals Online (AJOL)

    Introduction: The knowledge of the anatomy of greater occipital nerve and its relation to occipital artery is important for the surgeon. Blockage or surgical release of greater occipital nerve is clinically effective in reducing or eliminating chronic migraine symptoms. Aim: The aim of this research was to study the anatomy of ...

  9. INDUSTRIAL LAND DEVELOPMENT AND MANUFACTURING DECONCENTRATION IN GREATER JAKARTA

    NARCIS (Netherlands)

    Hudalah, Delik; Viantari, Dimitra; Firman, Tommy; Woltjer, Johan

    2013-01-01

    Industrial land development has become a key feature of urbanization in Greater Jakarta, one of the largest metropolitan areas in Southeast Asia. Following Suharto's market-oriented policy measures in the late 1980s, private developers have dominated the land development projects in Greater Jakarta.

  10. Strategies for Talent Management: Greater Philadelphia Companies in Action

    Science.gov (United States)

    Council for Adult and Experiential Learning (NJ1), 2008

    2008-01-01

    Human capital is one of the critical issues that impacts the Greater Philadelphia region's ability to grow and prosper. The CEO Council for Growth (CEO Council) is committed to ensuring a steady and talented supply of quality workers for this region. "Strategies for Talent Management: Greater Philadelphia Companies in Action" provides…

  11. Improving Access to Foundational Energy Performance Data

    Energy Technology Data Exchange (ETDEWEB)

    Studer, D.; Livingood, W.; Torcellini, P.

    2014-08-01

    Access to foundational energy performance data is key to improving the efficiency of the built environment. However, stakeholders often lack access to what they perceive as credible energy performance data. Therefore, even if a stakeholder determines that a product would increase efficiency, they often have difficulty convincing their management to move forward. Even when credible data do exist, such data are not always sufficient to support detailed energy performance analyses, or the development of robust business cases. One reason for this is that the data parameters that are provided are generally based on the respective industry norms. Thus, for mature industries with extensive testing standards, the data made available are often quite detailed. But for emerging technologies, or for industries with less well-developed testing standards, available data are generally insufficient to support robust analysis. However, even for mature technologies, there is no guarantee that the data being supplied are the same data needed to accurately evaluate a product?s energy performance. To address these challenges, the U.S. Department of Energy funded development of a free, publically accessible Web-based portal, the Technology Performance Exchange(TM), to facilitate the transparent identification, storage, and sharing of foundational energy performance data. The Technology Performance Exchange identifies the intrinsic, technology-specific parameters necessary for a user to perform a credible energy analysis and includes a robust database to store these data. End users can leverage stored data to evaluate the site-specific performance of various technologies, support financial analyses with greater confidence, and make better informed procurement decisions.

  12. Mars-Learning AN Open Access Educational Database

    Science.gov (United States)

    Kolankowski, S. M.; Fox, P. A.

    2016-12-01

    Schools across America have begun focusing more and more on science and technology, giving their students greater opportunities to learn about planetary science and engineering. With the development of rovers and advanced scientific instrumentation, we are learning about Mars' geologic history on a daily basis. These discoveries are crucial to our understanding of Earth and our solar system. By bringing these findings into the classroom, students can learn key concepts about Earth and Planetary sciences while focusing on a relevant current event. However, with an influx of readily accessible information, it is difficult for educators and students to find accurate and relevant material. Mars-Learning seeks to unify these discoveries and resources. This site will provide links to educational resources, software, and blogs with a focus on Mars. Activities will be grouped by grade for the middle and high school levels. Programs and software will be labeled, open access, free, or paid to ensure users have the proper tools to get the information they need. For new educators or those new to the subject, relevant blogs and pre-made lesson plans will be available so instructors can ensure their success. The expectation of Mars-Learning is to provide stress-free access to learning materials that falls within a wide range of curriculum. By providing a thorough and encompassing site, Mars-Learning hopes to further our understanding of the Red Planet and equip students with the knowledge and passion to continue this research.

  13. Environmental Influences on Forest Fire Regime in the Greater Hinggan Mountains, Northeast China

    Directory of Open Access Journals (Sweden)

    Qian Fan

    2017-09-01

    Full Text Available Fires are the major disturbances in the Greater Hinggan Mountains, the only boreal forest in Northeast China. A comprehensive understanding of the fire regimes and influencing environmental parameters driving them from small to large fires is critical for effective forest fire prevention and management. Assisted with satellite imagery, topographic data, and climatic records in this region, this study examines its fire regimes in terms of ignition causes, frequencies, seasonality, and burned sizes in the period of 1980–2005. We found an upward trend for fire occurrences and burned areas and an elongated fire season over the three decades. The dates of the first fire in a year did not vary largely but those of the last fire were significantly delayed. Topographically, spring fires were prevalent throughout the entire region, while summer fires mainly occurred at higher elevations under severe drought conditions. Fall fires were mostly human-caused in areas at lower elevations with gentle terrains. An ordinal logistic regression revealed temperature and elevation were both significant factors to the fire size severity in spring and summer. Other than that, environmental impacts were different. Precipitation in the preceding year greatly influenced spring fires, while summer fires were significantly affected by wind speed, fuel moisture, and human accessibility. An important message from this study is that distinct seasonal variability and a significantly increasing number of summer and fall fires since the mid-1990s suggest a changing fire regime of the boreal forests in the study area. The observed and modeled results could provide insights on establishing a sustainable, localized forest fire prevention strategy in a seasonal manner.

  14. 3D stress field simulation for Greater Munich, Germany

    Science.gov (United States)

    Ziegler, Moritz; Heidbach, Oliver; Reinecker, John; Przybycin, Anna Maria; Scheck-Wenderoth, Magdalena

    2016-04-01

    Geotechnical applications such as tunneling, storage of waste, wellbore planning, or reservoir engineering requires detailed 3D information on the rock properties and behavior of the continuum. One of the key parameters is the contemporary crustal in-situ stress state. However, generally the availability of stress data on reservoir scale is scarce or no data exists at all. Furthermore, stress data is often limited to the orientation of the maximum horizontal stress. Hence, geomechanical-numerical modelling provides an approximation of a continuous description of the 3D in-situ stress state. We present a model workflow that shows (1) how to calibrate a regional scale model of Greater Munich with stress orientations and magnitudes mainly from borehole data and (2) how to derive from the regional model boundary conditions for a local high-resolution model of a geothermal reservoir site. This approach using two models is an alternative to the required trade-off between resolution, computational cost and a sufficient number of calibration data which is otherwise inevitable for a single model. The incorporated 3D geological models contain the topography from a digital elevation model and 6 stratigraphic units with different elasto-plastic rock properties. The local model mimics the area of a planned reservoir and its resolution is significantly higher than in the regional model and down to 10 m near the planned borehole trajectories using 21×106 tetrahedron finite elements with linear approximation functions. The uncertainties of the calibrated regional model are large since no information on the magnitude of the maximum horizontal stress is available. Even in the entire Greater Munich area only two reliable leak-off tests that deliver the magnitude of the minimum horizontal stress could be used. These uncertainties are transferred also to the local model. Hence we also show how to quantify for the workflow in general the systematic uncertainties and discuss

  15. 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."

  16. 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 ...

  17. elevatr: Access Elevation Data from Various APIs

    Science.gov (United States)

    Several web services are available that provide access to elevation data. This package provides access to several of those services and returns elevation data either as a SpatialPointsDataFrame from point elevation services or as a raster object from raster elevation services. ...

  18. Testing the fecundity advantage hypothesis with Sitobion avenae, Rhopalosiphum padi, and Schizaphis graminum (Hemiptera: Aphididae) feeding on ten wheat accessions.

    Science.gov (United States)

    Hu, Xiang-Shun; Liu, Xiao-Feng; Thieme, Thomas; Zhang, Gai-Sheng; Liu, Tong-Xian; Zhao, Hui-Yan

    2015-12-18

    The fecundity advantage hypothesis suggests that females with a large body size produce more offspring than smaller females. We tested this hypothesis by exploring the correlations between life-history traits of three aphid species feeding on ten wheat accessions at three levels of analysis with respect to the host plant: overall, inter-accession, and intra-accession. We found that fecundity was significantly correlated with mean relative growth rate (MRGR), weight gain, and development time, and that the faster aphid develops the greater body and fecundity, depending on aphid species, wheat accession, and analyses level. Larger aphids of all three species produced more offspring overall; this held true for Sitobion avenae and Schizaphis graminum at the inter-accession level, and for S. avenae, Rhopalosiphum padi, and S. graminum for three, five, and eight accessions respectively at the intra-accession level. Only one correlation, between intrinsic rates of natural increase (rm) and MRGR, was significant for all aphid species at all three analysis levels. A more accurate statement of the fecundity advantage hypothesis is that cereal aphids with greater MRGR generally maintain higher rm on wheat. Our results also provide a method for exploring relationships between individual life-history traits and population dynamics for insects on host plants.

  19. Open Access Publishing with Drupal

    Directory of Open Access Journals (Sweden)

    Nina McHale

    2011-10-01

    Full Text Available In January 2009, the Colorado Association of Libraries (CAL suspended publication of its print quarterly journal, Colorado Libraries, as a cost-saving measure in a time of fiscal uncertainty. Printing and mailing the journal to its 1300 members cost CAL more than $26,000 per year. Publication of the journal was placed on an indefinite hiatus until the editorial staff proposed an online, open access format a year later. The benefits to migrating to open access included: significantly lower costs; a green platform; instant availability of content; a greater level of access to users with disabilities; and a higher level of visibility of the journal and the association. The editorial staff chose Drupal, including the E-journal module, and while Drupal is notorious for its steep learning curve—which exacerbated delays to content that had been created before the publishing hiatus—the fourth electronic issue was published recently at coloradolibrariesjournal.org. This article will discuss both the benefits and challenges of transitioning to an open access model and the choice Drupal as a platform over other more established journal software options.

  20. Male Astronauts Have Greater Bone Loss and Risk of Hip Fracture Following Long Duration Spaceflights than Females

    Science.gov (United States)

    Ellman, Rachel; Sibonga, Jean; Bouxsein, Mary

    2010-01-01

    This slide presentation reviews bone loss in males and compares it to female bone loss during long duration spaceflight. The study indicates that males suffer greater bone loss than females and have a greater risk of hip fracture. Two possible reason for the greater male bone loss are that the pre-menopausal females have the estrogen protection and the greater strength of men max out the exercise equipment that provide a limited resistance to 135 kg.

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

    Science.gov (United States)

    Mower, Allyson; Youngkin, Mary E

    2008-03-01

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

  2. Accessibility and sensory experiences

    DEFF Research Database (Denmark)

    Ryhl, Camilla

    2010-01-01

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

  3. Wheelchair users, access and exclusion in South African higher education

    Directory of Open Access Journals (Sweden)

    Desire Chiwandire

    2017-01-01

    Full Text Available Background: South Africa’s Constitution guarantees everyone, including persons with disabilities, the right to education. A variety of laws are in place obliging higher education institutions to provide appropriate physical access to education sites for all. In practice, however, many buildings remain inaccessible to people with physical disabilities.Objectives: To describe what measures South African universities are taking to make their built environments more accessible to students with diverse types of disabilities, and to assess the adequacy of such measures.Method: We conducted semi-structured in-depth face-to-face interviews with disability unit staff members (DUSMs based at 10 different public universities in South Africa.Results: Challenges with promoting higher education accessibility for wheelchair users include the preservation and heritage justification for failing to modify older buildings, ad hoc approaches to creating accessible environments and failure to address access to toilets, libraries and transport facilities for wheelchair users.Conclusion: South African universities are still not places where all students are equally able to integrate socially. DUSMs know what ought to be done to make campuses more accessible and welcoming to students with disabilities and should be empowered to play a leading role in sensitising non-disabled members of universities, to create greater awareness of, and appreciation for, the multiple ways in which wheelchair user students continue to be excluded from full participation in university life. South African universities need to adopt a systemic approach to inclusion, which fosters an understanding of inclusion as a fundamental right rather than as a luxury.

  4. Influence of Delhi Pollution on Aerosol Properties Over Greater Noida

    Science.gov (United States)

    Sharma, M.; Singh, R. P.; Kumar, R.

    2015-12-01

    Influence of Delhi Pollution on Aerosol Properties over Greater NoidaManish Sharma1, Ramesh P. Singh2 and Rajesh Kumar3 1Research and Technology Development Centre, Sharda University, Greater Noida, India. 2School of Earth and Environmental Sciences, Schmid College of Science, Chapman University, Orange 92866, USA 3School of Basic Sciences and Research, Sharda University, Greater Noida, India. Delhi capital of India is highly polluted during winter and summer seasons. Due to dominant westerly winds the air mass influence its neighboring city Greater Noida which is located 60 km south east of Delhi. Detailed analysis of multi satellite data and ground observations have been carried out during 2001-2015. The ground observation and satellite data show dynamic aerosol optical parameters over Greater Noida. During winter and summer seasons, dominant westerly wind outflow pollutants of Delhi that mix with the local anthropogenic emissions of Greater Noida influencing aerosol properties at different pressure levels. The characteristics of trace gases and aerosol parameters over Delhi and Greater Noida will be presented. The air quality is severely affected from the outflow of pollutants from Delhi which is threat to people living in the area. Due to dominant winds the air mass further transported towards eastern parts of Indo-Gangetic plains affecting weather conditions of the major cities.

  5. 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.

  6. Enteral nutrition access devices.

    Science.gov (United States)

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

    2010-08-01

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

  7. Efficient Access Control in Multimedia Social Networks

    Science.gov (United States)

    Sachan, Amit; Emmanuel, Sabu

    Multimedia social networks (MMSNs) have provided a convenient way to share multimedia contents such as images, videos, blogs, etc. Contents shared by a person can be easily accessed by anybody else over the Internet. However, due to various privacy, security, and legal concerns people often want to selectively share the contents only with their friends, family, colleagues, etc. Access control mechanisms play an important role in this situation. With access control mechanisms one can decide the persons who can access a shared content and who cannot. But continuously growing content uploads and accesses, fine grained access control requirements (e.g. different access control parameters for different parts in a picture), and specific access control requirements for multimedia contents can make the time complexity of access control to be very large. So, it is important to study an efficient access control mechanism suitable for MMSNs. In this chapter we present an efficient bit-vector transform based access control mechanism for MMSNs. The proposed approach is also compatible with other requirements of MMSNs, such as access rights modification, content deletion, etc. Mathematical analysis and experimental results show the effectiveness and efficiency of our proposed approach.

