WorldWideScience

Sample records for syringe access programs

  1. Evidence-based policy versus morality policy: the case of syringe access programs.

    Science.gov (United States)

    de Saxe Zerden, Lisa; O'Quinn, Erin; Davis, Corey

    2015-01-01

    Evidence-based practice (EBP) combines proven interventions with clinical experience, ethics, and client preferences to inform treatment and services. Although EBP is integrated into most aspects of social work and public health, at times EBP is at odds with social policy. In this article the authors explore the paradox of evidence-based policy using syringe access programs (SAP) as a case example, and review methods of bridging the gap between the emphasis on EBP and lack of evidence informing SAP policy. Analysis includes the overuse of morality policy and examines historical and current theories why this paradox exists. Action steps are highlighted for creating effective policy and opportunities for public health change. Strategies on reframing the problem and shifting target population focus to garner support for evidence-based policy change are included. This interdisciplinary understanding of the way in which these factors converge is a critical first step in moving beyond morality-based policy toward evidence-based policy.

  2. Multiple access to sterile syringes for injection drug users: vending machines, needle exchange programs and legal pharmacy sales in Marseille, France.

    Science.gov (United States)

    Moatti, J P; Vlahov, D; Feroni, I; Perrin, V; Obadia, Y

    2001-03-01

    In Marseille, southeastern France, HIV prevention programs for injection drug users (IDUs) simultaneously include access to sterile syringes through needle exchange programs (NEPs), legal pharmacy sales and, since 1996, vending machines that mechanically exchange new syringes for used ones. The purpose of this study was to compare the characteristics of IDUs according to the site where they last obtained new syringes. During 3 days in September 1997, all IDUs who obtained syringes from 32 pharmacies, four NEPs and three vending machines were offered the opportunity to complete a self-administered questionnaire on demographics, drug use characteristics and program utilization. Of 485 individuals approached, the number who completed the questionnaire was 141 in pharmacies, 114 in NEPs and 88 at vending machines (response rate = 70.7%). Compared to NEP users, vending machine users were younger and less likely to be enrolled in a methadone program or to report being HIV infected, but more likely to misuse buprenorphine. They also had lower financial resources and were less likely to be heroin injectors than both pharmacy and NEP users. Our results suggest that vending machines attract a very different group of IDUs than NEPs, and that both programs are useful adjuncts to legal pharmacy sales for covering the needs of IDUs for sterile syringes in a single city. Assessment of the effectiveness and cost-effectiveness of combining such programs for the prevention of HIV and other infectious diseases among IDUs requires further comparative research. Copyright 2001 S. Karger AG, Basel

  3. Not sold here: limited access to legally available syringes at pharmacies in Tijuana, Mexico.

    Science.gov (United States)

    Pollini, Robin A; Rosen, Perth C; Gallardo, Manuel; Robles, Brenda; Brouwer, Kimberly C; Macalino, Grace E; Lozada, Remedios

    2011-05-24

    Sterile syringe access is a critical component of HIV prevention programs. Although retail pharmacies provide convenient outlets for syringe access, injection drug users (IDUs) may encounter barriers to syringe purchase even where purchase without a prescription is legal. We sought to obtain an objective measure of syringe access in Tijuana, Mexico, where IDUs report being denied or overcharged for syringes at pharmacies. Trained "mystery shoppers" attempted to buy a 1 cc insulin syringe according to a predetermined script at all retail pharmacies in three Tijuana neighborhoods. The same pharmacies were surveyed by telephone regarding their syringe sales policies. Data on purchase attempts were analyzed using basic statistics to obtain an objective measure of syringe access and compared with data on stated sales policies to ascertain consistency. Only 46 (28.4%) of 162 syringe purchase attempts were successful. Leading reasons for unsuccessful attempts were being told that the pharmacy didn't sell syringes (35.3%), there were no syringes in stock (31.0%), or a prescription was required (20.7%). Of 136 pharmacies also surveyed by telephone, a majority (88.2%) reported selling syringes but only one-third (32.5%) had a successful mystery shopper purchase; the majority of unsuccessful purchases were attributed to being told the pharmacy didn't sell syringes. There was similar discordance regarding prescription policies: 74 pharmacies said in the telephone survey that they did not require a prescription for syringes, yet 10 of these pharmacies asked the mystery shopper for a prescription. IDUs in Tijuana have limited access to syringes through retail pharmacies and policies and practices regarding syringe sales are inconsistent. Reasons for these restrictive and inconsistent practices must be identified and addressed to expand syringe access, reduce syringe sharing and prevent HIV transmission.

  4. Syringe access for the prevention of blood borne infections among injection drug users

    Directory of Open Access Journals (Sweden)

    Rich Josiah D

    2003-11-01

    Full Text Available Abstract Background Approximately one-third of acquired immunodeficiency syndrome cases in the United States are associated with the practice of sharing of injection equipment and are preventable through the once-only use of syringes, needles and other injection equipment. Discussion Sterile syringes may be obtained legally by 4 methods depending on the state. They may be purchased over the counter, prescribed, obtained at syringe exchange programs or furnished by authorized agencies. Each of these avenues has advantages and disadvantages; therefore, legal access through all means is the most likely way to promote the use of sterile syringes. Summary By assisting illicit drug injectors to obtain sterile syringes the primary care provider is able to reduce the incidence of blood borne infections, and educate patients about safe syringe disposal. The provider is also able to initiate discussion about drug use in a nonjudgmental manner and to offer care to patients who are not yet ready to consider drug treatment.

  5. Geographic approaches to quantifying the risk environment: a focus on syringe exchange program site access and drug-related law enforcement activities

    Science.gov (United States)

    Cooper, Hannah LF; Bossak, Brian; Tempalski, Barbara; Des Jarlais, Don C.; Friedman, Samuel R.

    2009-01-01

    The concept of the “risk environment” – defined as the “space … [where] factors exogenous to the individual interact to increase the chances of HIV transmission” – draws together the disciplines of public health and geography. Researchers have increasingly turned to geographic methods to quantify dimensions of the risk environment that are both structural and spatial (e.g., local poverty rates). The scientific power of the intersection between public health and geography, however, has yet to be fully mined. In particular, research on the risk environment has rarely applied geographic methods to create neighbourhood-based measures of syringe exchange programs (SEPs) or of drug-related law enforcement activities, despite the fact that these interventions are widely conceptualized as structural and spatial in nature and are two of the most well-established dimensions of the risk environment. To strengthen research on the risk environment, this paper presents a way of using geographic methods to create neighbourhood-based measures of (1) access to SEP sites and (2) exposure to drug-related arrests, and then applies these methods to one setting (New York City). NYC-based results identified substantial cross-neighbourhood variation in SEP site access and in exposure to drug-related arrest rates (even within the subset of neighbourhoods nominally experiencing the same drug-related police strategy). These geographic measures – grounded as they are in conceptualizations of SEPs and drug-related law enforcement strategies – can help develop new arenas of inquiry regarding the impact of these two dimensions of the risk environment on injectors’ health, including exploring whether and how neighbourhood-level access to SEP sites and exposure to drug-related arrests shape a range of outcomes among local injectors. PMID:18963907

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

    Science.gov (United States)

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

    2014-01-01

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

  7. Commentary on Vorobjov et al., "Comparison of injection drug users who obtain syringes from pharmacies and syringe exchange programs in Tallinn, Estonia"

    Directory of Open Access Journals (Sweden)

    Werb Daniel

    2009-01-01

    Full Text Available Abstract Recent data suggest that globally, between 5% and 10% of all new HIV cases are the result of unsafe injecting practices, and experts agree that reducing these practices is key to tackling the spread of HIV. And yet, despite the overwhelming evidence that providing sterile syringes to injection drug users (IDU through syringe exchange programs (SEPs or other means is an effective way of reducing HIV transmission among high-risk subpopulations, IDU in most settings still do not have access to sterile injecting equipment or if they do, access remains too restricted to effectively reduce the risk of HIV transmission. Vorobjov and colleagues have presented in this journal an interesting and timely study from Estonia comparing individuals who obtain syringes from SEPs and those who obtain syringes from pharmacies. As the authors point out, Estonia faces an unacceptably high HIV incidence rate of 50 new HIV cases per 100,000, this rate driven primarily by injection drug use. As such, the authors argue that Estonia's SEP network does not have the capacity to serve a growing IDU population at risk of transmitting HIV and pharmacy dispensation of clean syringes may be one potential approach to decreasing syringe sharing among high-risk injectors. It may be overly optimistic to consider the impact of higher threshold interventions such as pharmacy-based SEPs, given that IDU populations that engage in HIV risk behaviours such as syringe sharing are often hidden or hard to reach. Despite the need for a cautious approach, however, the findings presented by Vorobjov et al. may chart one potential course towards a more comprehensive societal response to reducing the health harms associated with injection drug use.

  8. Barriers to Access to Sterile Syringes as Perceived by Pharmacists and Injecting Drug Users: Implications for Harm Reduction in Lebanon.

    Science.gov (United States)

    Ghaddar, Ali; Nassar, Karine; Elsoury, Ghadier

    2017-09-19

    Access to sterile syringes to injecting drug users (IDU) reduces sharing behavior and prevents the transmission of HIV. To describe the barriers to access to sterile syringes for IDUs in Lebanon from the perspectives of pharmacists and IDUs. in this qualitative study conducted in Lebanon, data were collected from 72 syringe purchase tests at pharmacies, 64 interviewees with pharmacists and 2 focus groups with injecting drug users. Two independent researchers analyzed the verbatim transcripts. Results revealed that pharmacists often deny access to sterile syringes to IDUs who are frequently stigmatized and intimidated at pharmacies. While no large gender differences in pharmacists' attitudes and practices were observed, inequalities in syringe access were noticed with men IDUs more often denied purchase. Pharmacists had several barriers to sell syringes to IDUs including fear of disease spread, increased drug use, inappropriately discarded syringes, staff and customer safety, and business concerns. IDUs had several challenges to purchase syringes including stigmatization, intimidation, physical harassment, concern to reveal identity, fear of arrest and syringe price abuse. Identifying the barriers to and facilitators of access to sterile syringes to IDUs is important to guide the development of efficient policies. Findings implicate the importance of empowering IDUs to purchase syringes at pharmacies through reducing the negative attitude towards IDUs and strengthening pharmacists' role in the promotion of health of IDUs. Findings also suggest that the habit of syringe sharing would decrease if the legal and cultural barriers to access are reduced.

  9. HIV Risk Behavior among Amphetamine Injectors at U.S. Syringe Exchange Programs

    Science.gov (United States)

    Braine, Naomi; Des Jarlais, Don C.; Goldblatt, Cullen; Zadoretzky, Cathy; Turner, Charles

    2005-01-01

    The goal of this study was to compare HIV risk behaviors of amphetamine and non-amphetamine injectors at syringe exchange programs (SEP) in the United States and to identify factors associated with injection risk. This analysis is based on data from a random cross-section of participants at 13 SEPs in different parts of the country. All interviews…

  10. Trend Analyses of Users of a Syringe Exchange Program in Philadelphia, Pennsylvania: 1999-2014.

    Science.gov (United States)

    Maurer, Laurie A; Bass, Sarah Bauerle; Ye, Du; Benitez, José; Mazzella, Silvana; Krafty, Robert

    2016-12-01

    This study examines trends of injection drug users' (IDUs) use of a Philadelphia, Pennsylvania, syringe exchange program (SEP) from 1999 to 2014, including changes in demographics, drug use, substance abuse treatment, geographic indicators, and SEP use. Prevention Point Philadelphia's SEP registration data were analyzed using linear regression, Pearson's Chi square, and t-tests. Over time new SEP registrants have become younger, more racially diverse, and geographically more concentrated in specific areas of the city, corresponding to urban demographic shifts. The number of new registrants per year has decreased, however syringes exchanged have increased. Gentrification, cultural norms, and changes in risk perception are believed to have contributed to the changes in SEP registration. Demographic changes indicate outreach strategies for IDUs may need adjusting to address unique barriers for younger, more racially diverse users. Implications for SEPs are discussed, including policy and continued ability to address current public health threats.

  11. Negotiating access: social barriers to purchasing syringes at pharmacies in Tijuana, Mexico.

    Science.gov (United States)

    Davidson, Peter J; Lozada, Remedios; Rosen, Perth C; Macias, Armando; Gallardo, Manuel; Pollini, Robin A

    2012-07-01

    One common public health response to the emergence of HIV has been the provision of sterile syringes to people who inject drugs. In Mexico specialized syringe exchanges are rare, and the sale of needles through pharmacies is often the only way people who inject drugs can obtain sterile syringes. However, people who inject drugs in Tijuana, Mexico report considerable social barriers to successfully purchasing syringes at pharmacies. Between October 2008 and March 2009 we conducted seven in-depth focus groups with 47 people who inject drugs in Tijuana, Mexico. Focus group transcripts were analysed using a descriptive and thematic approach rooted in grounded theory. We found that injectors offered a number of explanations for why pharmacies were reluctant to sell them syringes, including fear of police; attitudes toward drug use; fear of stereotypical drug user behaviour such as petty theft, violence, or distressing behaviour; and related fears that an obvious drug using clientèle would drive away other customers. Injectors described a range of ways of attempting to re-frame or negotiate interactions with pharmacy staff so that these and related concerns were ameliorated. These included tactics as simple as borrowing cleaner clothing, through to strategies for becoming 'known' to pharmacy staff as an individual rather than as a member of a stigmatized group. Increasing the ability of pharmacy staff and people who inject drugs to successfully negotiate syringe sales are highly desirable. Interventions designed to improve this likelihood need to capitalize on existing solutions developed ad hoc by people who inject drugs and pharmacy staff, and should focus on broadening the range of 'identities' which pharmacy staff are able to accept as legitimate customers. Approaches to achieve this end might include sensitizing pharmacy staff to the needs of people who inject drugs; facilitating individual drug users meeting individual pharmacy staff; and working with drug users

  12. Moving beyond non-engagement on regulated needle-syringe exchange programs in Australian prisons

    Directory of Open Access Journals (Sweden)

    Levy Michael

    2009-05-01

    Full Text Available Abstract Background Australia is at a fork in the road with the possibility of a needle-syringe exchange program (NSP to be introduced at the new prison in the ACT. However, the current situation is characterised by non-engagement from major stakeholders. We explore why informed discussion will not be enough to convince prison officers, policy makers and the wider community of the benefits of prison-based NSPs. Other methods of engagement and communication will be proposed – in that may provide avenues for "breakthrough". Methods A review of the literature on needle-syringe exchanges and harm reduction strategies within the context of prisons and prisoner health was conducted. Literature on strategies to change attitudes and move beyond intractable situations was also consulted. In addition, one author, DM, conducted a two-hour interview with an ex-prison officer. Results No studies were found which investigated the potential efficacy of interventions to modify attitudes or behaviours in the specific context of introducing an NSP into a prison. Nonetheless, several theories were identified which may explain the failure of informed discussion alone to create change in this situation and may therefore lead to suggestions for engagement and communication to move towards a resolution Discussion Cognitive-behavioural therapy highlights the importance of individual cognitions and how they shape behaviours in any change campaign. Social identity theory emphasizes changes to social processes that may open the prison officer workforce to change. Peace studies also suggests socialization strategies such as observing an established and effective prison-based needle-syringe exchange. Social marketing provides suggestions on how to sell an exchange to ensuring the benefits are framed to outweigh the costs. Conclusion Psychology, peace studies and social marketing all agree people's views must be carefully collected and analysed if people are going to be

  13. Social marketing of low dead space syringes in Vietnam: findings from a 1-year pilot program in Hanoi, Thai Nguyen, and Ho Chi Minh City.

    Science.gov (United States)

    Huong, Ngo Thi Thanh; Mundy, Gary; Neukom, Josselyn; Zule, William; Tuan, Nguyen Minh; Tam, Nguyen Minh

    2015-05-30

    Although a growing body of evidence suggests that low dead space syringes may reduce the risk of human immunodeficiency virus (HIV) and Hepatitis C virus infection associated with sharing syringes among people who inject drugs, there is little evidence of effective approaches to motivate people who inject drugs (PWID) to shift from high to low dead space syringes. Using a mix of consumer and trade marketing approaches, informed by rapid assessments of both the syringe market and PWID preferences, practices, and behaviors in Hanoi and Ho Chi Minh City, Population Services International (PSI) Vietnam piloted an intervention to increase the use of low dead space syringes (LDSS) in the three provinces of Hanoi, Ho Chi Minh City, and Thai Nguyen, where an estimated 31% of PWID are HIV positive and 58% are living with hepatitis C virus (HCV). This paper provides a summary of the social marketing activities implemented and results achieved by PSI Vietnam during an initial 1-year pilot period from December 2012 to December 2013 in these three provinces to explore their effectiveness in motivating PWID to use low dead space syringes. We found major increases in sales of LDSS accompanied by increases in reported use and consistent use of LDSS among PWID in the three provinces included in the pilot program and a positive and independent association (odds ratio (OR) 21.08; 95% confidence interval (CI) 10.6-27.3) between LDSS use and exposure to social marketing activities. We also found that LDSS use had a stronger association with perceptions of LDSS product quality than with perceptions regarding LDSS potential to reduce HIV transmission risk and use. We conclude that social marketing interventions have an important role to play in widening access to and the use of LDSS for PWID, as they address the need for PWID to find LDSS when and where they need them and also promote the benefits of LDSS use to PWID. High coverage of these activities among PWID appears to be the key in

  14. Syringe Sharing Among a Prospective Cohort of Street-Involved Youth: Implications for Needle Distribution Programs.

    Science.gov (United States)

    Bozinoff, Nikki; Wood, Evan; Dong, Huiru; Richardson, Lindsey; Kerr, Thomas; DeBeck, Kora

    2017-09-01

    The sharing of previously used syringes is associated with the transmission of Hepatitis C and HIV. This longitudinal study examines syringe borrowing and syringe lending within a prospective cohort of street-involved youth in Vancouver, Canada. From September 2005 to May 2014, data were collected from the At-Risk Youth Study, a cohort of street-involved youth age 14-26 at enrollment, and analyzed using generalized estimating equations. Among 505 participants, 142 (28.1%) reported syringe borrowing and 132 (26.1%) reported syringe lending during the study period. In separate multivariable analyses, having difficulty finding clean needles and homelessness were significantly associated with syringe borrowing (Adjusted Odds Ratio (AOR) = 2.28, 95% CI 1.66-3.12 and AOR = 1.52, CI 1.05-2.21, respectively) and syringe lending (AOR = 1.89, 95% CI 1.32-2.71 and AOR = 1.65, 95% CI 1.11-2.44, respectively) (all p values people is warranted.

  15. Needle and syringe programs in Yunnan, China yield health and financial return

    Directory of Open Access Journals (Sweden)

    Xun Zhuang

    2011-04-01

    Full Text Available Abstract Background As a harm reduction strategy in response to HIV epidemics needle and syringes programs (NSPs were initiated throughout China in 2002. The effectiveness of NSPs in reducing the spread of infection in such an established epidemic is unknown. In this study we use data from Yunnan province, the province most affected by HIV in China, to (1 estimate the population benefits in terms of infections prevented due to the programs; (2 calculate the cost-effectiveness of NSPs. Methods We developed a mathematical transmission model, informed by detailed behavioral and program data, which accurately reflected the unique HIV epidemiology among Yunnan injecting drug users (IDUs in the presence of NSPs. We then used the model to estimate the likely epidemiological and clinical outcomes without NSPs and conducted a health economics analysis to determine the cost-effectiveness of the program. Results It is estimated that NSPs in Yunnan have averted approximately 16-20% (5,200-7,500 infections of the expected HIV cases since 2002 and led to gains of 1,300-1,900 DALYs. The total $1.04 million spending on NSPs from 2002 to 2008 has resulted in an estimated cost-saving over this period of $1.38-$1.97 million due to the prevention of HIV and the associated costs of care and management. Conclusion NSPs are not only cost-effective but cost-saving in Yunnan. Significant scale-up of NSPs interventions across China and removal of the societal and political barriers that compromise the effects of NSPs should be a health priority of the Chinese government.

  16. Syringe sociology.

    Science.gov (United States)

    Vitellone, Nicole

    2015-06-01

    In this article I consider the impact of social epistemologies for understanding the object of the syringe. My aim is to examine the process through which the syringe transforms from an injecting device to a tool of social and political inquiry. Paying particular attention to the uses of Foucault, Becker, Bourdieu, Freud and Latour in empirical studies of injecting heroin use, I examine the sociology of the syringe through the lens of habit and habitus, discourse and deviance, mourning and melancholia, attachment and agencement. In pursuing the theory behind the object my goal is to address a sociological object in the making. In so doing I show how the syringe has been significant for social research, social theory, and sociology. It is the difference the object makes that this article seeks to describe. In tracing the epistemology of the syringe I show how the object is important not just for knowledge of addiction but sociology itself. © London School of Economics and Political Science 2015.

  17. Racial differences in acquisition of syringes from pharmacies under conditions of legal but restricted sales.

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    Costenbader, Elizabeth C; Zule, William A; Coomes, Curtis C

    2010-09-01

    Injecting drug users (IDUs) are at increased risk of acquiring and transmitting HIV and other bloodborne pathogens through the multi-person use of syringes. Although research has shown that increased access to syringes through syringe exchange programs (SEPs) is an effective strategy to reduce risky injection practices many areas of the United States still do not have SEPs. In the absence of SEPs, legislation allowing pharmacies over-the-counter sales of syringes has also been shown to reduce syringe sharing. The success of pharmacy sales however is limited by other legal stipulations, such as drug paraphernalia laws, which in turn may contribute to fear among IDUs about being caught purchasing and carrying syringes. Between 2003 and 2006, 851 out-of-treatment IDUs were recruited using street outreach in the Raleigh-Durham (North Carolina) area. Data were collected using audio-computer assisted interview (ACASI) technology. Multiple logistic regression analyses were performed to assess factors associated with purchasing syringes from pharmacies. In our study sample, African-American IDUs were one-fifth as likely as white IDUs to report pharmacies as their primary source of syringes. Given the absence of syringe exchange programs and the relatively high prevalence of HCV and HIV among IDUs in the Raleigh-Durham area, the limited use of pharmacies as a source of syringes among African-American IDUs in this study sample is problematic. The study findings support the need for effective multilevel interventions to increase access to clean needles in this population, as well as for policy interventions, such as legalization of SEPs and elimination of penalties for carrying syringes, to reduce harm and eliminate the health threats posed by receptive syringe sharing. Copyright 2010 Elsevier B.V. All rights reserved.

  18. 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

  19. Syringe vending machines for injection drug users: an experiment in Marseille, France.

    Science.gov (United States)

    Obadia, Y; Feroni, I; Perrin, V; Vlahov, D; Moatti, J P

    1999-01-01

    OBJECTIVES: This study evaluated the usefulness of vending machines in providing injection drug users with access to sterile syringes in Marseille, France. METHODS: Self-administered questionnaires were offered to 485 injection drug users obtaining syringes from 32 pharmacies, 4 needle exchange programs, and 3 vending machines. RESULTS: Of the 343 respondents (response rate = 70.7%), 21.3% used the vending machines as their primary source of syringes. Primary users of vending machines were more likely than primary users of other sources to be younger than 30 years, to report no history of drug maintenance treatment, and to report no sharing of needles or injection paraphernalia. CONCLUSIONS: Vending machines may be an appropriate strategy for providing access to syringes for younger injection drug users, who have typically avoided needle exchange programs and pharmacies. PMID:10589315

  20. Relationships between needle and syringe programs and police: An exploratory analysis of the potential role of in-service training.

    Science.gov (United States)

    Strike, Carol; Watson, Tara Marie

    2017-06-01

    Training police on the public health benefits of needle and syringe programs (NSPs) is viewed as a best practice to facilitate more collaborative relationships between police and these programs. To date, while the limited published literature contains promising cases of harm reduction in-service training for police, evaluative evidence is preliminary. Using an online survey, we asked NSP managers across Canada about their programs and the quality of their NSP-police relationships. We analyzed data from the responses of 75 program managers among whom 69% reported that their program had a "positive" or "mostly positive" relationship with the police. In-service training about topics such as needle-stick injury prevention and NSP effectiveness was provided by less than 50% of the programs surveyed. Seventy-five percent reported no established protocols to resolve conflicts between NSP staff and police. Four variables, all related to in-service training, were significantly related to positive NSP-police relationships, including training about: NSP program goals (OR 7.7; 95% CI 2.0, 33.1); needle-stick injury prevention and basics of blood-borne virus transmission (OR 4.0; 95% CI 1.1, 15.34); the health and social concerns of people who use drugs (OR 3.9; 95% CI 1.1, 13.5); and evidence about the impact of injection equipment distribution (OR 3.9; 95% CI 1.1, 13.5). Development of in-service training for police that is focused on harm reduction goals and initiatives is a new and evolving area. We highly encourage NSPs to offer and evaluate any such in-service training programs. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Scoping out the literature on mobile needle and syringe programs-review of service delivery and client characteristics, operation, utilization, referrals, and impact.

    Science.gov (United States)

    Strike, Carol; Miskovic, Miroslav

    2018-02-08

    Needle and syringe program (NSP) service delivery models encompass fixed sites, mobile services, vending machines, pharmacies, peer NSPs, street outreach, and inter-organizational agreements to add NSP services to other programs. For programs seeking to implement or improve mobile services, access to a synthesis of the evidence related to mobile services is beneficial, but lacking. We used a scoping study method to search MEDLINE, PSYCHInfo, Embase, Scopus, and Sociological for relevant literature. We identified 39 relevant manuscripts published between 1975 and November 2017 after removing duplicates and non-relevant manuscripts from the 1313 identified by the search. Charting of the data showed that these publications reported findings related to the service delivery model characteristics, client characteristics, service utilization, specialized interventions offered on mobile NSPs, linking clients to other services, and impact on injection risk behaviors. Mobile NSPs are implemented in high-, medium-, and low-income countries; provide equipment distribution and many other harm reduction services; face limitations to service complement, confidentiality, and duration of interactions imposed by physical space; adapt to changes in locations and types of drug use; attract people who engage in high-risk/intensity injection behavior and who are often not reached by other service models; and may lead to reduced injection-related risks. It is not clear from the literature reviewed, what are, or if there are, a "core and essential" complement of services that mobile NSPs should offer. Decisions about service complement for mobile NSPs need to be made in relation to the context and also other available services. Reports of client visits to mobile NSP provide a picture of the volume and frequency of utilization but are difficult to compare given varied measures and reference periods. Mobile NSPs have an important role to play in improving HIV and HCV prevention efforts

  2. Evaluation of a hepatitis C education intervention with clients enrolled in methadone maintenance and needle/syringe programs in Malaysia.

    Science.gov (United States)

    Mukherjee, Trena I; Pillai, Veena; Ali, Siti Hafizah; Altice, Frederick L; Kamarulzaman, Adeeba; Wickersham, Jeffrey A

    2017-09-01

    Approximately 40%-90% of people who inject drugs (PWID) in Malaysia have hepatitis C (HCV). PWID continue to be disproportionately affected by HCV due to their lack of knowledge, perceived risk and interest in HCV treatment. Education interventions may be an effective strategy for increasing HCV knowledge in PWID, and harm reduction services are uniquely positioned to implement and deploy such interventions. We recruited 176 clients from methadone maintenance treatment (MMT: N=110) and needle/syringe programs (NSP: N=66) between November 2015 and August 2016. After baseline knowledge assessments, clients participated in a standardized, 45-min HCV education program and completed post-intervention knowledge assessments to measure change in knowledge and treatment interest. Participants were mostly male (96.3%), Malay (94.9%), and in their early 40s (mean=42.6years). Following the intervention, overall knowledge scores and treatment interest in MMT clients increased by 68% and 16%, respectively (pMalaysia. Integrating a brief, but comprehensive HCV education session within harm reduction services may be a low-cost and effective strategy in improving overall HCV knowledge and risk behaviors in resource-limited settings. In order to be an effective public health approach, however, education interventions must be paired with strategies that improve social, economic and political outcomes for PWID. Doing so may reduce HCV disparities by increasing screening and treatment interest. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Attitudes of North Carolina law enforcement officers toward syringe decriminalization

    Science.gov (United States)

    Davis, Corey S.; Johnston, Jill; Zerden, Lisa de Saxe; Clark, Katie; Castillo, Tessie; Childs, Robert

    2015-01-01

    Background North Carolina, like much of the U.S. South, is disproportionately affected by HIV and hepatitis. This persistently high disease burden may be driven in part by laws that criminalize the possession and distribution of syringes for illicit drug use. Legal change to decriminalize syringes may reduce infection rates in the state, but is unlikely absent support from law enforcement actors. Methods We analyzed the responses of 350 North Carolina law enforcement officers to a confidential, anonymous survey. The survey instrument collected data regarding self-reported needle-stick injury (NSI), blood borne disease risk perception and attitudes toward syringe decriminalization. Results 82% of respondents reported that contracting HIV was a “big concern” for them. 3.8% of respondents reported ever receiving a job-related NSI, a rate of 36 NSI per 10,000 officer-years. Majorities of respondents reported positive views regarding syringe decriminalization, with approximately 63% agreeing that it would be “good for the community” and 60% agreeing that it would be “good for law enforcement.” Black and female officers were significantly less likely to agree that on-the-job NSI was a “big concern” and significantly more likely to agree that it would be good for law enforcement. Conclusions These findings suggest that many North Carolina LEOs understand the public health benefits of syringe access programs and may be inclined to support syringe decriminalization legislation. Further research is indicated to determine the causes of observed differences in perceptions of bloodborne disease risk and attitudes toward syringe decriminalization by race and sex. PMID:25193720

  4. Syringe shape and positioning relative to efficiency volume inside dose calibrators and its role in nuclear medicine quality assurance programs

    International Nuclear Information System (INIS)

    Santos, J.A.M.; Carrasco, M.F.; Lencart, J.; Bastos, A.L.

    2009-01-01

    A careful analysis of geometry and source positioning influence in the activity measurement outcome of a nuclear medicine dose calibrator is presented for 99m Tc. The implementation of a quasi-point source apparent activity curve measurement is proposed for an accurate correction of the activity inside several syringes, and compared with a theoretical geometric efficiency model. Additionally, new geometrical parameters are proposed to test and verify the correct positioning of the syringes as part of acceptance testing and quality control procedures.

  5. AVLIS industrial access program

    International Nuclear Information System (INIS)

    1984-01-01

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

  6. AVLIS industrial access program

    Energy Technology Data Exchange (ETDEWEB)

    1984-11-15

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

  7. The association of syringe type and syringe cleaning with HCV infection among IDUs in Budapest, Hungary

    Science.gov (United States)

    Gyarmathy, V. Anna; Neaigus, Alan; Mitchell, Mary M.; Ujhelyi, Eszter

    2008-01-01

    We assessed whether syringe type, syringe cleaning and distributive syringe sharing were associated with self-reported and laboratory confirmed HCV infection among Hungarian IDUs. Injecting drug users (N=215) were recruited from non-treatment settings in Budapest, Hungary between October 2005 and December 2006. Multivariate logistic regression models identified correlates of self-report of being HCV infected and testing positive for HCV. While 37% tested positive for HCV, 14% of the total (39% of those who tested positive) self-reported being HCV infected. Using any two piece syringes was significantly associated with self-reported HCV infection, while distributive syringe sharing was not associated with self-report of being HCV infected. Engaging in receptive sharing of only one-piece syringes but always cleaning before reuse was not associated with testing HCV positive, while any receptive sharing of only one-piece syringes and not always cleaning before reuse was significantly associated with testing HCV positive. Sharing cookers and squirting drugs from one syringe into another syringe were not associated with testing HCV positive. The high percent of those HCV infected who did not know they were infected highlights the need to provide better access to confidential testing and counseling services. Counseling should emphasize secondary prevention of HCV among HCV infected IDUs. Our findings also indicate that syringe type and syringe cleaning practices may play a role in HCV transmission. Ethnographic research should identify the reasons why IDUs may use two-piece syringes and suggest means to reduce their use. Thorough cleaning of one-piece syringes when sterile syringes are unavailable may be an efficient way to reduce the risk of HCV infection. PMID:19058925

  8. The Washington Needle Depot: fitting healthcare to injection drug users rather than injection drug users to healthcare: moving from a syringe exchange to syringe distribution model

    Directory of Open Access Journals (Sweden)

    Glickman Andrea

    2010-01-01

    Full Text Available Abstract Needle exchange programs chase political as well as epidemiological dragons, carrying within them both implicit moral and political goals. In the exchange model of syringe distribution, injection drug users (IDUs must provide used needles in order to receive new needles. Distribution and retrieval are co-existent in the exchange model. Likewise, limitations on how many needles can be received at a time compel addicts to have multiple points of contact with professionals where the virtues of treatment and detox are impressed upon them. The centre of gravity for syringe distribution programs needs to shift from needle exchange to needle distribution, which provides unlimited access to syringes. This paper provides a case study of the Washington Needle Depot, a program operating under the syringe distribution model, showing that the distribution and retrieval of syringes can be separated with effective results. Further, the experience of IDUs is utilized, through paid employment, to provide a vulnerable population of people with clean syringes to prevent HIV and HCV.

  9. Syringe shape and positioning relative to efficiency volume inside dose calibrators and its role in nuclear medicine quality assurance programs

    Energy Technology Data Exchange (ETDEWEB)

    Santos, J.A.M. [Servico de Fisica Medica, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal); Centro de Investigacao, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal)], E-mail: a.miranda@portugalmail.pt; Carrasco, M.F. [Servico de Fisica Medica, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal); Centro de Investigacao, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal); Lencart, J. [Servico de Fisica Medica, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal); Bastos, A.L. [Servico de Medicina Nuclear, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal)

    2009-06-15

    A careful analysis of geometry and source positioning influence in the activity measurement outcome of a nuclear medicine dose calibrator is presented for {sup 99m}Tc. The implementation of a quasi-point source apparent activity curve measurement is proposed for an accurate correction of the activity inside several syringes, and compared with a theoretical geometric efficiency model. Additionally, new geometrical parameters are proposed to test and verify the correct positioning of the syringes as part of acceptance testing and quality control procedures.

  10. Syringe Decriminalization Advocacy in Red States: Lessons from the North Carolina Harm Reduction Coalition.

    Science.gov (United States)

    Cloud, David H; Castillo, Tessie; Brinkley-Rubinstein, Lauren; Dubey, Manisha; Childs, Robert

    2018-05-08

    Syringe access programs (SAPs) are cornerstone harm reduction interventions for combatting the national opioid epidemic. The goal of this paper is to describe effective advocacy strategies for enacting syringe decriminalization legislation to foster the expansion of SAPs in high-need areas amidst political opposition. Decades or research shows that SAPs prevent the transmission of HIV among people who inject drugs (PWID) and are a cost-effective tool for linking PWID to medical care, health education, and social services. In the USA, state laws criminalizing distribution and possession of syringes impede the expansion of SAPs into areas where they are sorely needed. In 2016, North Carolina became the first state to legalize SAPs with a Republican super majority. This paper distills strategies for community organizations seeking to advance syringe decriminalization legislation in politically conservative states with histories of prioritizing punitive sanctions over public health responses to drug use.

  11. Awareness of pre-exposure prophylaxis (PrEP) among women who inject drugs in NYC: the importance of networks and syringe exchange programs for HIV prevention.