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

    OpenAIRE

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

    2012-01-01

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

  9. Perceptions of clients regarding family planning service delivery in a clinic of the Greater Johannesburg Metropolitan Council

    Directory of Open Access Journals (Sweden)

    A. Kellner

    2010-09-01

    Full Text Available Unwanted pregnancies with their negative impact on both women and children occur on an ongoing basis in Gauteng, South Africa. One way to prevent unwanted pregnancies is to use a reliable contraceptive method available free of charge from primary health care clinics providing family planning services throughout Gauteng Province. A literature review was completed on women and access to family planning services and an interview schedule (questionnaire was developed. The purpose of this study was to describe guidelines to meet the expectations of clients accessing family planning services provided by a clinic in Region F, Area 28 of the Greater Johannesburg metropolitan council. This quantitative, exploratory, descriptive and comparative study measured the gaps between the expectations of participants on service delivery and the extent to which these expectations were met. A convenience sample was conducted and consisted of 50 women of reproductive age (ages 15 to 49 attending the family planning clinic. Pre-testing of the instrument was conducted. Structured interviews with a interview schedule were conducted before and after women attended a family planning service. Inferential statistics indicated that there was a significant gap between the client expectations of family planning service delivery and the extent to which these expectations were met. Of the sixty-four items where women indicated the extent of their expectations the findings on only three items were not statistically significant. These gaps were addressed by proposing managerial guidelines to be implemented by the nurse manager in charge of the facility, on which this article will focus. Validity and reliability principles were ensured in the study. Ethical principles were adhered to during the research process.

  10. Lancet dynamics in greater horseshoe bats, Rhinolophus ferrumequinum.

    Science.gov (United States)

    He, Weikai; Pedersen, Scott C; Gupta, Anupam K; Simmons, James A; Müller, Rolf

    2015-01-01

    Echolocating greater horseshoe bats (Rhinolophus ferrumequinum) emit their biosonar pulses nasally, through nostrils surrounded by fleshy appendages ('noseleaves') that diffract the outgoing ultrasonic waves. Movements of one noseleaf part, the lancet, were measured in live bats using two synchronized high speed video cameras with 3D stereo reconstruction, and synchronized with pulse emissions recorded by an ultrasonic microphone. During individual broadcasts, the lancet briefly flicks forward (flexion) and is then restored to its original position. This forward motion lasts tens of milliseconds and increases the curvature of the affected noseleaf surfaces. Approximately 90% of the maximum displacements occurred within the duration of individual pulses, with 70% occurring towards the end. Similar lancet motions were not observed between individual pulses in a sequence of broadcasts. Velocities of the lancet motion were too small to induce Doppler shifts of a biologically-meaningful magnitude, but the maximum displacements were significant in comparison with the overall size of the lancet and the ultrasonic wavelengths. Three finite element models were made from micro-CT scans of the noseleaf post mortem to investigate the acoustic effects of lancet displacement. The broadcast beam shapes were found to be altered substantially by the observed small lancet movements. These findings demonstrate that-in addition to the previously described motions of the anterior leaf and the pinna-horseshoe bat biosonar has a third degree of freedom for fast changes that can happen on the time scale of the emitted pulses or the returning echoes and could provide a dynamic mechanism for the encoding of sensory information.

  11. Lancet dynamics in greater horseshoe bats, Rhinolophus ferrumequinum.

    Directory of Open Access Journals (Sweden)

    Weikai He

    Full Text Available Echolocating greater horseshoe bats (Rhinolophus ferrumequinum emit their biosonar pulses nasally, through nostrils surrounded by fleshy appendages ('noseleaves' that diffract the outgoing ultrasonic waves. Movements of one noseleaf part, the lancet, were measured in live bats using two synchronized high speed video cameras with 3D stereo reconstruction, and synchronized with pulse emissions recorded by an ultrasonic microphone. During individual broadcasts, the lancet briefly flicks forward (flexion and is then restored to its original position. This forward motion lasts tens of milliseconds and increases the curvature of the affected noseleaf surfaces. Approximately 90% of the maximum displacements occurred within the duration of individual pulses, with 70% occurring towards the end. Similar lancet motions were not observed between individual pulses in a sequence of broadcasts. Velocities of the lancet motion were too small to induce Doppler shifts of a biologically-meaningful magnitude, but the maximum displacements were significant in comparison with the overall size of the lancet and the ultrasonic wavelengths. Three finite element models were made from micro-CT scans of the noseleaf post mortem to investigate the acoustic effects of lancet displacement. The broadcast beam shapes were found to be altered substantially by the observed small lancet movements. These findings demonstrate that-in addition to the previously described motions of the anterior leaf and the pinna-horseshoe bat biosonar has a third degree of freedom for fast changes that can happen on the time scale of the emitted pulses or the returning echoes and could provide a dynamic mechanism for the encoding of sensory information.

  12. Interspecific nest parasitism by chukar on greater sage-grouse

    Science.gov (United States)

    Fearon, Michelle L.; Coates, Peter S.

    2014-01-01

    Nest parasitism occurs when a female bird lays eggs in the nest of another and the host incubates the eggs and may provide some form of parental care for the offspring (Lyon and Eadie 1991). Precocial birds (e.g., Galliformes and Anseriformes) are typically facultative nest parasites of both their own and other species (Lyon and Eadie 1991). This behavior increases a female’s reproductive success when she parasitizes other nests while simultaneously raising her own offspring. Both interspecific and conspecific nest parasitism have been well documented in several families of the order Galliformes, particularly the Phasianidae (Lyon and Eadie 1991, Geffen and Yom-Tov 2001, Krakauer and Kimball 2009). The Chukar (Alectoris chukar) has been widely introduced as a game bird to western North America from Eurasia and is now well established within the Great Basin from northeastern California east to Utah and north to Idaho and Oregon (Christensen 1996). Over much of this range the Chukar occurs with other phasianids, including the native Greater Sage-Grouse (Centrocercus urophasianus), within sagebrush (Artemisia spp.) steppe (Christensen 1996, Schroeder et al. 1999, Connelly et al. 2000). Chukar typically exploit a broader range of habitats than do sage-grouse, but both species use the same species of sagebrush and other shrubs for nesting cover (Christensen 1996, Schroeder et al. 1999). Chukar are known to parasitize nests of other individuals of their own species (Geffen and Yom-Tov 2001), but we are unaware of reported evidence that Chukar may parasitize nests of sage-grouse. Here we describe a case of a Chukar parasitizing a sage-grouse nest in the sagebrush steppe of western Nevada.

  13. Predictability of Seasonal Rainfall over the Greater Horn of Africa

    Science.gov (United States)

    Ngaina, J. N.

    2016-12-01

    The El Nino-Southern Oscillation (ENSO) is a primary mode of climate variability in the Greater of Africa (GHA). The expected impacts of climate variability and change on water, agriculture, and food resources in GHA underscore the importance of reliable and accurate seasonal climate predictions. The study evaluated different model selection criteria which included the Coefficient of determination (R2), Akaike's Information Criterion (AIC), Bayesian Information Criterion (BIC), and the Fisher information approximation (FIA). A forecast scheme based on the optimal model was developed to predict the October-November-December (OND) and March-April-May (MAM) rainfall. The predictability of GHA rainfall based on ENSO was quantified based on composite analysis, correlations and contingency tables. A test for field-significance considering the properties of finiteness and interdependence of the spatial grid was applied to avoid correlations by chance. The study identified FIA as the optimal model selection criterion. However, complex model selection criteria (FIA followed by BIC) performed better compared to simple approach (R2 and AIC). Notably, operational seasonal rainfall predictions over the GHA makes of simple model selection procedures e.g. R2. Rainfall is modestly predictable based on ENSO during OND and MAM seasons. El Nino typically leads to wetter conditions during OND and drier conditions during MAM. The correlations of ENSO indices with rainfall are statistically significant for OND and MAM seasons. Analysis based on contingency tables shows higher predictability of OND rainfall with the use of ENSO indices derived from the Pacific and Indian Oceans sea surfaces showing significant improvement during OND season. The predictability based on ENSO for OND rainfall is robust on a decadal scale compared to MAM. An ENSO-based scheme based on an optimal model selection criterion can thus provide skillful rainfall predictions over GHA. This study concludes that the

  14. Molecular insights into the biology of Greater Sage-Grouse

    Science.gov (United States)

    Oyler-McCance, Sara J.; Quinn, Thomas W.

    2011-01-01

    Recent research on Greater Sage-Grouse (Centrocercus urophasianus) genetics has revealed some important findings. First, multiple paternity in broods is more prevalent than previously thought, and leks do not comprise kin groups. Second, the Greater Sage-Grouse is genetically distinct from the congeneric Gunnison sage-grouse (C. minimus). Third, the Lyon-Mono population in the Mono Basin, spanning the border between Nevada and California, has unique genetic characteristics. Fourth, the previous delineation of western (C. u. phaios) and eastern Greater Sage-Grouse (C. u. urophasianus) is not supported genetically. Fifth, two isolated populations in Washington show indications that genetic diversity has been lost due to population declines and isolation. This chapter examines the use of molecular genetics to understand the biology of Greater Sage-Grouse for the conservation and management of this species and put it into the context of avian ecology based on selected molecular studies.

  15. LiveDiverse: Case study area, Greater Kruger South Africa

    CSIR Research Space (South Africa)

    Nortje, Karen

    2011-01-01

    Full Text Available Livelihoods and Biodiversity in Developing Countries Case study area: Greater Kruger, South Africa January 2011 Kolhapur, India Where are we? HARDSHIP LIVELIHOODS NATURE & BIODIVERSITY BELIEFS & CULTURAL PRACTISE threesansinv foursansinv onesansinv...

  16. Greater Sage-grouse Telemetry - Mono Co. [ds68

    Data.gov (United States)

    California Department of Resources — Combined telemetry locations for sage grouse in Mono County which were fitted with radio-transmitters for the USGS Greater sage-grouse project. Contains spatial and...

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

    Directory of Open Access Journals (Sweden)

    Lucas Arcanjo Cassini

    2016-03-01

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

  18. GREATER OMENTUM: MORPHOFUNCTIONAL CHARACTERISTICS AND CLINICAL SIGNIFICANCE IN PEDIATRICS

    Directory of Open Access Journals (Sweden)

    A.V. Nekrutov

    2007-01-01

    Full Text Available The review analyzes the structure organization and pathophysiological age specificities of the greater omentum, which determine its uniqueness and functional diversity in a child's organism. the article discusses protective functions of the organ, its role in the development of post operative complications of children, and the usage in children's reconstructive plastic surgery.Key words: greater omentum, omentitis, of post operative complications, children.

  19. The Albanian National Question and the Myth of Greater Albania

    Science.gov (United States)

    2013-03-01

    endured by the Albanians in Serbian-ruled Kosova. The 1997 instability in Albania, following the collapse of Ponzi Schemes , caused the cessation of...machinery to express the danger posed by the alleged Greater Albania scheme in order to demonize and morally downgrade the ANQ. However, one can easily...Greater Albania scheme in order to demonize and morally downgrade the ANQ. However, one can easily see that Albanians since the creation of their

  20. Greater saphenous vein anomaly and aneurysm with subsequent pulmonary embolism

    OpenAIRE

    Ma, Truong; Kornbau, Craig

    2017-01-01

    Abstract Venous aneurysms often present as painful masses. They can present either in the deep or superficial venous system. Deep venous system aneurysms have a greater risk of thromboembolism. Though rare, there have been case reports of superficial aneurysms and thrombus causing significant morbidity such as pulmonary embolism. We present a case of an anomalous greater saphenous vein connection with an aneurysm and thrombus resulting in a pulmonary embolism. This is the only reported case o...

  1. 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...

  2. Virtual Fieldwork Using Access Grid

    OpenAIRE

    Fielding, NG

    2010-01-01

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

  3. 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...

  4. 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...

  5. Onsite provision of specialized contraceptive services: does Title X funding enhance access?

    Science.gov (United States)

    Thiel de Bocanegra, Heike; Cross Riedel, Julie; Menz, Mary; Darney, Philip D; Brindis, Claire D

    2014-05-01

    This article presents the extent to which providers enrolled in California's Family Planning, Access, Care, and Treatment (Family PACT) program offer contraceptive methods onsite, thus eliminating one important access barrier. Family PACT has a diverse provider network, including public-sector providers receiving Title X funding, public-sector providers not receiving Title X funding, and private-sector providers. We explored whether Title X funding enhances providers' ability to offer contraceptive methods that require specialized skills onsite. Data were derived from 1,072 survey responses to a 2010 provider-capacity survey matched by unique identifier to administrative claims data. A significantly greater proportion of Title X-funded providers compared to non-Title X public and private providers offered onsite services for the following studied methods: intrauterine contraceptives (90% Title X, 51% public non-Title X, 38% private); contraceptive implants (58% Title X, 19% public non-Title X, 7% private); vasectomy (8% Title X, 4% public non-Title X, 1% private); and fertility-awareness methods (69% Title X, 55% public non-Title X, 49% private) (all pTitle X funding remained after stratifying individually by clinic specialty, facility capacity to provide reproductive health services (based on staffing), and rural/urban location. Extra funding for publicly funded family-planning programs, through mechanisms such as Title X, appears to be associated with increased onsite access to a wide range of contraceptive services, including those that require special skills and training.

  6. New supplemental landmark for the greater palatine foramen as found deep to soft tissue: application for the greater palatine nerve block.

    Science.gov (United States)

    Iwanaga, Joe; Voin, Vlad; Nasseh, Allen Ali; Kido, Junta; Tsukiyama, Teppei; Kamura, Yasuhiko; Tanaka, Tsuyoshi; Fisahn, Christian; Alonso, Fernando; Oskouian, Rod J; Tubbs, R Shane

    2017-09-01

    Many researches have investigated the morphology of the greater palatine foramina using dry skulls and cone-beam computed tomography. In most studies, some structures in the hard tissue have been measured and statistically analyzed. However, none of the studies has analyzed this foramen in regard to its location with overlying soft tissues, which is so clinically relevant. Therefore, this study was performed to provide the knowledge about relationship between the greater palatine foramen and foveola palatina for a better understanding of dental procedures such as greater palatine nerve block. Thirty sides, from fifteen fresh cadaveric heads, were used in this study. The specimens were derived from eight males and seven females. A 27-gauge needle was inserted into the fossa, which was palpated at the edge of a dental mirror at a 45° angle to the occlusal plane and parallel to the sagittal plane. The anteroposterior distance, which was parallel to the midline, between the penetration site and foveola palatina was measured. All the penetrations advanced to the greater palatine foramen. The distances ranged from 2.0 to 8.3 mm on right sides, and 1.1 to 8.2 mm on left sides, respectively. The results of this study could help dentists identify the correct location of the greater palatine foramen with a supplemental landmark.

  7. 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

  8. 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...

  9. Preferred provider organizations.

    Science.gov (United States)

    Davy, J D

    1984-05-01

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

  10. Limited school drinking water access for youth

    Science.gov (United States)

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

    2016-01-01

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

  11. Greater tibial bone strength in male tennis players than controls in the absence of greater muscle output

    Directory of Open Access Journals (Sweden)

    Alex Ireland

    2015-07-01

    Conclusion: Results suggest that sports with quick turning movements are highly osteogenic, even in the absence of greater muscular output. This may be related to the large torsional stresses produced during turning movements.