    Science.gov (United States)

    Walters, Suzan M; Reilly, Kathleen H; Neaigus, Alan; Braunstein, Sarah

    2017-06-29

    Women who inject drugs (WWID) are at heightened risk for HIV due to biological, behavioral, and structural factors. Pre-exposure prophylaxis (PrEP) could aid in HIV prevention for WWID. However, little is known about WWID awareness of PrEP, which is a necessary step that must occur before PrEP uptake. We report factors associated with greater awareness among WWID to identify efficient means of awareness dissemination. Data from the 2015 National HIV Behavioral Surveillance (NHBS) system cycle on injection drug use collected in New York City (NYC) were used. Bivariable analyses, using chi-squared statistics, were conducted to examine correlates of awareness of PrEP with socio-demographic, behavioral, and health care variables. Multivariable logistic regression was used to estimate adjusted associations and determine differences in awareness of PrEP. The analysis consisted of 118 WWID. Awareness of PrEP was relatively low (31%), and risk factors were high. In the last 12 months, almost two thirds (65%) reported condomless sex, approximately one third (31%) reported transactional sex, and one third (32%) reported sharing injection equipment. In multivariable logistic regression, increased PrEP awareness was associated with reported transactional sex (AOR 3.32, 95% CI 1.22-9.00) and having a conversation about HIV prevention at a syringe exchange program (SEP) (AOR 7.61, 95% CI 2.65-21.84). We did not find race, education, household income, age, binge drinking, or sexual identity to be significantly associated with PrEP awareness. Large proportions of WWID were unaware of PrEP. These findings suggest that social networks (specifically sex work and SEP networks) are an efficient means for disseminating messaging about prevention materials such as PrEP. We recommend that SEP access increase, SEP processes be adopted in other health care settings, and WWID networks be utilized to increase PrEP awareness.

  12. Predicting pharmacy syringe sales to people who inject drugs: Policy, practice and perceptions.

    Science.gov (United States)

    Meyerson, Beth E; Davis, Alissa; Agley, Jon D; Shannon, David J; Lawrence, Carrie A; Ryder, Priscilla T; Ritchie, Karleen; Gassman, Ruth

    2018-06-01

    Pharmacies have much to contribute to the health of people who inject drugs (PWID) and to community efforts in HIV and hepatitis C (HCV) prevention through syringe access. However, little is known about what predicts pharmacy syringe sales without a prescription. To identify factors predicting pharmacy syringes sales to PWID. A hybrid staggered online survey of 298 Indiana community pharmacists occurred from July-September 2016 measuring pharmacy policy, practice, and pharmacist perceptions about syringe sales to PWID. Separate bivariate logistical regressions were followed by multivariable logistic regression to predict pharmacy syringe sales and pharmacist comfort dispensing syringes to PWID. Half (50.5%) of Indiana pharmacies sold syringes without a prescription to PWID. Pharmacy syringe sales was strongly associated with pharmacist supportive beliefs about syringe access by PWID and their comfort level selling syringes to PWID. Notably, pharmacies located in communities with high rates of opioid overdose mortality were 56% less likely to sell syringes without a prescription than those in communities with lower rates. Pharmacist comfort dispensing syringes was associated with being male, working at a pharmacy that sold syringes to PWID and one that stocked naloxone, having been asked about syringe access by medical providers, and agreement that PWID should be able to buy syringes without a prescription. As communities with high rates of opioid overdose mortality were less likely to have pharmacies that dispensed syringes to PWID, a concerted effort with these communities and their pharmacies should be made to understand opportunities to increase syringe access. Future studies should explore nuances between theoretical support for syringe access by PWID without a prescription and actual dispensing behaviors. Addressing potential policy conflicts and offering continuing education on non-prescription syringe distribution for pharmacists may improve comfort

  13. High coverage needle/syringe programs for people who inject drugs in low and middle income countries: a systematic review

    Directory of Open Access Journals (Sweden)

    Des Jarlais Don C

    2013-01-01

    Full Text Available Abstract Background Persons who inject drugs (PWID are at an elevated risk for human immunodeficiency virus (HIV and hepatitis C virus (HCV infection. In many high-income countries, needle and syringe exchange programs (NSP have been associated with reductions in blood-borne infections. However, we do not have a good understanding of the effectiveness of NSP in low/middle-income and transitional-economy countries. Methods A systematic literature review based on PRISMA guidelines was utilized to collect primary study data on coverage of NSP programs and changes in HIV and HCV infection over time among PWID in low-and middle-income and transitional countries (LMICs. Included studies reported laboratory measures of either HIV or HCV and at least 50% coverage of the local injecting population (through direct use or through secondary exchange. We also included national reports on newly reported HIV cases for countries that had national level data for PWID in conjunction with NSP scale-up and implementation. Results Studies of 11 NSPs with high-coverage from Bangladesh, Brazil, China, Estonia, Iran, Lithuania, Taiwan, Thailand and Vietnam were included in the review. In five studies HIV prevalence decreased (range −3% to −15% and in three studies HCV prevalence decreased (range −4.2% to −10.2%. In two studies HIV prevalence increased (range +5.6% to +14.8%. HCV incidence remained stable in one study. Of the four national reports of newly reported HIV cases, three reported decreases during NSP expansion, ranging from −30% to −93.3%, while one national report documented an increase in cases (+37.6%. Estimated incidence among new injectors decreased in three studies, with reductions ranging from −11/100 person years at risk to −16/100 person years at risk. Conclusions While not fully consistent, the data generally support the effectiveness of NSP in reducing HIV and HCV infection in low/middle-income and transitional-economy countries. If

  14. Do your syringes count?

    International Nuclear Information System (INIS)

    Brewster, K.

    2002-01-01

    Full text: This study was designed to investigate anecdotal evidence that residual Sestamibi (MIBI) activity vaned in certain situations. For rest studies different brands of syringes were tested to see if the residuals varied. The period of time MIBI doses remained in the syringe between dispensing and injection was also considered as a possible source of increased residual counts. Stress Mibi syringe residual activities were measured to assess if the method of stress test affected residual activity. MIBI was reconstituted using 13 Gbq of Technetium in 3mls of normal saline then boiled for 10 minutes. Doses were dispensed according to department protocol and injected via cannula. Residual syringes were collected for three syringe types. In each case the barrel and plunger were measured separately. As the syringe is flushed during the exercise stress test and not the pharmacological stress test the chosen method was recorded. No relationship was demonstrated between the time MIBI remained in a syringe prior to injection and residual activity. Residual activity was not affected by method of stress test used. Actual injected activity can be calculated if the amount of activity remaining in the syringe post injection is known. Imaging time can be adjusted for residual activity to optimise count statistics. Preliminary results in this study indicate there is no difference in residual activity between syringe brands.Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  15. 77 FR 66052 - Program Access Rules

    Science.gov (United States)

    2012-10-31

    ... delivered, cable-affiliated RSNs in the 2010 Program Access Order. 3. With respect to the first element (the... exclusive contract involving a cable-affiliated RSN is an ``unfair act.'' In the 2010 Program Access Order... Agreements 18. ACA also urges the Commission to revise the program access rules to prohibit cable-affiliated...

  16. Randomized, community-based pharmacy intervention to expand services beyond sale of sterile syringes to injection drug users in pharmacies in New York City.

    Science.gov (United States)

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

    2013-09-01

    Structural interventions may help reduce racial/ethnic disparities in HIV. In 2009 to 2011, we randomized pharmacies participating in a nonprescription syringe access program in minority communities to intervention (pharmacy enrolled and delivered HIV risk reduction information to injection drug users [IDUs]), primary control (pharmacy only enrolled IDUs), and secondary control (pharmacy did not engage IDUs). Intervention pharmacy staff reported more support for syringe sales than did control staff. An expanded pharmacy role in HIV risk reduction may be helpful.

  17. A Multi-Center Randomized Controlled Trial of Adding Brief Skill-Based Psychoeducation to Primary Needle and Syringe Programs to prevent Human Immunodeficiency Virus: Study Protocol.

    Directory of Open Access Journals (Sweden)

    Morteza Naserbakht

    2014-09-01

    Full Text Available Our objective was to design an RCT in order to assess the effects of adding a brief skill-based psychoeducation (PE to routine Needle and Syringe Programs to reduce injection and high risk sexual behaviors associated with Human Immunodeficiency Virus (HIV infection among referrals of Drop-in Centers (DICs.This was a randomized control trial with the primary hypothesis that adding skill-based PE to the routine needle syringe program (NSP provided in the DICs would be more effective in reducing injection and high risk sexual behaviors associated with HIV infection compared to the routine programs. We intended to randomly allocate 60 patients per group after obtaining informed written consent,. The intervention group receive a combination of brief psychoeducation consisting two individual sessions of skill-based education concerning blood borne viral infection, specifically HIV. The control group received the routine primary NSP services provided in DIC. Study assessments were undertaken by a psychologist at baseline, 1 and 3 months after recruitment. The primary outcome measure was the comparison of the trend of alterations in high risk sexual and injection behaviors associated with HIV infection during 3 months after the initiation of the intervention between the two groups. Secondary outcome measures included the comparison of HIV/AIDS related knowledge and client satisfaction in the participants.This paper presents a protocol for an RCT of brief skill-based PE by a trained psychologist to reduce the sexual and injection related high risk behaviors among drug users who received primary NSP services in DIC. This trial tried to investigate the efficacy of the intervention on increasing HIV/AIDS related knowledge and client satisfaction. The results of different indicators of high risk behaviors will be discussed.

  18. Community syringe collection and disposal policies in 16 states.

    Science.gov (United States)

    Turnberg, Wayne L; Jones, T Stephen

    2002-01-01

    To review laws, regulations, and guidelines that affect the collection and disposal of hypodermic needles, syringes, and lancets used outside of professional health care settings (hereafter referred to as "community syringes"). Law and policy analysis. Alabama, California, Florida, Georgia, Hawaii, Massachusetts, Michigan, Minnesota, New Jersey, New York, Ohio, Oregon, Rhode Island, South Carolina, Washington, and Wisconsin. Information on syringe collection and disposal in the community was gathered from federal and state records and state agency personnel. Legally permissible means of syringe collection and disposal available to persons in the community injecting medical treatments and injection drug users. Laws, regulations, or guidelines in 13 states allowed community syringes to be legally discarded in household trash; guidelines for in-trash disposal varied among the states. Only 6 states had laws or regulations that specifically addressed community syringe collection. In 10 states, infectious waste laws and regulations that apply to medical facilities such as clinics would also apply to community syringe collection sites. In the 16 states studied, laws, regulations, and guidelines relating to community syringe collection and disposal were somewhat inconsistent and confusing and presented potential barriers to safe disposal. States should consider amending laws, regulations, and guidelines to promote community syringe collection programs. A national effort is needed to achieve consistent community syringe collection and disposal laws and guidelines for all states. Pharmacists can aid in safe syringe disposal by counseling their patients about safe disposal, providing or selling sharps containers, and accepting used syringes for safe disposal. Pharmacists can join other interested groups in advocating clarification of disposal laws and regulations that favor community programs designed to keep syringes out of the trash so that they can be disposed of as

  19. Charter Halibut Limited Access Program

    Data.gov (United States)

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

  20. Barriers and Potential Improvements for Needle and Syringe Exchange Programs (NSPs in China: A Qualitative Study from Perspectives of Both Health and Public Security Sectors.

    Directory of Open Access Journals (Sweden)

    Fung Kuen Koo

    Full Text Available This study explores the acceptability, the barriers to the implementation of needle and syringe exchange programs (NSPs and the potential improvement strategies in China from the perspectives of governmental health and public security officials. Purposive sampling was used for recruitment of participants who had been involved in NSPs implementation. Semi-Structured individual interviews were conducted in Mandarin to address three aspects of NSPs: (1 participants' attitudes towards NSPs, (2 participants' opinions on the effectiveness and barriers of NSPs, and (3 suggestions for improving the program. Content analysis was used to analyse the translated interview data. A total of 68 participants from 12 Hunan counties were interviewed (34 from each of the Bureau of Health and the Narcotic Division. Both groups recognised the importance and effectiveness of NSPs in HIV prevention, but public security officials regarded NSPs as a temporary intervention in place of punitive measures. Most health officials (32/34 regarded the main barriers to its implementation as administrative and structural, whereas participants from Narcotics Division (n=24 questioned the legitimacy of NSPs and concerned about the poor management of drug users' risk behaviours. Close cooperation between the health and public security sectors, engagement of the drug user community and an enabling policy environment were reportedly to be critical for potential improvements of NSPs in China. Misconceptions about NSPs encourage drug users' addictive behaviour, and an unclear leadership and insufficient support de-motivate the participants from the Bureau of Health and the Narcotics Division to actively support the program implementation.

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

    Data.gov (United States)

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

  2. Ocean Drilling Program: Web Site Access Statistics

    Science.gov (United States)

    web site ODP/TAMU Science Operator Home Ocean Drilling Program Web Site Access Statistics* Overview See statistics for JOIDES members. See statistics for Janus database. 1997 October November December

  3. Legal syringe purchases by injection drug users, Brooklyn and Queens, New York City, 2000-2001.

    Science.gov (United States)

    Des Jarlais, Don C; McKnight, Courtney; Friedmann, Patricia

    2002-01-01

    To assess preliminary results of the Expanded Syringe Access Demonstration Program (ESAP) in New York City. Temporal trends of pharmacy use among injection drug users (IDUs) in Brooklyn and Queens were analyzed from December 2000 through December 2001. Brooklyn and Queens, New York City. PARTIPANTS: IDUs. Attempts to purchase syringes from pharmacies and success in doing so. Of the 1,072 IDUs interviewed from December 2000 through December 2001, the majority were daily heroin injectors, but there was also substantial speedball and cocaine injection. There was a clear increase over time in both the percentage of subjects who attempted to purchase syringes in pharmacies and in the percentage who successfully purchased syringes. Among IDUs interviewed 4 or more months after ESAP began, large majorities of those who attempted to purchase syringes were successful in doing so. No differences in use of ESAP by IDUs were identified in Brooklyn versus Queens: 27% of IDUs interviewed in Queens reported that they had attempted to purchase syringes in pharmacies versus 28% in Brooklyn. Persons who reported injecting on a daily or more frequent basis were more likely to have attempted pharmacy purchases than persons who reported injecting less frequently, 32% versus 21%. The ESAP program has led to an increase in the use of pharmacies as sources of sterile injection equipment among IDUs in New York City. The extent to which pharmacies become an important source of sterile injection equipment and the effect of legal pharmacy sales on risk behaviors for human immunodeficiency virus (HIV) infection remain to be determined.

  4. Over-the-counter but out of reach: a pharmacy-based survey of OTC syringe sales in Tijuana, Mexico.

    Science.gov (United States)

    Pollini, Robin A; Gallardo, Manuel; Ruiz, Serena; Case, Patricia; Zaller, Nickolas; Lozada, Remedios

    2014-05-01

    Sterile syringe access is critical to HIV prevention efforts targeting injection drug users (IDUs) but some pharmacies do not sell syringes over-the-counter (OTC) even where such sales are legal. We conducted a pharmacy survey in Tijuana, Mexico (where OTC sales are legal) to characterize attitudes toward syringe sales and to explore support for expanding pharmacy-based HIV prevention efforts. Of 203 respondents, 28% supported OTC syringe sales to IDUs and 74% said their pharmacy required a prescription for at least some syringe sales. Support for OTC syringe sales was independently associated with selling OTC syringes, understanding the role of sterile syringes in HIV prevention, and recognizing pharmacies as an important health resource for IDUs. Most respondents supported an expanded role for pharmacies in HIV prevention, exclusive of OTC syringe sales. Our study provides information for developing interventions to promote OTC syringe sales and expanding pharmacy-based distribution of HIV-related information and resources.

  5. Syringe injectable electronics

    Science.gov (United States)

    Hong, Guosong; Zhou, Tao; Jin, Lihua; Duvvuri, Madhavi; Jiang, Zhe; Kruskal, Peter; Xie, Chong; Suo, Zhigang; Fang, Ying; Lieber, Charles M.

    2015-01-01

    Seamless and minimally-invasive three-dimensional (3D) interpenetration of electronics within artificial or natural structures could allow for continuous monitoring and manipulation of their properties. Flexible electronics provide a means for conforming electronics to non-planar surfaces, yet targeted delivery of flexible electronics to internal regions remains difficult. Here, we overcome this challenge by demonstrating syringe injection and subsequent unfolding of submicrometer-thick, centimeter-scale macroporous mesh electronics through needles with a diameter as small as 100 micrometers. Our results show that electronic components can be injected into man-made and biological cavities, as well as dense gels and tissue, with > 90% device yield. We demonstrate several applications of syringe injectable electronics as a general approach for interpenetrating flexible electronics with 3D structures, including (i) monitoring of internal mechanical strains in polymer cavities, (ii) tight integration and low chronic immunoreactivity with several distinct regions of the brain, and (iii) in vivo multiplexed neural recording. Moreover, syringe injection enables delivery of flexible electronics through a rigid shell, delivery of large volume flexible electronics that can fill internal cavities and co-injection of electronics with other materials into host structures, opening up unique applications for flexible electronics. PMID:26053995

  6. Syringe-injectable electronics.

    Science.gov (United States)

    Liu, Jia; Fu, Tian-Ming; Cheng, Zengguang; Hong, Guosong; Zhou, Tao; Jin, Lihua; Duvvuri, Madhavi; Jiang, Zhe; Kruskal, Peter; Xie, Chong; Suo, Zhigang; Fang, Ying; Lieber, Charles M

    2015-07-01

    Seamless and minimally invasive three-dimensional interpenetration of electronics within artificial or natural structures could allow for continuous monitoring and manipulation of their properties. Flexible electronics provide a means for conforming electronics to non-planar surfaces, yet targeted delivery of flexible electronics to internal regions remains difficult. Here, we overcome this challenge by demonstrating the syringe injection (and subsequent unfolding) of sub-micrometre-thick, centimetre-scale macroporous mesh electronics through needles with a diameter as small as 100 μm. Our results show that electronic components can be injected into man-made and biological cavities, as well as dense gels and tissue, with >90% device yield. We demonstrate several applications of syringe-injectable electronics as a general approach for interpenetrating flexible electronics with three-dimensional structures, including (1) monitoring internal mechanical strains in polymer cavities, (2) tight integration and low chronic immunoreactivity with several distinct regions of the brain, and (3) in vivo multiplexed neural recording. Moreover, syringe injection enables the delivery of flexible electronics through a rigid shell, the delivery of large-volume flexible electronics that can fill internal cavities, and co-injection of electronics with other materials into host structures, opening up unique applications for flexible electronics.

  7. Options for reducing HIV transmission related to the dead space in needles and syringes.

    Science.gov (United States)

    Zule, William A; Pande, Poonam G; Otiashvili, David; Bobashev, Georgiy V; Friedman, Samuel R; Gyarmathy, V Anna; Des Jarlais, Don C

    2018-01-15

    When shared by people who inject drugs, needles and syringes with different dead space may affect the probability of HIV and hepatitis C virus (HCV) transmission differently. We measured dead space in 56 needle and syringe combinations obtained from needle and syringe programs across 17 countries in Europe and Asia. We also calculated the amounts of blood and HIV that would remain in different combinations following injection and rinsing. Syringe barrel capacities ranged from 0.5 to 20 mL. Needles ranged in length from 8 to 38 mm. The average dead space was 3 μL in low dead space syringes with permanently attached needles, 13 μL in high dead space syringes with low dead space needles, 45 μL in low dead space syringes with high dead space needles, and 99 μL in high dead space syringes with high dead space needles. Among low dead space designs, calculated volumes of blood and HIV viral burden were lowest for low dead space syringes with permanently attached needles and highest for low dead space syringes with high dead space needles. The dead space in different low dead space needle and syringe combinations varied substantially. To reduce HIV transmission related to syringe sharing, needle and syringe programs need to combine this knowledge with the needs of their clients.

  8. The impact of harm reduction programs and police interventions on the number of syringes collected from public spaces. A time series analysis in Barcelona, 2004-2014.

    Science.gov (United States)

    Espelt, A; Villalbí, J R; Bosque-Prous, M; Parés-Badell, O; Mari-Dell'Olmo, M; Brugal, M T

    2017-12-01

    To estimate the effect of opening two services for people who use drugs and three police interventions on the number of discarded syringes collected from public spaces in Barcelona between 2004 and 2014. We conducted an interrupted time-series analysis of the monthly number of syringes collected from public spaces during this period. The dependent variable was the number of syringes collected per month. The main independent variables were month and five dummy variables (the opening of two facilities with safe consumption rooms, and three police interventions). To examine which interventions affected the number of syringes collected, we performed an interrupted time-series analysis using a quasi-Poisson regression model, obtaining relative risks (RR) and 95% confidence intervals (CIs). The number of syringes collected per month in Barcelona decreased from 13,800 in 2004 to 1655 in 2014 after several interventions. For example, following the closure of an open drug scene in District A of the city, we observed a decreasing trend in the number of syringes collected [RR=0.88 (95% CI: 0.82-0.95)], but an increasing trend in the remaining districts [RR=1.11 (95% CI: 1.05-1.17) and 1.08 (95% CI: 0.99-1.18) for districts B and C, respectively]. Following the opening of a harm reduction facility in District C, we observed an initial increase in the number collected in this district [RR=2.72 (95% CI: 1.57-4.71)] and stabilization of the trend thereafter [RR=0.97 (95% CI: 0.91-1.03)]. The overall number of discarded syringes collected from public spaces has decreased consistently in parallel with a combination of police interventions and the opening of harm reduction facilities. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Aquagenic syringeal acrokeratoderma

    Directory of Open Access Journals (Sweden)

    Belkiz Uyar

    2014-01-01

    Full Text Available Aquagenic syringeal acrokeratoderma is a rare, transient, and usually bilaterally symmetric, palmoplantar keratoderma. Patients complain of tingling and pain in the hands starting a few minutes after exposure to water and lasting for 20-30 minutes after removal. Clinically, there is marked wrinkling with edematous white papules on the palms or, less often, the soles. We present the case of a 21-year-old woman who used spironolactone for polycystic ovary syndrome and had similar clinical features 2 weeks later, after withdrawing the drug.

  10. The Association Between Law Enforcement Encounters and Syringe Sharing Among IDUs on Skid Row: A Mixed Methods Analysis

    Science.gov (United States)

    Simon-Freeman, Rebecca; Bluthenthal, Ricky N.

    2013-01-01

    The legal environment is one factor that influences injection drug users' (IDUs) risk for HIV and other bloodborne pathogens such as hepatitis C virus (HCV). We examined the association between law enforcement encounters (i.e., arrests and citations) and receptive syringe sharing among IDUs in the context of an intensified policing effort. We conducted a mixed methods analysis of 30 qualitative and 187 quantitative interviews with IDUs accessing services at a Los Angeles, CA syringe exchange program from 2008 to 2009. Qualitative findings illustrate concerns related to visibility, drug withdrawal, and previous history of arrest/incarceration. In quantitative analysis, the number of citations received, current homelessness, and perceiving that being arrested would be a “big problem” were independently associated with recent syringe sharing. Findings illustrate some of the unintended public health consequences associated with intensified street-level policing, including risk for HIV and HCV transmission. PMID:23620243

  11. Programming and Technology for Accessibility in Geoscience

    Science.gov (United States)

    Sevre, E.; Lee, S.

    2013-12-01

    Many people, students and professors alike, shy away from learning to program because it is often believed to be something scary or unattainable. However, integration of programming into geoscience education can be a valuable tool for increasing the accessibility of content for all who are interested. It is my goal to dispel these myths and convince people that: 1) Students with disabilities can use programming to increase their role in the classroom, 2) Everyone can learn to write programs to simplify daily tasks, 3) With a deep understanding of the task, anyone can write a program to do a complex task, 4) Technology can be combined with programming to create an inclusive environment for all students of geoscience, and 5) More advanced knowledge of programming and technology can lead geoscientists to create software to serve as assistive technology in the classroom. It is my goal to share my experiences using technology to enhance the classroom experience as a way of addressing the aforementioned issues. Through my experience, I have found that programming skills can be included and learned by all to enhance the content of courses without detracting from curriculum. I hope that, through this knowledge, geoscience courses can become more accessible for people with disabilities by including programming and technology to the benefit of all involved.

  12. The effectiveness and safety of syringe vending machines as a component of needle syringe programmes in community settings.

    Science.gov (United States)

    Islam, Mofizul; Wodak, Alex; Conigrave, Katherine M

    2008-12-01

    Syringe vending machines (SVMs) have been introduced in Europe and Australasia as part of the effort to increase the availability of sterile needles and syringes to injecting drug users (IDUs). This qualitative review of 14 published and grey literature studies examines whether community-based SVMs as a component of a comprehensive needle syringe programme (NSP) assist to reduce the spread of HIV and other blood-borne viruses amongst IDUs. The available evidence suggests that SVMs increase access to sterile injecting equipment, reduce needle and syringe sharing, and are likely to be cost efficient. SVMs also complement other modes of NSP delivery as they are used by IDUs who are less likely to attend staffed NSPs or pharmacies. If installed and properly maintained in a well-chosen location and with the local community well prepared, SVMs can enhance the temporal and geographical availability of sterile injecting equipment.

  13. Gas ampoule-syringe

    International Nuclear Information System (INIS)

    Gay, D.D.

    1986-01-01

    This patent describes disposable gas ampoule holding or containing a gas such as a radioactive gas, comprising: (a) a cylindrical glass tube which is adapted to hold the gas; (b) a layer of absorbent material which circumscribes and which contacts cylindrical glass tube (a) which absorbs the gas; (c) a plastic tube, which circumscribes and contacts absorbent material layer (b) and which is externally threaded on each of its end portions; (d) a cap, which is threaded onto a first end of plastic tube (c); (e) a cylindrical block, which is positioned in the first end of cylindrical glass tube (a) adjacent to cap (d), which contacts cylindrical glass tube (a), which is composed of a foamed material and which is impregnated with a gas adsorbent material; (f) a cylindrical plunger tip, which is located in the first end of cylindrical glass tube (a) in a gas-tight manner adjacent to cylindrical block (e); (g) an end stopper, which has a central cylindrical shaft that is positioned in the second end of cylindrical glass tube (a); and (h) a cap, which is threaded onto the second end of plastic tube (e). A combination of the disposable gas ampoule and syringe adapted to operably interface with the gas ampoule is also described

  14. Stellar Atmospheric Modelling for the ACCESS Program

    Science.gov (United States)

    Morris, Matthew; Kaiser, Mary Elizabeth; Bohlin, Ralph; Kurucz, Robert; ACCESS Team

    2018-01-01

    A goal of the ACCESS program (Absolute Color Calibration Experiment for Standard Stars) is to enable greater discrimination between theoretical astrophysical models and observations, where the comparison is limited by systematic errors associated with the relative flux calibration of the targets. To achieve these goals, ACCESS has been designed as a sub-orbital rocket borne payload and ground calibration program, to establish absolute flux calibration of stellar targets at flight candidates, as well as a selection of A and G stars from the CALSPEC database. Stellar atmosphere models were generated using Atlas 9 and Atlas 12 Kurucz stellar atmosphere software. The effective temperature, log(g), metallicity, and redenning were varied and the chi-squared statistic was minimized to obtain a best-fit model. A comparison of these models and the results from interpolation between grids of existing models will be presented. The impact of the flexibility of the Atlas 12 input parameters (e.g. solar metallicity fraction, abundances, microturbulent velocity) is being explored.

  15. 49 CFR 28.149 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Program accessibility: Discrimination prohibited... § 28.149 Program accessibility: Discrimination prohibited. Except as otherwise provided in § 28.150, no... otherwise be subjected to discrimination under any program or activity conducted by the Department. ...

  16. 32 CFR 1699.149 - Program accessibility: discrimination prohibited.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Program accessibility: discrimination prohibited... CONDUCTED BY SELECTIVE SERVICE SYSTEM § 1699.149 Program accessibility: discrimination prohibited. Except as... participation in, or otherwise be subject to discrimination under any program or activity conducted by the...

  17. The pneumatic syringe: a simple apparatus for self-administration of drugs by rats.

    Science.gov (United States)

    Weeks, J R

    1977-12-01

    Drug solution is delivered by a syringe operated by a pneumatic cylinder. Recommended delivery volumes are from 10 to 200 microliter. A solid-state control unit is described which can operate two syringes (drug injection and flush), has outputs for recording responses and injections, and can be programmed to provide several schedules of reinforcement. All components are readily commercially available.

  18. 45 CFR 2490.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

  19. IDA: An Intelligent Data Access Program

    National Research Council Canada - National Science Library

    Sagalowicz, Daniel

    1977-01-01

    .... The first component of LADDER is INLAND (Informal Natural Language Access to Navy Data), which allows the user to ask questions in English about information contained in databases similar to those currently...

  20. An Analysis of Naval Officer Accession Programs

    National Research Council Canada - National Science Library

    Lehner, William D

    2008-01-01

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

  1. 77 FR 6113 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

    Science.gov (United States)

    2012-02-07

    ... FEDERAL COMMUNICATIONS COMMISSION [DA 12-15] Video Programming and Accessibility Advisory.... SUMMARY: This document announces the next meeting of the Video Programming Accessibility Advisory... Commission regarding the provision of video description, access to emergency programming, and access to user...

  2. Nonprescription naloxone and syringe sales in the midst of opioid overdose and hepatitis C virus epidemics: Massachusetts, 2015.

    Science.gov (United States)

    Stopka, Thomas J; Donahue, Ashley; Hutcheson, Marguerite; Green, Traci C

    To determine the prevalence of nonprescription naloxone and sterile syringe sales, factors associated with nonprescription sales, geospatial access to nonprescription naloxone and syringe-selling pharmacies, and targets for potential interventions. Cross-sectional study. Massachusetts has experienced steep increases in reported opioid overdoses and hepatitis C virus cases in the past decade. Pharmacists have the potential to play a substantial role in increasing access to nonprescription naloxone and sterile syringes, which can reverse opioid overdoses and decrease hepatitis C virus transmission, respectively. We completed brief telephone surveys with 809 of 1042 retail pharmacies across Massachusetts (response rate = 77.6%) during 2015 to assess experience with nonprescription sales of naloxone and sterile syringes. Our primary outcomes were the stocking and selling of naloxone in the pharmacy (yes or no) for nonprescription sales and nonprescription syringe sales (yes or no). We conducted multivariable regression analyses and created maps using a geographic information system to identify factors associated with nonprescription sales of naloxone and sterile syringes, and to improve our understanding of geospatial access to pharmacy-based naloxone and syringe sales. More than 97% of pharmacies reported selling sterile syringes without requiring a prescription, and 45% of pharmacies reported stocking and selling naloxone. Factors associated with nonprescription sales included hours of operation, experience with and interest in harm reduction activities, and presence in an opioid overdose hotspot. Geographic access to nonprescription sale of sterile syringes is widespread, whereas geospatial access to naloxone is limited. Training to understand the benefits, applications, and distribution needs of naloxone is of interest to surveyed pharmacists. Access to sterile syringes through nonprescription sales is strong across Massachusetts, and although more than 350

  3. Large volume syringe pump extruder for desktop 3D printers

    Directory of Open Access Journals (Sweden)

    Kira Pusch

    2018-04-01

    Full Text Available Syringe pump extruders are required for a wide range of 3D printing applications, including bioprinting, embedded printing, and food printing. However, the mass of the syringe becomes a major challenge for most printing platforms, requiring compromises in speed, resolution and/or volume. To address these issues, we have designed a syringe pump large volume extruder (LVE that is compatible with low-cost, open source 3D printers, and herein demonstrate its performance on a PrintrBot Simple Metal. Key aspects of the LVE include: (1 it is open source and compatible with open source hardware and software, making it inexpensive and widely accessible to the 3D printing community, (2 it utilizes a standard 60 mL syringe as its ink reservoir, effectively increasing print volume of the average bioprinter, (3 it is capable of retraction and high speed movements, and (4 it can print fluids using nozzle diameters as small as 100 μm, enabling the printing of complex shapes/objects when used in conjunction with the freeform reversible embedding of suspended hydrogels (FRESH 3D printing method. Printing performance of the LVE is demonstrated by utilizing alginate as a model biomaterial ink to fabricate parametric CAD models and standard calibration objects. Keywords: Additive manufacturing, 3D bioprinting, Embedded printing, FRESH, Soft materials extrusion

  4. 77 FR 24301 - Revision of the Commission's Program Access Rules

    Science.gov (United States)

    2012-04-23

    ... afforded to multichannel video programming distributors by the program access rules--the prohibition on exclusive contracts involving satellite- delivered, cable-affiliated programming. The current exclusive... sections 4(i), 303(r), 616, and 628 of the Communications Act of 1934, as amended. Total Annual Burden: 43...

  5. 75 FR 34941 - Review of the Commission's Program Access Rules and Examination of Programming Tying Arrangements

    Science.gov (United States)

    2010-06-21

    ... Commission's Program Access Rules and Examination of Programming Tying Arrangements AGENCY: Federal... Program Access Rules and Examination of Programming Tying Arrangements, MB Docket No. 07-198, FCC 10-17... information collection is contained in Sections 4(i), 303(r), and 628 of the Communications Act of 1934, as...

  6. An Analysis of Naval Officer Accession Programs

    National Research Council Canada - National Science Library

    Lehner, William D

    2008-01-01

    This thesis conducts an extensive literature review of prior studies on the three major commissioning programs for United States naval officers the United States Naval Academy, Naval Reserve Officers...

  7. The development of accessibility indicators for distance learning programs

    Directory of Open Access Journals (Sweden)

    Sheryl Burgstahler

    2006-12-01

    Full Text Available A study was undertaken to explore program policies and practices related to the accessibility of American distance learning courses to qualified students with disabilities. A literature review was conducted, a draft list of accessibility indicators was created, examples of applications of the indicators in existing distance learning programs were collected, the indicators were systematically applied to one distance learning program, input from a variety of distance learning programs was used to further refine the indicators, and these programs were encouraged to adopt the indicators and make use of resources provided by the project. Results of this exploratory work suggest that incorporating accessibility considerations into policies, procedures and communications of a program requires consideration of the unique needs of students, course designers, instructors and evaluators; involves approval and implementation at a variety of administrative levels; and is an ongoing process that may be implemented in incremental steps.

  8. Technological Innovation and Cooperation for Foreign Information Access Program

    Science.gov (United States)

    Office of Postsecondary Education, US Department of Education, 2012

    2012-01-01

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

  9. Methods To Determine the Silicone Oil Layer Thickness in Sprayed-On Siliconized Syringes.

    Science.gov (United States)

    Loosli, Viviane; Germershaus, Oliver; Steinberg, Henrik; Dreher, Sascha; Grauschopf, Ulla; Funke, Stefanie

    2018-01-01

    -term exposure and emptying did not significantly influence the silicone oil layer at the investigated silicone level. It thus appears reasonable to use this approach to characterize silicone oil layers in filled syringes over time. The developed method characterizes non-destructively the layer thickness and distribution of silicone oil in empty syringes and provides fast access to reliable results. The gained information can be further used to support optimization of siliconization processes and increase the understanding of syringe functionality. LAY ABSTRACT: Silicone oil layers as lubricant are required to ensure functionality of prefilled syringes. Methods evaluating these layers are limited, and systematic evaluation is missing. The aim of this study was to develop and assess white light interferometry as an analytical method to characterize sprayed-on silicone oil layers in 1 mL prefilled syringes. White light interferometry showed a good accuracy (93-99%) as well as instrument and analyst precision (0.5% and 4.1%, respectively). Different applied instrument parameters had no significant impact on the measured layer thickness. The obtained values from white light interferometry applying a fully developed method concurred with orthogonal results from 3D-laser scanning microscopy and combined white light and laser interferometry. The average layer thicknesses in two investigated syringe lots gradually decreased from 170-190 nm at the flange to 100-90 nm at the needle side. The silicone layers were homogeneously distributed over the syringe barrel circumference (110-135 nm) for both lots. Empty break-loose (4-4.5 N) and gliding forces (2-2.5 N) were comparably low for both analyzed syringe lots. Syringe filling with a surrogate solution, including short-term exposure and emptying, did not significantly affect the silicone oil layer. The developed, non-destructive method provided reliable results to characterize the silicone oil layer thickness and distribution in empty

  10. Extractables and leachables considerations for prefilled syringes.

    Science.gov (United States)

    Jenke, Dennis R

    2014-10-01

    Use of pre-filled syringes as both a packaging and delivery system for pharmaceutical drug products is accelerating. Pre-filled syringes must meet the quality and suitability for use requirements for both systems, including compatibility with the drug product. Relevant incompatibilities between pre-filled syringes and drug products include the safety of syringe-based leachables that accumulate in drug products and the ability of leachables to interact with the drug product's ingredients as such interactions can affect safety, efficacy, stability and physical viability. Relevant suitability considerations for pre-filled syringes are discussed herein and specific examples of suitability for use issues for pre-filled syringes are cited, focusing on extractables associated with pre-filled syringes and leachables derived from such syringes. Aspects considered include the toxicological impact of leachables, their ability to alter the efficacy of drug products and to produce other undesirable outcomes such as aggregation and immunogenic responses. Materials used in pre-filled syringes and the conditions of use minimize the traditional safety risk associated with leachables. However, drug products that use pre-filled syringes are prone to non-traditional interactions such as disruption of protein conformation, leading to potential efficacy, safety and quality issues. In order to qualify pre-filled syringes for use, the traditional approach of measuring extractables and leachables and inferring their effect must be augmented by rigorous compatibility testing. Research into the fundamental relationship between leachables and drug substances will be necessary so the more time- and cost-efficient 'measure and infer' approach can be widely implemented.