  12. Building Service Provider Capabilities

    DEFF Research Database (Denmark)

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

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

  13. 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...

  14. 'Chasing for Water': Everyday Practices of Water Access in Peri-Urban Ashaiman, Ghana

    Directory of Open Access Journals (Sweden)

    Megan Peloso

    2014-02-01

    Full Text Available Despite recent reports suggesting that access to improved sources of drinking water is rising in Ghana, water access remains a daily concern for many of those living in the capital region. Throughout the Greater Accra Metropolitan Area (GAMA, the urban poor manage uncertainty and establish themselves in the city by leveraging a patchwork system of basic services that draws importantly from informal systems and supplies. This paper takes a case study approach, using evidence gathered from two-months of fieldwork in a peri-urban informal settlement on the fringe of Accra, to explore everyday practices involved in procuring water for daily needs that routinely lead residents outside of the official water supply system. Findings from this case study demonstrate that respondents make use of informal water services to supplement or 'patch up' gaps left by the sporadic water flow of the official service provider, currently Ghana Water Company Ltd. (GWCL. Basic water access is thus constructed through an assemblage of coping strategies and infrastructures. This analysis contributes to understandings of heterogeneity in water access by attending to the everyday practices by which informality is operationalised to meet the needs of the urban poor, in ways that may have previously been overshadowed. This research suggests, for example, that although water priced outside of the official service provider is generally higher per unit, greater security may be obtained from smaller repetitive transactions as well as having the flexibility to pursue multiple sources of water on a day-to-day basis.

  15. 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

  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. A National Study of American Indian and Alaska Native Substance Abuse Treatment: Provider and Program Characteristics.

    Science.gov (United States)

    Rieckmann, Traci; Moore, Laurie A; Croy, Calvin D; Novins, Douglas K; Aarons, Gregory

    2016-09-01

    American Indians and Alaska Natives (AIANs) experience major disparities in accessing quality care for mental health and substance use disorders. There are long-standing concerns about access to and quality of care for AIANs in rural and urban areas including the influence of staff and organizational factors, and attitudes toward evidence-based treatment for addiction. We conducted the first national survey of programs serving AIAN communities and examined workforce and programmatic differences between clinics located in urban/suburban (n=50) and rural (n=142) communities. We explored the correlates of openness toward using evidence-based treatments (EBTs). Programs located in rural areas were significantly less likely to have nurses, traditional healing consultants, or ceremonial providers on staff, to consult outside evaluators, to use strategic planning to improve program quality, to offer pharmacotherapies, pipe ceremonies, and cultural activities among their services, and to participate in research or program evaluation studies. They were significantly more likely to employ elders among their traditional healers, offer AA-open group recovery services, and collect data on treatment outcomes. Greater openness toward EBTs was related to a larger clinical staff, having addiction providers, being led by directors who perceived a gap in access to EBTs, and working with key stakeholders to improve access to services. Programs that provided early intervention services (American Society of Addiction Medicine level 0.5) reported less openness. This research provides baseline workforce and program level data that can be used to better understand changes in access and quality for AIAN over time. Copyright © 2016. Published by Elsevier Inc.

  18. Associations between Extending Access to Primary Care and Emergency Department Visits: A Difference-In-Differences Analysis.

    Science.gov (United States)

    Whittaker, William; Anselmi, Laura; Kristensen, Søren Rud; Lau, Yiu-Shing; Bailey, Simon; Bower, Peter; Checkland, Katherine; Elvey, Rebecca; Rothwell, Katy; Stokes, Jonathan; Hodgson, Damian

    2016-09-01

    Health services across the world increasingly face pressures on the use of expensive hospital services. Better organisation and delivery of primary care has the potential to manage demand and reduce costs for hospital services, but routine primary care services are not open during evenings and weekends. Extended access (evening and weekend opening) is hypothesized to reduce pressure on hospital services from emergency department visits. However, the existing evidence-base is weak, largely focused on emergency out-of-hours services, and analysed using a before-and after-methodology without effective comparators. Throughout 2014, 56 primary care practices (346,024 patients) in Greater Manchester, England, offered 7-day extended access, compared with 469 primary care practices (2,596,330 patients) providing routine access. Extended access included evening and weekend opening and served both urgent and routine appointments. To assess the effects of extended primary care access on hospital services, we apply a difference-in-differences analysis using hospital administrative data from 2011 to 2014. Propensity score matching techniques were used to match practices without extended access to practices with extended access. Differences in the change in "minor" patient-initiated emergency department visits per 1,000 population were compared between practices with and without extended access. Populations registered to primary care practices with extended access demonstrated a 26.4% relative reduction (compared to practices without extended access) in patient-initiated emergency department visits for "minor" problems (95% CI -38.6% to -14.2%, absolute difference: -10,933 per year, 95% CI -15,995 to -5,866), and a 26.6% (95% CI -39.2% to -14.1%) relative reduction in costs of patient-initiated visits to emergency departments for minor problems (absolute difference: -£767,976, -£1,130,767 to -£405,184). There was an insignificant relative reduction of 3.1% in total emergency

  19. Associations between Extending Access to Primary Care and Emergency Department Visits: A Difference-In-Differences Analysis.

    Directory of Open Access Journals (Sweden)

    William Whittaker

    2016-09-01

    Full Text Available Health services across the world increasingly face pressures on the use of expensive hospital services. Better organisation and delivery of primary care has the potential to manage demand and reduce costs for hospital services, but routine primary care services are not open during evenings and weekends. Extended access (evening and weekend opening is hypothesized to reduce pressure on hospital services from emergency department visits. However, the existing evidence-base is weak, largely focused on emergency out-of-hours services, and analysed using a before-and after-methodology without effective comparators.Throughout 2014, 56 primary care practices (346,024 patients in Greater Manchester, England, offered 7-day extended access, compared with 469 primary care practices (2,596,330 patients providing routine access. Extended access included evening and weekend opening and served both urgent and routine appointments. To assess the effects of extended primary care access on hospital services, we apply a difference-in-differences analysis using hospital administrative data from 2011 to 2014. Propensity score matching techniques were used to match practices without extended access to practices with extended access. Differences in the change in "minor" patient-initiated emergency department visits per 1,000 population were compared between practices with and without extended access. Populations registered to primary care practices with extended access demonstrated a 26.4% relative reduction (compared to practices without extended access in patient-initiated emergency department visits for "minor" problems (95% CI -38.6% to -14.2%, absolute difference: -10,933 per year, 95% CI -15,995 to -5,866, and a 26.6% (95% CI -39.2% to -14.1% relative reduction in costs of patient-initiated visits to emergency departments for minor problems (absolute difference: -£767,976, -£1,130,767 to -£405,184. There was an insignificant relative reduction of 3.1% in

  20. 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.

  1. Why are hispanics at greater risk for PTSD?

    Science.gov (United States)

    Pole, Nnamdi; Best, Suzanne R; Metzler, Thomas; Marmar, Charles R

    2005-05-01

    Several studies have found that Hispanic Americans have higher rates of posttraumatic stress disorder (PTSD) than non-Hispanic Caucasian and Black Americans. The authors identified predictors of PTSD symptom severity that distinguished Hispanic police officers (n=189) from their non-Hispanic Caucasian (n=317) and Black (n=162) counterparts and modeled them to explain the elevated Hispanic risk for PTSD. The authors found that greater peritraumatic dissociation, greater wishful thinking and self-blame coping, lower social support, and greater perceived racism were important variables in explaining the elevated PTSD symptoms among Hispanics. Results are discussed in the context of Hispanic culture and may be important for prevention of mental illness in the fastest growing ethnic group in the United States. Copyright (c) 2005 APA, all rights reserved.

  2. The seafloor off Greater Los Angeles: Visualizing Gigabytes of Data

    Science.gov (United States)

    Gardner, J. V.

    2002-12-01

    The seafloor off the greater Los Angeles area was mapped with three different high-resolution multibeam echosounders over a period of three field seasons. The mapping was untaken to provide a base map for ongoing marine geological studies in the area. The combined data set covers the entire continental shelf and basin slope from as shallow as the 20-m isobath (in some places the 5-m isobath) on the inner shelf to the 800-m isobath on the basin floor. These data represent more than 5 billion georeferenced depth soundings that cover an area of more than 1000 km2. In addition, each depth sounding location has an associated acoustic backscatter value, thereby effectively doubling the data volume that needs to be visualized. And, when the land area DEM is draped with Landsat imagery, the dataset enlarges to more than 6 billion points. The data can be visualized with many standard GIS packages but statically investigating 2D map views of such a large dataset, one view at a time, is cumbersome and can be tedious. In addition, the bathymetric data have various spatial resolutions that depend on the water depth. A dynamically interactive 3D visualization package that allows georeferenced datasets of mixed spatial resolutions was chosen to enhance the interpretation phase of the dataset. Some of the capabilities of this software will be demonstrated during the presentation. The bathymetric data reveal the complex nature of this basin-margin environment. Large debris avalanches have scarred the basin slope off the Palos Verdes Peninsula. Undercutting along the base of the basin slope suggests current erosion. The morphologies of the submarine canyons in the area range in complexity from a simple single canyon channel, such as Redondo Canyon, to a complex system of canyon channels, such as Newport and San Gabriel Canyons. Distinctive small canyon morphologies suggests the possibility of fresh-water springs outcropping along the San Pedro upper basin slope and along the mid and

  3. Surgical effect observation of lens dislocation greater than 2 quadrants

    Directory of Open Access Journals (Sweden)

    Wen-Wen Dou

    2017-08-01

    Full Text Available AIM: To investigate the clinical effect of cataract combined lens dislocation greater than 2 quadrants' patients after having phase I intracapsular cataract extraction and anterior vitrectomy, postoperative corrected vision greater than 0.3, and then taking phase II small incision suture-fixation of intraocular lens suspension.METHODS: Totally 34 cases with cataract combined lens dislocation greater than 2 quadrants had been treated in our hospital from July 2014 to December 2016. We investigated their 1wk, 1 and 3mo postoperative complications and the uncorrected visual acuity, best corrected visual acuity, intraocular pressure, corneal astigmatism who took phase II small incision suture-fixation of intraocular lens suspension with corrected vision greater than 0.3 after having phase I intracapsular cataract extraction and anterior vitrectomy.RESULTS: Along with the recovery time extension, patients' uncorrected visual acuity and best corrected visual acuity increased obviously than preoperative in each phase. On the 3mo postoperatively, the best corrected visual acuity of 1 eyes was between 0.3 and 0.1, 8 eyes was between 0.5 and 0.3, 16 eyes was between 0.7 and 0.5, and 9 eyes was better than 0.7. The best corrected visual acuity was achieved or near the best corrected visual acuity before surgery. Intraocular pressure rechecked became in the normal range at 1wk, 1 and 3mo postoperative. Surgery did not significantly increase the corneal astigmatism. CONCLUSION: It is a safe and effective way in improving eyesight effectively, with stable intraocular pressure and fewer complications towards cataract combined lens dislocation greater than 2 quadrants' patients having phase I intracapsular cataract extraction and anterior vitrectomy, whose postoperative corrected vision greater than 0.3, and then phase II small incision suture-fixation of intraocular lens suspension.

  4. 47 CFR 1.1849 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-10-01

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

  5. Ultrasound-guided corticosteroid injections for treatment of greater trochanteric pain syndrome: greater trochanter bursa versus subgluteus medius bursa.

    Science.gov (United States)

    McEvoy, Jennifer R; Lee, Kenneth S; Blankenbaker, Donna G; del Rio, Alejandro Munoz; Keene, James S

    2013-08-01

    The purpose of this study was to evaluate the effectiveness of corticosteroid injections into the greater trochanteric bursa as opposed to the subgluteus medius bursa in patients with greater trochanteric pain syndrome. We retrospectively reviewed 183 injections (149 performed in women, 34 performed in men; age range 23-90 years; median, 53 years) performed for treatment of greater trochanteric pain syndrome. A 10-cm visual analog scale survey was used to assess pain level before the procedure and 14 days after the procedure. A 3-mL corticosteroid solution was injected into either the greater trochanteric bursa or the subgluteus medius bursa under direct ultrasound guidance. Procedure images were retrospectively reviewed to determine the site of injection. Diagnostic images obtained at the time of the procedure were also reviewed for findings of tendinopathy, bursitis, and enthesopathy. Statistical analysis of differences in pain reduction was performed, as was analysis for association between pain relief and demographic variables of age, sex, previous injections, and ultrasound findings. Sixty-five injections met the inclusion criteria; 56 performed in women and nine performed in men (age range, 30-82 years; median, 53 years). Forty-one injections were into the greater trochanteric bursa and 24 into the subgluteus medius bursa. There was a statistically significant difference in pain reduction between greater trochanteric bursa and subgluteus medius bursa injections with a median pain reduction of 3 as opposed to 0 (p bursa may be more effective than injections into the subgluteus medius bursa for treatment of greater trochanteric pain syndrome.

  6. Measuring parental satisfaction of care quality provided in hospitalized children

    Directory of Open Access Journals (Sweden)

    Spyridoula Tsironi

    2017-03-01

    Full Text Available Introduction: Measuring parental satisfaction is of major importance for pediatric hospitals and the key component of evaluating the quality of services provided to health services. Aim: To assess the degree of parental satisfaction from the care provided to their hospitalized children.Methodology: A descriptive study conducted using a convenience sample of parents of hospitalized children in two public pediatric hospitals in Athens. Data collection was completed in a period of 3 months. 352 questionnaires were collected (response rate 88%. The Pyramid Questionnaire for parents of hospitalized children was used which estimates the degree of parental satisfaction from the care provided to their hospitalized child.Results: More parents were satisfied with health care professionals’ behavior (81,9%, the supplied care (78,2% and the information provision to parents regarding the hospitalized child’s disease (71,9%. In contrast, less parents were satisfied with their hospitalized child’s involvement in care (52,3% and the accessibility to the hospital (39,5%. The overall parental satisfaction ranged in very good level (76,8% and it was higher on hospital A (78,8%, among married parents (77,4% and those not al all concerned or concerned less for child’s illness (83,1%. Logistic regression model showed that hospitalization in hospital B and the great concern for child’s illness and its complications decreased ovewrall satisfaction by 24% and 17% respectively. Conclusions: The assessment of the degree of parental satisfaction is the most important indicator of hospitals’ proper functioning. From our study certain areas need improvement, such as: the parental involvement in child’s care, information provision, the accessibility to the hospital, the communication and the interpersonal health care in order greater satisfaction to be achieved.

  7. Housing Accessibility Methodology Targeting Older People

    DEFF Research Database (Denmark)

    Helle, Tina

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

  8. Web browser accessibility using open source software

    NARCIS (Netherlands)

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

    2007-01-01

    htmlabstractA Web browser provides a uniform user interface to different types of information. Making this interface universally accessible and more interactive is a long term goal still far from being achieved. Universally accessible browsers require novel interaction modalities and additional

  9. Internet Access in School Library Media Centers.

    Science.gov (United States)

    Everhart, Nancy

    1997-01-01

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

  10. 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…

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

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

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

  12. Doctors and nurses on wards with greater access to clinical dietitians have better focus on clinical nutrition

    DEFF Research Database (Denmark)

    Thoresen, L.; Rothenberg, E.; Beck, Anne Marie

    2008-01-01

    According to the Council of Europe, clinical dietitians should assume a more central role in nutritional support. The aim of this study was to assess the opinions among doctors, nurses and clinical dietitians regarding the use of clinical dietitians' expertise in the hospital units and, further......, to assess whether the presence of clinical dietitians in hospital departments influenced doctors and nurses focus on clinical nutrition. A questionnaire about the use of clinical nutrition was mailed to 6000 doctors and 6000 nurses working in hospital units where undernutrition is documented to be common......, as well as to 678 clinical dietitians working in Scandinavian hospitals. The response rate of clinical dietitians, nurses and doctors were 53%, 46% and 29%, respectively. Nurses and doctors who saw clinical dietitians often found it less difficult to identify undernourished patients and found that insight...

  13. Does Greater Accessibility to Higher Education Reduce Wage Inequality? The Case of the Arab Minority in Israel

    Science.gov (United States)

    Yirmiyahu, Albert; Rubin, Ofir D.; Malul, Miki

    2017-01-01

    Many studies assessing national policy reforms in education focus on the likelihood of acquiring an advanced education and the associated returns in the labor market. In this paper, the authors investigate the impact of the Israeli Academic Colleges Law that was designed to promote the acquisition of higher education among all segments of the…

  14. Towards Greater Individualization and Process-Oriented Learning through Electronic Self-Access: Project "e-daf"

    Science.gov (United States)

    Chan, Wai Meng; Kim, Dong-Ha

    2004-01-01

    Research in cognitive psychology and second language learning has underlined the significance of learners' cognitive processes and individual preferences in language learning. Helping learners to be aware of these processes and preferences has in fact become an important methodological principle of language teaching. Advances in information and…

  15. Possibility of a Light Pulse with Speed Greater than c

    OpenAIRE

    Zhou, Xian-jian

    2000-01-01

    In two models it is shown that a light pulse propagates from a vacuum into certain media with velocity greater than that of a light in a vacuum (c). By numerical calculation the propagating properties of such a light are given.

  16. Exploration of the Energy Efficiency of the Greater London Authority ...

    African Journals Online (AJOL)

    This research paper set out to explore the following research question: “what shape and form should a building be in order to achieve energy efficiency in the design and construction of the tall office building?” This involved the exploratory case study of a spheroid building, the Greater London Authority (GLA) building.

  17. Evolution of faster development does not lead to greater fluctuating ...

    Indian Academy of Sciences (India)

    Unknown

    Both strong directional selection and faster development are thought to destabilize development, giving rise to greater fluctuating asymmetry (FA), although there is no strong empirical evidence supporting this assertion. We compared. FA in sternopleural bristle number in four populations of Drosophila melanogaster ...

  18. 163 COUNTER-TERRORISM IN THE GREATER HORN OF AFRICA ...

    African Journals Online (AJOL)

    Administrator

    2010-07-11

    Jul 11, 2010 ... Al-Shabaab, a fundamentalist group in Somalia immediately claimed responsibility. These events sparked widespread debate within scholarly circles as far as the counter-terrorism agenda in the Greater Horn of Africa is concerned. In recent years, terrorism has grown to become a vice of global magnitude.

  19. College Students with ADHD at Greater Risk for Sleep Disorders

    Science.gov (United States)

    Gaultney, Jane F.

    2014-01-01

    The pediatric literature indicates that children with ADHD are at greater risk for sleep problems, daytime sleepiness, and some sleep disorders than children with no diagnosed disability. It has not been determined whether this pattern holds true among emerging adults, and whether comorbid sleep disorders with ADHD predict GPA. The present study…

  20. Introduction. China and the Challenges in Greater Middle East

    DEFF Research Database (Denmark)

    Sørensen, Camilla T. N.; Andersen, Lars Erslev; Jiang, Yang

    2016-01-01

    This collection of short papers is an outcome of an international conference entitled China and the Challenges in Greater Middle East, organized by the Danish Institute for International Studies and Copenhagen University on 10 November 2015. The conference sought answers to the following questions...

  1. Connectivity between the Algerian population of Greater Flamingo ...

    African Journals Online (AJOL)

    In the Mediterranean basin, Greater Flamingos Phoenicopterus roseus constitute a metapopulation with natal and breeding dispersal among colonies. However, the rate of exchange between European and North African colonies remains poorly known. In this paper, we document the wintering and breeding of European ...

  2. Adjustment of Business Expatriates in Greater China: A Strategic Perspective

    DEFF Research Database (Denmark)

    Selmer, Jan

    2006-01-01

    Research has found that due to similarities, firms which have gained business experience elsewhere in Greater China may exhibit relatively better performance in mainland China. Hence, the experience of business expatriates could be of strategic importance for the expansion path of their firms. Ba...

  3. Community Based Natural Resource Management in the Greater ...

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

    In 2002, Mozambique, South Africa and Zimbabwe signed an agreement establishing the enlarged Greater Limpopo Trans Frontier Conservation Area. The area includes designated national parks and a matrix of land between them that is mostly under communal tenure. This project will apply scenario planning to help ...

  4. Radiographic features of tuberculous osteitis in greater trochanter and lschium

    Energy Technology Data Exchange (ETDEWEB)

    Hahm, So Hee; Lee, Ye Ri [Hanil Hospital Affiliated to KEPCO, Seoul (Korea, Republic of); Kim, Dong Jin; Sung, Ki Jun [Yonsei Univ. Wonju College of Medicine, Wonju (Korea, Republic of); Lim, Jong Nam [Konkuk Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-11-01

    To evaluate, if possible, the radiographic features of tuberculous osteitis in the greater trochanter and ischium, and to determine the cause of the lesions. We reterospectively reviewed the plain radiographic findings of 14 ptients with histologically proven tuberculous osteitis involving the greater trochanter and ischium. In each case, the following were analyzed:morphology of bone destruction, including cortical erosion;periosteal reaction;presence or abscence of calcific shadows in adjacent soft tissue. On the basis of an analysis of radiographic features and correlation of the anatomy with adjacent structures we attempted to determine causes. Of the 14 cases evaluated, 12 showed varrious degrees of extrinsic erosion on the outer cortical bone of the greater trochanter and ischium ; in two cases, bone destruction was so severe that the radiographic features of advanced perforated osteomyelitis were simulated. In addition to findings of bone destruction, in these twelve cases, the presence of sequestrum or calcific shadows was seen in adjacent soft tissue. Tuberculous osteitis in the greater trochanter and ischium showed the characteristic findings of chronic extrinsic erosion. On the basis of these findings we can suggest that these lesions result from an extrinsic pathophysiologic cause such as adjacent bursitis.

  5. Control and Elimination of Helminth Zoonoses in the Greater ...

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

    This project will contribute evidence to help control and eliminate schistosomiasis and liver fluke infections in the Greater Mekong Subregion. This economic area is bound by the Mekong River, covering 2.6 million square kilometres, and includes a combined population of 326 million in Burma, Cambodia, China, Laos, ...

  6. Surgical anatomy of greater occipital nerve and its relation to ...

    African Journals Online (AJOL)

    Nancy Mohamed El Sekily

    2014-08-19

    Aug 19, 2014 ... Figure 1. A photograph of right half of head and neck specimen (posterior view) showing the greater occipital nerve (GON) emerging on the lower border of inferior oblique(IO) muscle in suboccipital triangle before piercing semispinalis capitis(SSC). (RC: rectus capitis minor and major –TR: trapezius). 200.

  7. Surgical treatment of high-standing greater trochanter.

    Science.gov (United States)

    Takata, K; Maniwa, S; Ochi, M

    1999-01-01

    Eleven patients with high-standing greater trochanter (13 joints) aged 13-36 years underwent surgery. Distal transfer of the greater trochanter (group T) was performed in 4 patients (5 joints) and lateral displacement osteotomy (group L) in 7 (8 joints). The average follow-up duration was 13.4 years in group T and 5.9 years in group L. Clinical results were evaluated by the hip score according to Merle d'Aubigne. The mean hip score in group T was 13.4 points before operation and 15.4 points after operation, and in group L, 12.8 and 17.4 points, respectively. The postoperative clinical results of group L were significantly better than those of group T (P = 0.0494). In radiological evaluation, although the articulo-trochanteric distance (ATD) increased in both groups in group L it improved remarkably from 9.8 to 24.3, indicating a large descending distance of the greater trochanter. The lever arm ratio (LAR) did not change significantly in group T, but it decreased from 1.97 to 1.60 in group L (P = 0.004). This means that the lever arm of the abductors can certainly be extended by lateral displacement osteotomy. Lateral displacement osteotomy is the most effective procedure for high-standing greater trochanter.

  8. Community Based Natural Resource Management in the Greater ...

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

    In 2002, Mozambique, South Africa and Zimbabwe signed an agreement establishing the enlarged Greater Limpopo Trans Frontier Conservation Area. The area includes ... Local level scenario planning, iterative assessment and adaptive management : final technical report, July 2006 to November 2011. Download PDF.

  9. at Nungua in the Greater Accra Region of Ghana

    African Journals Online (AJOL)

    komla

    The Mukwe lagoon and adjoining wetlandsnear Nungua in the Greater Accra Region of Ghana is one of the many coastal wetlands in Ghana which .... of sustainable use, as enjoined to date, the first five (i.e., Keta, Songor, by the Ramsar Convention. ... study was conducted over a 6-month period. To determine the effects of ...

  10. The first recorded reproduction of the Greater Flamingo ...

    African Journals Online (AJOL)

    Following several decades of unsuccessful attempts at locating breeding colonies of the Greater Flamingo Phoenicopterus roseus in Algeria, breeding was recorded on a natural islet of Garaet Ezzemoul, a seasonal salt lake near the town of Aïn M'lila in the Hauts Plateaux. This successful mass breeding event by at least 5 ...

  11. Ecology of greater sage-grouse in the Dakotas

    Science.gov (United States)

    Christopher C. Swanson

    2009-01-01

    Greater sage-grouse (Centrocercus urophasianus) populations and the sagebrush (Artemisia spp.) communities that they rely on have dramatically declined from historic levels. Moreover, information regarding sage-grouse annual life-history requirements at the eastern-most extension of sagebrush steppe communities is lacking....

  12. Male greater sage-grouse movements among leks

    Science.gov (United States)

    Aleshia L. Fremgen; Christopher T. Rota; Christopher P. Hansen; Mark A. Rumble; R. Scott Gamo; Joshua J. Millspaugh

    2017-01-01

    Movements among leks by breeding birds (i.e., interlek movements) could affect the population's genetic flow, complicate use of lek counts as a population index, and indicate a change in breeding behavior following a disturbance. We used a Bayesian multi-state mark-recapture model to assess the daily probability of male greater sage-grouse (Centrocercus...

  13. The Educational Afterlife of Greater Britain, 1903-1914

    Science.gov (United States)

    Gardner, Philip

    2012-01-01

    Following its late nineteenth-century emergence as an important element within federalist thinking across the British Empire, the idea of Greater Britain lost much of its political force in the years following the Boer War. The concept however continued to retain considerable residual currency in other fields of Imperial debate, including those…

  14. Prey selection by a reintroduced lion population in the Greater ...

    African Journals Online (AJOL)

    Lion prey selection was studied on the Greater Makalali Conservancy (140 km2), Limpopo Province, South Africa, in order to assist with management strategies. Monitoring was carried out between February 1998 and December 2001. Lion killed 15 species, with warthog, blue wildebeest, Burchell's zebra, kudu and ...

  15. The Mesozoic-Cenozoic tectonic evolution of the Greater Caucasus

    NARCIS (Netherlands)

    Saintot, A.N.; Brunet, M.F.; Yakovlev, F.; Sébrier, M.; Stephenson, R.A.; Ershov, A.V.; Chalot-Prat, F.; McCann, T.

    2006-01-01

    The Greater Caucasus (GC) fold-and-thrust belt lies on the southern deformed edge of the Scythian Platform (SP) and results from the Cenoozoic structural inversion of a deep marine Mesozoic basin in response to the northward displacement of the Transcaucasus (lying south of the GC subsequent to the

  16. 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

  17. Free access to hypertension and diabetes medicines among the elderly: a reality yet to be constructed.

    Science.gov (United States)

    Paniz, Vera Maria Vieira; Fassa, Anaclaudia Gastal; Facchini, Luiz Augusto; Piccini, Roberto Xavier; Tomasi, Elaine; Thumé, Elaine; da Silveira, Denise Silva; Rodrigues, Maria Aparecida; Domingues, Marlos Rodrigues; Bertoldi, Andréa Dâmaso

    2010-06-01

    The study evaluated free access to hypertension and diabetes medicines and the reasons reported for lack of access. The sample included 4,003 elderly people living in Primary Care Unit coverage areas from 41 Southern and Northeastern Brazilian cities. Free access was higher in the Northeast (62.4%). The strategy of the Family Health Program (Programa Saúde da Família - PSF) was more effective in providing access than the traditional model, with higher results in the Northeast (61.2%) than in the South (39.6%). Around 20% of medicines included in the Hypertension and Diabetes Program and 26% of those included in the National Essential Medicines List (RENAME) were paid out of pocket. In the Northeast, 25% of insulin and 32% of oral antidiabetics were paid out of pocket. Unavailability in the public sector and a lack of money determined the lack of access. Although the PSF, Hypertension and Diabetes Program and RENAME expanded free access, supplies were insufficient. A greater connection between programs and a clear definition of responsibilities can improve medicine acquisition process, increasing the effectiveness of pharmaceutical assistance.

  18. Reducing disparities in the access and use of Internet health information. a discussion paper.

    Science.gov (United States)

    Gilmour, Jean A

    2007-09-01

    Internet health information is rated highly by users and is used to compensate for gaps in health information provided by health professionals. Greater understanding of health issues and changes to personal health management has been reported as a consequence of Internet use. However, there are significant disparities in the access and use of Internet health information linked to income, education and ethnicity. In this paper a case is presented that on-line health information particularly benefits the already privileged in terms of health care; well-educated people with access to economic resources. Several intervention points are suggested to improve Internet health information accessibility and use for all population groups. Interventions at an institutional level include improving equity of Internet access through the provision of free services at strategic sites and improving the readability and cultural acceptability of health information. Individually focused interventions involve skill development to enable effective navigation of Internet sites, identification of patient and families' information needs and support to develop evaluation skills. The effectiveness of these interventions in reducing disparities is reliant on nurses and other health professionals' expertise in accessing, evaluating and using Internet health information in their clinical practise. On-line health information is a powerful medium for quick and dynamic knowledge distribution. The challenge for nurses and other health professionals is directing that knowledge to the groups most disadvantaged in the current health care systems, with an agenda of reducing inequalities in access to health information.