  11. 77 FR 66025 - Program Access Rules

    Science.gov (United States)

    2012-10-31

    ... distribution market if the prohibition were lifted.'' Accordingly, we rely on ``economic theory and predictive... incentive and the ability to harm competition and diversity in the distribution of video programming by entering into exclusive contracts. We undertake the same analysis here. Below, we consider the ``incentive...

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

    KAUST Repository

    Belli, Roberto; Hoefler, Torsten

    2015-01-01

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

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

    KAUST Repository

    Belli, Roberto

    2015-05-01

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

  14. 12 CFR 410.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Program accessibility: Existing facilities. 410.150 Section 410.150 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY EXPORT-IMPORT BANK OF THE UNITED...

  15. 12 CFR 410.149 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Program accessibility: Discrimination prohibited. 410.149 Section 410.149 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY EXPORT-IMPORT BANK OF THE UNITED...

  16. 49 CFR 28.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 28.150 Section 28.150 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION § 28...

  17. A novel IPTV program multiplex access system to EPON

    Science.gov (United States)

    Xu, Xian; Liu, Deming; He, Wei; Lu, Xi

    2007-11-01

    With the rapid development of high speed networks, such as Ethernet Passive Optical Network (EPON), traffic patterns in access networks have evolved from traditional text-oriented service to the mixed text-, voice- and video- based services, leading to so called "Triple Play". For supporting IPTV service in EPON access network infrastructure, in this article we propose a novel IPTV program multiplex access system to EPON, which enables multiple IPTV program source servers to seamlessly access to IPTV service access port of optical line terminal (OLT) in EPON. There are two multiplex schemes, namely static multiplex scheme and dynamic multiplex scheme, in implementing the program multiplexing. Static multiplex scheme is to multiplex all the IPTV programs and forward them to the OLT, regardless of the need of end-users. While dynamic multiplex scheme can dynamically multiplex and forward IPTV programs according to what the end-users actually demand and those watched by no end-user would not be multiplexed. By comparing these two schemes, a reduced traffic of EPON can be achieved by using dynamic multiplex scheme, especially when most end-users are watching the same few IPTV programs. Both schemes are implemented in our system, with their hardware and software designs described.

  18. Seroprevalence of HCV and HIV infection among clients of the nation's longest-standing statewide syringe exchange program: A cross-sectional study of Community Health Outreach Work to Prevent AIDS (CHOW).

    Science.gov (United States)

    Salek, Thomas P; Katz, Alan R; Lenze, Stacy M; Lusk, Heather M; Li, Dongmei; Des Jarlais, Don C

    2017-10-01

    The Community Health Outreach Work to Prevent AIDS (CHOW) Project is the first and longest-standing statewide integrated and funded needle and syringe exchange program (SEP) in the US. Initiated on O'ahu in 1990, CHOW expanded statewide in 1993. The purpose of this study is to estimate the prevalences of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection, and to characterize risk behaviors associated with infection among clients of a long-standing SEP through the analysis of the 2012 CHOW evaluation data. A cross-sectional sample of 130 CHOW Project clients was selected from January 1, 2012 through December 31, 2012. Questionnaires captured self-reported exposure information. HIV and HCV antibodies were detected via rapid, point-of-care FDA-approved tests. Log-binomial regressions were used to estimate prevalence proportion ratios (PPRs). A piecewise linear log-binomial regression model containing 1 spline knot was used to fit the age-HCV relationship. The estimated seroprevalence of HCV was 67.7% (95% confidence interval [CI]=59.5-75.8%). HIV seroprevalence was 2.3% (95% CI=0-4.9%). Anti-HCV prevalence demonstrated age-specific patterns, ranging from 31.6% through 90.9% in people who inject drugs (PWID) HIV prevalence compared with HCV prevalence reflects differences in transmissibility of these 2 blood-borne pathogens and suggests much greater efficacy of SEP for HIV prevention. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Decreased Odds of Injection Risk Behavior Associated With Direct Versus Indirect Use of Syringe Exchange: Evidence From Two California Cities.

    Science.gov (United States)

    Behrends, Czarina N; Li, Chin-Shang; Gibson, David R

    2017-07-29

    While there is substantial evidence that syringe exchange programs (SEPs) are effective in preventing HIV among people who inject drugs (PWID), nearly all the evidence comes from PWID who obtain syringes from an SEP directly. Much less is known about the benefits of secondary exchange to PWID who get syringes indirectly from friends or acquaintances who visit an SEP for them. We evaluated the effectiveness of direct versus indirect syringe exchange in reducing HIV-related high-risk injecting behavior among PWID in two separate studies conducted in Sacramento and San Jose, California, cities with quite different syringe exchange models. In both studies associations between direct and indirect syringe exchange and self-reported risk behavior were examined with multivariable logistic regression models. Study 1 assessed effects of a "satellite" home-delivery syringe exchange in Sacramento, while Study 2 evaluated a conventional fixed-site exchange in San Jose. Multivariable analyses revealed 95% and 69% reductions, respectively, in high-risk injection associated with direct use of the SEPs in Sacramento and San Jose, and a 46% reduction associated with indirect use of the SEP in Sacramento. Conclusions/Importance: The very large effect of direct SEP use in Sacramento was likely due in part to home delivery of sterile syringes. While more modest effects were associated with indirect use, such use nevertheless is valuable in reducing the risk of HIV transmission of PWID who are unable or unwilling to visit a syringe exchange.

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

    Science.gov (United States)

    Khan, Aziz; Mathelier, Anthony

    2018-05-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-10-01

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

  3. 76 FR 57989 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

    Science.gov (United States)

    2011-09-19

    ... FEDERAL COMMUNICATIONS COMMISSION [DA 11-1527] Video Programming and Accessibility Advisory.... SUMMARY: This document announces the next meeting of the Video Programming Accessibility Advisory... programming, and the interoperability and user interface of the equipment used to deliver video programming...

  4. Adrenaline in cardiac arrest: Prefilled syringes are faster.

    Science.gov (United States)

    Helm, Claire; Gillett, Mark

    2015-08-01

    Standard ampoules and prefilled syringes of adrenaline are widely available in Australasian EDs for use in cardiac arrest. We hypothesise that prefilled syringes can be administered more rapidly and accurately when compared with the two available standard ampoules. This is a triple arm superiority study comparing the time to i.v. administration and accuracy of dosing of three currently available preparations of adrenaline. In their standard packaging, prefilled syringes were on average more than 12 s faster to administer than the 1 mL 1:1000 ampoules and more than 16 s faster than the 10 mL 1:10,000 ampoules (P adrenaline utilising a Minijet (CSL Limited, Parkville, Victoria, Australia) is faster than using adrenaline in glass ampoules presented in their plastic packaging. Removing the plastic packaging from the 1 mL (1 mg) ampoule might result in more rapid administration similar to the Minijet. Resuscitation personnel requiring rapid access to adrenaline should consider storing it as either Minijets or ampoules devoid of packaging. These results might be extrapolatable to other clinical scenarios, including pre-hospital and anaesthesia, where other drugs are required for rapid use. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  5. 19 CFR 201.149 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-04-01

    .... 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination... agency's facilities are inaccessible to or unusable by handicapped persons, be denied the benefits of, be...

  6. Factors facilitating and inhibiting implementation of easy accessible sporting programs.

    NARCIS (Netherlands)

    Ooms, L.; Veenhof, C.

    2012-01-01

    Introduction: The organized sport sector has been identified as a potential setting for physical activity promotion. In The Netherlands, ten national sporting organizations were funded to develop and implement easy accessible sporting programs, especially for the least active population groups. A

  7. 41 CFR 51-10.149 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-07-01

    ...: Discrimination prohibited. 51-10.149 Section 51-10.149 Public Contracts and Property Management Other Provisions Relating to Public Contracts COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED 10... FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED § 51-10.149 Program accessibility...

  8. 75 FR 9691 - Review of the Commission's Program Access Rules and Examination of Programming Tying Arrangements

    Science.gov (United States)

    2010-03-03

    ... involving programming they own, that impede competition in the video distribution market. See H.R. Rep. No... availability of programming and charging discriminatory prices to non- cable technologies.'' H.R. Rep. No. 102... Access Rules and Examination of Programming Tying Arrangements; Final Rule #0;#0;Federal Register / Vol...

  9. [The effect of colored syringes and a colored sheet on the incidence of syringe swaps during anesthetic management].

    Science.gov (United States)

    Hirabayashi, Yoshihiro; Kawakami, Takayuki; Suzuki, Hideo; Igarashi, Takashi; Saitoh, Kazuhiko; Seo, Norimasa

    2005-09-01

    Syringe swap is an important problem in anesthetic care, causing harm to patients. We examined the effect of colored syringe and a colored sheet on the incidence of syringe swaps during anesthetic management. We determined the color code. The blue-syringe contains local anesthetics; yellow-syringe, sympathomimetic drugs; and white-syringe with a red label fixed opposite the scale, muscle relaxants. The colored sheet displays the photographs of the syringe with drug name, dose and volume. The colored syringe and colored sheet were supplied for use from February 2004. We compared the incidence of syringe swaps during the period from February 2004 to January 2005 with that from February 2003 to January 2004. Although five syringe swaps were recorded from February 2003 to January 2004, in 5901 procedures, we encountered no syringe swaps from February 2004 to January 2005, in 6078 procedures. The colored syringe and colored sheet significantly decreased the incidence of syringe swaps during anesthetic management (P sheet together with colored syringes can prevent syringe swaps during anesthesia.

  10. Object oriented programming techniques applied to device access and control

    International Nuclear Information System (INIS)

    Goetz, A.; Klotz, W.D.; Meyer, J.

    1992-01-01

    In this paper a model, called the device server model, has been presented for solving the problem of device access and control faced by all control systems. Object Oriented Programming techniques were used to achieve a powerful yet flexible solution. The model provides a solution to the problem which hides device dependancies. It defines a software framework which has to be respected by implementors of device classes - this is very useful for developing groupware. The decision to implement remote access in the root class means that device servers can be easily integrated in a distributed control system. A lot of the advantages and features of the device server model are due to the adoption of OOP techniques. The main conclusion that can be drawn from this paper is that 1. the device access and control problem is adapted to being solved with OOP techniques, 2. OOP techniques offer a distinct advantage over traditional programming techniques for solving the device access problem. (J.P.N.)

  11. How to start a minimal access mitral valve program

    OpenAIRE

    Hunter, Steven

    2013-01-01

    The seven pillars of governance established by the National Health Service in the United Kingdom provide a useful framework for the process of introducing new procedures to a hospital. Drawing from local experience, the author present guidance for institutions considering establishing a minimal access mitral valve program. The seven pillars of governance apply to the practice of minimally invasive mitral valve surgery, based on the principle of patient-centred practice. The author delineate t...

  12. 'It's risky to walk in the city with syringes': understanding access to HIV/AIDS services for injecting drug users in the former Soviet Union countries of Ukraine and Kyrgyzstan

    Directory of Open Access Journals (Sweden)

    Harmer Andrew

    2011-07-01

    Full Text Available Abstract Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV/AIDS interventions. This paper explores the multiple access barriers to HIV/AIDS services experienced by a key risk group-injecting drug users (IDUs. Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84, service providers (Ukraine n = 138, Kyrgyzstan n = 58 and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86. Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV/AIDS and drug use was an important barrier to IDUs accessing HIV/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV/AIDS services in Ukraine and Kyrgyzstan, this does not equate with greater

  13. 'It's risky to walk in the city with syringes': understanding access to HIV/AIDS services for injecting drug users in the former Soviet Union countries of Ukraine and Kyrgyzstan

    LENUS (Irish Health Repository)

    Spicer, Neil

    2011-07-13

    Abstract Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV\\/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU) countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV\\/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV\\/AIDS interventions. This paper explores the multiple access barriers to HIV\\/AIDS services experienced by a key risk group-injecting drug users (IDUs). Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84), service providers (Ukraine n = 138, Kyrgyzstan n = 58) and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86). Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV\\/AIDS and drug use was an important barrier to IDUs accessing HIV\\/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV\\/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV\\/AIDS services in Ukraine and Kyrgyzstan, this does not equate with

  14. Safety syringes and anti-needlestick devices in orthopaedic surgery.

    Science.gov (United States)

    Sibbitt, Wilmer L; Band, Philip A; Kettwich, Lawrence G; Sibbitt, Cristina R; Sibbitt, Lori J; Bankhurst, Arthur D

    2011-09-07

    The American Academy of Orthopaedic Surgery (AAOS), The Joint Commission, the Occupational Safety and Health Administration (OSHA), and the Needlestick Safety and Prevention Act encourage the integration of safety-engineered devices to prevent needlestick injuries to health-care workers and patients. We hypothesized that safety syringes and needles could be used in outpatient orthopaedic injection and aspiration procedures. The study investigated the orthopaedic uses and procedural idiosyncrasies of safety-engineered devices, including (1) four safety needles (Eclipse, SafetyGlide, SurGuard, and Magellan), (2) a mechanical safety syringe (RPD), (3) two automatic retractable syringes (Integra, VanishPoint), (4) three manual retractable syringes (Procedur-SF, Baksnap, Invirosnap), and (5) three shielded syringes (Safety-Lok, Monoject, and Digitally Activated Shielded [DAS] Syringe). The devices were first tested ex vivo, and then 1300 devices were used for 425 subjects undergoing outpatient arthrocentesis, intra-articular injections, local anesthesia, aspiration biopsy, and ultrasound-guided procedures. During the clinical observation, there were no accidental needlesticks (0 needlesticks per 1300 devices). Safety needles could be successfully used on a Luer syringe but were limited to ≤1.5 in (≤3.81 cm) in length and the shield could interfere with sonography. The mechanical safety syringes functioned well in all orthopaedic procedures. Automatic retractable syringes were too small for arthrocentesis of the knee, and the plunger blew out and prematurely collapsed with high-pressure injections. The manual retractable syringes and shielded syringes could be used with conventional needles for most orthopaedic procedures. The most effective and reliable safety devices for orthopaedic syringe procedures are shielded safety needles, mechanical syringes, manual retractable syringes, and shielded syringes, but not automatic retractable syringes. Even when adopting

  15. How to start a minimal access mitral valve program.

    Science.gov (United States)

    Hunter, Steven

    2013-11-01

    The seven pillars of governance established by the National Health Service in the United Kingdom provide a useful framework for the process of introducing new procedures to a hospital. Drawing from local experience, the author present guidance for institutions considering establishing a minimal access mitral valve program. The seven pillars of governance apply to the practice of minimally invasive mitral valve surgery, based on the principle of patient-centred practice. The author delineate the benefits of minimally invasive mitral valve surgery in terms of: "clinical effectiveness", including reduced length of hospital stay, "risk management effectiveness", including conversion to sternotomy and aortic dissection, "patient experience" including improved cosmesis and quicker recovery, and the effectiveness of communication, resources and strategies in the implementation of minimally invasive mitral valve surgery. Finally, the author have identified seven learning curves experienced by surgeons involved in introducing a minimal access mitral valve program. The learning curves are defined as: techniques of mitral valve repair, Transoesophageal Echocardiography-guided cannulation, incisions, instruments, visualization, aortic occlusion and cardiopulmonary bypass strategies. From local experience, the author provide advice on how to reduce the learning curves, such as practising with the specialised instruments and visualization techniques during sternotomy cases. Underpinning the NHS pillars are the principles of systems awareness, teamwork, communication, ownership and leadership, all of which are paramount to performing any surgery but more so with minimal access surgery, as will be highlighted throughout this paper.

  16. Combination syringe provides air-free blood samples

    Science.gov (United States)

    Pool, S. L.

    1970-01-01

    Standard syringe and spinal needle are combined in unique manner to secure air-free blood samples. Combination syringe obtains air free samples because air bubbles become insignificant when samples greater than 1 cc are drawn.

  17. Aspects of syringeal mechanics in avian phonation

    NARCIS (Netherlands)

    Larsen, O.N.; Goller, F.; Leeuwen, van J.L.

    2006-01-01

    The vocal organ of birds, the syrinx, is formed by modified cartilages of the trachea and bronchi. Recently, the use of thin, flexible endoscopes has made direct observation of the syrinx possible in situ. The effects of direct muscle stimulation on the syringeal aperture identified adductor and

  18. Syringe irrigation: blending endodontics and fluid dynamics

    NARCIS (Netherlands)

    Boutsioukis, C.; van der Sluis, L.W.M.; Basrani, B.

    2015-01-01

    Syringe irrigation remains a widely used irrigant delivery method during root canal treatment. An interdisciplinary approach involving well-established methods from the field of fluid dynamics can provide new insights into the mechanisms involved in cleaning and disinfection of the root canal system

  19. Open-Source Syringe Pump Library

    Science.gov (United States)

    Wijnen, Bas; Hunt, Emily J.; Anzalone, Gerald C.; Pearce, Joshua M.

    2014-01-01

    This article explores a new open-source method for developing and manufacturing high-quality scientific equipment suitable for use in virtually any laboratory. A syringe pump was designed using freely available open-source computer aided design (CAD) software and manufactured using an open-source RepRap 3-D printer and readily available parts. The design, bill of materials and assembly instructions are globally available to anyone wishing to use them. Details are provided covering the use of the CAD software and the RepRap 3-D printer. The use of an open-source Rasberry Pi computer as a wireless control device is also illustrated. Performance of the syringe pump was assessed and the methods used for assessment are detailed. The cost of the entire system, including the controller and web-based control interface, is on the order of 5% or less than one would expect to pay for a commercial syringe pump having similar performance. The design should suit the needs of a given research activity requiring a syringe pump including carefully controlled dosing of reagents, pharmaceuticals, and delivery of viscous 3-D printer media among other applications. PMID:25229451

  20. Duct Remediation Program: Engineered access research and construction

    International Nuclear Information System (INIS)

    Beckman, T.D.; Davis, M.M.; Karas, T.M.

    1992-01-01

    The Rocky Flats Plant, Duct Remediation mission concentrated on removing Plutonium Oxide from the process ductwork in the primary Plutonium processing facility. When possible, remediation took place from existing process gloveboxes. Fifteen locations were identified, however, that required accessing duct runs where no process gloveboxes existed. The building's second floor utility areas had many locations where long, inaccessible duct runs were prevalent. Consequently, an extensive program for design, procurement and construction was initiated to contain and isolate ducts for penetration when existing glovebox sites were not present

  1. 77 FR 5027 - Food and Drug Administration Transparency Initiative: Exploratory Program To Increase Access to...

    Science.gov (United States)

    2012-02-01

    ...] Food and Drug Administration Transparency Initiative: Exploratory Program To Increase Access to the... entitled ``Food and Drug Administration Transparency Initiative: Exploratory Program to [[Page 5028

  2. High dead-space syringe use among people who inject drugs in Tijuana, Mexico.

    Science.gov (United States)

    Rafful, Claudia; Zule, William; González-Zúñiga, Patricia E; Werb, Dan; Medina-Mora, María Elena; Magis-Rodriguez, Carlos; Strathdee, Steffanie A

    2015-05-01

    High dead-space syringes (HDSS) are believed to confer an elevated risk of acquiring HIV and other blood-borne infections. We identified prevalence and correlates of HDSS use among injection drug users (IDU) in Tijuana, Mexico, where syringe purchase and possession is legal without a prescription. Beginning in 2011, IDU who reported being 18 years or older and injected drugs within the last month were recruited into a prospective study. At baseline and semi-annually, 557 IDU underwent HIV-testing and interviewer-administered surveys. Logistic regression was used to identify correlates of using HDSS. Of 557 IDU, 40% had ever used HDSS, mostly because no other syringe type was available (72%), or because they were easier to get (20%). Controlling for sex and age at first injection, use of HDSS was associated with cocaine as the first drug injected (Adjusted Odds Ratio [AOR]: 2.68; Confidence Interval 95% [CI]: 1.15-6.22), having been stopped or arrested by police (AOR: 1.84; 95% CI: 1.11-3.07), being deported from the US (AOR: 1.64; 95% CI:1.06-2.53), and believing it is illegal to carry syringes (AOR:1.78; 95% CI: 1.01-3.15). Use of HDSS is surprisingly common among IDU in Tijuana. Efforts are needed to expand coverage of low-dead space syringes through existing syringe exchange programs. Education is required to increase awareness of the harms associated with HDSS, and to inform IDU that syringe possession is legal across Mexico.

  3. An Accessible User Interface for Geoscience and Programming

    Science.gov (United States)

    Sevre, E. O.; Lee, S.

    2012-12-01

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

  4. Assessing the role of syringe dispensing machines and mobile van outlets in reaching hard-to-reach and high-risk groups of injecting drug users (IDUs: a review

    Directory of Open Access Journals (Sweden)

    Islam Md Mofizul

    2007-10-01

    Full Text Available Abstract Reaching hard-to-reach and high-risk injecting drug users (IDUs is one of the most important challenges for contemporary needle syringe programs (NSPs. The aim of this review is to examine, based upon the available international experience, the effectiveness of syringe vending machines and mobile van/bus based NSPs in making services more accessible to these hard-to-reach and high-risk groups of IDUs. A literature search revealed 40 papers/reports, of which 18 were on dispensing machines (including vending and exchange machines and 22 on mobile vans. The findings demonstrate that syringe dispensing machines and mobile vans are promising modalities of NSPs, which can make services more accessible to the target group and in particular to the harder-to-reach and higher-risk groups of IDUs. Their anonymous and confidential approaches make services attractive, accessible and acceptable to these groups. These two outlets were found to be complementary to each other and to other modes of NSPs. Services through dispensing machines and mobile vans in strategically important sites are crucial elements in continuing efforts in reducing the spread of HIV and other blood borne viruses among IDUs.

  5. 76 FR 21741 - Twenty-First Century Communications and Video Programming Accessibility Act; Announcement of Town...

    Science.gov (United States)

    2011-04-18

    ... equipment distribution program for people who are deaf-blind. In addition, the law will fill accessibility... Programming Accessibility Act; Announcement of Town Hall Meeting AGENCY: Federal Communications Commission... The Twenty-First Century Communications and Video Programming Accessibility Act (the Act or CVAA...

  6. 76 FR 2686 - Video Programming and Emergency Access Advisory Committee; Announcement of Establishment and...

    Science.gov (United States)

    2011-01-14

    ... FEDERAL COMMUNICATIONS COMMISSION [DA 10-2320] Video Programming and Emergency Access Advisory... appointment of members of the Video Programming and Emergency Access Advisory Committee (``Committee'' or... change of the Committee's popular name to the Video Programming Accessibility Advisory Committee (``VPAAC...

  7. Development of Syringe/Bottle Hybrids for Sampling Slurries

    International Nuclear Information System (INIS)

    Coleman, C.J.

    1998-01-01

    A convenient and effective sample bottle system based on simple modifications of disposable plastic syringes and bottles has been devised and tested for slurry samples. Syringe/ bottle hybrids (hereafter referred to as syringe bottles) have the convenience of regular flat-bottom bottles with screw cap closures. In addition, the syringe imparts a sliding and adjustable bottom to the bottle that forces the entire contents from the bottle. The system was designed especially to collect samples for high temperature work-ups of DWPF slurry samples. The syringe bottles together with fixed-bottom sample vial inserts would provide the DWPF with convenient and reliable methods for dealing with slurry samples

  8. Comparative evaluation of endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe in obturation of primary teeth: An in vitro study

    OpenAIRE

    Hiremath, Mallayya C.; Srivastava, Pooja

    2016-01-01

    Purpose: The purpose of this in vitro study was to compare four methods of root canal obturation in primary teeth using conventional radiography. Materials and Methods: A total of 96 root canals of primary molars were prepared and obturated with zinc oxide eugenol. Obturation methods compared were endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe. The root canal obturations were evaluated by conventional radiography for the length of obturation and presenc...

  9. Newborn access and care in a health attention program

    Directory of Open Access Journals (Sweden)

    Poliana Remundini de Lima

    2016-03-01

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

  10. The impact of citrate introduction at UK syringe exchange programmes: a retrospective cohort study in Cheshire and Merseyside, UK

    Directory of Open Access Journals (Sweden)

    Wareing Michelle

    2007-12-01

    Full Text Available Abstract Background In 2003, it became legal in the UK for syringe exchange programmes (SEPs to provide citrate to injecting drug users to solubilise heroin. Little work has been undertaken on the effect of policy change on SEP function. Here, we examine whether the introduction of citrate in Cheshire and Merseyside SEPs has altered the number of heroin/crack injectors accessing SEPs, the frequency at which heroin/crack injectors visited SEPs and the number of syringes dispensed. Methods Eleven SEPs in Cheshire and Merseyside commenced citrate provision in 2003. SEP-specific data for the six months before and six months after citrate was introduced were extracted from routine monitoring systems relating to heroin and crack injectors. Analyses compared all individuals attending pre and post citrate and matched analyses only those individuals attending in both periods (defined as 'longitudinal attenders'. Non-parametric tests were used throughout. Results Neither new (first seen in either six months period nor established clients visited SEPs more frequently post citrate. New clients collected significantly less syringes per visit post citrate, than pre citrate (14.5,10.0; z = 1.992, P Conclusion The introduction of citrate did not negatively affect SEP attendance. 'Longitudinal attenders' visited SEPs more frequently post citrate, providing staff with greater opportunity for intervention and referral. As the number of syringes they collected each visit remained unchanged the total number of clean syringes made available to this group of injectors increased very slightly between the pre and post citrate periods. However, new clients collected significantly less syringes post citrate than pre citrate, possibly due to staff concerns regarding the amount of citrate (and thus syringes to dispense safely to new clients. These concerns should not be allowed to negatively impact on the number of syringes dispensed.

  11. Comparative evaluation of endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe in obturation of primary teeth: An in vitro study.

    Science.gov (United States)

    Hiremath, Mallayya C; Srivastava, Pooja

    2016-01-01

    The purpose of this in vitro study was to compare four methods of root canal obturation in primary teeth using conventional radiography. A total of 96 root canals of primary molars were prepared and obturated with zinc oxide eugenol. Obturation methods compared were endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe. The root canal obturations were evaluated by conventional radiography for the length of obturation and presence of voids. The obtained data were analyzed using Chi-square test. The results showed significant differences between the four groups for the length of obturation (P tube showed the poor results (37.5% optimal fillings) for the length of obturation. The insulin syringe (79.2% optimal fillings) and local anesthetic syringe (66.7% optimal fillings) showed acceptable results for the length of root canal obturation. However, minor voids were present in all the four techniques used. Endodontic pressure syringe produced the best results in terms of length of obturation and controlling paste extrusion from the apical foramen. However, insulin syringe and local anesthetic syringe can be used as effective alternative methods.

  12. The evaluation of a trial of syringe vending machines in Canberra, Australia.

    Science.gov (United States)

    McDonald, David

    2009-07-01

    Syringe vending machines (SVMs) have been trialled in Canberra, Australian Capital Territory, Australia, as an intervention aiming to increase the availability of sterile injecting equipment for use by IDUs. This study evaluated the 12-month trial. A utilisation-focused evaluation model, with both formative and summative components, was employed. Four SVMs were installed, each dispensing packs containing four 1 mL syringes and associated injecting paraphernalia. The trial participants were the clients of the SVMs and other key informants. The core measurements used were the number of syringes dispensed in Canberra by SVMs and other outlets, SVM clients' demographics and experiences of and attitudes towards SVMs, perceived impacts of SVMs on needle sharing, unsafe disposal of used syringes in the vicinity of SVMs, and community and stakeholder attitudes. The trial was implemented successfully, with no adverse consequences identified. The SVMs appear to be serving both the usual clients of the other outlets for sterile injecting equipment (community pharmacies and the Needle Syringe Program outlets) and others who are reluctant to use such outlets or find them inconvenient. The out-of-business-hours provision of syringes through the SVMs was particularly welcomed by both SVM clients and other stakeholders. The continuing operation of the initial four SVMs is widely supported, and additional machines are requested by clients and others. Owing to the success of the trial in terms of feasibility and outcomes for both IDUs and for the broader community, it is desirable that providing sterile injecting equipment through SVMs continues and be expanded as an integral component of harm reduction strategies.

  13. 47 CFR 76.1004 - Applicability of program access rules to common carriers and affiliates.

    Science.gov (United States)

    2010-10-01

    ... Cable Programming § 76.1004 Applicability of program access rules to common carriers and affiliates. (a... 47 Telecommunication 4 2010-10-01 2010-10-01 false Applicability of program access rules to common carriers and affiliates. 76.1004 Section 76.1004 Telecommunication FEDERAL COMMUNICATIONS COMMISSION...

  14. A study of gross morphological and histological syringeal features of ...

    African Journals Online (AJOL)

    A study of gross morphological and histological syringeal features of true francolins (Galliformes: Francolinus, Scleroptila, Peliperdix and Dendroperdix spp.) and spurfowls ( Pternistis spp.) in a phylogenetic context.

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

    Science.gov (United States)

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

    2016-10-10

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

  16. Container Closure Integrity Testing of Prefilled Syringes.

    Science.gov (United States)

    Peláez, Sarah S; Mahler, Hanns-Christian; Matter, Anja; Koulov, Atanas; Singh, Satish K; Germershaus, Oliver; Mathaes, Roman

    2018-04-04

    Prefilled syringes (PFSs) are increasingly preferred over vials as container closure systems (CCSs) for injectable drug products when facilitated or self-administration is required. However, PFSs are more complex compared to CCSs consisting of vial, rubber stopper and crimp cap. Container closure integrity (CCI) assurance and verification has been a specific challenge for PFSs as they feature several sealing areas. A comprehensive understanding of the CCS is necessary for an appropriate CCI assessment as well as for packaging development and qualification. A comprehensive CCI assessment of six different PFSs from three different manufacturers (including one polymeric PFS) was conducted using helium leak testing. PFS components were manipulated to systematically assess the contribution of the different sealing areas to CCI, namely rigid needle shield (RNS)/needle, RNS/tip cone and the individual ribs of a syringe plunger. The polymeric PFS required an equilibrium measurement for accurate CCIT. The different sealing areas and a single plunger rib were shown to provide adequate CCI. Acceptable tip cap movement until the point of CCI failure was estimated. The assessment of acceptable tip cap movement demonstrated the importance of considering the RNS/tip cone seal design to ensure CCI of the PFS upon post assembly possesses and shipment. Copyright © 2018. Published by Elsevier Inc.

  17. Sharing of Needles and Syringes among Men Who Inject Drugs: HIV Risk in Northwest Bangladesh.

    Directory of Open Access Journals (Sweden)

    M Kamal Pasa

    Full Text Available Injection drug use is prevalent in northwestern Bangladesh. We sought to explore the context of needle/syringe sharing among persons who inject drugs (PWID, examining risk exposures to blood-borne infections like the human immunodeficiency virus (HIV and hepatitis in a region where these dual epidemics are likely to expand.We used a qualitative research approach to learn about injection practices, conducting 60 in-depth interviews among PWID. We then conducted 12 focus group discussions (FGDs that generated a checklist of salient issues, and followed up with personal observations of typical days at the drug-use venues. Content and interpretative frameworks were used to analyze qualitative information and socio-demographic information, using SPSS software.We found that needle/syringe-sharing behaviours were integrated into the overall social and cultural lives of drug users. Sharing behaviours were an central component of PWID social organization. Sharing was perceived as an inherent element within reciprocal relationships, and sharing was tied to beliefs about drug effects, economic adversity, and harassment due to their drug user status. Carrying used needles/syringes to drug-use venues was deemed essential since user-unfriendly needle-syringe distribution schedules of harm reduction programmes made it difficult to access clean needles/syringes in off-hours. PWID had low self-esteem. Unequal power relationships were reported between the field workers of harm reduction programmes and PWID. Field workers expressed anti-PWID bias and judgmental attitudes, and also had had misconceptions about HIV and hepatitis transmission. PWID were especially disturbed that no assistance was forthcoming from risk reduction programme staff when drug users manifested withdrawal symptoms.Interventions must take social context into account when scaling up programmes in diverse settings. The social organization of PWID include values that foster needle-syringe

  18. 21 CFR 870.1670 - Syringe actuator for an injector.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Syringe actuator for an injector. 870.1670 Section 870.1670 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... actuator for an injector. (a) Identification. A syringe actuator for an injector is an electrical device...

  19. 41 CFR 105-8.152 - Program accessibility: Assignment of space.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Program accessibility: Assignment of space. 105-8.152 Section 105-8.152 Public Contracts and Property Management Federal Property...-8.152 Program accessibility: Assignment of space. (a) When GSA assigns or reassigns space to an...

  20. 77 FR 6479 - Leased Commercial Access; Development of Competition and Diversity in Video Programming...

    Science.gov (United States)

    2012-02-08

    ... Commercial Access; Development of Competition and Diversity in Video Programming Distribution and Carriage... contained in the Second Report and Order, FCC 11-119, pertaining to carriage of video programming vendors by multichannel video programming distributors (program carriage rules). This notice is consistent with the Secord...

  1. 76 FR 60651 - Leased Commercial Access; Development of Competition and Diversity in Video Programming...

    Science.gov (United States)

    2011-09-29

    ... programming services seeking access through their conduit.''); H.R. Rep. No. 102-628 (1992), at 41 (``[T]he... Programming Distribution and Carriage; Revision of the Commission's Program Carriage Rules; Final Rule and... Programming Distribution and Carriage AGENCY: Federal Communications Commission. ACTION: Final rule. SUMMARY...

  2. 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.

  3. 76 FR 66089 - Access Authorization Program for Nuclear Power Plants

    Science.gov (United States)

    2011-10-25

    ..., the public can gain entry into ADAMS, which provides text and image files of the NRC's public... ML112060028. The regulatory analysis may be found in ADAMS under Accession Number ML112060032. Regulatory...; e-mail: [email protected] . SUPPLEMENTARY INFORMATION: I. Introduction The NRC is issuing a...

  4. 75 FR 32341 - Import Administration IA ACCESS Pilot Program

    Science.gov (United States)

    2010-06-08

    ... submitted electronically need not also be submitted in hard copy. Persons wishing to submit written comments in hard copy should file one signed original and two copies of each set of comments to the address... . Any questions concerning file formatting, document conversion, access on the Internet, or other...

  5. Computer Access and Flowcharting as Variables in Learning Computer Programming.

    Science.gov (United States)

    Ross, Steven M.; McCormick, Deborah

    Manipulation of flowcharting was crossed with in-class computer access to examine flowcharting effects in the traditional lecture/laboratory setting and in a classroom setting where online time was replaced with manual simulation. Seventy-two high school students (24 male and 48 female) enrolled in a computer literacy course served as subjects.…

  6. Are major reductions in new HIV infections possible with people who inject drugs? The case for low dead-space syringes in highly affected countries.

    Science.gov (United States)

    Zule, William A; Cross, Harry E; Stover, John; Pretorius, Carel

    2013-01-01

    Circumstantial evidence from laboratory studies, mathematical models, ecological studies and bio behavioural surveys, suggests that injection-related HIV epidemics may be averted or reversed if people who inject drugs (PWID) switch from using high dead-space to using low dead-space syringes. In laboratory experiments that simulated the injection process and rinsing with water, low dead space syringes retained 1000 times less blood than high dead space syringes. In mathematical models, switching PWID from high dead space to low dead space syringes prevents or reverses injection-related HIV epidemics. No one knows if such an intervention is feasible or what effect it would have on HIV transmission among PWID. Feasibility studies and randomized controlled trials (RCTs) will be needed to answer these questions definitively, but these studies will be very expensive and take years to complete. Rather than waiting for them to be completed, we argue for an approach similar to that used with needle and syringe programs (NSP), which were promoted and implemented before being tested more rigorously. Before implementation, rapid assessments that involve PWID will need to be conducted to ensure buy-in from PWID and other local stakeholders. This commentary summarizes the existing evidence regarding the protective effects of low dead space syringes and estimates potential impacts on HIV transmission; it describes potential barriers to transitioning PWID from high dead space to low dead space needles and syringes; and it presents strategies for overcoming these barriers. Copyright © 2012 Elsevier B.V. All rights reserved.

  7. 5 CFR 1636.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-01-01

    ... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens... facilities. 1636.150 Section 1636.150 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL...

  8. 22 CFR 711.150 - Program accessibility: Existing facilities.

    Science.gov (United States)

    2010-04-01

    ... result in a fundamental alteration in the nature of a program or activity or in undue financial and....150 Section 711.150 Foreign Relations OVERSEAS PRIVATE INVESTMENT CORPORATION ADMINISTRATIVE PROVISIONS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY...

  9. 45 CFR 2490.149 - Program accessibility: Discrimination prohibited.

    Science.gov (United States)

    2010-10-01

    .... 2490.149 Section 2490.149 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.149 Program...

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

    Science.gov (United States)

    Craig, Dana; Etcheverry, Jose; Ferris, Stefan

    2016-01-01

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

  11. Health Care Access and Use Among Low-Income Children on Subsidized Insurance Programs in California.

    OpenAIRE

    Christopher Trenholm; Anna Saltzman; Shanna Shulman; Michael Cousineau; Dana Hughes

    2008-01-01

    This paper summarizes the CaliforniaKids and Healthy Kids programs—county-based insurance programs in California for low-income children. The study examined features of both programs, use of basic health care services by the children enrolled, and typical experiences accessing inpatient and other high-cost care. Children enrolled in the two programs made substantial use of outpatient health care, despite important variation in program features. The study concludes with recommendations on ho...

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

    Science.gov (United States)

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

    2017-12-01

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

  13. 47 CFR 76.1507 - Competitive access to satellite cable programming.

    Science.gov (United States)

    2010-10-01

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

  14. Autologous fat grafting: use of closed syringe microcannula system for enhanced autologous structural grafting

    Directory of Open Access Journals (Sweden)

    Alexander RW

    2013-04-01

    Full Text Available Robert W Alexander,1 David Harrell2 1Department of Surgery, School of Medicine and Dentistry, University of Washington, Seattle, WA, USA; 2Harvest-Terumo Inc, Plymouth, MA, USA Objectives: Provide background for use of acquiring autologous adipose tissue as a tissue graft and source of adult progenitor cells for use in cosmetic plastic surgery. Discuss the background and mechanisms of action of closed syringe vacuum lipoaspiration, with emphasis on accessing adipose-derived mesenchymal/stromal cells and the stromal vascular fraction (SVF for use in aesthetic, structural reconstruction and regenerative applications. Explain a proven protocol for acquiring high-quality autologous fat grafts (AFG with use of disposable, microcannula systems. Design: Explain the components and advantage of use of the patented super luer-lock and microcannulas system for use with the closed-syringe system. A sequential explanation of equipment selection for minimally traumatic lipoaspiration in small volumes is presented, including use of blunt injection cannulas to reduce risk of embolism. Results: Thousands of AFG have proven safe and efficacious for lipoaspiration techniques for large and small structural fat grafting procedures. The importance and advantages of gentle harvesting of the adipose tissue complex has become very clear in the past 5 years. The closed-syringe system offers a minimally invasive, gentle system with which to mobilize subdermal fat tissues in a suspension form. Resulting total nuclear counting of undifferentiated cells of the adipose-derived -SVF suggests that the yield achieved is better than use of always-on, constant mechanical pump applied vacuum systems. Conclusion: Use of a closed-syringe lipoaspiration system featuring disposable microcannulas offers a safe and effective means of harvesting small volumes of nonmanipulated adipose tissues and its accompanying progenitor cells within the SVF. Closed syringes and microcannulas are

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

    Directory of Open Access Journals (Sweden)

    Nancy Wise

    2011-06-01

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

  16. Feasibility of Using Fluorescence Spectrophotometry to Develop a Sensitive Dye Immersion Method for Container Closure Integrity Testing of Prefilled Syringes.

    Science.gov (United States)

    Lu, Xujin; Lloyd, David K; Klohr, Steven E

    2016-01-01

    has recently gained industry attention due to increased regulatory agency scrutiny regarding the analytical rigor of container closure integrity testing methods and expectations to use container closure integrity testing in lieu of sterility tests in stability programs. Methylene blue dye is often used for dye ingress testing of container closure integrity, but we found it unsuitable for reliable detection of small breaches in prefilled syringes of drug product. This work describes the suitability and advantages of using a fluorescent dye and spectroscopic detection for a robust, sensitive, and quality control-friendly container closure integrity testing method for prefilled syringes. © PDA, Inc. 2016.

  17. 34 CFR 395.12 - Access to program and financial information.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Access to program and financial information. 395.12... information. Each blind vendor under this part shall be provided access to all financial data of the State... annual financial reports, provided that such disclosure does not violate applicable Federal or State laws...

  18. 28 CFR 513.43 - Inmate access to certain Bureau Program Statements.

    Science.gov (United States)

    2010-07-01

    ... Statements. 513.43 Section 513.43 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE GENERAL... simple local access procedures described in this section to review certain Bureau Program Statements... 28 CFR), local access is available through the institution law library. (b) For a current Bureau...

  19. Accessibility

    DEFF Research Database (Denmark)

    Brooks, Anthony Lewis

    2017-01-01

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

  20. Costs of a Hospital-Based, Ready-To-Use Syringe Delivery Programme

    DEFF Research Database (Denmark)

    Risør, Bettina Wulff; Vand, S; Lisby, M

    2017-01-01

    %) and at €20,905 (an increase of 228%) for the endoscopy department. The ready-to-use delivery program imposed an additional cost of €11.32 per day surgery operation and €2.41 per endoscopy procedure. Conclusion: This ready-to-use programme increased the cost of the medical handling process. This incremental......Objective: The risk of errors in the medication administration process is high. Applications of pre lled syringes may improve patient safety but could be more costly. The objective of this study was to assess the additional costs of a ready-to-use syringe delivery programme in comparison...... with a conventional delivery programme at day surgery and endoscopy departments at a large university hospital. Methods: The cost analysis used the hospital perspective and developed an “activity-based costing” model to assess the costs of medicine- handling activities. The model was calibrated with six-month data...

  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. Evaluating the Navy’s Enlisted Accessions Testing Program Based on Future Talent Needs

    Science.gov (United States)

    2017-03-01

    NAVY’S ENLISTED ACCESSIONS TESTING PROGRAM BASED ON FUTURE TALENT NEEDS by Shereka F. Riley March 2017 Thesis Advisor: Joseph Sullivan Co...REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE EVALUATING THE NAVY’S ENLISTED ACCESSIONS TESTING PROGRAM BASED ON FUTURE TALENT ...public release. Distribution is unlimited. 12b. DISTRIBUTION CODE 13. ABSTRACT (maximum 200 words) In recent years, non-defense related industries

  3. Social network-related risk factors for bloodborne virus infections among injection drug users receiving syringes through secondary exchange.

    Science.gov (United States)

    De, Prithwish; Cox, Joseph; Boivin, Jean-François; Platt, Robert W; Jolly, Ann M

    2008-01-01

    Secondary syringe exchange (SSE) refers to the exchange of sterile syringes between injection drug users (IDUs). To date there has been limited examination of SSE in relation to the social networks of IDUs. This study aimed to identify characteristics of drug injecting networks associated with the receipt of syringes through SSE. Active IDUs were recruited from syringe exchange and methadone treatment programs in Montreal, Canada, between April 2004 and January 2005. Information on each participant and on their drug-injecting networks was elicited using a structured, interviewer-administered questionnaire. Subjects' network characteristics were examined in relation to SSE using regression models with generalized estimating equations. Of 218 participants, 126 were SSE recipients with 186 IDUs in their injecting networks. The 92 non-recipients reported 188 network IDUs. Networks of SSE recipients and non-recipients were similar with regard to network size and demographics of network members. In multivariate analyses adjusted for age and gender, SSE recipients were more likely than non-recipients to self-report being HIV-positive (OR=3.56 [1.54-8.23]); require or provide help with injecting (OR=3.74 [2.01-6.95]); have a social network member who is a sexual partner (OR=1.90 [1.11-3.24]), who currently attends a syringe exchange or methadone program (OR=2.33 [1.16-4.70]), injects daily (OR=1.77 [1.11-2.84]), and shares syringes with the subject (OR=2.24 [1.13-4.46]). SSE is associated with several injection-related risk factors that could be used to help focus public health interventions for risk reduction. Since SSE offers an opportunity for the dissemination of important prevention messages, SSE-based networks should be used to improve public health interventions. This approach can optimize the benefits of SSE while minimizing the potential risks associated with the practice of secondary exchange.

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

    Science.gov (United States)

    Ramsey, Jennifer; Gorgol, Laura

    2010-01-01

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

  5. Drug residues in used syringes in Switzerland: A comparative study.

    Science.gov (United States)

    Lefrançois, Elodie; Augsburger, Marc; Esseiva, Pierre

    2018-05-01

    Harm reduction services, including needle-exchange programmes, have been implemented in Switzerland for over 20 years. Their main aim is to lessen the negative social and/or physical consequences associated with illicit drug consumption and, therefore, improve prevention messages. To this end, knowledge of illicit drug consumption practices is necessary. Periodic self-report surveys are the primary source of data for monitoring drug users' behaviour. Analysis of residual content of used syringes can bring further and objective knowledge about consumed products through analytically confirmed data. Used syringes were sampled in 2 syringe-exchange facilities in Lausanne. These structures are a bus where the users bring back their syringes (ABS) and an automatic injecting kit dispenser (AIKD). Once syringes were collected, a validated gas chromatography-mass spectrometry (GC-MS) method was implemented in order to detect drugs (licit or illicit) contained in the residual content of used syringes. Cocaine was the most common drug detected alone (39% in ABS and 31% in AIKD), followed by the simultaneous detection of heroin and cocaine (12% and 17%) and heroin and midazolam (12% and 17%). The differences between the illicit drugs distribution of used syringes collected in AIKD and ABS were not statistically significant. Analysis of residual content of used syringes as a monitoring tool is an original approach that has already led to a better understanding of the habits of drug-injection users. Over the long term, this approach is a powerful tool to track and detect new consumption practices in a quasi-real-time. Copyright © 2017 John Wiley & Sons, Ltd.

  6. [Morphine self-administration by rats using a pneumatic syringe].

    Science.gov (United States)

    Akiyama, Y; Takayama, S

    1988-06-01

    An apparatus for drug self-administration by rats using a pneumatic syringe was developed by Weeks. A microliter syringe operated by a pneumatic cylinder supplies an accurate volume of drug solution within one second. When coefficient of variation of infusion volume was compared among pneumatic syringe, infusion pump, and peristaltic pump, pneumatic syringe showed higher accuracy in infusion volume than the other two pumps. Since the infusion speed by a pneumatic syringe is very rapid (less than one second per infusion), the effect of infusion speed on reinforcing property of morphine was investigated. When rats self-administered 0.1, 0.3, 1.0, and 3.0 mg/kg/infusion of morphine by pneumatic syringes, the patterns of self-infusion were more stable, the number of self-infusions and the amount self-administered were larger, and a dose-response relationship was clearer in comparison with those self-infused the same doses of morphine for 5.6 seconds by infusion pumps or peristaltic pumps.

  7. Decreasing dialysis catheter rates by creating a multidisciplinary dialysis access program.

    Science.gov (United States)

    Rosenberry, Patricia M; Niederhaus, Silke V; Schweitzer, Eugene J; Leeser, David B

    2018-03-01

    Centers for Medicare and Medicaid Services have determined that chronic dialysis units should have 45%. A multidisciplinary program was established with goals of decreasing catheter rates in order to decrease central line-associated bloodstream infections, decrease mortality associated with central line-associated bloodstream infection, decrease hospital days, and provide savings to the healthcare system. We collected the catheter rates within three dialysis centers served over a 5-year period. Using published data surrounding the incidence and related costs of central line-associated bloodstream infection and mortality per catheter day, the number of central line-associated bloodstream infection events, the costs, and the related mortality could be determined prior to and after the initiation of the dialysis access program. An organized dialysis access program resulted in a 82% decrease in the number of central venous catheter days which lead to a concurrent reduction in central line-associated bloodstream infection and deaths. As a result of creating an access program, central venous catheter rates decreased from an average rate of 45% to 8%. The cost savings related to the program was calculated to be over US$5 million. The decrease in the number of mortalities is estimated to be between 13 and 27 patients. We conclude that a formalized access program decreases catheter rates, central line-associated bloodstream infection, and the resultant hospitalizations, mortality, and costs. Areas with high hemodialysis catheter rates should develop access programs to better serve their patient population.

  8. 77 FR 24169 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2012-04-23

    ... for the 2013 Market Access Program (MAP). The intended effect of this notice is to solicit...-term agricultural trade strategy and a program effectiveness time line against which results can be... part of the FAS resource allocation strategy to fund applicants who can demonstrate performance and...

  9. 76 FR 21325 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2011-04-15

    ... for the 2012 Market Access Program (MAP). The intended effect of this notice is to solicit...-term agricultural trade strategy and a program effectiveness time line against which results can be... part of the FAS resource allocation strategy to fund applicants who can demonstrate performance and...

  10. 78 FR 23893 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2013-04-23

    ... inviting proposals for the 2014 Market Access Program (MAP). The intended effect of this notice is to... strategy and a program effectiveness time line against which results can be measured at specific intervals... allocation strategy to fund applicants who can demonstrate performance and address the objectives of the GPRA...

  11. 75 FR 26194 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Science.gov (United States)

    2010-05-11

    ... for the 2011 Market Access Program (MAP). The intended effect of this notice is to solicit... considers whether the applicant provides a clear, long-term agricultural trade strategy and a program... the greatest growth potential. These factors are part of the FAS resource allocation strategy to fund...

  12. Dual Language Immersion Program Equity and Access: Is There Equity for All Students?

    Science.gov (United States)

    Fernandez, Patricia Espinoza

    2016-01-01

    This is a mixed methods study of K-12 school administrators with dual language immersion school leadership expertise. The paramount research focus was to identify equity and access issues in dual language immersion programs serving grades K-12, as identified by school administrators who have led such programs. A total pool of 498 were invited to…

  13. 12 CFR 410.151 - Program accessibility: New construction and alterations.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Program accessibility: New construction and alterations. 410.151 Section 410.151 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY EXPORT-IMPORT BANK OF THE UNITED...

  14. Moving from College Aspiration to Attainment: Learning from One College Access Program

    Science.gov (United States)

    Dyce, Cherrel Miller; Albold, Cheryll; Long, Deborah

    2013-01-01

    Using data from a survey of 75 parents and high school students who were eligible for a college access program, this article examines parents' and students' college aspirations and their confidence in fulfilling that goal. The authors argue that pre-college preparation programs can benefit from the non-economic forms of capital that these families…

  15. 49 CFR 28.151 - Program accessibility: New construction and alterations.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Program accessibility: New construction and alterations. 28.151 Section 28.151 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION...

  16. Associative programming language and virtual associative access manager

    Science.gov (United States)

    Price, C.

    1978-01-01

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

  17. Professional ideologies and the development of syringe exchange: Wales as a case study.

    Science.gov (United States)

    Keene, J M; Stimson, G V

    1997-12-01

    This paper is derived from an evaluative study of HIV prevention programs for drug injectors across Wales. It considers how different professional territories and ideologies, concepts of drug misuse and models of HIV prevention may influence policy development. The research involved monitoring the introduction and development of agency and community based syringe exchange schemes and initiatives taken by community pharmacists. Interviews with staff, managers and administrators, and descriptions of service history, development and delivery inform the discussion. HIV prevention varied in different areas of Wales depending on the particular professional group involved, local ideologies regarding drug use treatment, and the extent to which HIV prevention was seen either as a specialist area of expertise and specific remit of drug workers or a generic health care task. Drug agencies with an abstinence policy rejected syringe exchange; instead, prevention in those areas developed in ad hoc ways as health care workers and pharmacists attempted to develop a community based service. Drug agencies with a pre-existing harm minimisation model easily integrated syringe exchange into their work and played the major part in establishing the service, but there was difficulty in extending it beyond their professional caseloads. As there were disincentives to use treatment agencies, and their catchment areas were limited, these factors influenced effective service provision.

  18. Federal funding for syringe exchange in the US: Explaining a long-term policy failure.

    Science.gov (United States)

    Showalter, David

    2018-05-01

    The United States prohibited federal funding for syringe exchange programs for people who inject drugs nearly continuously from 1988 to 2015, despite growing scientific evidence, diminishing AIDS-related controversy, and tens of thousands of deaths from injection-related AIDS. This study investigates the political and institutional bases of this long-term failure to support lifesaving public policy. This study draws on national, regional, and local media coverage, archival sources, and semi-structured, in-depth interviews with 6 long-time syringe exchange researchers and activists from California. I use case-oriented process tracing methods to explain the persistence and reform of the federal funding ban. Though previous studies focus on the symbolic clash between conservative morality and empirical science, I find that changing demographic and regional inequalities in the effects of the AIDS epidemic and dynamics produced by the federal structure of US government were more important factors in the creation and persistence of the funding ban. The persistence and eventual repeal of the ban on federal funding for syringe exchange was a product of the changing demographic, geographic, and political effects of the AIDS epidemic within the federal structure of US government, rather than a consequence of intractable morality politics. These contextual dynamics continue to shape AIDS and public health policy at all levels of government. Copyright © 2018. Published by Elsevier B.V.

  19. Social-structural contexts of needle and syringe sharing behaviours of HIV-positive injecting drug users in Manipur, India: a mixed methods investigation

    Directory of Open Access Journals (Sweden)

    Shunmugam Murali

    2011-05-01

    Full Text Available Abstract Background Few investigations have assessed risk behaviours and social-structural contexts of risk among injecting drug users (IDUs in Northeast India, where injecting drug use is the major route of HIV transmission. Investigations of risk environments are needed to inform development of effective risk reduction interventions. Methods This mixed methods study of HIV-positive IDUs in Manipur included a structured survey (n = 75, two focus groups (n = 17, seven in-depth interviews, and two key informant interviews. Results One-third of survey participants reported having shared a needle/syringe in the past 30 days; among these, all the men and about one-third of the women did so with persons of unknown HIV serostatus. A variety of social-structural contextual factors influenced individual risk behaviours: barriers to carrying sterile needles/syringes due to fear of harassment by police and "anti-drug" organizations; lack of sterile needles/syringes in drug dealers' locales; limited access to pharmacy-sold needles/syringes; inadequate coverage by needle and syringe programmes (NSPs; non-availability of sterile needles/syringes in prisons; and withdrawal symptoms superseding concern for health. Some HIV-positive IDUs who shared needles/syringes reported adopting risk reduction strategies: being the 'last receiver' of needles/syringes and not a 'giver;' sharing only with other IDUs they knew to be HIV-positive; and, when a 'giver,' asking other IDUs to wash used needles/syringes with bleach before using. Conclusions Effective HIV prevention and care programmes for IDUs in Northeast India may hinge on several enabling contexts: supportive government policy on harm reduction programmes, including in prisons; an end to harassment by the police, army, and anti-drug groups, with education of these entities regarding harm reduction, creation of partnerships with the public health sector, and accountability to government policies that protect IDUs

  20. [Safe injection rooms and police crackdowns in areas with heavy drug dealing. Evaluation by counting discarded syringes collected from the public space].

    Science.gov (United States)

    Vecino, Carmen; Villalbí, Joan R; Guitart, Anna; Espelt, Albert; Bartroli, Montserrat; Castellano, Yolanda; Brugal, M Teresa

    2013-01-01

    The evolution of drug injection in public places is analysed using as indicator the number of syringes collected from public spaces, evaluating as well the influence of public health harm reduction interventions and of police actions, with a before and after quasi experimental study. Monthly syringe counts on the semester before and after each intervention were compared both in the involved district and in the city as a whole, using the U and z tests with a 95% confidence level. The average number of collected syringes drops from 13.132 in 2004 to 3.190 in 2012. Comparing indicators before and after health and police interventions, the opening of a facility with a supervised drug consumption room in the inner city was associated with a huge reduction in the number of abandoned syringes in the city, while its number did not rise in the district where the facility was located. The subsequent opening of another drug consumption room did not have a significant impact in collected syringes in the area. Some police interventions in 2005-2006 and 2011 had a significant impact in the indicators of the involved districts, while others did not. Harm reduction programs might have a favourable impact on drug injection in public spaces and related syringe presence. Some police interventions appear to have an impact while others do not or just have a modest local and temporary effect.

  1. 25 CFR 170.128 - Are housing access roads and housing streets eligible for IRR Program funding?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Are housing access roads and housing streets eligible for... INTERIOR LAND AND WATER INDIAN RESERVATION ROADS PROGRAM Indian Reservation Roads Program Policy and Eligibility Irr Housing Access Roads § 170.128 Are housing access roads and housing streets eligible for IRR...

  2. Retention and variability of hydrogen (H2) samples stored in plastic syringes

    DEFF Research Database (Denmark)

    Rumessen, J J; Gudmand-Høyer, E

    1987-01-01

    The utility of two brands of 20 ml plastic syringes for storage of hydrogen (H2) samples as obtained in H2 breath tests were studied. Plastipak syringes were found to be significantly better with regard to the stability of the H2 concentration and the variability between the H2 samples. Storage...... of the H2 samples in Plastipak syringes at 5 degrees C significantly improved the H2 retention, whereas refrigeration of H2 samples stored in Once syringes did not reduce H2 loss. Storage of H2 samples in refrigerated plastic syringes is efficient and reliable for several days if syringes with minimal...... sample variation are used....

  3. Good, now keep going: challenging the status quo in STEM pipeline and access programs

    Science.gov (United States)

    Wiseman, Dawn; Herrmann, Randy

    2018-03-01

    This contribution engages in conversation with McMahon, Griese, and Kenyon (this issue) to consider how the SURE program they describe represents a pragmatic approach to addressing the issue of underrepresentation of Indigenous people in STEM post-secondary programs. We explore how such programs are generally positioned and how they might be positioned differently to challenge the status quo within Western post-secondary institutions. The challenge arises from moving beyond the immediate pragmatics of addressing an identifiable issue framed as a problem to considering how post-secondary institutions and people developing access recruitment programs might begin unlearning colonialism.

  4. Spring-loaded syringe for multiple rapid injections

    Directory of Open Access Journals (Sweden)

    C R Srinivas

    2017-01-01

    Full Text Available Mesotherapy refers to multiple injections of small quantity of the drug over a large area. The mesoguns available are expensive and the motor-driven models tends to waste the expensive material to be injected since the plunger stops after injecting without recoil. We searched for a less expensive device which would inject like the mesogun and still not waste the solution. On searching the web, we identified a spring-loaded syringe. We describe the assembly and use of this inexpensive syringe for delivering multiple injections with minimal wastage.

  5. Spring-loaded Syringe for Multiple Rapid Injections

    Science.gov (United States)

    Srinivas, CR; Somani, Anirudh; Shashidharan Nair, CK; Mylswamy, Thirumurthy

    2017-01-01

    Mesotherapy refers to multiple injections of small quantity of the drug over a large area. The mesoguns available are expensive and the motor-driven models tends to waste the expensive material to be injected since the plunger stops after injecting without recoil. We searched for a less expensive device which would inject like the mesogun and still not waste the solution. On searching the web, we identified a spring-loaded syringe. We describe the assembly and use of this inexpensive syringe for delivering multiple injections with minimal wastage. PMID:28529423

  6. Women's experiences accessing a women-centered cardiac rehabilitation program: a qualitative study.

    Science.gov (United States)

    Rolfe, Danielle E; Sutton, Erica J; Landry, Mireille; Sternberg, Len; Price, Jennifer A D

    2010-01-01

    The health benefits of cardiac rehabilitation (CR) for women living with heart disease are well documented, yet women remain underrepresented in traditionally structured CR programs. This health service delivery gap has been attributed to a number of sex-related factors experienced by women, including lower rates of physician referral, travel-related barriers, competing work and caregiving responsibilities, greater cardiovascular disease severity, and number of comorbid health conditions. Whether a program specifically designed for women is able to address these barriers and facilitate women's participation is a question that has seldom been explored in the CR literature. As part of a larger study exploring whether 6 predefined principles of women's health (empowerment of women, accessible programs, broad definition of health care, high-quality of care, collaborative planning, and innovative and creative approaches) are reflected in the practices of the Women's Cardiovascular Health Initiative (WCHI) (a comprehensive CR and primary prevention program designed for women), the objective of this analysis was to explore how the principle of "accessible programs" is experienced by women participating in the WCHI. Fourteen women previously enrolled in the WCHI program participated in a single, in-person qualitative interview. Transcripts were analyzed using a constant-comparative approach to identify relevant themes related to program accessibility. Key themes identified included participants' experiences with acquiring physician referral, negotiating transportation issues, and navigating program schedules. Women discussed how peer support and staff members' willingness to address their health-related concerns facilitated their participation. While a women-centered CR/primary prevention program may facilitate and encourage women's participation by providing flexible program schedules as well as peer and professional support, efforts are still required to address

  7. Evaluation of the content and accessibility of microsurgery fellowship program websites.

    Science.gov (United States)

    Silvestre, Jason; Vargas, Christina R; Ho, Olivia; Lee, Bernard T

    2015-10-01

    Microsurgery fellowship applicants utilize Internet-based resources such as the San Francisco Match (SF Match) to manage their applications. In deciding where to apply, applicants rely on advice from mentors and online resources including microsurgery fellowship websites (MFWs). The purpose of this study was to evaluate the content and accessibility of MFWs. While microsurgery is practiced by many surgical specialties, this study focused on MFWs for programs available in the 2014 Microsurgery Fellowship Match. Program lists from the American Society for Reconstructive Microsurgery (ASRM) and the San Francisco Match (SF Match) were analyzed for the accessibility of MFW links. MFWs were evaluated for education and recruitment content, and MFW comprehensiveness was compared on the basis of program characteristics using chi square tests. Of the 25 fellowships available, only 18 had websites (72%). SF Match and ASRM listed similar programs (96% overlap) and provided website links (89%, 76%), but only a minority connected directly to the MFW (38%, 23%). A minority of programs were responsive via email inquiry (36%). MFWs maintained minimal education and recruitment content. MFW comprehensiveness was not associated with program characteristics. MFWs are often not readily accessible and contain limited information for fellowship applicants. Given the relative low-cost of website development, MFWs may be improved to facilitate fellow recruitment. © 2015 Wiley Periodicals, Inc.

  8. 76 FR 19356 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

    Science.gov (United States)

    2011-04-07

    ... you will need and tell us how to contact you if we need more information. Make your request as early...-418-2498 (voice), 202-418-1169 (TTY), or [email protected] (e-mail); or Alison Neplokh, Media Bureau... or digital broadcast television; accessible user interfaces on video programming devices; and...

  9. All in One Stop? The Accessibility of Work Support Programs at One-Stop Centers.

    Science.gov (United States)

    Richer, Elise; Kubo, Hitomi; Frank, Abbey

    The accessibility of work support programs at one-stop centers was examined in a study during which 33 telephone directors or managers of one-stop centers in 22 states were interviewed by telephone. The interviews established the existence of extensive differences between one-stop centers from the standpoint of all aspects of their operation,…

  10. The Arts and 504, A Handbook for Accessible Arts Programming. Revised.

    Science.gov (United States)

    National Endowment for the Arts, Washington, DC.

    This handbook is designed to assist arts organizations in complying with disability access regulations. It details how to include the needs of disabled people into programming efforts and also provides information on the Arts Endowment's 504 Regulation, which applies to federally funded organizations, and the 1990 Americans with Disabilities Act…

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

    NARCIS (Netherlands)

    Ooms, L.; Veenhof, C.

    2014-01-01

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

  12. Determining serum bicarbonate; a simple syringe titrator and colorimeter.

    Science.gov (United States)

    BOONE, C W; FIELD, J B

    1953-12-01

    The use of a tuberculin syringe as a burette has made possible an easy bedside technique for the determination of serum bicarbonate. By combining it with the use of a simple colorimeter, a relatively untrained person can do numerous bicarbonate determinations with a high degree of accuracy. The same technique also lends itself to other colorimetric clinical procedures such as determination of gastric acidity.

  13. The benefits and drawbacks of syringe drivers in palliative care.

    Science.gov (United States)

    Costello, John; Nyatanga, Brian; Mula, Carole; Hull, Jenny

    2008-03-01

    This article will outline the use of continuous subcutaneous infusion pumps, known as syringe drivers, including their benefits and drawbacks in a palliative care context. There have been over 5000 articles published globally describing syringe drivers in the medical and nursing literature within the last decade. Many provide guidance on their use, although much of the data are repetitious, disease or age-group specific, and focused on pragmatic issues to do with clinical application. Several trusts and hospices across the UK are carrying out trials of the recently launched McKinley T34 syringe driver. Therefore, it seems timely to consider their wider use internationally. Globally, practitioners in palliative care are very familiar with their use, although the literature lacks specific guidance and, at times, the information is ambiguous. Having briefly reviewed their benefits, the article considers the limitations of using syringe drivers and comments on some of the lesser known/reported practical and patient-focused drawbacks associated with their use. We conclude by considering why, when so much education and training exists to help practitioners use these devices effectively, so many human errors occur.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Rosarin Sruamsiri

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

  16. Spontaneous diffusion of an effective skin cancer prevention program through Web-based access to program materials.

    Science.gov (United States)

    Hall, Dawn M; Escoffery, Cam; Nehl, Eric; Glanz, Karen

    2010-11-01

    Little information exists about the diffusion of evidence-based interventions, a process that can occur naturally in organized networks with established communication channels. This article describes the diffusion of an effective skin cancer prevention program called Pool Cool through available Web-based program materials. We used self-administered surveys to collect information from program users about access to and use of Web-based program materials. We analyzed the content of e-mails sent to the official Pool Cool Web site to obtain qualitative information about spontaneous diffusion. Program users were dispersed throughout the United States, most often learning about the program through a Web site (32%), publication (26%), or colleague (19%). Most respondents (86%) reported that their pool provided educational activities at swimming lessons. The Leader's Guide (59%) and lesson cards (50%) were the most commonly downloaded materials, and most respondents reported using these core items sometimes, often, or always. Aluminum sun-safety signs were the least frequently used materials. A limited budget was the most commonly noted obstacle to sun-safety efforts at the pool (85%). Factors supporting sun safety at the pool centered around risk management (85%) and health of the pool staff (78%). Diffusion promotes the use of evidence-based health programs and can occur with and without systematic efforts. Strategies such as providing well-packaged, user-friendly program materials at low or no cost and strategic advertisement of the availability of program materials may increase program use and exposure. Furthermore, highlighting the benefits of the program can motivate potential program users.

  17. Global Access Programs: A Collaborative Approach for Effective Implementation and Management.

    Science.gov (United States)

    Ainge, Debra; Aitken, Suzanne; Corbett, Mark; De-Keyzer, David

    Global access programs (GAPs) provide access to medicinal products for patients with serious medical conditions and no commercially available treatment options. Providing early access to medicines can be challenging for a pharmaceutical company. The demand for a GAP often occurs at a time when other activities are the prime focus, such as delivery of pivotal clinical trials or gaining of marketing authorization. Furthermore, the skills, experience, and infrastructure necessary to implement and manage a successful GAP vary significantly from those required for regular clinical trial execution, and the regulatory environment presents its own challenges, with regulations often poorly defined and with considerable inter-country variation. This article considers the triggers for early access requests and examines the need for companies to develop a global strategy for GAPs in order to respond appropriately to requests for early access. It also provides a comprehensive overview of the processes for GAP set-up, implementation, management, and closure, along with the considerations affecting the type and scope of GAP, such as demand, regulatory feasibility, license status of the product, drug pricing structure, company strategy, costs, and product supply. Also discussed is the need for appropriate personnel to implement and manage the GAP, and when to consider collaboration with an external GAP provider. In summary, GAPs require careful and efficient planning and management, from set-up to closure. Well-run GAPs provide an ethical and regulatory-compliant pathway for access of new treatments to patients with serious conditions and an unmet medical need.

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

    Science.gov (United States)

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

    2018-01-10

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

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

    Directory of Open Access Journals (Sweden)

    Robert Vaagan

    2005-01-01

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

  20. The National Access to Antiretroviral Program for PHA (NAPHA) in Thailand.

    Science.gov (United States)

    Chasombat, Sanchai; Lertpiriyasuwat, Cheewanan; Thanprasertsuk, Sombat; Suebsaeng, Laksami; Lo, Ying Ru

    2006-07-01

    To describe the development, components, initial results and lessons learned from Thailand's National Access to Antiretroviral Program for People living with HIV/AIDS (NAPHA), a historical review was conducted and program monitoring was analyzed. The national antiretroviral therapy program at different levels of the public health system was implemented with all major program components; ARV protocol development, health care professional training, drug supply chain management, laboratory network formation, monitoring and evaluation, and multi-sector and PHA involvement since 2001, which was based on elements of research, pilot projects, training, national guideline development, experiences and policy making. A national monitoring system was developed to monitor the progress of the program. From February 2001 to December 2004, the monitoring reports received from implementing hospitals showed that 58,133 cases had received antiretroviral therapy (ART), and 85% (49,477) of them were continuing to take ARV drugs. In conclusion, the NAPHA was implemented nationwide with comprehensive systems. The reports indicate achievement of expansion of the ART program. Lessons learned from the program initiation and scaling up show local leadership, comprehensive training, adherence, and coordination are essential to program effectiveness and sustainability.

  1. Reuse prevention syringes for reconstitution of lyophilized vaccines: Operational study and UNICEF plans for expanding introduction.

    Science.gov (United States)

    Fleming, Jessica A; Hoekstra, Edward John; Moniaga, Vanda; Widjaya, Anton; Soepardi, Jane; Supartha, Nyoman; Salovaara, Annika; Khamassi, Selma; Nelson, Carib

    2009-01-01

    Since the 1990s, the United Nation's Children's Fund has encouraged injection safety for immunizations through bundling vaccines with appropriate amounts of supporting equipment and by supplying autodisable (AD) syringes for injections. However, poor vaccine reconstitution practices continue to be reported worldwide. By 2009, UNICEF will begin to phase out the distribution of standard disposable syringes for vaccine reconstitution and replace them with reuse prevention (RUP) syringes, with a full transition expected by the end of 2010. A field evaluation in Indonesia was conducted to identify introduction requirements, issues with healthcare worker training and acceptance, and RUP syringe performance and safety. Managers and health workers felt that RUP syringes improved injection safety and fit easily into country logistical systems. Healthcare workers felt they were intuitive to use, but recommended special training. The integration of RUP reconstitution syringes by UNICEF could increase injection safety by preventing the reuse of syringes and reducing vaccine contamination.