  19. Single port access adrenalectomy.

    Science.gov (United States)

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

    2008-08-01

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

  20. Provider of Services File

    Data.gov (United States)

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

  1. The Provident Principal.

    Science.gov (United States)

    McCall, John R.

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

  2. What HERA may provide?

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-09-15

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

  3. care Providers in Ibadan

    African Journals Online (AJOL)

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

  4. Regular users of supermarkets in Greater Tunis have a slightly improved diet quality.

    Science.gov (United States)

    Tessier, Sophie; Traissac, Pierre; Maire, Bernard; Bricas, Nicolas; Eymard-Duvernay, Sabrina; El Ati, Jalila; Delpeuch, Francis

    2008-04-01

    Despite the recent and rapid expansion of supermarkets in developing countries, their association with diet quality has been hardly studied. The study took place in Tunisia, where incidences of obesity and nutrition-related diseases are rising. The target population was households of the Greater Tunis area where supermarkets are mostly located. Households (n = 724) were selected by a 2-stage clustered random sampling. A purposely developed quantitative questionnaire assessed food retail habits. Socioeconomic data were collected at individual and household levels. The diet quality index-international (DQI-I) derived from a FFQ specific for Tunisia measured diet quality. Data analysis by regression or logistic regression models adjusted for energy intake and socioeconomic confounders when relevant. Overall, 60% of the households used supermarkets. Most households still used the nearby grocer; only 26% shopped at the market. Characteristics associated with supermarket use were urban milieu, small-sized households, greater educational attainment, higher economic level, steady income, or easy access. Associations between these variables and using supermarkets as a first shopping place (20% of households) were even stronger. After adjustment for energy intake and socioeconomic and access data, using supermarkets chosen as first food shopping place vs. other retail resulted in a slightly higher DQI-I (63.2 vs. 59.6; P = 0.0004). Despite the long-standing presence of supermarkets in Tunis, shopping at supermarkets has not yet spread to the whole population. Supermarkets do not yet markedly modify food consumption in the Greater Tunis. However, a slight improvement of diet quality can be observed among those people who use supermarkets regularly.

  5. Female Sprague-Dawley rats display greater appetitive and consummatory responses to alcohol.

    Science.gov (United States)

    Nieto, Steven J; Kosten, Therese A

    2017-06-01

    The narrowing of the gender gap in alcohol drinking patterns is a concern because women are more susceptible to adverse health consequences of alcohol use. Animal models of alcohol-seeking and -consuming are useful to delineate sex differences to test for effective sex-specific pharmacological treatments. We investigated potential sex differences in appetitive and consummatory responses to alcohol. Appetitive behaviors included numbers of head entries into the dipper access area and active lever presses. Consummatory behaviors included number of reinforcers delivered and consumed. Male and female Sprague-Dawley rats were placed on an overnight alcohol (10%) drinking schedule and trained to lever press for alcohol (10% solution). Separate groups of male and female animals had access to water overnight and were trained to lever press for sucrose (3% solution). Tests were conducted under a progressive ratio schedule of reinforcement. Alcohol-responding females demonstrated higher alcohol intake overnight and showed greater appetitive and consummatory responses compared to males. Similar sex differences were seen in the sucrose group. Effect sizes indicated greater sex differences in consummatory measures in the alcohol vs. sucrose groups. Conversely, greater sex differences in appetitive behaviors were observed in the sucrose vs. alcohol groups. Overall, the magnitude of the sex differences was stronger for appetitive behaviors compared to consummatory behaviors. Findings of quantitative sex differences in appetitive and consummatory behaviors for alcohol and for the natural reinforcer, sucrose, suggest this procedure is useful to assess efficacy of sex-specific treatments aimed at reducing appetitive and consummatory responses to alcohol. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Effects of sexual dimorphism and landscape composition on the trophic behavior of Greater Prairie-Chicken.

    Directory of Open Access Journals (Sweden)

    Beatriz Blanco-Fontao

    Full Text Available Partitioning of ecological niche is expected in lekking species that show marked sexual size dimorphism as a consequence of sex-specific ecological constraints. However, niche partitioning is uncertain in species with moderate sexual dimorphism. In addition, the ecological niche of a species may also be affected by landscape composition; particularly, agricultural fragmentation may greatly influence the trophic behavior of herbivores. We studied trophic niche variation in Greater Prairie-Chickens (Tympanuchus cupido, a grouse species that shows moderate sex-dimorphism. Greater Prairie-Chickens are native to tallgrass prairies of North America, although populations persist in less natural mosaics of cropland and native habitats. We used stable isotope analysis of carbon and nitrogen in blood, claws and feathers to assess seasonal differences in trophic niche breadth and individual specialization between male and female Greater Prairie-Chickens, and between birds living in continuous and fragmented landscapes. We found that females showed broader niches and higher individual specialization than males, especially in winter and autumn. However, differences between females and males were smaller in spring when birds converge at leks, suggesting that females and males may exhibit similar feeding behaviors during the lekking period. In addition, we found that birds living in native prairies showed greater annual trophic variability than conspecifics in agricultural mosaic landscapes. Native habitats may provide greater dietary diversity, resulting in greater diversity of feeding strategies.

  7. Interactive, open source, travel time scenario modelling: tools to facilitate participation in health service access analysis.

    Science.gov (United States)

    Fisher, Rohan; Lassa, Jonatan

    2017-04-18

    Modelling travel time to services has become a common public health tool for planning service provision but the usefulness of these analyses is constrained by the availability of accurate input data and limitations inherent in the assumptions and parameterisation. This is particularly an issue in the developing world where access to basic data is limited and travel is often complex and multi-modal. Improving the accuracy and relevance in this context requires greater accessibility to, and flexibility in, travel time modelling tools to facilitate the incorporation of local knowledge and the rapid exploration of multiple travel scenarios. The aim of this work was to develop simple open source, adaptable, interactive travel time modelling tools to allow greater access to and participation in service access analysis. Described are three interconnected applications designed to reduce some of the barriers to the more wide-spread use of GIS analysis of service access and allow for complex spatial and temporal variations in service availability. These applications are an open source GIS tool-kit and two geo-simulation models. The development of these tools was guided by health service issues from a developing world context but they present a general approach to enabling greater access to and flexibility in health access modelling. The tools demonstrate a method that substantially simplifies the process for conducting travel time assessments and demonstrate a dynamic, interactive approach in an open source GIS format. In addition this paper provides examples from empirical experience where these tools have informed better policy and planning. Travel and health service access is complex and cannot be reduced to a few static modeled outputs. The approaches described in this paper use a unique set of tools to explore this complexity, promote discussion and build understanding with the goal of producing better planning outcomes. The accessible, flexible, interactive and

  8. 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....

  9. 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.

  10. 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.

  11. Access control Tutorial 5

    CERN Document Server

    CERN. Geneva; Oberknapp, Bernd

    2007-01-01

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

  12. Factors Influencing Army Accessions.

    Science.gov (United States)

    1982-12-01

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

  13. Optimal wildlife management in the greater Yellowstone ecosystem: A spatiotemporal model of disease risk

    Science.gov (United States)

    South of Yellowstone National Park there are twenty-three sites where elk herds are provided supplementary feeding during the winter and spring months. Supplementary feeding of elk in the Greater Yellowstone Ecosystem (GYE) has been practiced since the early twentieth century, but the practice has b...

  14. Hygrophoraceae (Agaricales) of the Greater Antilles : Hygrocybe subgenus Pseudohygrocybe sections Coccineae and Neohygrocybe

    Science.gov (United States)

    Sharon A. Cantrell; D. Jean Lodge

    2004-01-01

    A key to 17 species in the genus Hygrocybe, subgenus Pseudohygrocybe, sections Coccineae and Neohygrocybe sensu Boertmann is provided for the Greater Antilles. Five new species and five taxa that are new reports for the region are described. The new species in section Coccineae are H. pseudoadonis, H. viridiphylla, and H. zonata. The new species in section Neohygrocybe...

  15. Does Greater Autonomy Improve School Performance? Evidence from a Regression Discontinuity Analysis in Chicago

    Science.gov (United States)

    Steinberg, Matthew P.

    2014-01-01

    School districts throughout the United States are increasingly providing greater autonomy to local public (non-charter) school principals. In 2005-06, Chicago Public Schools initiated the Autonomous Management and Performance Schools program, granting academic, programmatic, and operational freedoms to select principals. This paper provides…

  16. Spring-staging ecology of midcontinent greater white-fronted geese

    Science.gov (United States)

    Krapu, G.L.; Reinecke, K.J.; Jorde, Dennis G.; Simpson, S.G.

    1995-01-01

    A major part of the midcontinent greater white-fronted goose (Anser albifrons) population stages for several weeks in spring in the Rainwater Basin Area (RBA) of south-central Nebraska where substantial mortality from disease occurs periodically. Effective management of this population requires better data on use of habitat, vulnerability to disease, and the role of staging areas in migration and reproduction, We studied use of habitat, foods, nutrient dynamics, and effect of changes in agriculture on food availability and habitat needs in spring 1979-80. During daylight, geese were observed primarily in harvested cornfields (76%) and growing winter wheat (23%). Corn grain and winter wheat shoots composed 90 and 9%, respectively, of foods consumed by collected geese (n = 42). Feeding activity did not vary among post-harvest cornfield treatments except that little feeding occurred (P lt 0.05) in moldboard-plowed fields ( lt 1%). Fat content for all geese increased (P ltoreq 0.01) with Julian date; protein content increased (P = 0.03) only among adult females, and there was no evidence (P gt 0.05) of temporal variation in calcium content. Adult geese storing 14.2 g of fat per day deposited approximately 582 g of fat between 22 February and 3 April. Energy requirements for thermal regulation were small compared with requirements for fat synthesis and probably had little effect on nutrient deposition. The 34,000 white-fronted geese present on the Harvard Marsh and Prairie Dog Marsh study areas in March 1980 probably used lt 20% of the corn available within a 5-km radius. We believe that midcontinent white-fronted geese arrive on Arctic breeding grounds with larger and less variable fat reserves than prior to modern agricultural development. We attribute this response to increased food availability on staging areas where the net effect of agricultural changes has been an increase in corn availability. Waterfowl managers can increase dispersion of geese and provide

  17. Providing plastic zone extrusion

    Science.gov (United States)

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

    2017-04-11

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

  18. AccessAbility @ Cleveland Public Library.

    Science.gov (United States)

    Mates, Barbara T.

    2003-01-01

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

  19. 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

  20. The Greater Zurich Area is Well-positioned in the Life Sciences in Switzerland and Europe.

    Science.gov (United States)

    Jenni, Mario

    2014-12-01

    The Greater Zurich Area has become a hub for the life sciences industry in recent years, with above-average numbers of medtech companies and brisk spin-off activities from the Zurich universities. The spin-offs have established themselves near their scientific origins, in incubators and parks where they have access to functional and affordable laboratory infrastructures. Numerous cluster initiatives and networks foster exchanges between start-ups, established companies and academia. An international regional comparison conducted within the framework of the EU HealthTIES project gave the region of Zurich a good score in the life sciences area. The detailed comparison shows that Zurich is strong in the academic field and the existing companies are well-positioned. However, weaknesses are evident in the field of clinical research and in the interface between academia and industry. The infrastructure offerings in the Greater Zurich Area for life sciences companies and for exchanges between academia and industry will be further expanded in the coming years. Whether the high growth rate of the industry in the Greater Zurich Area can be maintained or even increased depends on the economy and other factors, but also on the political environment.

  1. Providing traceability for neuroimaging analyses.

    Science.gov (United States)

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

    2013-09-01

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

  2. Selection of cotton genotypes for greater length of fibers

    Directory of Open Access Journals (Sweden)

    Luiz Paulo de Carvalho

    2016-11-01

    Full Text Available In cotton breeding programs, it is necessary to identify genotypes with predictable behavior on the length of fibers, and which are responsive to environmental variations, in specific or broad conditions. The aim of this study was to employ the methodology of mixed models for simultaneous selection of cotton genotypes with greater length of fibers, adaptability and stability. It was evaluated 36 lines in three trials located in Apodi (2013 and 2014 and Santa Helena (2013, in a randomized block design with two replications. Genetic parameters were estimated by the restricted maximum likelihood/best linear unbiased predictor method (REML/BLUP and the selection was based on the method of harmonic mean of the relative performance of genetic values. The genotypes CNPA 2012-55, CNPA 2012-58, CNPA 2012-62 and CNPA 2012-64 can be grown in all tested environments, since they gather greater length of fibers, stability and adaptability.

  3. Greater temperature sensitivity of plant phenology at colder sites

    DEFF Research Database (Denmark)

    Prevey, Janet; Vellend, Mark; Ruger, Nadja

    2017-01-01

    Warmer temperatures are accelerating the phenology of organisms around the world. Temperature sensitivity of phenology might be greater in colder, higher latitude sites than in warmer regions, in part because small changes in temperature constitute greater relative changes in thermal balance...... at colder sites. To test this hypothesis, we examined up to 20 years of phenology data for 47 tundra plant species at 18 high-latitude sites along a climatic gradient. Across all species, the timing of leaf emergence and flowering was more sensitive to a given increase in summer temperature at colder than...... warmer high-latitude locations. A similar pattern was seen over time for the flowering phenology of a widespread species, Cassiope tetragona. These are among the first results highlighting differential phenological responses of plants across a climatic gradient and suggest the possibility of convergence...

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

    Science.gov (United States)

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

    2017-03-01

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

  5. Teenagers’ access to contraception in Mexico City

    Directory of Open Access Journals (Sweden)

    Sofía Gómez-Inclán

    2017-05-01

    Full Text Available Objective. To study and understand the phenomenon of access to contraceptive methods in Mexican teenages, through the use of the Levesque model, which allows for the observation of both the system and the system and the user´s participation in the access process. Materials and methods. A qualitative study was conducted with focus groups technique in a middle and high school of Mexico City. Results. The perception of ability to access to health care is limited, teenagers do not know the mechanisms of care or supply of contraceptive methods. Prejudices of service providers provoke a negative reaction. The family is a source of information for adolescents to make decisions. Conclusions. The model allowed the assessment of access to contraceptive methods in teenagers. It were identified dif­ferent aspects that act as barriers to access and may inform health care providers about this population in their sexual and reproductive health.

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

    Science.gov (United States)

    Gómez-Inclán, Sofía; Durán-Arenas, Luis

    2017-01-01

    To study and understand the phenomenon of access to contraceptive methods in Mexican teenages, through the use of the Levesque model, which allows for the observation of both the system and the system and the user´s participation in the access process. A qualitative study was conducted with focus groups technique in a middle and high school of Mexico City. The perception of ability to access to health care is limited, teenagers do not know the mechanisms of care or supply of contraceptive methods. Prejudices of service providers provoke a negative reaction. The family is a source of information for adolescents to make decisions. The model allowed the assessment of access to contraceptive methods in teenagers. It were identified different aspects that act as barriers to access and may inform health care providers about this population in their sexual and reproductive health.

  7. Health equity and migrants in the Greater Mekong Subregion

    OpenAIRE

    McMichael, Celia; Healy, Judith

    2017-01-01

    ABSTRACT Background: Migrant health is receiving increasing international attention, reflecting recognition of the health inequities experienced among many migrant populations and the need for health systems to adapt to diverse migrant populations. In the Greater Mekong Subregion (GMS) there is increasing migration associated with uneven economic integration and growth, socio-economic vulnerabilities, and disparities between countries. There has been limited progress, however, in improving mi...

  8. Sentence-level dialects identification in the greater China region

    OpenAIRE

    Xu, Fan; Wang, Mingwen; Li, Maoxi

    2017-01-01

    Identifying the different varieties of the same language is more challenging than unrelated languages identification. In this paper, we propose an approach to discriminate language varieties or dialects of Mandarin Chinese for the Mainland China, Hong Kong, Taiwan, Macao, Malaysia and Singapore, a.k.a., the Greater China Region (GCR). When applied to the dialects identification of the GCR, we find that the commonly used character-level or word-level uni-gram feature is not very efficient sinc...

  9. Restaurants in the greater Athens area: a service for all?

    OpenAIRE

    Deffner, Alex M.; Maloutas, Thomas

    2002-01-01

    Eating (especially dining) in restaurants as a form of entertainment constitutes a practice that has been intensely developed, and socially broadened, in recent decades in most of the developed countries. The conditions in the labour market and the changing demographic structures have created much greater needs for consuming meals outside the home. At the same time, the growth of tourism, migration, and, more generally, of the international movement of people and goods have increased the rele...

  10. Innovation in the tourism sector in greater Poland

    OpenAIRE

    Przybylska, Anna

    2014-01-01

    Innovation in the tourism sector is increasingly becoming a source of competitive advantage. The factors which have most influenced this process include: advances in technology, increasingly demanding consumers, the limited life-span of a tourism product and growing competition. The paper presents the results of research into innovative solutions applied by tourism enterprises based in the Greater Poland market, taking into account above all the nature of the service industry. The ...

  11. Taxonomy of Greater White-fronted Geese (Aves: Anatidae)

    Science.gov (United States)

    Banks, Richard C.

    2011-01-01

    Five subspecies of the Greater White-fronted Goose, Anser albifrons (Scopoli, 1769), have been named, all on the basis of wintering birds, and up to six subspecies have been recognized. There has been confusion over the application of some names, particularly in North America, because of lack of knowledge of the breeding ranges and type localities, and incorrect taxonomic decisions. There is one clinally varying subspecies in Eurasia, one that breeds in Greenland, and three in North America, one newly named herein.

  12. Health Care Access Among Deaf People

    National Research Council Canada - National Science Library

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    .... The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in global health...

  13. Seamless access to OER with mobile technologies

    NARCIS (Netherlands)

    Tabuenca, Bernardo

    2014-01-01

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

  14. Morphometry of the Greater Palatal Canal in Adult Skulls.

    Science.gov (United States)

    Soto, Reinaldo A; Cáceres, Felipe; Vera, Cristóbal

    2015-07-01

    The purpose of this study was to evaluate in dry skulls the length and angle between the greater palatine foramen and the foramen rotundum in both the frontal and sagittal planes. In 50 human skulls from the department of morphology, the distance and angulation required to reach the foramen rotundum through the greater palatine canal were measured in the frontal and sagittal planes. A stylet was introduced up to the foramen rotundum in each greater palatine canal and fixed. The skulls were then photographed from a front and lateral view (both right and left). Finally, the stylets were photographed on graph paper. These images were analyzed with Photoshop software. In the frontal plane, mean angulations of 5.32 degrees on the right side and 6.15 degrees on the left side were obtained. In the sagittal plane, mean angulations of 61.66 degrees on the right side and 61.81 degrees on the left side were obtained. Finally, the mean length required to reach the foramen rotundum was 31.95  mm on the right side and 32.49  mm on the left side. Some of these results differ from those stated in the foreign literature (10 degrees front, 70 degrees sagittal). These differences should be considered for both clinical practice and teaching in Chile.

  15. Dietary phosphorus is associated with greater left ventricular mass.

    Science.gov (United States)

    Yamamoto, Kalani T; Robinson-Cohen, Cassianne; de Oliveira, Marcia C; Kostina, Alina; Nettleton, Jennifer A; Ix, Joachim H; Nguyen, Ha; Eng, John; Lima, Joao A C; Siscovick, David S; Weiss, Noel S; Kestenbaum, Bryan

    2013-04-01

    Dietary phosphorus consumption has risen steadily in the United States. Oral phosphorus loading alters key regulatory hormones and impairs vascular endothelial function, which may lead to an increase in left ventricular mass (LVM). We investigated the association of dietary phosphorus with LVM in 4494 participants from the Multi-Ethnic Study of Atherosclerosis, a community-based study of individuals who were free of known cardiovascular disease. The intake of dietary phosphorus was estimated using a 120-item food frequency questionnaire and the LVM was measured using magnetic resonance imaging. Regression models were used to determine associations of estimated dietary phosphorus with LVM and left ventricular hypertrophy (LVH). Mean estimated dietary phosphorus intake was 1167 mg/day in men and 1017 mg/day in women. After adjustment for demographics, dietary sodium, total calories, lifestyle factors, comorbidities, and established LVH risk factors, each quintile increase in the estimated dietary phosphate intake was associated with an estimated 1.1 g greater LVM. The highest gender-specific dietary phosphorus quintile was associated with an estimated 6.1 g greater LVM compared with the lowest quintile. Higher dietary phosphorus intake was associated with greater odds of LVH among women, but not men. These associations require confirmation in other studies.

  16. Integrating parasitology and marine ecology: Seven challenges towards greater synergy

    Science.gov (United States)

    Poulin, Robert; Blasco-Costa, Isabel; Randhawa, Haseeb S.

    2016-07-01

    Despite their very different historical origins as scientific disciplines, parasitology and marine ecology have already combined successfully to make important contributions to our understanding of the functioning of natural ecosystems. For example, robust assessments of the contribution of parasites to ecosystem biomass and energetics, and of their impact on community-wide biodiversity and food web structure, have all been made for the first time in marine systems. Nevertheless, for the marriage between parasitology and marine ecology to remain fruitful, several challenges must first be overcome. We discuss seven such challenges on the road to a greater synergy between these disciplines: (1) Raising awareness of parasitism as an ecological force by increasing the proportion of articles about parasites and diseases in marine ecology journals; (2) Making greater use of theory and conceptual frameworks from marine ecology to guide parasitological research; (3) Speeding up or at least maintaining the current rate at which marine parasites are found and described; (4) Elucidating a greater proportion of life cycles in all major groups of marine parasites; (5) Increasing the number of host-parasite model systems on which our knowledge is based; (6) Extending parasitological research offshore and into ocean depths; and (7) Developing, as needed, new epidemiological theory and transmission models for the marine environment. None of these challenges is insurmountable, and addressing just a few of them should guarantee that parasitology and marine ecology will continue to join forces and make further substantial contributions.

  17. Providing Compassion through Flow

    Directory of Open Access Journals (Sweden)

    Lydia Royeen

    2015-07-01

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

  18. Ysla S. Catalina & Providence

    OpenAIRE

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

    2010-01-01

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

  19. Open access, library and publisher competition, and the evolution of general commerce.

    Science.gov (United States)

    Odlyzko, Andrew M

    2015-02-01

    Discussions of the economics of scholarly communication are usually devoted to Open Access, rising journal prices, publisher profits, and boycotts. That ignores what seems a much more important development in this market. Publishers, through the oft-reviled Big Deal packages, are providing much greater and more egalitarian access to the journal literature, an approximation to true Open Access. In the process, they are also marginalizing libraries and obtaining a greater share of the resources going into scholarly communication. This is enabling a continuation of publisher profits as well as of what for decades has been called "unsustainable journal price escalation." It is also inhibiting the spread of Open Access and potentially leading to an oligopoly of publishers controlling distribution through large-scale licensing. The Big Deal practices are worth studying for several general reasons. The degree to which publishers succeed in diminishing the role of libraries may be an indicator of the degree and speed at which universities transform themselves. More importantly, these Big Deals appear to point the way to the future of the whole economy, where progress is characterized by declining privacy, increasing price discrimination, increasing opaqueness in pricing, increasing reliance on low-paid or unpaid work of others for profits, and business models that depend on customer inertia. © The Author(s) 2014.

  20. Will China's WTO Accession Worsen Rural Poverty?

    OpenAIRE

    Anderson, Kym; Huang, Jikun; Ianchovichina, Elena

    2004-01-01

    Many fear China’s accession to WTO will impoverish its farmers, via greater import competition in its agricultural markets. We explore that possibility bearing in mind that, even if producer prices of some (land-intensive) farm products fall, prices of other (labour-intensive) farm and non-farm products could rise. New estimates, from the global, economy-wide numerical simulation model known as GTAP, of the likely changes in agricultural and other product prices as a result of WTO accession a...

  1. Access to augmentative and alternative communication: new technologies and clinical decision-making.

    Science.gov (United States)

    Fager, Susan; Bardach, Lisa; Russell, Susanne; Higginbotham, Jeff

    2012-01-01

    Children with severe physical impairments require a variety of access options to augmentative and alternative communication (AAC) and computer technology. Access technologies have continued to develop, allowing children with severe motor control impairments greater independence and access to communication. This article will highlight new advances in access technology, including eye and head tracking, scanning, and access to mainstream technology, as well as discuss future advances. Considerations for clinical decision-making and implementation of these technologies will be presented along with case illustrations.

  2. Automated Computer Access Request System

    Science.gov (United States)

    Snook, Bryan E.

    2010-01-01

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

  3. Absenteeism movement in Greater Poland in 1840–1902

    Directory of Open Access Journals (Sweden)

    Izabela Krasińska

    2013-12-01

    Full Text Available The article presents the origins and development of the idea of absenteeism in Greater Poland in the 19th century. The start date for the research is 1840, which is considered to be a breakthrough year in the history of an organized absenteeism movement in Greater Poland. It was due to the Association for the Suppression of the Use of Vodka (Towarzystwo ku Przytłumieniu Używania Wódki in the Great Duchy of Posen that was then established in Kórnik. It was a secular organization that came into being on an initiative of doctor De La Roch, who was a German surgeon of a French origin. However, as early as 1844, the idea of absenteeism raised an interest of catholic clergymen of Greater Poland with high ranking clergy such as Rev. Leon Michał Przyłuski, Archbishop of Gniezno and Rev. Jan Kanty Dąbrowski, Archbishop of Posen, and later on Archbishops Rev. Mieczysław Halka Ledóchowski and Rev. Florian Oksza Stablewski. They were fascinated with activities of Rev. Jan Nepomucen Fick, Parish Priest of Piekary Śląskie and several other priests on whose initiative a lot of church brotherhoods of so called holy continence were set up in Upper Silesia as early as the first half-year of 1844. It was due to Bishop Dąbrowski that 100 000 people took vows of absenteeism in 1844–1845, becoming members of brotherhoods of absenteeism. In turn, it was an initiative of Archbishop Przyłuski that Jesuit missionaries – Rev. Karol Bołoz Antoniewicz, Rev. Teofil Baczyński and Rev. Kamil Praszałowicz, arrived in Greater Poland from Galicia in 1852 to promote the idea of absenteeism. Starting from 1848, they were helping Silesian clergymen to spread absenteeism. Clergymen of Greater Poland were also active in secular absenteeism associations. They became involved in the workings of the Association for the Promotion of Absenteeism that was set up by Zygmunt Celichowski in Kórnik in 1887, and especially in the Jutrzenka Absenteeism Association

  4. Minerals, markets and open access

    OpenAIRE

    Mitchell, Clive

    2014-01-01

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

  5. Interventions to Improve Access to Primary Care for People Who Are Homeless: A Systematic Review.

    Science.gov (United States)

    2016-01-01

    People who are homeless encounter barriers to primary care despite having greater needs for health care, on average, than people who are not homeless. We evaluated the effectiveness of interventions to improve access to primary care for people who are homeless. We performed a systematic review to identify studies in English published between January 1, 1995, and July 8, 2015, comparing interventions to improve access to a primary care provider with usual care among people who are homeless. The outcome of interest was access to a primary care provider. The risk of bias in the studies was evaluated, and the quality of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. From a total of 4,047 citations, we identified five eligible studies (one randomized controlled trial and four observational studies). With the exception of the randomized trial, the risk of bias was considered high in the remaining studies. In the randomized trial, people who were homeless, without serious mental illness, and who received either an outreach intervention plus clinic orientation or clinic orientation alone, had improved access to a primary care provider compared with those receiving usual care. An observational study that compared integration of primary care and other services for people who are homeless with usual care did not observe any difference in access to a primary care provider between the two groups. A small observational study showed improvement among participants with a primary care provider after receiving an intervention consisting of housing and supportive services compared with the period before the intervention. The quality of the evidence was considered moderate for both the outreach plus clinic orientation and clinic orientation alone, and low to very low for the other interventions. Despite limitations, the literature identified reports of interventions developed to overcome

  6. ACCESS Pointing Control System

    Science.gov (United States)

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

    2010-01-01

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

  7. Market Access and Welfare

    DEFF Research Database (Denmark)

    Raimondos-Møller, Pascalis; Woodland, Alan D.

    2015-01-01

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

  8. The accessible city

    NARCIS (Netherlands)

    Woestenburg, A.K.

    2017-01-01

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

  9. Self-Access Systems.

    Science.gov (United States)

    Miller, Lindsay; Rogerson-Revell, Pamela

    1993-01-01

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

  10. Comparing Information Access Approaches.

    Science.gov (United States)

    Chalmers, Matthew

    1999-01-01

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

  11. 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

  12. Unmet healthcare needs in homeless women with children in the Greater Paris area in France.

    Directory of Open Access Journals (Sweden)

    Cécile Vuillermoz

    Full Text Available Despite their poor health status, homeless women encounter many barriers to care. The objectives of our study were to estimate the prevalence of unmet healthcare needs in homeless women and to analyse associated relationships with the following factors: financial and spatial access to care, housing history, migration status, healthcare utilisation, victimization history, caring for children, social network and self-perceived health status.We used data from 656 homeless women interviewed during the ENFAMS representative survey of sheltered homeless families, conducted in the Paris region in 2013. Structural equation models (SEM were used to estimate the impact of various factors on homeless women's unmet healthcare needs.Among those interviewed, 25.1% (95%CI[21.3-29.0] had at least one unmet healthcare need over the previous year. Most had given up on visiting general practitioners and medical specialists. No association with factors related to financial access or to health insurance status was found. However, food insecurity, poor spatial health access and poor self-perceived health were associated with unmet healthcare needs. Self-perceived health appeared to be affected by victimization and depression.The lower prevalence of unmet healthcare needs in homeless women compared with women in stable housing situations suggests that homeless women have lower needs perceptions and/or lower expectations of the healthcare system. This hypothesis is supported by the results from SEM. Strategies to provide better access to care for this population should not only focus on financial interventions but also more broadly on spatial healthcare access, cultural norms, and perceptions of health. Reducing their unmet needs and improving their access to healthcare and prevention must include an improvement in their living, financial and housing conditions.