  2. Pediatric Diabetes Telemedicine Program Improves Access to Care for Rural Families: Role of APRNs.

    Science.gov (United States)

    Smith, Nancy Marie; Satyshur, Rosemarie DiMauro

    2016-01-01

    Type 1 diabetes mellitus has increased in children by 23% from 2001 to 2009. Rural communities additionally have increased disparities related to access barriers and a large minority population with poorer overall health. Research evidence supports telemedicine as an effective alternative to bring preventive diabetes care to remote areas. This article presents an overview of the leadership role of advanced practice registered nurses (APRNs) with the implementation and evaluation of a pediatric diabetes telemedicine program at a rural pediatric outpatient specialty clinic in partnership with a tertiary center telemedicine network. The telemedicine program quality improvement (QI) project explored caregiver satisfaction with a convenience sample of caregivers (N = 14) using a nine-item Telemedicine Diabetes Caregiver Satisfaction Survey (TDCSS), with responses ranging from 1 = strongly disagree to 5 = strongly agree. Findings indicate caregivers were highly satisfied with communication/ privacy (M = 4.8), access to care (M = 4.1), and quality of services (M = 5.0). The multidisciplinary collaborative teamwork, continuous QI, and dependable technology were integral to the quality of the telemedicine clinical initiative. APRNs provided technology expertise, interdisciplinary collaboration leadership, care coordination, and advocacy for policy changes. Results demonstrate that telemedicine and APRN leadership can help implement innovative programs into rural communities to improve access to care, healthcare cost, and outcomes.

  3. Prefilled syringes for intravitreal injection reduce preparation time

    DEFF Research Database (Denmark)

    Subhi, Yousif; Kjer, Birgit; Munch, Inger Christine

    2016-01-01

    INTRODUCTION: The demand for intravitreal therapy has increased dramatically with the introduction of vascular endo-thelial growth factor inhibitors. Improved utilisation of existing resources is crucial to meeting the increased future demand. We investigated time spent preparing intravitreal inj...... had no influence on the design of the study, analysis of the data, preparation of the manuscript or the decision to publish. TRIAL REGISTRATION: not relevant.......INTRODUCTION: The demand for intravitreal therapy has increased dramatically with the introduction of vascular endo-thelial growth factor inhibitors. Improved utilisation of existing resources is crucial to meeting the increased future demand. We investigated time spent preparing intravitreal...... injection treatment using either prefilled syringes or vials in routine clinical practice. METHODS: We video-recorded preparations of intravitreal injections (n = 172) for each preparation type (ranibizumab prefilled syringe (n = 56), ranibizumab vial (n = 56) and aflibercept vial (n = 60)) in a multi...

  4. DETERMINING SERUM BICARBONATE—A Simple Syringe Titrator and Colorimeter

    Science.gov (United States)

    Boone, Charles W.; Field, John B.

    1953-01-01

    The use of a tuberculin syringe as a burette has made possible an easy bedside technique for the determination of serum bicarbonate. By combining it with the use of a simple colorimeter, a relatively untrained person can do numerous bicarbonate determinations with a high degree of accuracy. The same technique also lends itself to other colorimetric clinical procedures such as determination of gastric acidity. PMID:13106724

  5. Stability of erythropoietin repackaging in polypropylene syringes for clinical use

    Directory of Open Access Journals (Sweden)

    Angela Marsili

    2017-02-01

    Full Text Available Introduction: Epoetin alfa (Eprex® is a subcutaneous, injectable formulation of short half-life recombinant human erythropoietin (rHuEPO. To current knowledge there are no published studies regarding the stability of rHuEPO once repackaging occurs (r-EPO for clinical trial purposes. Materials and methods: We assessed EPO concentration in Eprex® and r-EPO syringes at 0, 60, 90, and 120 days after repackaging in polypropylene syringes. R-EPO was administered to 56 patients taking part in a clinical trial in Friedreich Ataxia. Serum EPO levels were measured at baseline and 48 h after r-EPO administration. Results: No differences were found between r-EPO and Eprex® syringes, but both globally decreased in total EPO content during storage at 4 °C. Patients receiving r-EPO had similar levels in EPO content as expected from previous trials in Friedreich Ataxia and from pharmacokinetics studies in healthy volunteers. Discussion: We demonstrate that repackaging of EPO does not alter its concentration if compared to the original product (Eprex®. This is true both for repackaging procedures and for the stability in polypropylene tubes. The expiration date of r-EPO can be extended from 1 to 4 months after repackaging, in accordance with pharmacopeia rules.

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

    Science.gov (United States)

    Petrakis, P. L.

    1993-01-01

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

  7. 3D Printing Prototypes for Healthcare Professionals: Creating a Reciprocating Syringe.

    Science.gov (United States)

    Rothenberg, Steven; Abdullah, Selwan; Hirsch, Jeffrey

    2017-10-01

    3D printing (additive manufacturing) has been around since 1984, but interest in the technology has increased exponentially as it has become both accessible and inexpensive. The applications of the technology in healthcare are still being explored; however, initial forays have been encouraging. It has the potential to revolutionize the process of prototyping for healthcare professionals by democratizing the process and enhancing collaboration, making it cheaper to do iterative prototyping with little or no engineering experience. This case report details the creation of a multi-lumen reciprocating syringe with 3D printing. The product has been created and tested using a variety of publicly available resources. It provides a detailed overview of the approach and the framework required to create such a medical device. However, the implications of this report are much larger than this one product, and the fundamental ideas discussed here could be used for creating customized solutions for many healthcare problems.

  8. Survival of Hepatitis C Virus in Syringes: Implication for Transmission among Injection Drug Users

    Science.gov (United States)

    Paintsil, Elijah; He, Huijie; Peters, Christopher; Lindenbach, Brett D.; Heimer, Robert

    2010-01-01

    Background We hypothesized that the high prevalence of HCV among injection drug users (IDUs) might be due to prolonged virus survival in contaminated syringes. Methods We developed a microculture assay to examine the viability of HCV. Syringes were loaded with blood spiked with HCV reporter virus (Jc1/GLuc2A) to simulate two scenarios of residual volumes; low (2 μl) void volume for 1-ml insulin syringes, and high (32 μl) void volume for 1-ml tuberculin syringes. Syringes were stored at 4°C, 22°C, and 37°C for up to 63 days before testing for HCV infectivity using luciferase activity. Results The virus decay rate was biphasic (t½ α = 0.4h and t½β = 28h). Insulin syringes failed to yield viable HCV beyond day one at all storage temperatures except for 4o in which 5% of syringes yielded viable virus on day 7. Tuberculin syringes yielded viable virus from 96%, 71%, and 52% of syringes following storage at 4o, 22° and 37o for 7 days, respectively, and yielded viable virus up to day 63. Conclusions The high prevalence of HCV among IDUs may be partly due to the resilience of the virus and the syringe type. Our findings may be used to guide prevention strategies. PMID:20726768

  9. Analysis of event logs from syringe pumps: a retrospective pilot study to assess possible effects of syringe pumps on safety in a university hospital critical care unit in Germany.

    Science.gov (United States)

    Kastrup, Marc; Balzer, Felix; Volk, Thomas; Spies, Claudia

    2012-07-01

    Medication errors occur in approximately one out of five doses in a typical hospital setting. Patients in the intensive care unit (ICU) are particularly susceptible to errors during the application of intravenous drugs as they receive numerous potent drugs applied by syringe pumps. The aim of this study was to analyse the effects on potential harmful medication errors and to address factors that have potential for improving medication safety after the introduction of a standardized drug library into syringe pumps with integrated decision support systems. A team of physicians and nurses developed a dataset that defined standardized drug concentrations, application rates and alert limits to prevent accidental overdosing of intravenous medications. This dataset was implemented in 100 syringe pumps with the ability to log programming errors, alerts, reprogramming events and overrides ('smart pumps'). In this retrospective pilot study, all pump-related transaction data were obtained from the pump logs, by downloading the data from the pumps, covering 20 months of use between 1 April 2008 and 30 November 2009. Patient data were gathered from the electronic patient charts. The study was performed in a cardiothoracic ICU of the Charité University Hospital, Berlin, Germany. A total of 7884 patient treatment days and 133,601 infusion starts were evaluated. The drug library with the features of the dose rate was used in 92.8% of the syringe pump starts, in 1.5% of the starts a manual dosing mode without the use of the drug library was used and in 5.7% of the starts the mode 'mL/h', without any calculation features, was used. The most frequently used drugs were vasoactive drugs, followed by sedation medication. The user was alerted for a potentially harmful overdosing in 717 cases and in 66 cases the pumps were reprogrammed after the alert. During the early morning hours a higher rate of alarms was generated by the pumps, compared with the rest of the day. Syringe pumps with

  10. Design and management of database using microsoft access program: application in neurointerventional unit

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Seon Moon; Jeong, Gyeong Un; Kim, Tae Il; Cha, Ji Hyeon; Pyun, Hae Wook; Woo, Ryu Chang; Kim, Ho Sung; Suh, Dae Chul [University of Ulsan, College of Medicine, Seoul (Korea, Republic of)

    2005-10-15

    Complex clinical information in cerebral angiointervention unit requires effective management of statistical analysis for the classification of diagnosis and intervention including follow-up data from the interventional treatment. We present an application of Microsoft Access program for the management of patient data in cerebral angiointervention unit which suggests practical methods in recording and analyzing the patient data. Since January 2002, patient information from cerebral angiointervention was managed by a database with over 4000 patients. We designed a program which incorporates size items; Table, Query, Form, Report, Page and Macro. Patient data, follow-up data and information regarding diagnosis and intervention were established in the Form section, related by serial number, and connected to each other to an independent Table. Problems in running the program were corrected by establishing Entity Relationship (ER) diagnosis of Tables to define relationships between Tables. Convenient Queries, Forms and Reports were created to display expected information were applied from selected Tables. The relationship program which incorporated six items conveniently provided the number of cases per year, incidence of disease, lesion site, and case analysis based on interventional treatment. We were able to follow the patients after the interventional procedures by creating queries and reports. Lists of disease and patients files were identified easily each time by the Macro function. In addition, product names, size and characteristics of materials used were indexed and easily available. Microsoft Access program is effective in the management of patient data in cerebral angiointervention unit. Accumulation of large amounts of complex data handled by multiple users may require client/sever solutions such as a Microsoft SQL Server.

  11. The Prison Economy of Needles and Syringes: What Opportunities Exist for Blood Borne Virus Risk Reduction When Prices Are so High?

    Directory of Open Access Journals (Sweden)

    Carla Treloar

    Full Text Available A formal Needle and Syringe Program (NSP is not provided in Australian prisons. Injecting equipment circulates in prisons as part of an informal and illegal economy. This paper examined how this economy generates blood-borne virus (BBV risk and risk mitigation opportunities for inmates.The HITS-p cohort recruited New South Wales inmates who had reported ever injecting drugs and who had a negative HCV serological test within 12 months prior to enrolment. For this study, qualitative interviews were conducted with 30 participants enrolled in HITS-p. Participants included 10 women and were incarcerated in 12 prisons.A needle/syringe was nominated as being typically priced in the 'inside' prison economy at $100-$150, with a range of $50-$350. Purchase or hire of equipment was paid for in cash (including transactions that occurred outside prison and in exchange for drugs and other commodities. A range of other resources was required to enable successful needle/syringe economies, especially relationships with visitors and other prisoners, and violence to ensure payment of debts. Strategies to mitigate BBV risk included retaining one needle/syringe for personal use while hiring out others, keeping drug use (and ownership of equipment "quiet", stealing used equipment from the prison health clinic, and manufacture of syringes from other items available in the prison.The provision of prison NSP would disrupt the inside economies built around contraband needles/syringes, as well as minimise BBV risk. However, any model of prison NSP should be interrogated for any unanticipated markets that could be generated as a result of its regulatory practices.

  12. The Prison Economy of Needles and Syringes: What Opportunities Exist for Blood Borne Virus Risk Reduction When Prices Are so High?

    Science.gov (United States)

    Treloar, Carla; McCredie, Luke; Lloyd, Andrew R

    2016-01-01

    A formal Needle and Syringe Program (NSP) is not provided in Australian prisons. Injecting equipment circulates in prisons as part of an informal and illegal economy. This paper examined how this economy generates blood-borne virus (BBV) risk and risk mitigation opportunities for inmates. The HITS-p cohort recruited New South Wales inmates who had reported ever injecting drugs and who had a negative HCV serological test within 12 months prior to enrolment. For this study, qualitative interviews were conducted with 30 participants enrolled in HITS-p. Participants included 10 women and were incarcerated in 12 prisons. A needle/syringe was nominated as being typically priced in the 'inside' prison economy at $100-$150, with a range of $50-$350. Purchase or hire of equipment was paid for in cash (including transactions that occurred outside prison) and in exchange for drugs and other commodities. A range of other resources was required to enable successful needle/syringe economies, especially relationships with visitors and other prisoners, and violence to ensure payment of debts. Strategies to mitigate BBV risk included retaining one needle/syringe for personal use while hiring out others, keeping drug use (and ownership of equipment) "quiet", stealing used equipment from the prison health clinic, and manufacture of syringes from other items available in the prison. The provision of prison NSP would disrupt the inside economies built around contraband needles/syringes, as well as minimise BBV risk. However, any model of prison NSP should be interrogated for any unanticipated markets that could be generated as a result of its regulatory practices.

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

    Science.gov (United States)

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

    2016-01-01

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

  14. Enabling Highly-Scalable Remote Memory Access Programming with MPI-3 One Sided

    Directory of Open Access Journals (Sweden)

    Robert Gerstenberger

    2014-01-01

    Full Text Available Modern interconnects offer remote direct memory access (RDMA features. Yet, most applications rely on explicit message passing for communications albeit their unwanted overheads. The MPI-3.0 standard defines a programming interface for exploiting RDMA networks directly, however, it's scalability and practicability has to be demonstrated in practice. In this work, we develop scalable bufferless protocols that implement the MPI-3.0 specification. Our protocols support scaling to millions of cores with negligible memory consumption while providing highest performance and minimal overheads. To arm programmers, we provide a spectrum of performance models for all critical functions and demonstrate the usability of our library and models with several application studies with up to half a million processes. We show that our design is comparable to, or better than UPC and Fortran Coarrays in terms of latency, bandwidth and message rate. We also demonstrate application performance improvements with comparable programming complexity.

  15. Low-Cost Touchscreen Driven Programmable Dual Syringe Pump for Life Science Applications

    OpenAIRE

    Liu, Jamin; Garcia, Valentina; Derisi, Joseph

    2018-01-01

    Syringe pumps are powerful tools able to automate routine laboratory practices that otherwise consume large amounts of manual labor time. Commercially available syringe pumps are expensive, difficult to customize, and often preset for a narrow range of operations. Here, we show how to build a programmable dual syringe pump (PDSP) that overcomes these limitations. The PDSP is driven by a Raspberry Pi paired with a stepper motor controller to allow maximal customization via Python scripting. Th...

  16. Embedded nanomicro syringe on chip for molecular therapy

    Directory of Open Access Journals (Sweden)

    Jalil MA

    2011-11-01

    Full Text Available Muhammad Arif Jalil1, Nathaporn Suwanpayak2,3, Kathawut Kulsirirat3, Saisudawan Suttirak3, Jalil Ali4, Preecha P Yupapin31Ibnu Sina Institute of Fundamental Science Studies, Nanotechnology Research Alliance, Universiti Teknologi Malaysia, Johor Bahru, Malaysia; 2King Mongkut's Institute of Technology Ladkrabang, Chumphon Campus, Chumphon, Thailand; 3Nanoscale Science and Engineering Research Alliance, Advanced Research Center for Photonics, Faculty of Science, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand; 4Institute of Advanced Photonics Science, Nanotechnology Research Alliance, Universiti Teknologi Malaysia, Johor Bahru, MalaysiaBackground: A novel nanomicro syringe system was proposed for drug storage and delivery using a PANDA ring resonator and atomic buffer. A PANDA ring is a modified optical add/drop filter, named after the well known Chinese bear. In principle, the molecule/drug is trapped by the force generated by different combinations of gradient fields and scattering photons within the PANDA ring. A nanomicro needle system can be formed by optical vortices in the liquid core waveguide which can be embedded on a chip, and can be used for long-term treatment. By using intense optical vortices, the required genes/molecules can be trapped and transported dynamically to the intended destinations via the nanomicro syringe, which is available for drug delivery to target tissues, in particular tumors. The advantage of the proposed system is that by confining the treatment area, the effect can be decreased. The use of different optical vortices for therapeutic efficiency is also discussed.Keywords: nanomicro syringe, nanomicro needle, molecular therapy, therapeutic efficiency, cancer

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

    Science.gov (United States)

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

    2003-12-01

    hosted these Web Services as a part of the SCEC Community Modeling Environment (SCEC/CME) ITR Project (http://www.scec.org/cme). We have implemented Web Services for several of the reasons sited previously. For example, we implemented a FORTRAN-based Earthquake Rupture Forecast (ERF) as a Web Service for use by client computers that don't support a FORTRAN runtime environment. We implemented a Generic Mapping Tool (GMT) Web Service for use by systems that don't have local access to GMT. We implemented a Hazard Map Calculator Web Service to execute Hazard calculations that are too computationally intensive to run on a local system. We implemented a Coordinate Conversion Web Service to enforce a standard and consistent method for converting between UTM and Lat/Lon. Our experience developing these services indicates both strengths and weakness in current Web Service technology. Client programs that utilize Web Services typically need network access, a significant disadvantage at times. Programs with simple input and output parameters were the easiest to implement as Web Services, while programs with complex parameter-types required a significant amount of additional development. We also noted that Web services are very data-oriented, and adapting object-oriented software into the Web Service model proved problematic. Also, the Web Service approach of converting data types into XML format for network transmission has significant inefficiencies for some data sets.

  18. A Comparison of Protein Stability in Prefillable Syringes Made of Glass and Plastic.

    Science.gov (United States)

    Waxman, Lloyd; Vilivalam, Vinod D

    2017-01-01

    The development of protein therapeutics requires stabilization of these labile molecules during shipment and storage. Biologics, particularly monoclonal antibodies, are frequently packaged at high concentration in prefillable syringes traditionally made of glass. However, some biologics are unstable in glass due to sensitivity to silicone oil, tungsten, glue, or metal ions. Syringes made from the plastic cyclic olefin polymer, Daikyo Crystal Zenith® (CZ), with a Flurotec-laminated piston, have none of these issues. This study compared the stability of several proteins including biotherapeutics when stored up to 14 months at 5 °C and 25 °C in prefillable siliconized syringes made of glass or silicone oil-free CZ syringes, and when subjected to mild agitation by end-over-end rotation at room temperature. At each time point, proteins were analyzed by several techniques including turbidity, size exclusion high-performance liquid chromatography, reversed phase high-performance liquid chromatography, ion-exchange chromatography, electrophoresis, and light scattering to monitor changes in aggregation and degradation. The results show that proteins have comparable stability when stored in glass syringes or in syringes made of CZ sterilized by E-beam or autoclave. In addition, proteins stressed by agitation were generally more stable and aggregated less in syringes made of CZ than in ones made of glass. LAY ABSTRACT: Biotherapeutic protein drugs such as monoclonal antibodies are frequently packaged at high concentration in prefillable syringes, which allows the drug to be directly administered by the patient or caregiver. Protein drugs, or biologics, can be unstable, and may aggregate, particularly when shaken. These aggregates can be immunogenic, stimulating the body's immune system to produce antibodies that can reduce the drug's efficacy. Although prefillable syringes are traditionally made of glass, some biologics are unstable in glass syringes due to the presence of

  19. Botulinum Toxin Therapy: Is Syringe Type Related to Cost-Effectiveness?

    Science.gov (United States)

    Foglietti, Mark Anthony; Wright, Lauren; Foglietti-Fostyk, Alanna

    2018-03-01

    Clostridium botulinum toxin is effective through cleaving presynaptic proteins at the neuromuscular junction, which prevents the release of acetylcholine and inhibits muscle contraction. Several serotypes of botulinum toxin (BT) exist; however, only 2 types have been approved by the US Food and Drug Administration for commercial and medical use, A and B. Both types of BT must be administered intramuscularly with a syringe, but the type of syringe is the injector's preference. Which syringe type is most efficient in minimizing product waste and most cost-effective for the patient and provider? We performed a single-center, open-label, analytical study using BT therapy and 2 types of syringes for analytics of cost-effectiveness. OnabotulinumtoxinA was the neuromodulator used in this report. Vials (100 U) of BT A were each reconstituted with 2.5 mL of 0.9% sodium chloride, for a final concentration of 4 U/0.1 mL. High-dead-space syringes are compared with low-dead-space syringes: 1-mL tuberculin (TB) luer slip syringe with detachable 25-gauge needle and 1-mL ultrafine insulin syringe with an attached 31-gauge needle, respectively. After each syringe was evacuated, the TB syringe was noted to contain 0.05 mL of the remaining product in the hub. Providers are discarding approximately 2 U of BT per TB syringe product injection. If the physician uses 30 syringes per day, 3 days a week, for 1 year, it equals to a lost revenue of approximately $155,500 per year. To individualize the cost-effective analysis, average quantity of syringes used per patient and overall patient volume must be considered, with corresponding adjustment of cost and units discarded. The American Society of Plastic Surgeons reported that the use of neuromodulators has increased by approximately 797% from 2000 to 2016. During that period, the price of neuromodulators has also increased by approximately 85%. Considering these statistics, the type of syringe used for BT neuromodular injection is a

  20. Lessons learned from a data-driven college access program: The National College Advising Corps.

    Science.gov (United States)

    Horng, Eileen L; Evans, Brent J; Antonio, Anthony L; Foster, Jesse D; Kalamkarian, Hoori S; Hurd, Nicole F; Bettinger, Eric P

    2013-01-01

    This chapter discusses the collaboration between a national college access program, the National College Advising Corps (NCAC), and its research and evaluation team at Stanford University. NCAC is currently active in almost four hundred high schools and through the placement of a recent college graduate to serve as a college adviser provides necessary information and support for students who may find it difficult to navigate the complex college admission process. The advisers also conduct outreach to underclassmen in an effort to improve the school-wide college-going culture. Analyses include examination of both quantitative and qualitative data from numerous sources and partners with every level of the organization from the national office to individual high schools. The authors discuss balancing the pursuit of evaluation goals with academic scholarship. In an effort to benefit other programs seeking to form successful data-driven interventions, the authors provide explicit examples of the partnership and present several examples of how the program has benefited from the data gathered by the evaluation team. © WILEY PERIODICALS, INC.

  1. The financial performance of rural hospitals and implications for elimination of the Critical Access Hospital program.

    Science.gov (United States)

    Holmes, George M; Pink, George H; Friedman, Sarah A

    2013-01-01

    To compare the financial performance of rural hospitals with Medicare payment provisions to those paid under prospective payment and to estimate the financial consequences of elimination of the Critical Access Hospital (CAH) program. Financial data for 2004-2010 were collected from the Healthcare Cost Reporting Information System (HCRIS) for rural hospitals. HCRIS data were used to calculate measures of the profitability, liquidity, capital structure, and financial strength of rural hospitals. Linear mixed models accounted for the method of Medicare reimbursement, time trends, hospital, and market characteristics. Simulations were used to estimate profitability of CAHs if they reverted to prospective payment. CAHs generally had lower unadjusted financial performance than other types of rural hospitals, but after adjustment for hospital characteristics, CAHs had generally higher financial performance. Special payment provisions by Medicare to rural hospitals are important determinants of financial performance. In particular, the financial condition of CAHs would be worse if they were paid under prospective payment. © 2012 National Rural Health Association.

  2. Breastfeeding Support in a Community Pharmacy: Improving Access through the Well Babies at Walgreens Program.

    Science.gov (United States)

    Lenell, Amy; Friesen, Carol A; Hormuth, Laura

    2015-11-01

    Well Babies at Walgreens is a unique community-based corporate partnership program that offers breastfeeding support by a lactation professional in a private room at the pharmacy. Walgreens is a community pharmacy chain with more than 8000 locations in the United States, Puerto Rico, and the US Virgin Islands. The primary goal of Well Babies is to support breastfeeding women using a model that is expandable to other Walgreens pharmacy sites. The Well Babies program offers drop-in services, with a professional consultation by a lactation consultant and baby weight check, if desired. Well Babies creators are developing a business plan for Walgreens and a toolkit that would help other stores implement the program. An additional goal is to improve continuity of care for breastfeeding by engaging pharmacists as vital members of the health care team. Offering breastfeeding support at a pharmacy improves access and encourages support persons to attend while simultaneously allowing the family to complete other errands. This initiative included education for pharmacists to improve the recommendations they make for breastfeeding mothers and to improve awareness among pharmacists of the benefits associated with breastfeeding and the need to preserve the breastfeeding relationship. The first drop-in location opened in April 2012. Grant funding from the US Centers for Disease Control and Prevention, awarded to the Indiana State Department of Health, made it possible to open a second drop-in location in June 2013. Future plans include developing an employee lactation program and expanding Well Babies at Walgreens at other store locations. © The Author(s) 2015.

  3. Doula Services Within a Healthy Start Program: Increasing Access for an Underserved Population.

    Science.gov (United States)

    Thomas, Mary-Powel; Ammann, Gabriela; Brazier, Ellen; Noyes, Philip; Maybank, Aletha

    2017-12-01

    Women of color in the United States, particularly in high-poverty neighborhoods, experience high rates of poor birth outcomes, including cesarean section, preterm birth, low birthweight, and infant mortality. Doula care has been linked to improvements in many perinatal outcomes, but women of color and low-income women often face barriers in accessing doula support. To address this issue, the New York City Department of Health and Mental Hygiene's Healthy Start Brooklyn introduced the By My Side Birth Support Program in 2010. The goal was to complement other maternal home-visiting programs by providing doula support during labor and birth, along with prenatal and postpartum visits. Between 2010 and 2015, 489 infants were born to women enrolled in the program. Data indicate that By My Side is a promising model of support for Healthy Start projects nationwide. Compared to the project area, program participants had lower rates of preterm birth (6.3 vs. 12.4%, p < 0.001) and low birthweight (6.5 vs. 11.1%, p = 0.001); however, rates of cesarean birth did not differ significantly (33.5 vs. 36.9%, p = 0.122). Further research is needed to explore possible reasons for this finding, and to examine the influence of doula support on birth outcomes among populations with high rates of chronic disease and stressors such as poverty, racism, and exposure to violence. However, feedback from participants indicates that doula support is highly valued and helps give women a voice in consequential childbirth decisions. Available evidence suggests that doula services may be an important component of an effort to address birth inequities.

  4. The measurement of activity in vials and syringes using a radionuclide assay calibrator

    International Nuclear Information System (INIS)

    Hooper, S.A.; Davies, I.H.

    1993-01-01

    To enable accurate measurements of the activity in both vials and syringes, a series of measurements was undertaken to ascertain the changes in response with geometry in nine isotope assay calibrators. From these measurements, two jigs were made for each calibrator to enable (a) optimal measurement of activity in vials and (b) optimal measurement of activity in a variety of syringe sizes. (Author)

  5. Strength training in community settings: impact of lay leaders on program access and sustainability for rural older adults.

    Science.gov (United States)

    Washburn, Lisa T; Cornell, Carol E; Phillips, Martha; Felix, Holly; Traywick, LaVona

    2014-09-01

    The effect of volunteer lay leaders on availability and sustainability of strength-training programs for older adults has not been well explored. We describe implementation of the StrongWomen strength training program by the Arkansas Cooperative Extension Service, and report on the relationship between delivery approach (agent-led, lay-led, or combination of agent- and lay-led) and program access and sustainability. All state Extension agents (n = 66) were surveyed on program implementation, continuance, and use of lay leaders. Program records were used to identify the number of trained lay leaders. Regression models were used to examine the relationship between delivery approach and group availability. Counties using lay leaders had twice as many groups as counties using only agents. There was a significant, positive relationship between the number of lay leaders and the number of groups. Counties using lay leaders were 8.3 times more likely to have continuing groups compared with counties not using lay leaders. Program continuance was significantly and positively associated with lay leader use. Lay delivery expanded access to strength training programs and increased the likelihood that programs would continue. This approach can be used to increase access to and sustainability of strength training programs, particularly in resource-constrained areas.

  6. 77 FR 47440 - Office of the Assistant Secretary for Office of Disability Employment Program Accessible...

    Science.gov (United States)

    2012-08-08

    ... employment and creating accessible human resource management systems (e.g., accessible online job application... to develop and operate the Accessible Technology Action Center (ATAC), a new national resource to..., coordinate and publicize resources on accessible technology in the workplace; (2) promote effective employer...

  7. 50 CFR 648.60 - Sea scallop area access program requirements.

    Science.gov (United States)

    2010-10-01

    ... subsequent fishing year. For example, a vessel that terminates an Elephant Trunk Access Area trip on December...) Elephant Trunk Access Area. For the 2010 fishing year, the observer set-aside for the Elephant Trunk Access... Area. For the 2010 fishing year, the research set-aside for the Elephant Trunk Access Area is 277,060...

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

    Science.gov (United States)

    McClellan, Sean R.

    2013-01-01

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

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

    Science.gov (United States)

    Snowden, Lonnie R; McClellan, Sean R

    2013-09-01

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

  10. Syringe calibration factors and volume correction factors for the NPL secondary standard radionuclide calibrator

    CERN Document Server

    Tyler, D K

    2002-01-01

    The activity assay of a radiopharmaceutical administration to a patient is normally achieved via the use of a radionuclide calibrator. Because of the different geometries and elemental compositions between plastic syringes and glass vials, the calibration factors for syringes may well be significantly different from those for the glass containers. The magnitude of these differences depends on the energies of the emitted photons. For some radionuclides variations have been observed of 70 %, it is therefore important to recalibrate for syringes or use syringe calibration factors. Calibration factors and volume correction factors have been derived for the NPL secondary standard radionuclide calibrator, for a variety of commonly used syringes and needles, for the most commonly used medical radionuclide.

  11. [Trial manufacture of a plunger shield for a disposable plastic syringe].

    Science.gov (United States)

    Murakami, Shigeki; Emoto, Takashi; Mori, Hiroshige; Fujita, Katsuhisa; Kubo, Naoki

    2008-08-20

    A syringe-type radiopharmaceutical being supplied by a manufacturer has a syringe shield and a plunger shield, whereas an in-hospital labeling radiopharmaceutical is administered by a disposable plastic syringe without the plunger shield. In cooperation with Nihon Medi-Physics Co. Ltd., we have produced a new experimental plunger shield for the disposable plastic syringe. In order to evaluate this shielding effect, we compared the leaked radiation doses of our plunger shield with those of the syringe-type radiopharmaceutical (Medi shield type). Our plunger shield has a lead plate of 21 mm in diameter and 3 mm thick. This shield is equipped with the plunger-end of a disposal plastic syringe. We sealed 99mTc solution into a plastic syringe (Terumo Co.) of 5 ml with our plunger shield and Medi shield type of 2 ml. We measured leaked radiation doses around syringes using fluorescent glass dosimeters (Dose Ace). The number of measure points was 18. The measured doses were converted to 70 microm dose equivalent at 740 MBq of radioactivity. The results of our plunger shield and the Medi shield type were as follows: 4-13 microSv/h and 3-14 microSv/h at shielding areas, 3-545 microSv/h and 6-97 microSv/h at non-shielding areas, 42-116 microSv/h and 88-165 microSv/h in the vicinity of the syringe shield, and 1071 microSv/h and 1243 microSv/h at the front of the needle. For dose rates of shielding areas around the syringe, the shielding effects were approximately the same as those of the Medi shield type. In conclusion, our plunger shield may be useful for reducing finger exposure during the injection of an in-hospital labeled radiopharmaceutical.

  12. The educational impact of the Specialty Care Access Network-Extension of Community Healthcare Outcomes program.

    Science.gov (United States)

    Salgia, Reena J; Mullan, Patricia B; McCurdy, Heather; Sales, Anne; Moseley, Richard H; Su, Grace L

    2014-11-01

    With the aging hepatitis C cohort and increasing prevalence of fatty liver disease, the burden on primary care providers (PCPs) to care for patients with liver disease is growing. In response, the Veterans Administration implemented initiatives for primary care-specialty referral to increase PCP competency in complex disease management. The Specialty Care Access Network-Extension of Community Healthcare Outcomes (SCAN-ECHO) program initiative was designed to transfer subspecialty knowledge to PCPs through case-based distance learning combined with real-time consultation. There is limited information regarding the initiative's ability to engage PCPs to learn and influence their practice. We surveyed PCPs to determine the factors that led to their participation in this program and the educational impact of participation. Of 51 potential participants, 24 responded to an anonymous survey. More than 75% of respondents participated more than one time in a SCAN-ECHO clinic. Providers were motivated to participate by a desire to learn more about liver disease, to apply the knowledge gained to future patients, and to save their patients time traveling to another center for specialty consultation. Seventy-one percent responded that the didactic component and case-based discussion were equally important. It is important that participation changed clinical practice: 75% of providers indicated they had personally discussed the information they learned from the case presentations with their colleague(s), and 42% indicated they helped a colleague care for their patient with the knowledge learned during discussions of other participants' cases. This study shows that the SCAN-ECHO videoconferencing program between PCPs and specialists can educate providers in the delivery of specialty care from a distance and potentially improve healthcare delivery.

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

    Science.gov (United States)

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

    2017-01-01

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

  14. Epinephrine syringe exchange events in a paediatric cardiovascular ICU: analysing the storm.

    Science.gov (United States)

    Achuff, Barbara-Jo; Achuff, Jameson C; Park, Hwan H; Moffett, Brady; Acosta, Sebastian; Rusin, Craig G; Checchia, Paul A

    2018-03-01

    Introduction Haemodynamically unstable patients can experience potentially hazardous changes in vital signs related to the exchange of depleted syringes of epinephrine to full syringes. The purpose was to determine the measured effects of epinephrine syringe exchanges on the magnitude, duration, and frequency of haemodynamic disturbances in the hour after an exchange event (study) relative to the hours before (control). Materials and methods Beat-to-beat vital signs recorded every 2 seconds from bedside monitors for patients admitted to the paediatric cardiovascular ICU of Texas Children's Hospital were collected between 1 January, 2013 and 30 June, 2015. Epinephrine syringe exchanges without dose/flow change were obtained from electronic records. Time, magnitude, and duration of changes in systolic blood pressure and heart rate were characterised using Matlab. Significant haemodynamic events were identified and compared with control data. In all, 1042 syringe exchange events were found and 850 (81.6%) had uncorrupted data for analysis. A total of 744 (87.5%) exchanges had at least 1 associated haemodynamic perturbation including 2958 systolic blood pressure and 1747 heart-rate changes. Heart-rate perturbations occurred 37% before exchange and 63% after exchange, and 37% of systolic blood pressure perturbations happened before syringe exchange, whereas 63% occurred after syringe exchange with significant differences found in systolic blood pressure frequency (pexchange events.

  15. Efficacy trial of Camouflage Syringe to reduce dental fear and anxiety.

    Science.gov (United States)

    Ujaoney, S; Mamtani, M; Thakre, T; Tote, J; Hazarey, V; Hazarey, P; Kulkarni, H

    2013-12-01

    Dental fear and anxiety in early childhood are widely prevalent and contribute to dental problems and behaviour in adulthood. Novel ways to reduce dental fear and anxiety in children are needed. Our aim was to conduct an efficacy trial of a novel Camouflage Syringe to reduce dental fear and anxiety in children. randomised controlled trial of efficacy of the Camouflage Syringe. We designed a Camouflage Syringe with a toy-like appearance that veils the conventional syringe to permit topical application and injection of local anaesthesia and ensure more involvement of the patient in the treatment process. We conducted a concurrent parallel, randomised controlled trial (NCT01398007) on the efficacy of this Camouflage Syringe to reduce the dental fear and anxiety in children seeking dental treatment who required the use of local anaesthesia. Using Venham's clinical rating scale, Venham's picture test, parental stress questionnaire and recall questionnaire, the efficacy of the Camouflage Syringe to reduce dental fear and anxiety ranged from 82% to 97% for various outcomes and from 60% to 100% for prevention of related adverse outcomes. For all outcomes, the number needed to treat was close to unity. Our results strongly favour the use of Camouflage Syringe to reduce dental fear and anxiety in children.

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

    Science.gov (United States)

    Ramamurthy, M. K.

    2016-12-01

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

  17. 76 FR 26927 - National Organic Program; Notice on the Ruminant Slaughter Stock Provision of the Access to...