  13. Coded Random Access

    DEFF Research Database (Denmark)

    Paolini, Enrico; Stefanovic, Cedomir; Liva, Gianluigi

    2015-01-01

    , in which the structure of the access protocol can be mapped to a structure of an erasure-correcting code defined on graph. This opens the possibility to use coding theory and tools for designing efficient random access protocols, offering markedly better performance than ALOHA. Several instances of coded......The rise of machine-to-machine communications has rekindled the interest in random access protocols as a support for a massive number of uncoordinatedly transmitting devices. The legacy ALOHA approach is developed under a collision model, where slots containing collided packets are considered...... as waste. However, if the common receiver (e.g., base station) is capable to store the collision slots and use them in a transmission recovery process based on successive interference cancellation, the design space for access protocols is radically expanded. We present the paradigm of coded random access...

  14. Access to scientific publications: the scientist's perspective.

    Directory of Open Access Journals (Sweden)

    Yegor Voronin

    Full Text Available BACKGROUND: Scientific publishing is undergoing significant changes due to the growth of online publications, increases in the number of open access journals, and policies of funders and universities requiring authors to ensure that their publications become publicly accessible. Most studies of the impact of these changes have focused on the growth of articles available through open access or the number of open-access journals. Here, we investigated access to publications at a number of institutes and universities around the world, focusing on publications in HIV vaccine research--an area of biomedical research with special importance to the developing world. METHODS AND FINDINGS: We selected research papers in HIV vaccine research field, creating: 1 a first set of 50 most recently published papers with keywords "HIV vaccine" and 2 a second set of 200 articles randomly selected from those cited in the first set. Access to the majority (80% of the recently published articles required subscription, while cited literature was much more accessible (67% freely available online. Subscriptions at a number of institutions around the world were assessed for providing access to subscription-only articles from the two sets. The access levels varied widely, ranging among institutions from 20% to 90%. Through the WHO-supported HINARI program, institutes in low-income countries had access comparable to that of institutes in the North. Finally, we examined the response rates for reprint requests sent to corresponding authors, a method commonly used before internet access became widespread. Contacting corresponding authors with requests for electronic copies of articles by email resulted in a 55-60% success rate, although in some cases it took up to 1.5 months to get a response. CONCLUSIONS: While research articles are increasingly available on the internet in open access format, institutional subscriptions continue to play an important role. However

  15. The post-orgasmic prolactin increase following intercourse is greater than following masturbation and suggests greater satiety.

    Science.gov (United States)

    Brody, Stuart; Krüger, Tillmann H C

    2006-03-01

    Research indicates that prolactin increases following orgasm are involved in a feedback loop that serves to decrease arousal through inhibitory central dopaminergic and probably peripheral processes. The magnitude of post-orgasmic prolactin increase is thus a neurohormonal index of sexual satiety. Using data from three studies of men and women engaging in masturbation or penile-vaginal intercourse to orgasm in the laboratory, we report that for both sexes (adjusted for prolactin changes in a non-sexual control condition), the magnitude of prolactin increase following intercourse is 400% greater than that following masturbation. The results are interpreted as an indication of intercourse being more physiologically satisfying than masturbation, and discussed in light of prior research reporting greater physiological and psychological benefits associated with coitus than with any other sexual activities.

  16. Accessibility Guidelines for Astronomy and Astrophysics Meetings

    Science.gov (United States)

    Monkiewicz, Jacqueline; Murphy, Nicholas; Diaz-Merced, Wanda Liz; Aarnio, Alicia; Knierman, Karen; AAS Working Group for Accessibility and Disability

    2018-01-01

    Attendance at meetings and conferences is a critical component of an astronomer's professional life, providing opportunities for presenting one's work, staying current in the field, career networking, and scientific collaboration. Exclusion from these gatherings due to lack of accessibility and accommodation failure is a reality for disabled astronomers, and contributes substantially to low levels of representation in the senior-most levels of the field. We present a preview of the AAS Working Group for Accessibility and Disability's best practice recommendations for meetings accessibility. Applying the principles of universal access and barrier-free design, we model a paradigm of anticipating and removing accessibility barriers in advance, rather than putting the burden of requesting accommodation solely on disabled astronomers and students. We cite several professional and nonprofessional societies identified as meetings accessibility exemplars, and model our guidelines on their best practices. We establish standards for accessibility budgeting, venue choice, publication of policies online, designating point persons, and identifying barriers. We make recommendations for oral and poster presentations, event registration, receptions and banquets, excursions, and other typical conference activities. For meetings which are constrained by fixed budgets and venue choice, we identify a number of low cost/high reward accessibility steps which might still have a large beneficial impact. We likewise provide adapted recommendations for low budget meetings. THIS IS A POSTER LOCATED IN THE AAS BOOTH

  17. Open Access Publishing - Strengths and Strategies

    Science.gov (United States)

    Rasmussen, Martin

    2010-05-01

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

  18. Lower Extremity Permanent Dialysis Vascular Access.

    Science.gov (United States)

    Parekh, Vishal B; Niyyar, Vandana D; Vachharajani, Tushar J

    2016-09-07

    Hemodialysis remains the most commonly used RRT option around the world. Technological advances, superior access to care, and better quality of care have led to overall improvement in survival of patients on long-term hemodialysis. Maintaining a functioning upper extremity vascular access for a prolonged duration continues to remain a challenge for dialysis providers. Frequently encountered difficulties in clinical practice include (1) a high incidence of central venous catheter-related central vein stenosis and (2) limited options for creating a functioning upper extremity permanent arteriovenous access. Lack of surgical skills, fear of complications, and limited involvement of the treating nephrologists in the decision-making process are some of the reasons why lower extremity permanent dialysis access remains an infrequently used option. Similar to upper extremity vascular access options, lower extremity arteriovenous fistula remains a preferred access over arteriovenous synthetic graft. The use of femoral tunneled catheter as a long-term access should be avoided as far as possible, especially with the availability of newer graft-catheter hybrid devices. Our review provides a summary of clinical evidence published in surgical, radiology, and nephrology literature highlighting the pros and cons of different types of lower extremity permanent dialysis access. Copyright © 2016 by the American Society of Nephrology.

  19. Access to medicines: relations with the institutionalization of pharmaceutical services.

    Science.gov (United States)

    Barros, Rafael Damasceno de; Costa, Ediná Alves; Santos, Djanilson Barbosa Dos; Souza, Gisélia Santana; Álvares, Juliana; Guerra, Augusto Afonso; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mario; Leite, Silvana Nair

    2017-11-13

    To analyze the relationship between access to medicines by the population and the institutionalization of pharmaceutical services in Brazilian primary health care. This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services 2015), a cross-sectional, exploratory, and evaluative study composed of an information survey in a representative sample of cities, stratified by Brazilian regions. Access was defined based on the acquisition of medicines reported by the patient, ranging between: total, partial, or null. The institutionalization of pharmaceutical services was analyzed based on information provided by pharmaceutical services providers and by those responsible for medicines delivery. Chi-square test and multinomial logistic regression were used in the statistical analysis. Full access to medicines was greater when professionals affirmed there were the following aspects of the dimensions: "management tools," "participation and social control," "financing," and "personnel structure," with significant associations in the bivariate analysis. The "pharmaceutical care" dimension did not achieve such an association. After multinomial logistic regression, full access was more prevalent when those in charge of pharmaceutical services stated that: they always or repeatedly attend meetings of the Municipal Health Council, OR = 3.3 (95%CI 1.5-7.3); there are protocols for medicines delivery, OR = 2.7 (95%CI 1.2-6.1); there is computerized system for managing pharmaceutical services, OR = 3.9 (95%CI 1.9-8.0); those responsible for medicines delivery reported having participated in a course or training for professionals in the past two years, OR = 2.0 (95%CI 1.1-3.5); there is computerized system for pharmaceutical services management, OR = 4.3 (95%CI 2.4-7.5). Aspects related to the institutionalization of

  20. Access to medicines: relations with the institutionalization of pharmaceutical services

    Directory of Open Access Journals (Sweden)

    Rafael Damasceno de Barros

    2017-11-01

    Full Text Available ABSTRACT OBJETIVE To analyze the relationship between access to medicines by the population and the institutionalization of pharmaceutical services in Brazilian primary health care. METHODS This study is part of the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services 2015, a cross-sectional, exploratory, and evaluative study composed of an information survey in a representative sample of cities, stratified by Brazilian regions. Access was defined based on the acquisition of medicines reported by the patient, ranging between: total, partial, or null. The institutionalization of pharmaceutical services was analyzed based on information provided by pharmaceutical services providers and by those responsible for medicines delivery. Chi-square test and multinomial logistic regression were used in the statistical analysis. RESULTS Full access to medicines was greater when professionals affirmed there were the following aspects of the dimensions: “management tools,” “participation and social control,” “financing,” and “personnel structure,” with significant associations in the bivariate analysis. The “pharmaceutical care” dimension did not achieve such an association. After multinomial logistic regression, full access was more prevalent when those in charge of pharmaceutical services stated that: they always or repeatedly attend meetings of the Municipal Health Council, OR = 3.3 (95%CI 1.5-7.3; there are protocols for medicines delivery, OR = 2.7 (95%CI 1.2-6.1; there is computerized system for managing pharmaceutical services, OR = 3.9 (95%CI 1.9-8.0; those responsible for medicines delivery reported having participated in a course or training for professionals in the past two years, OR = 2.0 (95%CI 1.1-3.5; there is computerized system for pharmaceutical services management, OR

  1. What HERA May Provide?

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Hannes; /DESY; De Roeck, Albert; /CERN; Bartels, Jochen; /Hamburg U., Inst. Theor. Phys. II; Behnke, Olaf; Blumlein, Johannes; /DESY; Brodsky, Stanley; /SLAC /Durham U., IPPP; Cooper-Sarkar, Amanda; /Oxford U.; Deak, Michal; /DESY; Devenish, Robin; /Oxford U.; Diehl, Markus; /DESY; Gehrmann, Thomas; /Zurich U.; Grindhammer, Guenter; /Munich, Max Planck Inst.; Gustafson, Gosta; /CERN /Lund U., Dept. Theor. Phys.; Khoze, Valery; /Durham U., IPPP; Knutsson, Albert; /DESY; Klein, Max; /Liverpool U.; Krauss, Frank; /Durham U., IPPP; Kutak, Krzysztof; /DESY; Laenen, Eric; /NIKHEF, Amsterdam; Lonnblad, Leif; /Lund U., Dept. Theor. Phys.; Motyka, Leszek; /Hamburg U., Inst. Theor. Phys. II /Birmingham U. /Southern Methodist U. /DESY /Piemonte Orientale U., Novara /CERN /Paris, LPTHE /Hamburg U. /Penn State U.

    2011-11-10

    More than 100 people participated in a discussion session at the DIS08 workshop on the topic What HERA may provide. A summary of the discussion with a structured outlook and list of desirable measurements and theory calculations is given. The HERA accelerator and the HERA experiments H1, HERMES and ZEUS stopped running in the end of June 2007. This was after 15 years of very successful operation since the first collisions in 1992. A total luminosity of {approx} 500 pb{sup -1} has been accumulated by each of the collider experiments H1 and ZEUS. During the years the increasingly better understood and upgraded detectors and HERA accelerator have contributed significantly to this success. The physics program remains in full swing and plenty of new results were presented at DIS08 which are approaching the anticipated final precision, fulfilling and exceeding the physics plans and the previsions of the upgrade program. Most of the analyses presented at DIS08 were still based on the so called HERA I data sample, i.e. data taken until 2000, before the shutdown for the luminosity upgrade. This sample has an integrated luminosity of {approx} 100 pb{sup -1}, and the four times larger statistics sample from HERA II is still in the process of being analyzed.

  2. Livelihood patterns of displaced households in greater khartoum.

    Science.gov (United States)

    Hamid, G M

    1992-09-01

    Members of impoverished households in Greater Khartoum, who have been displaced from their homelands by famine and civil war, gain a livelihood by utilising a wide variety of subsistence activities and sources. These include moonlighting, income diversification and pooling, exchange relations, scavenging, relief supplies from aid agencies and remittances from relatives working in other areas. This finding challenges the widely held view of the displaced as dependent and parasitic on the wider urban community. Several public policies are identified which have a detrimental effect on the livelihood of the displaced.

  3. Range-wide patterns of greater sage-grouse persistence

    Science.gov (United States)

    Aldridge, C.L.; Nielsen, S.E.; Beyer, H.L.; Boyce, M.S.; Connelly, J.W.; Knick, S.T.; Schroeder, M.A.

    2008-01-01

    Aim: Greater sage-grouse (Centrocercus urophasianus), a shrub-steppe obligate species of western North America, currently occupies only half its historical range. Here we examine how broad-scale, long-term trends in landscape condition have affected range contraction. Location: Sagebrush biome of the western USA. Methods: Logistic regression was used to assess persistence and extirpation of greater sage-grouse range based on landscape conditions measured by human population (density and population change), vegetation (percentage of sagebrush habitat), roads (density of and distance to roads), agriculture (cropland, farmland and cattle density), climate (number of severe and extreme droughts) and range periphery. Model predictions were used to identify areas where future extirpations can be expected, while also explaining possible causes of past extirpations. Results: Greater sage-grouse persistence and extirpation were significantly related to sagebrush habitat, cultivated cropland, human population density in 1950, prevalence of severe droughts and historical range periphery. Extirpation of sage-grouse was most likely in areas having at least four persons per square kilometre in 1950, 25% cultivated cropland in 2002 or the presence of three or more severe droughts per decade. In contrast, persistence of sage-grouse was expected when at least 30 km from historical range edge and in habitats containing at least 25% sagebrush cover within 30 km. Extirpation was most often explained (35%) by the combined effects of peripherality (within 30 km of range edge) and lack of sagebrush cover (less than 25% within 30 km). Based on patterns of prior extirpation and model predictions, we predict that 29% of remaining range may be at risk. Main Conclusions: Spatial patterns in greater sage-grouse range contraction can be explained by widely available landscape variables that describe patterns of remaining sagebrush habitat and loss due to cultivation, climatic trends, human

  4. New summer areas and mixing of two greater sandhill crane populations in the Intermountain West

    Science.gov (United States)

    Collins, Daniel P.; Grisham, Blake A.; Conring, Courtenay M.; Knetter, Jeffrey M.; Conway, Warren C.; Carleton, Scott A.; Boggie, Matthew A.

    2016-01-01

    Population delineation throughout the annual life cycle for migratory birds is needed to formulate regional and national management and conservation strategies. Despite being well studied continentally, connectivity of sandhill crane Grus canadensis populations throughout the western portion of their North American range remains poorly described. Our objectives were to 1) use global positioning system satellite transmitter terminals to identify summer distributions for the Lower Colorado River Valley Population of greater sandhill cranes Grus canadensis tabida and 2) determine whether intermingling occurs among any of the western greater sandhill crane populations: Rocky Mountain Population, Lower Colorado River Valley Population, and Central Valley Population. Capture and marking occurred during winter and summer on private lands in California and Idaho as well as on two National Wildlife Refuges: Cibola and Sonny Bono Salton Sea National Wildlife Refuges. A majority of marked greater sandhill cranes summered in what is established Lower Colorado River Valley Population breeding areas in northeastern Nevada and southwestern Idaho. A handful of greater sandhill cranes summered outside of traditional breeding areas in west-central Idaho around Cascade Reservoir near Donnelly and Cascade, Idaho. For example, a greater sandhill crane colt captured near Donnelly in July 2014 survived to winter migration and moved south to areas associated with the Rocky Mountain Population. The integration of the greater sandhill crane colt captured near Donnelly provides the first evidence of potential intermingling between the Lower Colorado River Population and Rocky Mountain Population. We suggest continued marking and banding efforts of all three western populations of greater sandhill cranes will accurately delineate population boundaries and connectivity and inform management decisions for the three populations.

  5. Bilingual approach to online cancer genetics education for Deaf American Sign Language users produces greater knowledge and confidence than English text only: A randomized study.

    Science.gov (United States)

    Palmer, Christina G S; Boudreault, Patrick; Berman, Barbara A; Wolfson, Alicia; Duarte, Lionel; Venne, Vickie L; Sinsheimer, Janet S

    2017-01-01

    Deaf American Sign Language-users (ASL) have limited access to cancer genetics information they can readily understand, increasing risk for health disparities. We compared effectiveness of online cancer genetics information presented using a bilingual approach (ASL with English closed captioning) and a monolingual approach (English text). Bilingual modality would increase cancer genetics knowledge and confidence to create a family tree; education would interact with modality. We used a parallel 2:1 randomized pre-post study design stratified on education. 150 Deaf ASL-users ≥18 years old with computer and internet access participated online; 100 (70 high, 30 low education) and 50 (35 high, 15 low education) were randomized to the bilingual and monolingual modalities. Modalities provide virtually identical content on creating a family tree, using the family tree to identify inherited cancer risk factors, understanding how cancer predisposition can be inherited, and the role of genetic counseling and testing for prevention or treatment. 25 true/false items assessed knowledge; a Likert scale item assessed confidence. Data were collected within 2 weeks before and after viewing the information. Significant interaction of language modality, education, and change in knowledge scores was observed (p = .01). High education group increased knowledge regardless of modality (Bilingual: p education group increased knowledge with bilingual (p Bilingual modality yielded greater confidence creating a family tree (p = .03). Bilingual approach provides a better opportunity for lower educated Deaf ASL-users to access cancer genetics information than a monolingual approach. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  6. Access Agent Improving The Performance Of Access Control Lists

    Directory of Open Access Journals (Sweden)

    Thelis R. S.

    2015-08-01

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

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

    Science.gov (United States)

    Jacob, Tamar; Parag, Ayala

    2015-07-01

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

  8. Park Accessibility Impacts Housing Prices in Seoul

    Directory of Open Access Journals (Sweden)

    Jin Han Park

    2017-01-01

    Full Text Available Housing prices are determined by a variety of factors, including the features of the building and the neighborhood environment, and a potential buyer decides to buy a house after reviewing these factors and concluding that it is worth the price. We used Hedonic Price Methods to find the relationship between monetary value of house and access conditions to urban parks. Two meaningful results were discovered in this study: first, as the distance from the park increases, the value of the park inherent in the housing price decreases; second, the greater walking accessibility, to the park, the higher the park value inherent in housing prices. Despite presenting shorter distances to walk and more entrances, poorly accessible zones were deemed as such due to the necessity of crossing an arterial road. This indicates that the results can define accessibility not as the Euclidian distance but as the shortest walking distance while considering crossroads and park entrances. The results of this study have significant implications for urban park economic impact analyses in Seoul. Also, the increase in housing prices closer to parks supports the idea that access is dependent on the residents’ socioeconomic status. Lastly, the results of this study can improve walking accessibility to the park.

  9. Market Access and Welfare

    DEFF Research Database (Denmark)

    Raimondos-Møller, Pascalis; Woodland, Alan D.

    objectives of trade policy is problematic and calls for finding alternative tariff reform rules that can achieve both objectives at the same time. The present paper contributes to this aim by using a new set of tariff reforms that are based on local optimality. Using such reforms it is shown that market......According to the literature, 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. Such conflict between welfare and market access...

  10. Towards Greater Cross-Border Trade in Gas

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Angus

    2007-07-01

    Despite differences in our national agendas, the countries represented by the WEC are united in our desire to secure a long-term, affordable and sustainable energy supply for our nations. As the price of oil increases and concerns mount over the environmental impact of coal, gas will form an increasingly important part of the energy equation, with demand for gas expected to double over the next 25 years. Critically we are still facing many of the same concerns: rapidly increasing demand for energy from the industrialisation of developing countries, particularly China and India; slow technology innovation in the power industry; and increasing construction costs, in terms of price of the raw materials as well as access to sufficient skilled and qualified labour, across the value chain. (auth)

  11. Multimodal route choice models of public transport passengers in the Greater Copenhagen Area

    DEFF Research Database (Denmark)

    Anderson, Marie Karen; Nielsen, Otto Anker; Prato, Carlo Giacomo

    2014-01-01

    not only of the in-vehicle times for different public transport modes, but also of the other time components (e.g., access, walking, waiting, transfer) composing the door-to-door experience of using a multimodal public transport network, differentiating by trip length and purpose, and accounting......Understanding route choice behavior is crucial to explain travelers’ preferences and to predict traffic flows under different scenarios. A growing body of literature has concentrated on public transport users without, however, concentrating on multimodal public transport networks because......,641 public transport users in the Greater Copenhagen Area.A two-stage approach consisting of choice set generation and route choice model estimation allowed uncovering the preferences of the users of this multimodal large-scale public transport network. The results illustrate the rates of substitution...

  12. Regional Online Union Catalog of the Greater Midwest Regional Medical Library Network: development and operation.

    Science.gov (United States)

    Hammell, K A

    1984-04-01

    The GMRMLN Online Catalog was developed as an easily accessible locator tool for monographs and audiovisuals held within the Greater Midwest Regional Medical Library Network. The catalog was generated from machine-readable records in MARC formats contributed by regional libraries. It was mounted by BRS as a private database and is fully free text searchable using BRS search. Each institutional file was merged and purged of duplicates to create a single entry for each title. The catalog features an online interlibrary loan system that automatically routes a request to the two nearest, smallest libraries that own the title. If the request is not filled within the region, the system automatically routes it to the National Library of Medicine without the need to rekeyboard data. The system collects management data on interlibrary loan processing. Funding for the catalog permitted a trial period of use with cost support. Data on system operation were gathered during this demonstration.

  13. The Importance of Government Effectiveness for Transitions toward Greater Electrification in Developing Countries

    Directory of Open Access Journals (Sweden)

    Rohan Best

    2017-08-01

    Full Text Available Electricity is a vital factor underlying modern living standards, but there are many developing countries with low levels of electricity access and use. We seek to systematically identify the crucial elements underlying transitions toward greater electrification in developing countries. We use a cross-sectional regression approach with national-level data up to 2012 for 135 low- and middle-income countries. The paper finds that the effectiveness of governments is the most important governance attribute for encouraging the transition to increased electrification in developing countries, on average. The results add to the growing evidence on the importance of governance for development outcomes. Donors seeking to make more successful contributions to electrification may wish to target countries with more effective governments.

  14. Health care access for rural youth on equal terms? A mixed methods study protocol in northern Sweden.

    Science.gov (United States)

    Goicolea, Isabel; Carson, Dean; San Sebastian, Miguel; Christianson, Monica; Wiklund, Maria; Hurtig, Anna-Karin

    2018-01-11

    The purpose of this paper is to propose a protocol for researching the impact of rural youth health service strategies on health care access. There has been no published comprehensive assessment of the effectiveness of youth health strategies in rural areas, and there is no clearly articulated model of how such assessments might be conducted. The protocol described here aims to gather information to; i) Assess rural youth access to health care according to their needs, ii) Identify and understand the strategies developed in rural areas to promote youth access to health care, and iii) Propose actions for further improvement. The protocol is described with particular reference to research being undertaken in the four northernmost counties of Sweden, which contain a widely dispersed and diverse youth population. The protocol proposes qualitative and quantitative methodologies sequentially in four phases. First, to map youth access to health care according to their health care needs, including assessing horizontal equity (equal use of health care for equivalent health needs,) and vertical equity (people with greater health needs should receive more health care than those with lesser needs). Second, a multiple case study design investigates strategies developed across the region (youth clinics, internet applications, public health programs) to improve youth access to health care. Third, qualitative comparative analysis of the 24 rural municipalities in the region identifies the best combination of conditions leading to high youth access to health care. Fourth, a concept mapping study involving rural stakeholders, care providers and youth provides recommended actions to improve rural youth access to health care. The implementation of this research protocol will contribute to 1) generating knowledge that could contribute to strengthening rural youth access to health care, as well as to 2) advancing the application of mixed methods to explore access to health care.

  15. Accessing Data Federations with CVMFS

    Science.gov (United States)

    Weitzel, Derek; Bockelman, Brian; Dykstra, Dave; Blomer, Jakob; Meusel, Ren

    2017-10-01

    Data federations have become an increasingly common tool for large collaborations such as CMS and Atlas to efficiently distribute large data files. Unfortunately, these typically are implemented with weak namespace semantics and a non-POSIX API. On the other hand, CVMFS has provided a POSIX-compliant read-only interface for use cases with a small working set size (such as software distribution). The metadata required for the CVMFS POSIX interface is distributed through a caching hierarchy, allowing it to scale to the level of about a hundred thousand hosts. In this paper, we will describe our contributions to CVMFS that merges the data scalability of XRootD-based data federations (such as AAA) with metadata scalability and POSIX interface of CVMFS. We modified CVMFS so it can serve unmodified files without copying them to the repository server. CVMFS 2.2.0 is also able to redirect requests for data files to servers outside of the CVMFS content distribution network. Finally, we added the ability to manage authorization and authentication using security credentials such as X509 proxy certificates. We combined these modifications with the OSGs StashCache regional XRootD caching infrastructure to create a cached data distribution network. We will show performance metrics accessing the data federation through CVMFS compared to direct data federation access. Additionally, we will discuss the improved user experience of providing access to a data federation through a POSIX filesystem.

  16. Optimizing Cooperative Cognitive Radio Networks with Opportunistic Access

    KAUST Repository

    Zafar, Ammar

    2012-09-16

    Optimal resource allocation for cooperative cognitive radio networks with opportunistic access to the licensed spectrum is studied. Resource allocation is based on minimizing the symbol error rate at the receiver. Both the cases of all-participate relaying and selective relaying are considered. The objective function is derived and the constraints are detailed for both scenarios. It is then shown that the objective functions and the constraints are nonlinear and nonconvex functions of the parameters of interest, that is, source and relay powers, symbol time, and sensing time. Therefore, it is difficult to obtain closed-form solutions for the optimal resource allocation. The optimization problem is then solved using numerical techniques. Numerical results show that the all-participate system provides better performance than its selection counterpart, at the cost of greater resources. © 2012 Ammar Zafar et al.

  17. [The publishing industry against open access journals].

    Science.gov (United States)

    Camargo Junior, Kenneth Rochel de

    2012-12-01

    Open-access journal publishing has significantly grown in recent years. Restricted access publications have, in turn, increasing access costs as they benefit from a unique economic model in which relevant work and essential inputs are provided free of charge to vendors who have a captive market that has almost no competition. An additional issue typical of industries that work under the copyright regime is that the oligopoly market structure of the publishing industry which in turn further contributes to increase their products' prices. Mandatory open-access policies, as determined by the NIH, constitute a threat to this business model and are being challenged by the industry on several fronts, including the passage of legislation to undermine these initiatives. The purpose of this commentary article was to review key aspects of this confrontation and to suggest potential strategies for encouraging open-access publishing in Brazil.

  18. Bariatric surgery in Medicare patients: greater risks but substantial benefits.

    Science.gov (United States)

    Yuan, Xiang; Martin Hawver, Lisa R; Ojo, Peter; Wolfe, Luke M; Meador, Jill G; Kellum, John M; Maher, James W

    2009-01-01

    Recent reports have documented greater mortality for bariatric surgery in Medicare (MC) patients compared with patients from other payors. We reviewed our database for the mortality and outcomes of 282 MC and 3169 non-Medicare (NMC) patients undergoing bariatric surgery. Of the MC patients, 27 were >65 years of age, and 255 were receiving disability. The average age was 48.45 +/- 11.8 years, and the average BMI was 52.4 +/- 10.0 kg/m2. NMC patients had average age of 40.0 +/- 10.1 years and a BMI of 50.6 +/- 9.1 kg/m2. The co-morbidities were greater in the MC patients than in the NMC patients (hypertension 71.9% versus 48.4%, diabetes mellitus 39.72% versus 19.4%, obstructive sleep apnea 46.45% versus 28.46%, and obesity hypoventilation syndrome 9.93% versus 2.71%). The mortality rate was 2.48% in the MC patients and .76% in the NMC patients. Mortality was absent in MC patients >65 years old. The percentage of excess weight lost was less in the MC patients (60.8%) than in the NMC patients (66.5%, P obstructive sleep apnea 79.17% versus 54.51%; and obesity hypoventilation syndrome 26.39% versus 7.64%). The operative mortality rate was 5.6% for the male MC patients and 1.5% for the female MC patients. The weight loss was similar for the male MC and male NMC patients. The male MC patients had slightly better resolution of both hypertension (MC patients 54.8% versus NMC patients 26.7%, P = .0025) and diabetes mellitus (MC patients 30% versus NMC patients 22.5%, P = .745). When the patients were stratified into low-, intermediate-, and high-risk groups using a previously validated risk scale, patients with similar risk factors had similar mortality in both groups. The results of our study have shown that disabled MC patients have greater operative mortality than NMC patients that appears to be associated with more prevalent risk factors. However, the risk was counterbalanced by a substantial improvement in health.

  19. Roundabouts and access management.

    Science.gov (United States)

    2014-03-01

    Transportation engineers and planners are becoming more interested in using roundabouts to address access : management and safety concerns in the transportation system. While roundabouts are being used increasingly in a : variety of contexts, existin...

  20. First Accessible Boat Launch

    Science.gov (United States)

    This is a story about how the Northwest Indiana urban waters partnership location supported the process to create and open the first handicap accessible canoe and kayak launch in the state of Indiana.