    Science.gov (United States)

    2011-05-10

    ... commenters requested that the NOP facilitate a means to obtain organic certification and grass-fed..., can elect to pursue claims, such as grass-fed, in addition to and separate from organic certification...-11-07] National Organic Program; Notice on the Ruminant Slaughter Stock Provision of the Access to...

  18. Can free open access resources strengthen knowledge-based emerging public health priorities, policies and programs in Africa?

    Science.gov (United States)

    Tambo, Ernest; Madjou, Ghislaine; Khayeka-Wandabwa, Christopher; Tekwu, Emmanuel N; Olalubi, Oluwasogo A; Midzi, Nicolas; Bengyella, Louis; Adedeji, Ahmed A; Ngogang, Jeanne Y

    2016-01-01

    Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems.  As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs.

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

    Science.gov (United States)

    Mahmud, Aidalina; Aljunid, Syed Mohamed

    2018-01-01

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

  20. Increasing access to evidence-based smoking cessation treatment: effectiveness of a free nicotine patch program among Chinese immigrants.

    Science.gov (United States)

    Shelley, Donna; Nguyen, Nam; Peng, Cha-Hui; Chin, Margaret; Chang, Ming-der; Fahs, Marianne

    2010-04-01

    Pharmacotherapy substantially increases smoking cessation rates. However, programs to reduce barriers to this evidence-based treatment may not improve access among high risk immigrant non English speaking populations. This study estimates the effectiveness of a tailored free nicotine patch (NRT) program among Chinese American smokers living in New York City (NYC). Between July 2004 and May 2005 NRT was distributed to 375 smokers through two community-based organizations that serve the Asian American population in NYC. Participants completed an in person baseline survey and a 4-month follow-up telephone survey. Using an intention to treat analysis the abstinence rate at 4 months was 26.7% (100/375). Predictors of cessation included higher levels of self efficacy at baseline, not smoking while using the patch and concern about personal health risks. Distribution through easy to access, culturally competent local community organizations increased the reach of a free nicotine patch program and assisted smokers in quitting.

  1. Study on the radiation effect of plastic syringe materials

    International Nuclear Information System (INIS)

    Byun, H.C.; Yun, B.M.; Kim, K.Y.; Kong, Y.K.; Park, H.Y.

    1983-01-01

    From the viewpoint of gammasterilization, the defects of domestic polypropylene as the syringe material are to get worse the mechanical properties and discoloration by irradiation. Therefore, the domestic polystyrene (GPPS 150) were inspected to use as substitute for the polypropylene. The gel point of the polystyrene was about 100Mrad and none momentous change of the mechanical properties were appeared until the dose reached to the point. Above the point, as the crosslinking reaction proceed both strength of tensile and impact were increased with discoloration. No significant problem was also found in the water extract test and chemical resistance test. In addition to the pure polystyrene, the copolymer of butadiene (HIPS 425) and the blend material of polypropylene were also inspected for the purpose and almost same results were obtained in the radiation irradiation. From the above result, it is considered that polystyrene and the copolymer and the blend mentioned above are available for the medical plastics which would be sterilized by gamma-radiation. (Author)

  2. Evaluation of syringe shield effectiveness in handling radiopharmaceuticals

    Directory of Open Access Journals (Sweden)

    Cho Yong-In

    2015-01-01

    Full Text Available The purpose of this study was to evaluate the effectiveness of the radiation shield of radionuclide syringes and the personal dose equivalent by performing a simulation of radionuclides used in nuclear medicine diagnosis. In order to evaluate the dose depending on the distance between the radiation source and the ICRU sphere against the thickness of the shielding device, the distance at which a nuclear medicine worker may inadvertently come into contact with radiation from the radiation source was set at 0 cm to 30 cm according to the thickness of the shield, thus fixing the ICRU sphere. For a dose evaluation, Hp(10, Hp(3, and Hp(0.07 measurable in specific depth of the ICRU were evaluated. It was found that a dose measured on skin surface of nuclear medicine workers was relatively higher, that the dose varied in relation to the thickness of the radiation shield, and that the shielding effect decreased for some radiation sources such as 67Ga and 111In. It proved necessary to increase thickness of shielding device to the radiation sources such as 67Ga and 111In. It is also considered that a study of proper shielding thickness will be needed in future.

  3. Mechanized syringe homogenization of human and animal tissues.

    Science.gov (United States)

    Kurien, Biji T; Porter, Andrew C; Patel, Nisha C; Kurono, Sadamu; Matsumoto, Hiroyuki; Scofield, R Hal

    2004-06-01

    Tissue homogenization is a prerequisite to any fractionation schedule. A plethora of hands-on methods are available to homogenize tissues. Here we report a mechanized method for homogenizing animal and human tissues rapidly and easily. The Bio-Mixer 1200 (manufactured by Innovative Products, Inc., Oklahoma City, OK) utilizes the back-and-forth movement of two motor-driven disposable syringes, connected to each other through a three-way stopcock, to homogenize animal or human tissue. Using this method, we were able to homogenize human or mouse tissues (brain, liver, heart, and salivary glands) in 5 min. From sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis and a matrix-assisted laser desorption/ionization time-of-flight mass spectrometric enzyme assay for prolidase, we have found that the homogenates obtained were as good or even better than that obtained used a manual glass-on-Teflon (DuPont, Wilmington, DE) homogenization protocol (all-glass tube and Teflon pestle). Use of the Bio-Mixer 1200 to homogenize animal or human tissue precludes the need to stay in the cold room as is the case with the other hands-on homogenization methods available, in addition to freeing up time for other experiments.

  4. Direct observation of syringeal muscle function in songbirds and a parrot

    DEFF Research Database (Denmark)

    Larsen, Ole Næsbye; Goller, Franz

    2002-01-01

    on the syrinx. Contraction of m. tracheobronchialis ventralis enlarges the syringeal lumen and thus increases airflow by abducting the LL but does not affect the ML. The largest syringeal muscle, m. syringealis ventralis, plays a minor role, if any, in direct aperture control and thus in gating airflow...... the LTMs further into the tracheal lumen but does not close the syringeal aperture fully. The intrinsic deep muscle, m. syringealis profundus, abducts the LTMs through cranio-laterad movement of a paired, protruding half-ring. The weakly developed extrinsic m. sternotrachealis seems to increase tension......The role of syringeal muscles in controlling the aperture of the avian vocal organ, the syrinx, was evaluated directly for the first time by observing and filming through an endoscope while electrically stimulating different muscle groups of anaesthetised birds. In songbirds (brown thrashers...

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

    Directory of Open Access Journals (Sweden)

    Emily Saurman

    2014-07-01

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

  6. Variability in syringe components and its impact on functionality of delivery systems.

    Science.gov (United States)

    Rathore, Nitin; Pranay, Pratik; Eu, Bruce; Ji, Wenchang; Walls, Ed

    2011-01-01

    Prefilled syringes and autoinjectors are becoming increasingly common for parenteral drug administration primarily due to the convenience they offer to the patients. Successful commercialization of such delivery systems requires thorough characterization of individual components. Complete understanding of various sources of variability and their ranking is essential for robust device design. In this work, we studied the impact of variability in various primary container and device components on the delivery forces associated with syringe injection. More specifically, the effects of barrel size, needle size, autoinjector spring force, and frictional forces have been evaluated. An analytical model based on underlying physics is developed that can be used to fully characterize the design space for a product delivery system. Use of prefilled syringes (syringes prefilled with active drug) is becoming increasingly common for injectable drugs. Compared to vials, prefilled syringes offer higher dose accuracy and ease of use due to fewer steps required for dosage. Convenience to end users can be further enhanced through the use of prefilled syringes in combination with delivery devices such as autoinjectors. These devices allow patients to self-administer the drug by following simple steps such as pressing a button. These autoinjectors are often spring-loaded and are designed to keep the needle tip shielded prior to injection. Because the needle is not visible to the user, such autoinjectors are perceived to be less invasive than syringes and help the patient overcome the hesitation associated with self-administration. In order to successfully develop and market such delivery devices, we need to perform an in-depth analysis of the components that come into play during the activation of the device and dose delivery. Typically, an autoinjector is activated by the press of a button that releases a compressed spring; the spring relaxes and provides the driving force to push the

  7. Implementation Study of Patient-Ready Syringes Containing 25 mg/mL Methotrexate Solution for Use in Treating Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    R. Respaud

    2014-01-01

    Full Text Available Background. Ectopic pregnancy (EP is a significant cause of morbidity and mortality during the first trimester of pregnancy. Small unruptured tubal pregnancies can be treated medically with a single dose of methotrexate (MTX. Objective. The aim of this study was to evaluate the stability of a 25 mg/mL solution of MTX to devise a secure delivery circuit for the preparation and use of this medication in the management of EP. Method. MTX solutions were packaged in polypropylene syringes, stored over an 84-day period, and protected from light either at +2 to +8°C or at 23°C. We assessed the physical and chemical stability of the solutions at various time points over the storage period. A pharmaceutical delivery circuit was implemented that involved the batch preparation of MTX syringes. Results. We show that 25 mg/mL MTX solutions remain stable over an 84-day period under the storage conditions tested. Standard doses were prepared, ranging from 50 mg to 100 mg. The results of this study suggest that MTX syringes can be prepared in advance by the pharmacy, ready to be dispensed at any time that a diagnosis of EP is made. Conclusion. The high stability of a 25 mg/mL MTX solution in polypropylene syringes makes it possible to implement a flexible and cost-effective delivery circuit for ready-to-use preparations of this drug, providing 24-hour access and preventing treatment delays.

  8. 75 FR 6790 - Interagency Guidance on Response Programs for Unauthorized Access to Customer Information and...

    Science.gov (United States)

    2010-02-10

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

  9. Where Are the Women? A Report into Issues Related to Women's Access to Workplace Literacy Programs.

    Science.gov (United States)

    Milton, Marion

    A study investigated provision of workplace literacy courses available for women in female-dominated industries and women's access to and participation in those courses. A literature review revealed very little research on the required increased literacy skills in Australia and no previous studies on women's access to workplace literacy courses in…

  10. 76 FR 15028 - Airport Improvement Program (AIP): Interim Policy Regarding Access to Airports From Residential...

    Science.gov (United States)

    2011-03-18

    ... transparent. As a result of these efforts, the agency expects to have reliable information on the utilization... issued, most commenters supported FAA's proposal to allow existing residential through-the-fence access... commenters supported the FAA's proposal to allow through-the-fence access where it exists, if the airport can...

  11. Retraction of the Plunger on a Syringe of Hyaluronic Acid Before Injection: Are We Safe?

    Science.gov (United States)

    Carey, Wayne; Weinkle, Susan

    2015-12-01

    Controversy exists concerning the need for aspiration before injection with hyaluronic acid (HA) fillers. The authors undertook a study of HA products to determine if blood could be aspirated back into a syringe of HA when the needle has been primed or filled with HA. Two studies were set up to determine if or when blood could be withdrawn from a heparinized fresh tube of blood into the HA syringe. Two different techniques were tested; one using a slow-pull retraction of the plunger and up to a 5-second waiting time before release versus a rapid pullback and quick release. Review of these data demonstrates that the usual clinical method, which involves quick withdrawal and instant release of the syringe plunger does not allow for sufficient removal of the filler found intraluminal in the needle and may give rise to false negative results in vitro and likely in vivo with the exception being the Galderma/Medicis products. In summary, withdrawal of the syringe plunger with no visible blood in the syringe does not eliminate the possibility of intravascular placement of the syringe needle.

  12. Adsorption of technetium-99m tetrofosmin and technetium-99m furifosmin on plastic syringes

    International Nuclear Information System (INIS)

    Bartosch, R.; Granegger, S.; Sinzinger, H.

    1998-01-01

    Some groups have reported that adsorption of radiopharmaceuticals on disposable plastic syringes can reach levels of almost 50%. This high loss of radioactivity stimulated us to carry out similar studies. Our measurements were done in combination with patient studies. Therefore, we used 2-ml syringes, all of the same brand. The radioactivity in the syringe was measured immediately before and after injection. a total of 500-600 MBq technetium-99m labelled tetrofosmin or technetium-99m furifosmin was administered to 48 patients using four different injection techniques (n = 6 for each technique with each tracer): with needles, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer; with butterflies, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer. Neither in syringes nor in needles or butterflies did more than 7% of the initial radioactivity remain. The entire residual activity in syringe plus needle or syringe plus butterfly together never exceeded the 9% limit. Furthermore, in a pilot study we measured the remaining radioactivity in the vial; here, too, we found no more than 14% of total radioactivity. These findings indicate that total retention of radioactivity during elution and application of 99m Tc-tetrofosmin and 99m Tc-furifosmin with material used in our setting does not approach relevant amounts. (orig.)

  13. Adsorption of technetium-99m tetrofosmin and technetium-99m furifosmin on plastic syringes

    Energy Technology Data Exchange (ETDEWEB)

    Bartosch, R.; Granegger, S.; Sinzinger, H. [Department of Nuclear Medicine, University of Vienna (Austria)

    1998-09-01

    Some groups have reported that adsorption of radiopharmaceuticals on disposable plastic syringes can reach levels of almost 50%. This high loss of radioactivity stimulated us to carry out similar studies. Our measurements were done in combination with patient studies. Therefore, we used 2-ml syringes, all of the same brand. The radioactivity in the syringe was measured immediately before and after injection. a total of 500-600 MBq technetium-99m labelled tetrofosmin or technetium-99m furifosmin was administered to 48 patients using four different injection techniques (n = 6 for each technique with each tracer): with needles, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer; with butterflies, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer. Neither in syringes nor in needles or butterflies did more than 7% of the initial radioactivity remain. The entire residual activity in syringe plus needle or syringe plus butterfly together never exceeded the 9% limit. Furthermore, in a pilot study we measured the remaining radioactivity in the vial; here, too, we found no more than 14% of total radioactivity. These findings indicate that total retention of radioactivity during elution and application of {sup 99m}Tc-tetrofosmin and {sup 99m}Tc-furifosmin with material used in our setting does not approach relevant amounts. (orig.) With 4 figs., 1 tab., 7 refs.

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

    Science.gov (United States)

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

    2017-10-01

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

  15. Integrated employee assistance program/managed behavioral health care benefits: relationship with access and client characteristics.

    Science.gov (United States)

    Levy Merrick, Elizabeth S; Hodgkin, Dominic; Horgan, Constance M; Hiatt, Deirdre; McCann, Bernard; Azzone, Vanessa; Zolotusky, Galina; Ritter, Grant; Reif, Sharon; McGuire, Thomas G

    2009-11-01

    This study examined service user characteristics and determinants of access for enrollees in integrated EAP/behavioral health versus standard managed behavioral health care plans. A national managed behavioral health care organization's claims data from 2004 were used. Integrated plan service users were more likely to be employees rather than dependents, and to be diagnosed with adjustment disorder. Logistic regression analyses found greater likelihood in integrated plans of accessing behavioral health services (OR 1.20, CI 1.17-1.24), and substance abuse services specifically (OR 1.23, CI 1.06-1.43). Results are consistent with the concept that EAP benefits may increase access and address problems earlier.

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

    Science.gov (United States)

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

    2017-09-01

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

  17. The University of Arizona Nanosat Program: Making Space accessible to scientific and commercial packages.

    Science.gov (United States)

    Fink, U.; Fevig, R. A.

    2003-05-01

    For the last couple of years we have been engaged in building nanosatellites within a student-mentor framework. The satellites are 10x10x10cm cubes, have a maximum mass of 1 kg, and power of a few watts. The standardized "cube-sat" form factor was suggested by Bob Twiggs of Stanford University so that a common launch platform could be utilized and more Universities could participate. We have now built four "cube-sats': a launchable Engineering model, Rincon 1 & 2, (funded by Rincon corporation), and Alcatel funded by Alcatel Espace. The costs for the four satellites are \\250,000. Launch costs using a Russian SS-18 are typically \\10,000 per kg. The payload for Rincon 1 & 2 is a sophisticated telecommunications board using only 10 mw of transmitting power. The Alcatel payload consists of three communications IC's whose radiation exposure and annealing properties will be studied over a period of years. Future nanosatellites will have considerable value in providing low cost access to space for experiments in nanotechnology, space electronics, micropropulsion, radiation experiments, astrobionics and climate change studies. For the latter area we are considering experiments to monitor the solar constant, the solar UV spectrum, the chromospheric activity through the Mg II index, the Earth's Albedo, etc. For this purpose we are developing a slightly larger satellite, 20x20x20cm and 10 kg. We have built a C-MOS camera with a 1 ms exposure time for attitude determination, and we are working with Honeywell Industries to develop micro-reaction wheels for attitude control. We are also working on micro-propulsion units with the Air Force and several aerospace companies. Preliminary calculations show that we can develop delta-V's of 5km/s which will allow us to visit 5% (about 100) of the NEA population or possibly some comets. We firmly believe a vigorous nanosatellite program will allow useful space experiments for costs of millions of Dollars instead of the present tens of

  18. 75 FR 2583 - Over-the-Road Bus Accessibility Program Grants

    Science.gov (United States)

    2010-01-15

    ... complying with DOT's over- the-road bus accessibility regulation. The authorizing legislation calls for..., 915 Chicago, IL 60606, Tel. 312-353- Second Avenue, Suite 3142, 2789. Seattle, WA 98174-1002, Tel. 206...

  19. Implementing a Healthy Food Distribution Program: A Supply Chain Strategy to Increase Fruit and Vegetable Access in Underserved Areas.

    Science.gov (United States)

    DeFosset, Amelia R; Kwan, Allison; Rizik-Baer, Daniel; Gutierrez, Luis; Gase, Lauren N; Kuo, Tony

    2018-05-24

    Increasing access to fresh produce in small retail venues could improve the diet of people in underserved communities. However, small retailers face barriers to stocking fresh produce. In 2014, an innovative distribution program, Community Markets Purchasing Real and Affordable Foods (COMPRA), was launched in Los Angeles with the aim of making it more convenient and profitable for small retailers to stock fresh produce. Our case study describes the key processes and lessons learned in the first 2 years of implementing COMPRA. Considerable investments in staff capacity and infrastructure were needed to launch COMPRA. Early successes included significant week-to-week increases in the volume of produce distributed. Leveraging partnerships, maintaining a flexible operational and funding structure, and broadly addressing store owners' needs contributed to initial gains. We describe key challenges and next steps to scaling the program. Lessons learned from implementing COMPRA could inform other jurisdictions considering supply-side approaches to increase access to healthy food.

  20. Small scale farmers’ access to and participation in markets : The case of the P4P program in western Kenya

    OpenAIRE

    Skjöldevald, Maja

    2012-01-01

    The purpose of this thesis is to understand how small scale farmers navigate the market to access and participate in the formal maize market to improve their revenue, utilising the case of the P4P program inKenya. The empirical material was collected during fieldwork in Kenya. Qualitative methods were found to be the most suitable for this thesis. The methods that was utilised were a case study strategy, semi structured interviews, focus groups, observations and analysis of secondary sources....

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

    Data.gov (United States)

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

  2. After-School Programs: Expanding Access and Ensuring Quality. PPI Policy Report

    Science.gov (United States)

    Gayl, Chrisanne L.

    2004-01-01

    High quality after-school programs provide numerous social, family, and community benefits. In addition to helping parents balance work and life responsibilities, these programs offer prime opportunities to enhance learning--particularly for struggling students. After-school programs also help to promote equity among students by providing…

  3. Safe and unsafe spaces: Non-fatal overdose, arrest, and receptive syringe sharing among people who inject drugs in public and semi-public spaces in Baltimore City.

    Science.gov (United States)

    Hunter, Kyle; Park, Ju Nyeong; Allen, Sean T; Chaulk, Patrick; Frost, Taeko; Weir, Brian W; Sherman, Susan G

    2018-04-13

    The spaces in which drug use occurs constitutes a key aspect of the "risk environment" of people who inject drugs (PWID). We aimed to add nuance to the characterization of "safe" and "unsafe" spaces in PWID's environments to further understand how these spaces amplify the risk of morbidities associated with injection drug use. PWID were recruited through the Baltimore City syringe service program and through peer referral. Participants completed a socio-behavioral survey. Multivariable logistic regression was used to identify associations between utilization of public, semi-public and private spaces with arrest, non-fatal overdose, and receptive syringe sharing. The sample of PWID (N = 283) was mostly 45 years and older (54%), male (69%), Black (55%), and heroin users (96%). Compared to PWID who primarily used private settings, the adjusted odds of recent overdose were greater among PWID who mostly used semi-public and public locations to inject drugs. We also found independent associations between arrest and semi-public spaces, and between receptive syringe sharing and public spaces (all p spaces where PWID can reduce their risk of overdose, likelihood of arrest and blood-borne diseases, and the dual potential of the environment in promoting health and risk. Copyright © 2018 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2012-10-01

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

  5. Comparison of drug delivery with autoinjector versus manual prefilled syringe and between three different autoinjector devices administered in pig thigh

    Directory of Open Access Journals (Sweden)

    Hill RL

    2016-08-01

    Full Text Available Robert L Hill,1,* John G Wilmot,1,* Beth A Belluscio,1 Kevin Cleary,2 David Lindisch,3 Robin Tucker,4 Emmanuel Wilson,2 Rajesh B Shukla11Meridian Medical Technologies Inc., Columbia, MD, 2Children’s National Medical Center, 3Washington DC VA Medical Center, 4Georgetown University Medical Center, Washington, DC, USA *These authors have contributed equally to this work Abstract: Parenteral routes of drug administration are often selected to optimize actual dose of drug delivered, assure high bioavailability, bypass first-pass metabolism or harsh gastrointestinal environments, as well as maximize the speed of onset. Intramuscular (IM delivery can be preferred to intravenous delivery when initiating intravenous access is difficult or impossible. Drugs can be injected intramuscularly using a syringe or an automated delivery device (autoinjector. Investigation into the IM delivery dynamics of these methods may guide further improvements in the performance of injection technologies. Two porcine model studies were conducted to compare differences in dispersion of injectate volume for different methods of IM drug administration. The first study compared the differences in the degree of dispersion and uptake of injectate following the use of a manual syringe and an autoinjector. The second study compared the spatial spread of the injected formulation, or dispersion volume, and uptake of injectate following the use of five different autoinjectors (EpiPen® [0.3 mL], EpiPen® Jr [0.3 mL], Twinject® [0.15 mL, 0.3 mL], and Anapen® 300 [0.3 mL] with varying needle length, needle gauge, and force applied to the plunger. In the first study, the autoinjector provided higher peak volumes of injectate, indicating a greater degree of dispersion, compared with manual syringe delivery. In the second study, EpiPen autoinjectors resulted in larger dispersion volumes and higher initial dispersion ratios, which decreased rapidly over time, suggesting a greater

  6. A Widely-Accessible Distributed MEMS Processing Environment. The MEMS Exchange Program

    Science.gov (United States)

    2012-10-29

    all of these patterns in advance, we made a new cost model, called the Python Code cost model, which utilizes the power of a high level programming ...document entitled “The Beginners Guide to MEMS Processing” on the MEMSNet and MEMS Exchange The MEMS Exchange Program Final Technical Report October 29...from the Government is absolutely necessary. As said The MEMS Exchange Program Final Technical Report October 29, 2012 Page 57 of 58 before

  7. 77 FR 48199 - Privacy Act; System of Records: State-35, Information Access Programs Records

    Science.gov (United States)

    2012-08-13

    ..., the Privacy Act, the Ethics in Government Act, the access provisions of Executive Order 13526 or a...; requester's name and requester's mailing and email address; Social Security number (if provided by the...: Hard copy and electronic media. RETRIEVABILITY: Individual name, case number. SAFEGUARDS: All users are...

  8. 77 FR 44515 - Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property

    Science.gov (United States)

    2012-07-30

    ... commercial service airport sponsor's inability to comply with the law and/or the standards of compliance as a...) proposes that the FAA may consider a commercial service airport's inability to comply with the law and/or... the access plan represents an Agency determination that the commercial service airport has met the law...

  9. Energizing Africa : Achievements and Lessons from the Africa Renewable Energy and Access Program Phase I

    OpenAIRE

    World Bank Group

    2015-01-01

    Access to energy and economic development go hand in hand. Improving electricity supply and distribution boosts economic growth, creates jobs, and expands the reach of educational and health services. It can also empower women, providing income-generating opportunities and enabling them to spend their time more productively. Unfortunately, more than 589 million people in Sub-Saharan Africa...

  10. 75 FR 54946 - Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property

    Science.gov (United States)

    2010-09-09

    ... summarized as follows: Comment: Residential through-the-fence access provides a supportive community that... accommodate new aircraft types. Secondly, while through-the-fence communities sometimes attempt to limit ownership to aircraft owners, there is no effective way to prevent turnover of these properties to non...

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

    Science.gov (United States)

    Greenberg, Maya Delgado; Kuns, Jerry

    2012-01-01

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

  12. Influence of Syringe Volume on Foam Stability in Sclerotherapy for Varicose Vein Treatment.

    Science.gov (United States)

    Bai, Taoping; Jiang, Wentao; Fan, Yubo

    2018-05-01

    Despite the popularity of sclerotherapy for treating varicose veins, it still exhibits various problems, such as pulmonary embolism, deep-vein thrombosis, phlebitis, and visual disorders. To investigate syringe volume influence on foam stability, obtain the foam decay rule, and provide a reference for clinics. Five types of syringes are used to prepare foam at room temperature with various liquid-gas ratios. Foam decay process experiments were performed 5 times and recorded by video. The stability indices used include drainage time, half-life, bubble diameter, bubble surface density, and drainage rate. The 30 and 2-mL syringes, respectively, recorded the highest and lowest drainage speeds. Foam drainage time and half-life, differences varied between 15 and 70 seconds, and 20 and 100 seconds, respectively. Foam bubble diameters were distributed over 0.1 to 2.0 mm with roughly 200 to 700 bubbles per square centimeter. Increased syringe volume causes the bubble diameter to increase. Thus, foam dispersion increases and foam half-life decreases; hence, foam becomes unstable. It is, thus, better to use a small syringe several times to prepare foam in clinics using segmented injections.

  13. A syringe-sharing model for the spread of HIV: application to Omsk, Western Siberia.

    Science.gov (United States)

    Artzrouni, Marc; Leonenko, Vasiliy N; Mara, Thierry A

    2017-03-01

    A system of two differential equations is used to model the transmission dynamics of human immunodeficiency virus between 'persons who inject drugs' (PWIDs) and their syringes. Our vector-borne disease model hinges on a metaphorical urn from which PWIDs draw syringes at random which may or may not be infected and may or may not result in one of the two agents becoming infected. The model's parameters are estimated with data mostly from the city of Omsk in Western Siberia. A linear trend in PWID prevalence in Omsk could only be fitted by considering a time-dependent version of the model captured through a secular decrease in the probability that PWIDs decide to share a syringe. A global sensitivity analysis is performed with 14 parameters considered random variables in order to assess their impact on average numbers infected over a 50-year projection. With obvious intervention implications the drug injection rate and the probability of syringe-cleansing are the only parameters whose coefficients of correlations with numbers of infected PWIDs and infected syringes have an absolute value close to or larger than 0.40. © The authors 2015. Published by Oxford University Press on behalf of the Institute of Mathematics and its Applications. All rights reserved.

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

    Science.gov (United States)

    Wainer, Allison L.; Ingersoll, Brooke R.

    2015-01-01

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

  15. Between Vulnerability and Risk: Promoting Access and Equity in a School-University Partnership Program

    Science.gov (United States)

    Bourke, Alan; Jayman, Alison Jenkins

    2011-01-01

    This article utilizes interview data to explore how notions of risk operate in a school-university partnership program. Our analysis traces the divergence between conceptualizations of "at-risk" in scholarship, its use in policy, and students' responses to this terminology. Although students targeted in such programs are often…

  16. 45 CFR 2490.151 - Program accessibility: New construction and alterations.

    Science.gov (United States)

    2010-10-01

    ... alterations. 2490.151 Section 2490.151 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.151 Program...

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

    Science.gov (United States)

    Ramsey, Jennifer

    2010-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  19. Connecting people with cancer to physical activity and exercise programs: a pathway to create accessibility and engagement

    Science.gov (United States)

    Mina, D. Santa; Sabiston, C.M.; Au, D.; Fong, A.J.; Capozzi, L.C.; Langelier, D.; Chasen, M.; Chiarotto, J.; Tomasone, J.R.; Jones, J.M.; Chang, E.; Culos-Reed, S.N.

    2018-01-01

    Recent guidelines concerning exercise for people with cancer provide evidence-based direction for exercise assessment and prescription for clinicians and their patients. Although the guidelines promote exercise integration into clinical care for people with cancer, they do not support strategies for bridging the guidelines with related resources or programs. Exercise program accessibility remains a challenge in implementing the guidelines, but that challenge might be mitigated with conceptual frameworks (“pathways”) that connect patients with exercise-related resources. In the present paper, we describe a pathway model and related resources that were developed by an expert panel of practitioners and researchers in the field of exercise and rehabilitation in oncology and that support the transition from health care practitioner to exercise programs or services for people with cancer. The model acknowledges the nuanced distinctions between research and exercise programming, as well as physical activity promotion, that, depending on the available programming in the local community or region, might influence practitioner use. Furthermore, the pathway identifies and provides examples of processes for referral, screening, medical clearance, and programming for people after a cancer diagnosis. The pathway supports the implementation of exercise guidelines and should serve as a model of enhanced care delivery to increase the health and well-being of people with cancer. PMID:29719431

  20. Connecting people with cancer to physical activity and exercise programs: a pathway to create accessibility and engagement.

    Science.gov (United States)

    Mina, D Santa; Sabiston, C M; Au, D; Fong, A J; Capozzi, L C; Langelier, D; Chasen, M; Chiarotto, J; Tomasone, J R; Jones, J M; Chang, E; Culos-Reed, S N

    2018-04-01

    Recent guidelines concerning exercise for people with cancer provide evidence-based direction for exercise assessment and prescription for clinicians and their patients. Although the guidelines promote exercise integration into clinical care for people with cancer, they do not support strategies for bridging the guidelines with related resources or programs. Exercise program accessibility remains a challenge in implementing the guidelines, but that challenge might be mitigated with conceptual frameworks ("pathways") that connect patients with exercise-related resources. In the present paper, we describe a pathway model and related resources that were developed by an expert panel of practitioners and researchers in the field of exercise and rehabilitation in oncology and that support the transition from health care practitioner to exercise programs or services for people with cancer. The model acknowledges the nuanced distinctions between research and exercise programming, as well as physical activity promotion, that, depending on the available programming in the local community or region, might influence practitioner use. Furthermore, the pathway identifies and provides examples of processes for referral, screening, medical clearance, and programming for people after a cancer diagnosis. The pathway supports the implementation of exercise guidelines and should serve as a model of enhanced care delivery to increase the health and well-being of people with cancer.

  1. Does a voucher program improve reproductive health service delivery and access in Kenya?

    Science.gov (United States)

    Njuki, Rebecca; Abuya, Timothy; Kimani, James; Kanya, Lucy; Korongo, Allan; Mukanya, Collins; Bracke, Piet; Bellows, Ben; Warren, Charlotte E

    2015-05-23

    Current assessments on Output-Based Aid (OBA) programs have paid limited attention to the experiences and perceptions of the healthcare providers and facility managers. This study examines the knowledge, attitudes, and experiences of healthcare providers and facility managers in the Kenya reproductive health output-based approach voucher program. A total of 69 in-depth interviews with healthcare providers and facility managers in 30 voucher accredited facilities were conducted. The study hypothesized that a voucher program would be associated with improvements in reproductive health service provision. Data were transcribed and analyzed by adopting a thematic framework analysis approach. A combination of inductive and deductive analysis was conducted based on previous research and project documents. Facility managers and providers viewed the RH-OBA program as a feasible system for increasing service utilization and improving quality of care. Perceived benefits of the program included stimulation of competition between facilities and capital investment in most facilities. Awareness of family planning (FP) and gender-based violence (GBV) recovery services voucher, however, remained lower than the maternal health voucher service. Relations between the voucher management agency and accredited facilities as well as existing health systems challenges affect program functions. Public and private sector healthcare providers and facility managers perceive value in the voucher program as a healthcare financing model. They recognize that it has the potential to significantly increase demand for reproductive health services, improve quality of care and reduce inequities in the use of reproductive health services. To improve program functioning going forward, there is need to ensure the benefit package and criteria for beneficiary identification are well understood and that the public facilities are permitted greater autonomy to utilize revenue generated from the voucher program.

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

    Directory of Open Access Journals (Sweden)

    Maria Gudelia Rangel Gomez

    2017-06-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  4. Doula Services Within a Healthy Start Program: Increasing Access for an Underserved Population

    OpenAIRE

    Thomas, Mary-Powel; Ammann, Gabriela; Brazier, Ellen; Noyes, Philip; Maybank, Aletha

    2017-01-01

    Purpose Women of color in the United States, particularly in high-poverty neighborhoods, experience high rates of poor birth outcomes, including cesarean section, preterm birth, low birthweight, and infant mortality. Doula care has been linked to improvements in many perinatal outcomes, but women of color and low-income women often face barriers in accessing doula support. Description To address this issue, the New York City Department of Health and Mental Hygiene’s Healthy Start Brooklyn int...

  5. SuperB R&D computing program: HTTP direct access to distributed resources

    Science.gov (United States)

    Fella, A.; Bianchi, F.; Ciaschini, V.; Corvo, M.; Delprete, D.; Diacono, D.; Di Simone, A.; Franchini, P.; Donvito, G.; Giacomini, F.; Gianoli, A.; Longo, S.; Luitz, S.; Luppi, E.; Manzali, M.; Pardi, S.; Perez, A.; Rama, M.; Russo, G.; Santeramo, B.; Stroili, R.; Tomassetti, L.

    2012-12-01

    The SuperB asymmetric energy e+e- collider and detector to be built at the newly founded Nicola Cabibbo Lab will provide a uniquely sensitive probe of New Physics in the flavor sector of the Standard Model. Studying minute effects in the heavy quark and heavy lepton sectors requires a data sample of 75 ab-1 and a luminosity target of 1036cm-2s-1. The increasing network performance also in the Wide Area Network environment and the capability to read data remotely with good efficiency are providing new possibilities and opening new scenarios in the data access field. Subjects like data access and data availability in a distributed environment are key points in the definition of the computing model for an HEP experiment like SuperB. R&D efforts in such a field have been brought on during the last year in order to release the Computing Technical Design Report within 2013. WAN direct access to data has been identified as one of the more interesting viable option; robust and reliable protocols as HTTP/WebDAV and xrootd are the subjects of a specific R&D line in a mid-term scenario. In this work we present the R&D results obtained in the study of new data access technologies for typical HEP use cases, focusing on specific protocols such as HTTP and WebDAV in Wide Area Network scenarios. Reports on efficiency, performance and reliability tests performed in a data analysis context have been described. Future R&D plan includes HTTP and xrootd protocols comparison tests, in terms of performance, efficiency, security and features available.

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

    Directory of Open Access Journals (Sweden)

    Pallen Mark J

    2010-06-01

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

  7. Safety and efficacy results of the advanced renal cell carcinoma sorafenib expanded access program in North America.

    Science.gov (United States)

    Stadler, Walter M; Figlin, Robert A; McDermott, David F; Dutcher, Janice P; Knox, Jennifer J; Miller, Wilson H; Hainsworth, John D; Henderson, Charles A; George, Jeffrey R; Hajdenberg, Julio; Kindwall-Keller, Tamila L; Ernstoff, Marc S; Drabkin, Harry A; Curti, Brendan D; Chu, Luis; Ryan, Christopher W; Hotte, Sebastien J; Xia, Chenghua; Cupit, Lisa; Bukowski, Ronald M

    2010-03-01

    The Advanced Renal Cell Carcinoma Sorafenib (ARCCS) program made sorafenib available to patients with advanced renal cell carcinoma (RCC) before regulatory approval. In this nonrandomized, open-label expanded access program, 2504 patients from the United States and Canada were treated with oral sorafenib 400 mg twice daily. Safety and efficacy were explored overall and in subgroups of patients including those with no prior therapy, nonclear cell (nonclear cell) RCC, brain metastases, prior bevacizumab treatment, and elderly patients. Sorafenib was approved for RCC 6 months after study initiation, at which time patients with no prior therapy or with nonclear cell RCC could enroll in an extension protocol for continued assessment for a period of 6 months. The most common grade > or =2 drug-related adverse events were hand-foot skin reaction (18%), rash (14%), hypertension (12%), and fatigue (11%). In the 1891 patients evaluable for response, complete response was observed in 1 patient, partial response in 67 patients (4%), and stable disease for at least 8 weeks in 1511 patients (80%). Median progression-free survival in the extension population was 36 weeks (95% confidence interval [CI], 33-45 weeks; censorship rate, 56%); median overall survival in the entire population was 50 weeks (95% CI, 46-52 weeks; censorship rate, 63%). The efficacy and safety results were similar across the subgroups. Sorafenib 400 mg twice daily demonstrated activity and a clinically acceptable toxicity profile in all patient subsets enrolled in the ARCCS expanded access program (clinicaltrials.gov identifier: NCT00111020).

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

    Data.gov (United States)

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

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

    OpenAIRE

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

    2016-01-01

    BRAINS: Broadening the Representation of Academic Investigators in NeuroScience is a National Institutes of Health?funded, national program that addresses challenges to the persistence of diverse early-career neuroscientists. In doing so, BRAINS aims to advance diversity in neuroscience by increasing career advancement and retention of post-PhD, early-career neuroscientists from underrepresented groups (URGs). The comprehensive professional development program is structured to catalyze conver...

  10. Evaluation and validation of a bee venom sting challenge performed by a micro-syringe.

    Science.gov (United States)

    Cortellini, Gabriele; Severino, Maurizio; Francescato, Elisabetta; Turillazzi, Stefano; Spadolini, Igino; Rogkakou, Anthi; Passalacqua, Giovanni

    2012-12-01

    The honeybee sting challenge is considered a reliable procedure to evaluate the efficacy of specific immunotherapy, but it is difficult and unpractical to perform in clinical practice, because live insects are required. To assess the feasibility and reliability of a challenge test using a micro-syringe, and compared the procedure with sting challenge. Patients on bee venom immunotherapy and without systemic reactions at field sting were enrolled. They underwent a sting challenge with live bee, and large local reactions were assessed up to 48 hours. Those patients displaying systemic reactions at the sting challenge were excluded from the syringe challenge for ethical reasons. The syringe challenge was done by injecting 0.5 μL fresh unfiltered bee venom at 2 mm depth (the length of the sting left by a bee). The same follow-up as at the first challenge was performed. Bee-specific immunoglobulin E (IgE) and tryptase were measured after each challenge. Nineteen patients underwent the sting challenge with live bees. Four had immediate systemic reactions (urticaria or asthma) and were excluded from the second challenge. The remaining 15 patients with large local reaction underwent the syringe challenge. No significant difference was seen in the maximum area of the large local reactions between the challenge with live bees and the syringe challenge. Also, no change was seen in tryptase and specific antibodies. This preliminary study suggests that the micro-syringe challenge with honeybee venom is feasible and produces results indistinguishable from those of the traditional sting challenge. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  11. Syringe-vacuum microfluidics: A portable technique to create monodisperse emulsions.

    Science.gov (United States)

    Abate, Adam R; Weitz, David A

    2011-03-16

    We present a simple method for creating monodisperse emulsions with microfluidic devices. Unlike conventional approaches that require bulky pumps, control computers, and expertise with device physics to operate devices, our method requires only the microfluidic device and a hand-operated syringe. The fluids needed for the emulsion are loaded into the device inlets, while the syringe is used to create a vacuum at the device outlet; this sucks the fluids through the channels, generating the drops. By controlling the hydrodynamic resistances of the channels using hydrodynamic resistors and valves, we are able to control the properties of the drops. This provides a simple and highly portable method for creating monodisperse emulsions.

  12. Access to health programs at the workplace and the reduction of work presenteeism: a population-based cross-sectional study.

    Science.gov (United States)

    Bustillos, Arnaldo Sanchez; Trigoso, Oswaldo Ortiz

    2013-11-01

    To examine access to health programs at workplace as a determinant of presenteeism among adults. Data source was a subsample of the 2009-2010 Canadian Community Health Survey. The outcome was self-reported reduced activities at work (presenteeism). The explanatory variable was self-reported access to a health program at workplace. Logistic regression was used to measure the association between outcome and explanatory variables adjusting for potential confounders. Adjusting for sex, age, education, income, work stress, and chronic conditions, presenteeism was not associated with having access to a health program at workplace (adjusted odds ratio, 1.23; 95% confidence interval, 0.91 to 1.65). The odds of presenteeism were higher in workers who reported high work stress and those with chronic medical conditions. This study found that access to health programs at workplace is not significantly associated with a decline in presenteeism.

  13. Individual- and area-level disparities in access to the road network, subway system and a public bicycle share program on the Island of Montreal, Canada.

    Science.gov (United States)

    Fuller, Daniel; Gauvin, Lise; Kestens, Yan

    2013-02-01

    Few studies have examined potential disparities in access to transportation infrastructures, an important determinant of population health. To examine individual- and area-level disparities in access to the road network, public transportation system, and a public bicycle share program in Montreal, Canada. Examining associations between sociodemographic variables and access to the road network, public transportation system, and a public bicycle share program, 6,495 adult respondents (mean age, 48.7 years; 59.0 % female) nested in 33 areas were included in a multilevel analysis. Individuals with lower incomes lived significantly closer to public transportation and the bicycle share program. At the area level, the interaction between low-education and low-income neighborhoods showed that these areas were significantly closer to public transportation and the bicycle share program controlling for individual and urbanicity variables. More deprived areas of the Island of Montreal have better access to transportation infrastructure than less-deprived areas.

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

    Directory of Open Access Journals (Sweden)

    Moon S. Chen, Jr

    2010-01-01

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

  15. Creating community-based access to primary healthcare for the uninsured through strategic alliances and restructuring local health department programs.

    Science.gov (United States)

    Scotten, E Shirin L; Absher, Ann C

    2006-01-01

    In 2003, the Wilkes County Health Department joined with county healthcare providers to develop the HealthCare Connection, a coordinated and continuous system of low-cost quality care for uninsured and low-income working poor. Through this program, local providers of primary and specialty care donate specialty care or ancillary services not provided by the Health Department, which provides case management for the program. Basing their methods on business models learned through the UNC Management Academy for Public Health, planners investigated the best practices for extending healthcare coverage to the underinsured and uninsured, analyzed operational costs, discovered underutilized local resources, and built capacity within the organization. The HealthCare Connection is an example of how a rural community can join together in a common business practice to improve healthcare access for uninsured and/or low-income adults.

  16. Microbial contamination of syringes during preparation: the direct influence of environmental cleanliness and risk manipulations on end-product quality.

    Science.gov (United States)

    Stucki, Cyril; Sautter, Anna-Maria; Favet, Jocelyne; Bonnabry, Pascal

    2009-11-15

    The direct influence of environmental cleanliness and risk manipulations on prepared syringes was evaluated. Media-fill testing was used to estimate potential microbial contamination. Syringes were prepared in three different environments using four different uncontrolled high-risk manipulations. The three environments included an International Organization for Standardization (ISO) class 5 horizontal laminar-airflow hood in an ISO class 6 cleanroom (in accordance with United States Pharmacopeia [USP] chapter 797), an ISO class 7 drug preparation area of an operating room, and an uncontrolled decentralized pharmacy in a ward. For each combination of environment and manipulation, 100 syringes were filled by a single operator. The four high-risk manipulations used included simple filling of syringes with trypticase soy broth, three-second contact by the ungloved fingers of the operator with the hub of the syringe, three-second contact between an object and the hub of the syringe, and exposure of the filled syringes to ambient air for 10 minutes. Of the 1500 syringes prepared in three different environments, none produced within the cleanroom contained microorganisms, 6% were contaminated in the operating room, and 16% were contaminated in the ward (p ISO class 5 cleanroom in accordance with USP chapter 797 requirements was demonstrated to be the best way to avoid bacterial or fungal contamination of injectable drugs directly resulting in patient infections.

  17. Programmatic Knowledge Management: Technology, Literacy, and Access in 21st-Century Writing Programs

    Science.gov (United States)

    York, Eric James

    2015-01-01

    Growing out of research in Technical Communication, Composition Studies, and Writing Program Administration, the articles in this dissertation explicitly seek to address changes in the practices and products of writing and writing studies wrought by the so-called "digital revolution" in communication technology, which has been ongoing in…

  18. 78 FR 2449 - Office of Small Credit Unions (OSCUI) Grant Program Access for Credit Unions

    Science.gov (United States)

    2013-01-11

    ... members to stimulate economic activities in their communities. Through the OSCUI Grant Program, NCUA... March, 15, 2013 OSCUI will accept applications from credit unions under the Collaboration Initiative..., scalable, replicable and cost-saving collaboration. Under this initiative a single LICU must collaborate...

  19. 47 CFR 79.2 - Accessibility of programming providing emergency information.

    Science.gov (United States)

    2010-10-01

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

  20. 78 FR 77721 - Office of Small Credit Unions (OSCUI) Grant Program Access for Credit Unions

    Science.gov (United States)

    2013-12-24

    ... any success or failure to meet objectives for use of proceeds, outcome, or impact. NCUA, in its sole... availability. The OSCUI Grant Program serves as a source of financial support, in the form of technical... provides financial support in the form of technical assistance grants to LICUs. These funds help improve...

  1. Farmers' Market Use Patterns Among Supplemental Nutrition Assistance Program Recipients With High Access to Farmers' Markets.

    Science.gov (United States)

    Freedman, Darcy A; Flocke, Susan; Shon, En-Jung; Matlack, Kristen; Trapl, Erika; Ohri-Vachaspati, Punam; Osborne, Amanda; Borawski, Elaine

    2017-05-01

    Evaluate farmers' market (FM) use patterns among Supplemental Nutrition Assistance Program (SNAP) recipients. Cross-sectional survey administered June to August, 2015. Cleveland and East Cleveland, OH. A total of 304 SNAP recipients with children. Participants lived within 1 mile of 1 of 17 FMs. Most were African American (82.6%) and female (88.1%), and had received SNAP for ≥5 years (65.8%). Patterns of FM shopping, awareness of FM near home and of healthy food incentive program, use of SNAP to buy fruits and vegetables and to buy other foods at FMs, receipt of healthy food incentive program. Two-stage cluster analysis to identify segments with similar FM use patterns. Bivariate statistics including chi-square and ANOVA to evaluate main outcomes, with significance at P ≤ .05. A total of 42% reported FM use in the past year. Current FM shoppers (n = 129) were segmented into 4 clusters: single market, public market, multiple market, and high frequency. Clusters differed significantly in awareness of FM near home and the incentive program, use of SNAP to buy fruit and vegetables at FMs, and receipt of incentive. Findings highlight distinct types of FM use and had implications for tailoring outreach to maximize first time and repeat use of FMs among SNAP recipients. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  2. A Scholarship Workshop Program to Improve Underrepresented Student Access to Higher Education

    Science.gov (United States)

    Murr, Christopher D.

    2010-01-01

    This study examines the effectiveness of a scholarship workshop program to better prepare low socio-economic and minority students to compete for collegiate scholarships. The study involves 1,367 high risk 9th to 12th grade students in Texas. Analysis of the pre- and post tests, using a t-test for dependent variables, indicates a statistically…

  3. Ecological and environmental data as under-utilized national resources: results of the TIE/ACCESS program

    Energy Technology Data Exchange (ETDEWEB)

    Armentano, T.V.; Loucks, O.L.

    1979-06-01

    The goal of The Institute of Energy (TIE) 1977 to 1979 ACCESS program was to define the national need for ecological and environmental data and the extent to which present data documentation and archiving are meeting this need. The principal steps focussed on current data documentation and research in government, private and academic sectors of the natural science technical community, particularly as they bear on the accessibility of environmental data to secondary users. The extent to which existing data services are satisfying the needs of data users also was emphasized. The results indicate that the potential contributions which existing data and models could make are not being achieved because of inconsistencies in data documentation, inadequate communication between data suppliers and data users, and a lack of overall coordination of the data bases in national research and monitoring programs. A nationally coordinated network is proposed which focuses on regional data centers and ties together the hierarchy of data bases (national, state, and local) with the broad spectrum of potential users. The network concept includes immediate development of a comprehensive catalog of data resources in each region, with later production of a data abstract journal as one of two methods for communicating between regional and local data centers and the user community.

  4. News from the Library: Facilitating access to a program for radiation shielding - the Library can help

    CERN Multimedia

    CERN Library

    2013-01-01

    MicroShield® is a comprehensive photon/gamma ray shielding and dose assessment programme. It is widely used for designing shields, estimating source strength from radiation measurements, minimising exposure to people, and teaching shielding principles.   Integrated tools allow the graphing of results, material and source file creation, source inference with decay (dose-to-Bq calculations accounting for decay and daughter buildup), the projection of exposure rate versus time as a result of decay, access to material and nuclide data, and decay heat calculations. The latest version is able to export results using Microsoft Office (formatted and colour-coded for readability). Sixteen geometries accommodate offset dose points and as many as ten standard shields plus source self-shielding and cylinder cladding are available. The library data (radionuclides, attenuation, build-up and dose conversion) reflect standard data from ICRP 38 and 107* as well as ANSI/ANS standards and RSICC publicat...

  5. Youth Voucher Program in Madagascar Increases Access to Voluntary Family Planning and STI Services for Young People

    Science.gov (United States)

    Burke, Eva; Gold, Judy; Razafinirinasoa, Lalaina; Mackay, Anna

    2017-01-01

    ABSTRACT Background: Young people often express a preference for seeking family planning information and services from the private sector. However, in many Marie Stopes International (MSI) social franchise networks, the proportion of young clients, and particularly those under 20 years of age, remains low. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention—youth-friendly social franchisee training and quality monitoring—with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people. Methods: Young people identified by MSM's community health educators (CHEs) received a free voucher redeemable at a BlueStar social franchisee for a package of voluntary family planning and sexually transmitted infection (STI) information and services. BlueStar social franchisees—private providers accredited by MSM—are reimbursed for the cost of providing these services. We reviewed service statistics data from the first 18 months of the youth voucher program, from July 2013 to December 2014, as well as client demographic profile data from July 2015. Findings: Between July 2013 and December 2014, 58,417 vouchers were distributed to young people by CHEs through a range of community mobilization efforts, of which 43,352 (74%) were redeemed for family planning and STI services. Most clients (78.5%) chose a long-acting reversible contraceptive (LARC), and just over half (51%) of young people benefited from STI counseling as part of their voucher service. Most (78%) services were provided in the Analamanga region (the capital and its surroundings), which was expected given the population density in this region and the high concentration of BlueStar franchisees. The client profile data snapshot from July 2015 revealed that 69% of voucher clients had never previously used a contraceptive method, and 96% of clients were aged 20 or younger, suggesting that the voucher

  6. Youth Voucher Program in Madagascar Increases Access to Voluntary Family Planning and STI Services for Young People.

    Science.gov (United States)

    Burke, Eva; Gold, Judy; Razafinirinasoa, Lalaina; Mackay, Anna

    2017-03-24

    Young people often express a preference for seeking family planning information and services from the private sector. However, in many Marie Stopes International (MSI) social franchise networks, the proportion of young clients, and particularly those under 20 years of age, remains low. Marie Stopes Madagascar (MSM) piloted a youth voucher program that joins a supply-side intervention-youth-friendly social franchisee training and quality monitoring-with a corresponding demand-side-component, free vouchers that reduce financial barriers to family planning access for young people. Young people identified by MSM's community health educators (CHEs) received a free voucher redeemable at a BlueStar social franchisee for a package of voluntary family planning and sexually transmitted infection (STI) information and services. BlueStar social franchisees-private providers accredited by MSM-are reimbursed for the cost of providing these services. We reviewed service statistics data from the first 18 months of the youth voucher program, from July 2013 to December 2014, as well as client demographic profile data from July 2015. Findings: Between July 2013 and December 2014, 58,417 vouchers were distributed to young people by CHEs through a range of community mobilization efforts, of which 43,352 (74%) were redeemed for family planning and STI services. Most clients (78.5%) chose a long-acting reversible contraceptive (LARC), and just over half (51%) of young people benefited from STI counseling as part of their voucher service. Most (78%) services were provided in the Analamanga region (the capital and its surroundings), which was expected given the population density in this region and the high concentration of BlueStar franchisees. The client profile data snapshot from July 2015 revealed that 69% of voucher clients had never previously used a contraceptive method, and 96% of clients were aged 20 or younger, suggesting that the voucher program is successfully reaching the

  7. Homicide by Sch from a syringe-like dart ejected by a compound crossbow.

    Science.gov (United States)

    Guo, Wei; Luo, Guochang; Wang, Hao; Meng, Xiangzhi

    2015-02-01

    The compound crossbow can be used to eject syringe-like dart loaded with poisonous solution. Succinylcholine (Sch) is a short-acting neuromuscular blocker medically used to achieve complete relaxation of muscle for a good intubation condition. Without the help of an artificial respirator, intramuscular injection of a large dose of Sch can paralyze the respiratory muscle and result in the receiver's death. In this paper, we present the homicide case of a young male killed by Sch from a syringe-like dart ejected by a compound crossbow. The subcutaneous and muscular hemorrhages observed around the entry were more severe than that caused by a medical injection. Additionally, other autopsy results showed the external appearance of a pinhole, general asphyxia signs and pathological findings which were not characteristic. The discovery of a syringe-like dart at the scene is the critical clue and reason for analyzing for Sch, which is commonly used to load syringe-like dart to paralyze and steal dog in the countryside of China. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  8. An introduction to the Micrel Micropump MP Daily portable syringe driver.

    Science.gov (United States)

    Groves, Karen E

    2003-11-01

    In this article the author describes the Micrel Micropump MP Daily (MP Daily) portable syringe driver. This follows the author's experience of a 4-month pilot of the device by an inpatient palliative care unit. Portable syringe drivers are commonly used to deliver continuous subcutaneous infusions in palliative care situations. Those in current use are not without problems and serious adverse events have occasionally been reported, mainly resulting from confusion between models. The MP Daily syringe driver addresses some of these issues while remaining small, lightweight and inexpensive, with a long battery life and fitting into the pocket of a shirt of pyjama jacket. Improvements over current models include an on/off button, the absence of facilities to set a zero rate or change the rate once the syringe driver is running, and the absence of a boost button. In addition, there are improved alarms, a message display system and a configuration menu. Although confusion remains a problem, and the ideal has not yet been reached, the MP Daily goes some considerable way towards reducing risks and opportunities for human error.

  9. Effectiveness of a grant program's efforts to promote synergy within its funded initiatives: perceptions of participants of the Southern Rural Access Program

    Directory of Open Access Journals (Sweden)

    Weiner Bryan J

    2008-12-01

    Full Text Available Abstract Background Foundations and public agencies commonly fund focused initiatives for individual grantees. These discrete, stand-alone initiatives can risk failure by being carried out in isolation. Fostering synergy among grantees' initiatives is one strategy proposed for promoting the success and impact of grant programs. We evaluate an explicit strategy to build synergy within the Robert Wood Johnson Foundation's Southern Rural Access Program (SRAP, which awarded grants to collaboratives within eight southeastern U.S. states to strengthen basic health care services in targeted rural counties. Methods We interviewed 39 key participants of the SRAP, including the program director within each state and the principal subcontractors heading the program's funded initiatives that supported heath professionals' recruitment, retention and training, made loans to health care providers, and built networks among providers. Interews were recorded and transcribed. Two investigators independently coded the transcripts and a third investigator distilled the main points. Results Participants generally perceived that the SRAP yielded more synergies than other grant programs in which they had participated and that these synergies added to the program's impact. The synergies most often noted were achieved through relationship building among grantees and with outside agencies, sharing information and know-how, sharing resources, combining efforts to yield greater capacity, joining voices to advocate for common goals, and spotting gaps in services offered and then filling these gaps. The SRAP's strategies that participants felt fostered synergy included targeting funding to culturally and geographically similar states, supporting complementary types of initiatives, promoting opportunities to network through semi-annual meetings and regular conference calls, and the advocacy efforts of the program's leadership. Participants noted that synergies were sometimes

  10. Effectiveness of a grant program's efforts to promote synergy within its funded initiatives: perceptions of participants of the Southern Rural Access Program

    Science.gov (United States)

    Pathman, Donald E; Chuang, Emmeline; Weiner, Bryan J

    2008-01-01

    Background Foundations and public agencies commonly fund focused initiatives for individual grantees. These discrete, stand-alone initiatives can risk failure by being carried out in isolation. Fostering synergy among grantees' initiatives is one strategy proposed for promoting the success and impact of grant programs. We evaluate an explicit strategy to build synergy within the Robert Wood Johnson Foundation's Southern Rural Access Program (SRAP), which awarded grants to collaboratives within eight southeastern U.S. states to strengthen basic health care services in targeted rural counties. Methods We interviewed 39 key participants of the SRAP, including the program director within each state and the principal subcontractors heading the program's funded initiatives that supported heath professionals' recruitment, retention and training, made loans to health care providers, and built networks among providers. Interews were recorded and transcribed. Two investigators independently coded the transcripts and a third investigator distilled the main points. Results Participants generally perceived that the SRAP yielded more synergies than other grant programs in which they had participated and that these synergies added to the program's impact. The synergies most often noted were achieved through relationship building among grantees and with outside agencies, sharing information and know-how, sharing resources, combining efforts to yield greater capacity, joining voices to advocate for common goals, and spotting gaps in services offered and then filling these gaps. The SRAP's strategies that participants felt fostered synergy included targeting funding to culturally and geographically similar states, supporting complementary types of initiatives, promoting opportunities to network through semi-annual meetings and regular conference calls, and the advocacy efforts of the program's leadership. Participants noted that synergies were sometimes hindered by turf issues and

  11. Excluding Orphan Drugs from the 340B Drug Discount Program: the Impact on 18 Critical Access Hospitals

    Directory of Open Access Journals (Sweden)

    Madeline Carpinelli Wallack

    2012-01-01

    Full Text Available Purpose: The 340B Drug Pricing Program is a federal program designed to reduce the amount that safety net providers spend on outpatient drugs. The Patient Protection and Affordable Health Care Act of 2010 extended eligibility for 340B to critical access hospitals (CAHs for all drugs except those designated as “orphan.” Because this policy is unprecedented, this study quantifies the gross financial impact that this exemption has on a group of CAHs. Methods: Drug spending for 2010 from 18 CAHs in Minnesota and Wisconsin are reviewed to identify the prevalence of orphan drug purchases and to calculate the price differentials between the 340B price and the hospitals’ current cost. Results: The 18 CAHs’ purchases of orphan drugs comprise an average of 44% of the total annual drug budgets, but only 5% of units purchased, thus representing a very high proportion of their expenditures. In the aggregate, the 18 hospitals would have saved $3.1 million ($171,000 average per hospital had purchases of drugs with orphan designations been made at the 340B price. Because CAH claims for Medicare are reimbursed on a cost-basis, the Federal government is losing an opportunity for savings. Conclusion: The high prevalence of orphan drug use and considerable potential for cost reduction through the 340B program demonstrate the loss of benefit to the hospitals, Federal government and the states.

  12. Access and Diversity in the Running Start Program: A Comparison of Washington's Running Start Program to Other State Level Dual Enrollment Programs Hosted on a College Campus

    Science.gov (United States)

    Smith, Karl

    2014-01-01

    Since 1990, high school students in Washington have had the choice of earning college credit through the Running Start program. Running start is a dual enrollment and dual credit program that allows eleventh and twelfth grade high school students to take college courses at any of Washington's 34 community and technical colleges, Central Washington…

  13. Making a difference? Applying Vitellone's Social Science of the Syringe to performance and image enhancing drug injecting.

    Science.gov (United States)

    Hart, Aaron

    2018-04-18

    Vitellone's Social Science of the Syringe investigates epistemologies of injecting drug use. She argues for a methodology that can be simultaneously sensitive to biopolitical power regimes; the trajectories of social stratification; and the resistance, creativity and dignity of human agency. She proposes a methodological focus on the syringe-in-use as an active participant in these dynamics. Harm reduction policy and service provision frameworks have paid little attention to the phenomena of performance and image enhancing drug (PIEDs) injection. One way of assessing the merit of Vitellone's proposal is to use it to investigate these phenomena. I argue that Vitellone's method can be used to articulate a range of significant differences between people who inject PIEDs and other people who inject drugs, and that these differences can inform harm reduction initiatives. When compared to the heroin syringe, the PIED syringe participates in different socio-economic and material contexts, gendered identities, and biopolitical governance regimes. These differences materialise in different rates of syringe sharing and blood-borne virus transmission; and different experiences of needle exchange services. I offer a thought experiment demonstrating how a different syringe might alter the structural dynamics, biopolitical governance, and the agentic choices of people who inject PIEDs. Judging by the productive effects of diffracting Vitellone's analysis through an empirical concern with PIED injecting, I concur with Vitellone's proposition that 'something objective may be gained from an empirical investigation of the syringe-in-use' (p. 33). Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Dump the pump: manual aspiration thrombectomy (MAT) with a syringe is technically effective, expeditious, and cost-efficient.

    Science.gov (United States)

    Gross, Bradley A; Jadhav, Ashutosh P; Jovin, Tudor G; Jankowitz, Brian Thomas

    2018-04-01

    Syringe aspiration for manual aspiration thrombectomy (MAT) is a cost- and time-efficient alternative to an aspiration pump with likely similar efficacy. It is counterintuitive to expect the pump to perform better than direct vacuum with a syringe, as the pump must deliver vacuum additionally through a canister and meters of tubing. To present in vitro and clinical results of MAT with a syringe. An in vitro analysis was performed comparing vacuum pressures generated by syringe aspiration and with pump aspiration. This was then complemented with prospective clinical data providing details of angiographic and clinical outcomes for syringe MAT. The in vitro analysis demonstrated that equal to slightly greater vacuum pressures were generated by a 60 cc syringe as compared with the pump in both static and partial flow conditions. In our clinical series, 106/113 acute stroke thrombectomies over a 6-month period were performed with syringe MAT on the first pass. Syringe usage instead of pump tubing and a canister led to a total savings of $58 300. The rate of Thrombolysis in Cerebral Infarction 2b/3 recanalization was 93%. Adjunctive stentriever usage was performed in 23% of cases. Median puncture to reperfusion time was 25 min; mean change in National Institute of Health Stroke Scale score at 24 hours was an improvement of 5.1 (median 6). The in-hospital mortality rate was 10%. Seventy percent of patients were discharged to home (modified Rankin Scale (mRS) score 0-2) or a rehabilitation facility (mRS score 2-4). MAT using a syringe is a safe, fast, and more cost-effective approach than using an aspiration pump. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. A standard data access layer for fusion devices R and D programs

    Energy Technology Data Exchange (ETDEWEB)

    Neto, A. [Associacao Euratom/IST, Centro de Fusao Nuclear, Av. Rovisco Pais, P-1049-001 Lisboa (Portugal); Fernandes, H. [Associacao Euratom/IST, Centro de Fusao Nuclear, Av. Rovisco Pais, P-1049-001 Lisboa (Portugal)], E-mail: hf@cfn.ist.utl.pt; Alves, D.; Valcarcel, D.F.; Carvalho, B.B.; Ferreira, J. [Associacao Euratom/IST, Centro de Fusao Nuclear, Av. Rovisco Pais, P-1049-001 Lisboa (Portugal); Vega, J.; Sanchez, E.; Pena, A. [Asociacion Euratom/CIEMAT para Fusion, Madrid (Spain); Hron, M. [Asociace EURATOM IPP.CR, Prague (Czech Republic); Varandas, C.A.F. [Associacao Euratom/IST, Centro de Fusao Nuclear, Av. Rovisco Pais, P-1049-001 Lisboa (Portugal)

    2007-10-15

    Each EURATOM Association stores data using proprietary schemes, usually developed by the research unit or using third party software. The temporary exchange of researchers between laboratories is a common practice nowadays. When the researchers returns to the home laboratory, there is usually the need to follow the work. The amount of available data is becoming enormous and the main data index is changing from shot number to time and events, where the pulse number is just one among the most relevant events against data is catalogued. These difficulties can be overcome by using a common software layer between end-users and laboratories. The components needed to create this software abstraction layer, between users and laboratories data, have already been developed using a universal and well known remote procedure call standard (RPC) based on the eXtensible Markup Language (XML): XML-RPC. The library allows data retrieval using the same methods for all associations. Users are authenticated through the PAPI system ( (http://papi.rediris.es)), allowing each organization to use its own authentication schema. Presently there are libraries and server implementations in Java and C++. These libraries have been included and tested in some of the most common data analysis programs such as MatLab and IDL. The system is already being used in ISTTOK/PT and CASTOR/CZ.

  16. A standard data access layer for fusion devices R and D programs

    International Nuclear Information System (INIS)

    Neto, A.; Fernandes, H.; Alves, D.; Valcarcel, D.F.; Carvalho, B.B.; Ferreira, J.; Vega, J.; Sanchez, E.; Pena, A.; Hron, M.; Varandas, C.A.F.

    2007-01-01

    Each EURATOM Association stores data using proprietary schemes, usually developed by the research unit or using third party software. The temporary exchange of researchers between laboratories is a common practice nowadays. When the researchers returns to the home laboratory, there is usually the need to follow the work. The amount of available data is becoming enormous and the main data index is changing from shot number to time and events, where the pulse number is just one among the most relevant events against data is catalogued. These difficulties can be overcome by using a common software layer between end-users and laboratories. The components needed to create this software abstraction layer, between users and laboratories data, have already been developed using a universal and well known remote procedure call standard (RPC) based on the eXtensible Markup Language (XML): XML-RPC. The library allows data retrieval using the same methods for all associations. Users are authenticated through the PAPI system ( (http://papi.rediris.es)), allowing each organization to use its own authentication schema. Presently there are libraries and server implementations in Java and C++. These libraries have been included and tested in some of the most common data analysis programs such as MatLab and IDL. The system is already being used in ISTTOK/PT and CASTOR/CZ

  17. WOMEN'S ACCESSION TO THE PROGRAM FOR CANCER PREVENTION OF CERVICAL IN PRIMARY CARE, ANANINDEUA-PA

    Directory of Open Access Journals (Sweden)

    Fernanda Suelen Jacques Sousa de Assis

    2014-02-01

    Full Text Available Objective: To evaluate the adherence of women to take on the Prevention of Cervical Cancer (PCC, their difficulties and their knowledge. Methods: Cross-sectional study by interviewing women enrolled in a Family Health Strategy (FHS, Ananindeua-Pará. Results: Most women were between 20-39 years of age (72.6%, had low income and low education. Reported the exam annually (64.0% and every two years (17.0%, while 14.0% of them never realized. Of the participants who never performed the examination, the age group of 20-29 was the most prevalent (73.3% (p<0.05. It was found that the women had heard about the disease (97.1% and considered cancer as a wound that can lead to death (81.4%. There was a significant relationship between knowledge about cancer of the cervix (heard, concept, as it is known, timing, late detection, first sexual intercourse, condom use, contraceptive use and sexually transmitted disease with the examination (p<0.05. Shame was reported as greater difficulty (25.5%, followed by neglect (22.5% and lack of time (12.5%. Women who were examined rated as "Good" program PCC FHS. Conclusion: Women showed good adhesion to take PCC, said the main difficulty shame and demonstrated the concept on the subject.

  18. NCI Program for Natural Product Discovery: A Publicly-Accessible Library of Natural Product Fractions for High-Throughput Screening.

    Science.gov (United States)

    Thornburg, Christopher C; Britt, John R; Evans, Jason R; Akee, Rhone K; Whitt, James A; Trinh, Spencer K; Harris, Matthew J; Thompson, Jerell R; Ewing, Teresa L; Shipley, Suzanne M; Grothaus, Paul G; Newman, David J; Schneider, Joel P; Grkovic, Tanja; O'Keefe, Barry R

    2018-06-13

    The US National Cancer Institute's (NCI) Natural Product Repository is one of the world's largest, most diverse collections of natural products containing over 230,000 unique extracts derived from plant, marine, and microbial organisms that have been collected from biodiverse regions throughout the world. Importantly, this national resource is available to the research community for the screening of extracts and the isolation of bioactive natural products. However, despite the success of natural products in drug discovery, compatibility issues that make extracts challenging for liquid handling systems, extended timelines that complicate natural product-based drug discovery efforts and the presence of pan-assay interfering compounds have reduced enthusiasm for the high-throughput screening (HTS) of crude natural product extract libraries in targeted assay systems. To address these limitations, the NCI Program for Natural Product Discovery (NPNPD), a newly launched, national program to advance natural product discovery technologies and facilitate the discovery of structurally defined, validated lead molecules ready for translation will create a prefractionated library from over 125,000 natural product extracts with the aim of producing a publicly-accessible, HTS-amenable library of >1,000,000 fractions. This library, representing perhaps the largest accumulation of natural-product based fractions in the world, will be made available free of charge in 384-well plates for screening against all disease states in an effort to reinvigorate natural product-based drug discovery.

  19. Stability of busulfan solutions in polypropylene syringes and infusion bags as determined with an original assay.

    Science.gov (United States)

    Guichard, Nicolas; Bonnabry, Pascal; Rudaz, Serge; Fleury-Souverain, Sandrine

    2017-11-15

    The stability of busulfan solution in 0.9% sodium chloride and stored in polypropylene syringes or infusion bags was evaluated. Busulfan solutions (0.54 mg/mL) were prepared and transferred to 50-mL polypropylene syringes and 100- and 500-mL polypropylene infusion bags and stored at 2-8 and 23-27 °C. Chemical stability was measured using a stability-indicating, ultrahigh performance liquid chromatography coupled to mass spectrometry method. The stability of busulfan was assessed by measuring the percentage of the initial concentration remaining at the end of each time point of analysis. The initial busulfan concentration was defined as 100%. Stability was defined as retention of at least 90% of the initial busulfan concentration. A visual inspection of the samples for particulate matter, clarity, and color without instrumentation of magnification was conducted at each time point of analysis. The visual inspection demonstrated no influence of the storage container when busulfan infusions diluted in 0.9% sodium chloride injection were stored at 23-27 °C. No color change or precipitate was observed at this temperature; however, a rapid decrease of the busulfan content in all containers stored at room temperature was observed. Busulfan in syringes was chemically stable for 12 hours, while busulfan in infusion bags (100 and 500 mL) was stable only for 3 hours at 23-27 °C. Busulfan 0.54-mg/mL solution in 0.9% sodium chloride injection was physically and chemically stable for 30 hours when stored in 50-mL polypropylene syringes at 2-8 °C and protected from light. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  20. Syringe needle skull penetration reduces brain injuries and secondary inflammation following intracerebral neural stem cell transplantation

    OpenAIRE

    Gao, Mou; Dong, Qin; Zhang, Hongtian; Yang, Yang; Zhu, Jianwei; Yang, Zhijun; Xu, Minhui; Xu, Ruxiang

    2017-01-01

    Intracerebral neural stem cell (NSC) transplantation is beneficial for delivering stem cell grafts effectively, however, this approach may subsequently result in brain injury and secondary inflammation. To reduce the risk of promoting brain injury and secondary inflammation, two methods were compared in the present study. Murine skulls were penetrated using a drill on the left side and a syringe needle on the right. Mice were randomly divided into three groups (n=84/group): Group A, receiving...

  1. Drugs given by a syringe driver: a prospective multicentre survey of palliative care services in the UK.

    Science.gov (United States)

    Wilcock, Andrew; Jacob, Jayin K; Charlesworth, Sarah; Harris, Elayne; Gibbs, Margaret; Allsop, Helen

    2006-10-01

    The use of a syringe driver to administer drugs by continuous subcutaneous infusion is common practice in the UK. Over time, drug combinations used in a syringe driver are likely to change and the aim of this survey was to obtain a more recent snapshot of practice. On four separate days, at two-week intervals, a questionnaire was completed for every syringe driver in use by 15 palliative care services. Of 336 syringe drivers, the majority contained either two or three drugs, but one-fifth contained only one drug. The median (range) volume of the infusions was 15 (9.5-48) mL, and duration of infusion was generally 24 hours. Only one combination was reported as visually incompatible, and there were 13 site reactions (4% of total). Laboratory physical and chemical compatibility data are available for less than half of the most frequently used combinations.

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

    Directory of Open Access Journals (Sweden)

    Allison P Hawkes

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

  3. Behavioral response and pain perception to computer controlled local anesthetic delivery system and cartridge syringe

    Directory of Open Access Journals (Sweden)

    T D Yogesh Kumar

    2015-01-01

    Full Text Available Aim: The present study evaluated and compared the pain perception, behavioral response, physiological parameters, and the role of topical anesthetic administration during local anesthetic administration with cartridge syringe and computer controlled local anesthetic delivery system (CCLAD. Design: A randomized controlled crossover study was carried out with 120 children aged 7-11 years. They were randomly divided into Group A: Receiving injection with CCLAD during first visit; Group B: Receiving injection with cartridge syringe during first visit. They were further subdivided into three subgroups based on the topical application used: (a 20% benzocaine; (b pressure with cotton applicator; (c no topical application. Pulse rate and blood pressure were recorded before and during injection procedure. Objective evaluation of disruptive behavior and subjective evaluation of pain were done using face legs activity cry consolability scale and modified facial image scale, respectively. The washout period between the two visits was 1-week. Results: Injections with CCLAD produced significantly lesser pain response, disruptive behavior (P < 0.001, and pulse rate (P < 0.05 when compared to cartridge syringe injections. Application of benzocaine produced lesser pain response and disruptive behavior when compared to the other two subgroups, although the result was not significant. Conclusion: Usage of techniques which enhance behavioral response in children like injections with CCLAD can be considered as a possible step toward achieving a pain-free pediatric dental practice.

  4. Iloprost infusion by a new device as a portable syringe pump: safety, tolerability and agreement

    Directory of Open Access Journals (Sweden)

    Paola Faggioli

    2012-12-01

    Full Text Available Background Iloprost, prostacyclin (PGI2 analogue, effective in treatment of peripheral arterial disease, secondary Raynaud's phenomenon (RP to connective tissue disease (CTD, vasculitis, pulmonary hypertension, is usually infused through peristaltic pump, or recently through a flow regulator.Materials and methods We tested a new portable syringe pump (Pompa Infonde®, Italfarmaco S.p.A., Cinisello Balsamo, Milano on 120 patients affected by RP to CTD and cryoglobulinaemia, in iloprost therapy with a flow regulator.Results Iloprost infused through portable syringe pump is better tolerated, better appreciated by the patients and nurses and no difference was observed on therapeutic effects, with a lower incidence of side effects statistically significant. Only 3 patients were unable to tolerate the device (2 for changes in pressure and 1 for fear and shifted to traditional method of iloprost infusion.Conclusions Iloprost infusion through the portable syringe Pompa Infonde® appears to be safe, better tolerated, more acceptable and equally effective compared to infusion through a flow regulator.

  5. Determination of bismuth and cadmium after solid-phase extraction with chromosorb-107 in a syringe

    International Nuclear Information System (INIS)

    Tokman, Nilgun; Akman, Suleyman

    2004-01-01

    The determination of bismuth and cadmium by graphite furnace atomic absorption spectrometry (GFAAS) after solid-phase extraction (SPE) on Chromosorb-107 filled in a syringe was described. To retain the analytes, the sample solution treated with and without ammonium pyrolidine dithiocarbamate (APDC) was drawn into the syringe filled with Chromosorb-107 and discharged back manually. Bismuth and cadmium were quantitatively sorbed at pH ≥ 6 irrespective of whether the analyte was complexed with APDC prior to passing through the Chromosorb-107. Analyte elements sorbed on the resin were quantitatively eluted with 3.0 M of HNO 3 again drawing and discharging the eluent into the syringe and ejected it back. Optimum flow rates of sample or eluent for sorption and elution processes were 20 ml min -1 for drawing and 20 ml min -1 for discharging in all cases. Bismuth and cadmium were analyzed by graphite furnace atomic absorption spectrometry. The elements could be concentrated by drawing and discharging several portions of sample successively but eluting only one time. The validity of the proposed method was checked with standard reference materials (NIST SRM 1515 Apple-Leaves, CWW-TM-E Waste Water and CRM-SW Sea Water). The analyte elements were quantitatively (>95%) recovered from different matrices irrespective of treated samples with APDC. Detection limits (δ) were 0.8 and 1.2 μg l -1 for Bi and Cd, respectively. The method can be characterized with fastness, simplicity, quantitative recovery and high reproducibility

  6. In-syringe-stirring: A novel approach for magnetic stirring-assisted dispersive liquid–liquid microextraction

    International Nuclear Information System (INIS)

    Horstkotte, Burkhard; Suárez, Ruth; Solich, Petr; Cerdà, Víctor

    2013-01-01

    Graphical abstract: -- Highlights: •We propose a new automatic magnetic stirring assisted dispersive liquid–liquid microextraction. •It allows the extraction of aluminum from seawater and freshwater samples within less than 4 min. •The method was applicable to the natural samples. -- Abstract: For the first time, the use of a magnetic stirrer within the syringe of an automated syringe pump and the resulting possible analytical applications are described. A simple instrumentation following roughly the one from sequential injection analyzer systems is used in combination with an adaptor, which is placed onto the barrel of a glass syringe. Swirling around the longitudinal axis of the syringe and holding two strong neodymium magnets, it causes a rotating magnetic field and serves as driver for a magnetic stirring bar placed inside of the syringe. In a first study it was shown that this approach leads to a sealed but also automatically adaptable reaction vessel, the syringe, in which rapid and homogeneous mixing of sample with the required reagents within short time can be carried out. In a second study in-a-syringe magnetic stirring-assisted dispersive liquid–liquid microextraction (MSA-DLLME) was demonstrated by the application of the analyzer system to fluorimetric determination of aluminum in seawater samples using lumogallion. A linear working range up to 1.1 μmol L −1 and a limit of detection of 6.1 nmol L −1 were found. An average recovery of 106.0% was achieved for coastal seawaters with a reproducibility of 4.4%. The procedure lasted 210 s including syringe cleaning and only 150 μL of hexanol and 4.1 mL of sample were required

  7. Potential Air Contamination During CO2 Angiography Using a Hand-Held Syringe: Theoretical Considerations and Gas Chromatography

    International Nuclear Information System (INIS)

    Cho, David R.; Cho, Kyung J.; Hawkins, Irvin F.

    2006-01-01

    Purpose. To assess air contamination in the hand-held syringes currently used for CO 2 delivery and to determine whether there is an association between their position and the rate of air contamination. Methods. Assessment of air contamination in the syringe (20 ml) included theoretical modeling, mathematical calculation, and gas chromatography (GC). The model was used with Fick's first law to calculate the diffusion of CO 2 and the amount of air contamination. For GC studies, the syringes were placed in the upright, horizontal, and inverted positions and gas samples were obtained after 5, 10, 20, 30, and 60 min. All trials with each position for each sampling time were performed five times. Results. The amounts of air contamination with time calculated mathematically were 5-10% less than those of GC. With the diffusivity of air-CO 2 at 0.1599 cm 2 /sec (9.594 cm 2 /min), air contamination was calculated to be 60% at 60 min. With GC air contamination was 13% at 5 min, 31% at 20 min, 43% at 30 min, and 68% at 60 min. There was no difference in air contamination between the different syringe positions. Conclusion. Air contamination occurs in hand-held syringes filled with CO 2 when they are open to the ambient air. The amounts of air contamination over time are similar among syringes placed in the upright, horizontal, and inverted positions

  8. Potential air contamination during CO2 angiography using a hand-held syringe: theoretical considerations and gas chromatography.

    Science.gov (United States)

    Cho, David R; Cho, Kyung J; Hawkins, Irvin F

    2006-01-01

    To assess air contamination in the hand-held syringes currently used for CO2 delivery and to determine whether there is an association between their position and the rate of air contamination. Assessment of air contamination in the syringe (20 ml) included theoretical modeling, mathematical calculation, and gas chromatography (GC). The model was used with Fick's first law to calculate the diffusion of CO2 and the amount of air contamination. For GC studies, the syringes were placed in the upright, horizontal, and inverted positions and gas samples were obtained after 5, 10, 20, 30, and 60 min. All trials with each position for each sampling time were performed five times. The amounts of air contamination with time calculated mathematically were 5-10% less than those of GC. With the diffusivity of air-CO2 at 0.1599 cm2/sec (9.594 cm2/min), air contamination was calculated to be 60% at 60 min. With GC air contamination was 13% at 5 min, 31% at 20 min, 43% at 30 min, and 68% at 60 min. There was no difference in air contamination between the different syringe positions. Air contamination occurs in hand-held syringes filled with CO2 when they are open to the ambient air. The amounts of air contamination over time are similar among syringes placed in the upright, horizontal, and inverted positions.

  9. An evaluation of the availability, accessibility, and quality of online content of vascular surgery training program websites for residency and fellowship applicants.

    Science.gov (United States)

    Huang, Bryant Y; Hicks, Taylor D; Haidar, Georges M; Pounds, Lori L; Davies, Mark G

    2017-12-01

    Vascular surgery residency and fellowship applicants commonly seek information about programs from the Internet. Lack of an effective web presence curtails the ability of programs to attract applicants, and in turn applicants may be unable to ascertain which programs are the best fit for their career aspirations. This study was designed to evaluate the presence, accessibility, comprehensiveness, and quality of vascular surgery training websites (VSTW). A list of accredited vascular surgery training programs (integrated residencies and fellowships) was obtained from four databases for vascular surgery education: the Accreditation Council for Graduate Medical Education, Electronic Residency Application Service, Fellowship and Residency Electronic Interactive Database, and Society for Vascular Surgery. Programs participating in the 2016 National Resident Matching Program were eligible for study inclusion. Accessibility of VSTW was determined by surveying the Accreditation Council for Graduate Medical Education, Electronic Residency Application Service, and Fellowship and Residency Electronic Interactive Database for the total number of programs listed and for the presence or absence of website links. VSTW were analyzed for the availability of recruitment and education content items. The quality of VSTW was determined as a composite of four dimensions: content, design, organization, and user friendliness. Percent agreements and kappa statistics were calculated for inter-rater reliability. Eighty-nine of the 94 fellowship (95%) and 45 of the 48 integrated residencies (94%) programs participating in the 2016 Match had a VSTW. For program recruitment, evaluators found an average of 12 of 32 content items (35.0%) for fellowship programs and an average of 12 of 32 (37%) for integrated residencies. Only 47.1% of fellowship programs (53% integrated residencies) specified the number of positions available for the 2016 Match, 20% (13% integrated residencies) indicated alumni

  10. 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

  11. The rapid access palliative radiotherapy program: blueprint for initiation of a one-stop multidisciplinary bone metastases clinic.

    Science.gov (United States)

    Fairchild, A; Pituskin, E; Rose, B; Ghosh, S; Dutka, J; Driga, A; Tachynski, P; Borschneck, J; Gagnon, L; Macdonnell, S; Middleton, J; Thavone, K; Carstairs, S; Brent, D; Severin, D

    2009-02-01

    Radiotherapy (RT) for palliation of pain due to bone metastases (BM) is effective but underutilized likely due to the traditional practice of separate clinic visits for consultation, treatment planning, and RT delivery. However, recent evidence proves one RT treatment is as effective as multiple for analgesia, enabling investigation of an alternative model of RT delivery, the rapid access palliative radiotherapy program (RAPRP). Prior to the start of the program, needs assessment was performed to determine the composition of the optimal team. Screening tools were implemented to streamline holistic, multidisciplinary assessment. An advertising strategy, treatment and research protocols, and mechanisms for patient feedback were established. After RAPRP implementation, patient outcomes such as symptom relief were tracked. Eighty-six patients with painful BM were referred over the 25-week pilot. Median age was 69.9 years; 64% had prostate cancer, and median performance status was 70. Patient-rated pain was on average 6.1/10 at baseline, improving to 2.6/10 by week 4 post-RT. On average, 6.2 symptoms were reported (baseline) compared to 5.2 (week 4). Team members assessed 10-100% of patients and were successful in stabilizing or improving all symptoms in >75% contacted at week 4. One hundred percent of patients surveyed were satisfied with their experience. Early needs assessment was advantageous in determining the optimal team and methods of assessment for our 'one-stop' BM clinic. This approach was successful in improving pain and other symptoms, and the convenience of seeing multiple providers on 1 day was appreciated by the patients.

  12. Effects of an emergency medical services-based resource access program on frequent users of health services.

    Science.gov (United States)

    Tadros, Anthony S; Castillo, Edward M; Chan, Theodore C; Jensen, Anne Marie; Patel, Ekta; Watts, Kerin; Dunford, James V

    2012-01-01

    A small group of adults disproportionately and ineffectively use acute services including emergency medical services (EMS) and emergency departments (EDs). The resulting episodic, uncoordinated care is of lower quality and higher cost and simultaneously consumes valuable public safety and acute care resources. To address this issue, we measured the impact of a pilot, EMS-based case management and referral intervention termed the San Diego Resource Access Program (RAP) to reduce EMS, ED, and inpatient (IP) visits. This was a historical cohort study of RAP records and billing data of EMS and one urban hospital for 51 individuals sequentially enrolled in the program. The study sample consisted of adults with ≥ 10 EMS transports within 12 months and others reported by prehospital personnel with significant recent increases in transports. Data were collected over a 31-month time period from December 2006 to June 2009. Data were collected for equal pre- and postenrollment time periods based on date of initial RAP contact, and comparisons were made using the Wilcoxon signed-rank test. Overall use for subjects is reported. The majority of subjects were male (64.7%), homeless (58.8%), and 40 to 59 years of age (72.5%). Between the pre and post periods, EMS encounters declined 37.6% from 736 to 459 (p = 0.001), resulting in a 32.1% decrease in EMS charges from $689,743 to $468,394 (p = 0.004). The EMS task time and mileage decreased by 39.8% and 47.5%, respectively, accounting for 262 (p = 0.008) hours and 1,940 (p = 0.006) miles. The number of ED encounters at the one participating hospital declined 28.1% from 199 to 143, which correlated with a 12.7% decrease in charges from $413,410 to $360,779. The number of IP admissions declined by 9.1% from 33 to 30, corresponding to a 5.9% decrease in IP charges from $687,306 to $646,881. Hospital length of stay declined 27.9%, from 122 to 88 days. Across all services, total charges declined by $314,406. This pilot study

  13. 75 FR 4409 - Ryan White HIV/AIDS Program Part D-Coordinated HIV Services and Access to Research for Women...

    Science.gov (United States)

    2010-01-27

    ... HIV/AIDS Program Part D--Coordinated HIV Services and Access to Research for Women, Infants, Children... Orange County Health Department, Orlando, Florida, that will ensure continuity of Part D HIV/AIDS care and treatment services without disruption to HIV/ AIDS-infected women, infants and children in Orange...

  14. Investigating Liquid Leak from Pre-Filled Syringes upon Needle Shield Removal: Effect of Air Bubble Pressure.

    Science.gov (United States)

    Chan, Edwin; Maa, Yuh-Fun; Overcashier, David; Hsu, Chung C

    2011-01-01

    This study is to investigate the effect of headspace air pressure in pre-filled syringes on liquid leak (dripping) from the syringe needle upon needle shield removal. Drip tests to measure drip quantity were performed on syringes manually filled with 0.5 or 1.0 mL of various aqueous solutions. Parameters assessed included temperature (filling and test), bulk storage conditions (tank pressure and the type of the pressurized gas), solution composition (pure water, 0.9% sodium chloride, and a monoclonal antibody formulation), and testing procedures. A headspace pressure analyzer was used to verify the drip test method. Results suggested that leakage is indeed caused by headspace pressure increase, and the temperature effect (ideal gas expansion) is a major, but not the only, factor. The dissolved gases in the liquid bulk prior to or during filling may contribute to leakage, as these gases could be released into the headspace due to solubility changes (in response to test temperature and pressure conditions) and cause pressure increase. Needle shield removal procedures were found to cause dripping, but liquid composition played little role. Overall, paying attention to the processing history (pressure and temperature) of the liquid bulk is the key to minimize leakage. The headspace pressure could be reduced by decreasing liquid bulk storage pressure, filling at a higher temperature, or employing lower solubility gas (e.g., helium) for bulk transfer and storage. Leakage could also be mitigated by simply holding the syringe needle pointing upward during needle shield removal. Substantial advances in pre-filled syringe technology development, particularly in syringe filling accuracy, have been made. However, there are factors, as subtle as how the needle shield (or tip cap) is removed, that may affect dosing accuracy. We recently found that upon removal of the tip cap from a syringe held vertically with needle pointed downwards, a small amount of solution, up to 3-4% of

  15. A workplace intervention program and the increase in HIV knowledge, perceived accessibility and use of condoms among young factory workers in Thailand.

    Science.gov (United States)

    Chamratrithirong, Aphichat; Ford, Kathleen; Punpuing, Sureeporn; Prasartkul, Pramote

    2017-12-01

    Vulnerability to Human Immunodeficiency Virus (HIV) infection among factory workers is a global problem. This study investigated the effectiveness of an intervention to increase AIDS knowledge, perceived accessibility to condoms and condom use among young factory workers in Thailand. The intervention was a workplace program designed to engage the private sector in HIV prevention. A cross-sectional survey conducted in 2008 to measure program outcomes in factories in Thailand was used in this study. The workplace intervention included the development of policies for management of HIV-positive employees, training sessions for managers and workers, and distribution of educational materials and condoms. A multi-level analysis was used to investigate the effect of HIV/AIDS prevention program components at the workplace on HIV/AIDS knowledge, perceived accessibility to condoms and condom use with regular sexual partners among 699 young factory workers (aged 18-24 years), controlling for their individual socio-demographic characteristics. Interventions related to the management and services component including workplace AIDS policy formulation, condom services programs and behavioral change campaigns were found to be significantly related to increased AIDS knowledge, perceived accessibility to condoms and condom use with regular partners. The effect of the HIV/AIDS training for managers, peer leaders and workers was positive but not statistically significant. With some revision of program components, scaling up of workplace interventions and the engagement of the private sector in HIV prevention should be seriously considered.

  16. 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

  17. Making Nasopalatine Blocks Comfortable: A Randomised Prospective Clinical Comparison of Pain Associated with the Injection Using an Insulin Syringe and a Standard Disposable 3 mL Syringe.

    Science.gov (United States)

    Prabhu, Sundararaman; Faizel, Syed; Pahlajani, Vedant; Prabhu, Shweta Jha

    2013-12-01

    This study was conducted to compare and evaluate the pain associated with administration of Nasopalatine blocks using a disposable insulin syringe and the conventional disposable 3 mL syringe. Forty patients requiring intraalveolar extractions of maxillary central incisors were randomly assigned to two groups of 20 patients each; one (Group A) received the nasopalatine block with a standard 3mL syringe and the other (Group B) received the block with an insulin syringe. Patients were asked to rate the pain associated with the injection on a visual analog scale (VAS) and the results were analysed using a Chi Square Test. The mean VAS score for Group A and B was 1.55 and 1 respectively. Chi Square value was calculated to be 8.603 (degree of freedom= 3, P value= 0.0351). There were no differences in the effectiveness of anesthesia between the groups. Pain associated with administration of the nasopalatine blocks may be significantly mitigated by using the Insulin syringe.

  18. Value-Based Payment Reform and the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015: A Primer for Plastic Surgeons.

    Science.gov (United States)

    Squitieri, Lee; Chung, Kevin C

    2017-07-01

    In 2015, the U.S. Congress passed the Medicare Access and Children's Health Insurance Program Reauthorization Act, which effectively repealed the Centers for Medicare and Medicaid Services sustainable growth rate formula and established the Centers for Medicare and Medicaid Services Quality Payment Program. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents an unparalleled acceleration toward value-based payment models and a departure from traditional volume-driven fee-for-service reimbursement. The Quality Payment Program includes two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. The Merit-Based Incentive Payment System pathway replaces existing quality reporting programs and adds several new measures to create a composite performance score for each provider (or provider group) that will be used to adjust reimbursed payment. The advanced alternative payment model pathway is available to providers who participate in qualifying Advanced Alternative Payment Models and is associated with an initial 5 percent payment incentive. The first performance period for the Merit-Based Incentive Payment System opens January 1, 2017, and closes on December 31, 2017, and is associated with payment adjustments in January of 2019. The Centers for Medicare and Medicaid Services estimates that the majority of providers will begin participation in 2017 through the Merit-Based Incentive Payment System pathway, but aims to have 50 percent of payments tied to quality or value through Advanced Alternative Payment Models by 2018. In this article, the authors describe key components of the Medicare Access and Children's Health Insurance Program Reauthorization Act to providers navigating through the Quality Payment Program and discuss how plastic surgeons may optimize their performance in this new value-based payment program.

  19. [Preference for etanercept pen versus syringe in patients with chronic arthritis. Nurse education workshop].

    Science.gov (United States)

    Garcia-Diaz, Silvia; Girabent-Farrés, Montserrat; Roig-Vilaseca, Daniel; Reina, Delia; Cerdà, Dacia; González, Marina; Torrente-Segarra, Vicenç; Fíguls, Ramon; Corominas, Hèctor

    2013-01-01

    The aims of this study are to evaluate the level of fear of post-injection pain prior to the administration, the difficulty in handling the device, and the level of satisfaction of patients using a pre-filled syringe versus an etanercept pen, as well as to evaluate the usefulness of the training given by nursing staff prior to starting with the pen, and the preferences of patients after using both devices. A prospective study was designed to follow-up a cohort of patients during a 6 months period. The data was collected using questionnaires and analyzed with SPSS 18.00. Rank and McNemar tests were performed. Statistical significance was pre-set at an α level of 0.05. A total of 29 patients were included, of whom 69% female, and with a mean age 52.5±10.9 years. Of these, 48% had rheumatoid arthritis, 28% psoriatic arthritis, 21% ankylosing spondylitis, and 3% undifferentiated spondyloarthropathy. There were no statistically significant differences either with the fear or pain or handling of the device between the syringe and the pen (P=.469; P=.812; P=.169 respectively). At 6 months, 59% of patients referred to being satisfied or very satisfied with the pen. Almost all (93%) found useful or very useful the training given by nursing staff prior to using the pen, and 55% preferred the pen over the pre-filled syringe. The etanercept pen is another subcutaneous device option for patients with chronic arthritis. According to the present study, nursing educational workshops before starting this therapy are recommended. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  20. Community food environments and healthy food access among older adults: A review of the evidence for the Senior Farmers' Market Nutrition Program (SFMNP).

    Science.gov (United States)

    O'Dare Wilson, Kellie

    2017-04-01

    Although an array of federal, state, and local programs exist that target food insecurity and the specific nutritional needs of seniors, food insecurity among older adults in the United States remains a persistent problem, particularly in minority and rural populations. Food insecurity is highly predictive of inadequate fresh fruit and vegetable (FFV) consumption in particular. The Senior Farmers' Market Nutrition Program (SFMNP) is a community-based program to help seniors purchase FFVs at farmer's markets in their neighborhoods. The SFMNP continues to grow; however, little is known about the effectiveness of the program. The purposes of this article are to (1) highlight the importance of community and neighborhood based food insecurity programs, specifically emphasizing the importance of FFV access for seniors, (2) review the current state of the evidence on the SFMNP, and (3) provide recommendations for researchers and policy-makers wishing to continue to advance the knowledge base in neighborhood-based food security among older adults.

  1. Emission characteristics of plastic syringes sterilized with ethylene oxide--a controlled study.

    Science.gov (United States)

    Chien, Yeh-Chung; Su, Po-Chi; Lee, Lien-Hsiung; Chen, Chang-Yuh

    2009-11-01

    This study examined the emission characteristics of ethylene oxide (EO)-sterilized syringes under various environmental conditions, aiming to develop control strategies to minimize worker exposure. Experiments were performed in a facility in which temperature, relative humidity (RH), and air change rate (ACR) were controlled. Analytical results indicate that the main effects of the four test variables on kinetic parameters were statistically significant (p Plastic content, temperature, RH, and ACR affected EO emissions. ACR is an achievable means of control; however, the aeration area/system should be isolated to ensure adequate ventilation is achieved.

  2. Syringe confiscation as an HIV risk factor: the public health implications of arbitrary policing in Tijuana and Ciudad Juarez, Mexico.

    Science.gov (United States)

    Beletsky, Leo; Lozada, Remedios; Gaines, Tommi; Abramovitz, Daniela; Staines, Hugo; Vera, Alicia; Rangel, Gudelia; Arredondo, Jaime; Strathdee, Steffanie A

    2013-04-01

    Female sex workers who inject drugs (FSW-IDUs) face elevated risk for HIV/STIs and constitute a key population for public health prevention. Through direct and indirect pathways including human rights violations, policing practices like syringe confiscation can compound FSW-IDU health risk and facilitate the spread of disease. We studied correlates of experiencing syringe confiscation among FSW-IDUs in northern Mexico, where formal policy allows for syringes to be available over the counter without a prescription, but police practices are often at odds with the law. FSW-IDUs reporting recent syringe sharing and unprotected sex with clients in Tijuana and Ciudad Juarez were administered surveys and HIV/STI testing. Logistic regression was used to identify correlates of syringe confiscation. Among 624 respondent FSW-IDUs, prevalence of syringe confiscation in the last 6 months was 48%. The following factors were positively associated with syringe confiscation: testing positive for HIV (adjusted odds ratio [aOR] = 2.54, 95% confidence interval [CI] = 1.11-5.80), reporting sexual abuse by police (aOR = 12.76, 95% CI = 6.58-24.72), engaging in groin injection (aOR = 1.84, 95% CI = 1.15-2.93), injecting in public (aOR = 1.64; 95% CI = 1.14-2.36), and obtaining syringes from pharmacies (aOR = 1.54; 95% CI = 1.06-2.23). Higher education level was negatively associated with syringe confiscation (aOR = 0.92, 95% CI = 0.87-0.98) as was frequent injection with clients within the last month (aOR = 0.64, 95% CI = 0.44-0.94). This analysis adds to the body of evidence linking unauthorized law enforcement actions targeting high-risk groups with HIV and other adverse health outcomes. Using a public health lens to conceptualize abuse as a structural risk factor, we advocate for multi-prong prevention, systematic monitoring, and evidence-based intervention response to deleterious police practices.

  3. Comparison between syringe irrigation and RinsEndo in reduction of Enterococcus faecalis in experimentally infected root canal

    Directory of Open Access Journals (Sweden)

    Sharareh Mousavi Zahed

    2015-05-01

    Full Text Available Background and Aims: To ensure root canal treatment success, endodontic microbiota should be efficiently reduced. Several irrigation devices have been recently introduced with the main objective of improving root canal disinfection.The purpose of this study was to evaluate the rinsing effect of RinsEndo system in reduction of enterococcus faecalis in comparison with conventional hand syringe in infected root canals.   Materials and Methods: 60 extracted single canal anterior teeth were infected with enterococcus faecalis and divided into 3 groups: RinsEndo system, conventional hand syringe and control group. The enterococcus faecalis colonies were counted in each group before and after rinsing. Data were analyzed using Variance and Kruskal Wallis test.   Results: The mean of enterococcus faecalis growth after rinsing was 3.50×103 in group with conventional syring rinsing, 2.04×103 in group with RinsEndo washing and 6.11×103 in control group. Reduction of enterococcus faecalis after rinsing was statistically significant in each group (P<0.001. The amount of reduction in number of colonies with RinsEndo and conventional syringe rinsing was higher in comparison with control group and this difference was significant (P<0.001. RinsEndo rinsing effect was statistically significantly higher in comparison to conventional syringe as well (P<0.001.   Conclusion: Rinsing with RinsEndo system was significantly more efficient in reduction of enterococcus faecalis from root canal in comparison with hand syringe washing.

  4. The impact of threshold language assistance programming on the accessibility of mental health services for persons with limited English proficiency in the Medi-Cal setting.

    Science.gov (United States)

    McClellan, Sean R; Wu, Frances M; Snowden, Lonnie R

    2012-06-01

    Title VI of the 1964 Civil Rights Act prohibits federal funds recipients from providing care to limited English proficiency (LEP) persons more limited in scope or lower in quality than care provided to others. In 1999, the California Department of Mental Health implemented a "threshold language access policy" to meet its Title VI obligations. Under this policy, Medi-Cal agencies must provide language assistance programming in a non-English language where a county's Medical population contains either 3000 residents or 5% speakers of that language. We examine the impact of threshold language policy-required language assistance programming on LEP persons' access to mental health services by analyzing the county-level penetration rate of services for Russian, Spanish, and Vietnamese speakers across 34 California counties, over 10 years of quarterly data. Exploiting a time series with nonequivalent control group study design, we studied this phenomena using linear regression with random county effects to account for trends over time. Threshold language policy-required assistance programming led to an immediate and significant increase in the penetration rate of mental health services for Russian (8.2, P language speaking persons. Threshold language assistance programming was effective in increasing mental health access for Russian and Vietnamese, but not for Spanish-speaking LEP persons.

  5. 47 CFR 76.977 - Minority and educational programming used in lieu of designated commercial leased access capacity.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Minority and educational programming used in... Cable Rate Regulation § 76.977 Minority and educational programming used in lieu of designated... of programming from a qualified minority programming source or from any qualified educational...

  6. "Utstein style" spreadsheet and database programs based on Microsoft Excel and Microsoft Access software for CPR data management of in-hospital resuscitation.

    Science.gov (United States)

    Adams, Bruce D; Whitlock, Warren L

    2004-04-01

    In 1997, The American Heart Association in association with representatives of the International Committee on Resuscitation (ILCOR) published recommended guidelines for reviewing, reporting and conducting in-hospital cardiopulmonary resuscitation (CPR) outcomes using the "Utstein style". Using these guidelines, we developed two Microsoft Office based database management programs that may be useful to the resuscitation community. We developed a user-friendly spreadsheet based on MS Office Excel. The user enters patient variables such as name, age, and diagnosis. Then, event resuscitation variables such as time of collapse and CPR team arrival are entered from a "code flow sheet". Finally, outcome variables such as patient condition at different time points are recorded. The program then makes automatic calculations of average response times, survival rates and other important outcome measurements. Also using the Utstein style, we developed a database program based on MS Office Access. To promote free public access to these programs, we established at a website. These programs will help hospitals track, analyze, and present their CPR outcomes data. Clinical CPR researchers might also find the programs useful because they are easily modified and have statistical functions.

  7. Correlates of lending needles/syringes among HIV-seropositive injection drug users.

    Science.gov (United States)

    Metsch, Lisa R; Pereyra, Margaret; Purcell, David W; Latkin, Carl A; Malow, Robert; Gómez, Cynthia A; Latka, Mary H

    2007-11-01

    Among HIV-positive injection drug users (IDUs), we examined the correlates of lending needles/syringes with HIV-negative and unknown status injection partners. HIV-positive IDUs (N=738) from 4 cities in the United States who reported injection drug use with other IDUs in the past 3 months participated in an audio computer-assisted self-administered interview. Eighteen percent of study participants self-reported having lent their needles to HIV-negative or unknown status injection partners. Multivariate analyses showed that 6 variables were significantly associated with this high-risk injecting practice. Older IDUs, high school graduates, and those reporting more supportive peer norms for safer drug use were less likely to lend needles/syringes. Admission to a hospital for drug treatment in the past 6 months, having injected with >1 person in the past 3 months, and having more psychiatric symptoms were all associated with more risk. These findings underscore the need for a continued prevention focus on HIV-positive IDUs that recognizes the combination of drug use, mental health factors, and social factors that might affect this high-risk injecting practice, which could be associated with HIV and hepatitis C transmission.

  8. A practical guide for nurses in diluent selection for subcutaneous infusion using a syringe driver.

    Science.gov (United States)

    McLeod, Fiona; Flowers, Charne

    2006-12-01

    Appropriate diluent selection in continuous subcutaneous infusion optimises symptom management and client well-being. The responsibility of diluent selection is commonly one of the attending nurse. This paper was developed with the intention of providing nurses with practical instruction for diluent selection when preparing medications for administration subcutaneously using a syringe driver. A literature review was undertaken of published journal databases and published guidelines sites. Recommendations regarding diluent choice were reviewed in two iterations by an expert panel of palliative care nurse clinicians. The principles for diluent selection are presented. They are based primarily on expert opinion level of evidence given a lack of primary research evidence in the area of diluent selection. There is a pressing need for manufacturers' guidance on diluent selection and independent research to establish the impact of diluents on drug and drug combinations when using syringe drivers. Until such time that this evidence is available to guide practice, clinicians need to be trained to inspect solutions and assess the effectiveness of the medication in controlling symptoms. The capacity of this paper to provide practical instruction has been limited by the lack of rigorous evidence available, and indeed, the process of developing this guide identified perhaps more questions than answers available at the present time.

  9. Syringe test screening of microbial gas production activity: Cases denitrification and biogas formation.

    Science.gov (United States)

    Østgaard, Kjetill; Kowarz, Viktoria; Shuai, Wang; Henry, Ingrid A; Sposob, Michal; Haugen, Hildegunn Hegna; Bakke, Rune

    2017-01-01

    Mass produced plastic syringes may be applied as vessels for cheap, simple and large scale batch culture testing. As illustrated for the cases of denitrification and of biogas formation, metabolic activity was monitored by direct reading of the piston movement due to the gas volume formed. Pressure buildup due to friction was shown to be moderate. A piston pull and slide back routine can be applied before recording gas volume to minimize experimental errors due to friction. Inoculum handling and activity may be conveniently standardized as illustrated by applying biofilm carriers. A robust set of positive as well as negative controls ("blanks") should be included to ensure quality of the actual testing. The denitrification test showed saturation response at increasing amounts of inoculum in the form of adapted moving bed biofilm reactor (MBBR) carriers, with well correlated nitrate consumption vs. gas volume formed. As shown, the denitrification test efficiently screened different inocula at standardized substrates. Also, different substrates were successfully screened and compared at standardized inocula. The biogas potential test showed efficient screening of different substrates with effects of relative amounts of carbohydrate, protein, fat. A second case with CO 2 capture reclaimer waste as substrate demonstrated successful use of co-feeding to support waste treatment and how temperature effects on kinetics and stoichiometry can be observed. In total, syringe test screening of microbial gas production seems highly efficient at a low cost when properly applied. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. A National Long-term Outcomes Evaluation of U.S. Premedical Postbaccalaureate Programs Designed to Promote Health care Access and Workforce Diversity.

    Science.gov (United States)

    McDougle, Leon; Way, David P; Lee, Winona K; Morfin, Jose A; Mavis, Brian E; Matthews, De'Andrea; Latham-Sadler, Brenda A; Clinchot, Daniel M

    2015-08-01

    The National Postbaccalaureate Collaborative (NPBC) is a partnership of Postbaccalaureate Programs (PBPs) dedicated to helping promising college graduates from disadvantaged and underrepresented backgrounds get into and succeed in medical school. This study aims to determine long-term program outcomes by looking at PBP graduates, who are now practicing physicians, in terms of health care service to the poor and underserved and contribution to health care workforce diversity. We surveyed the PBP graduates and a randomly drawn sample of non-PBP graduates from the affiliated 10 medical schools stratified by the year of medical school graduation (1996-2002). The PBP graduates were more likely to be providing care in federally designated underserved areas and practicing in institutional settings that enable access to care for vulnerable populations. The NPBC graduates serve a critical role in providing access to care for underserved populations and serve as a source for health care workforce diversity.

  11. Impacts of the Interim Federal Health Program reforms: A stakeholder analysis of barriers to health care access and provision for refugees.

    Science.gov (United States)

    Antonipillai, Valentina; Baumann, Andrea; Hunter, Andrea; Wahoush, Olive; O'Shea, Timothy

    2017-11-09

    Changes to the Interim Federal Health Program (IFHP) in 2012 reduced health care access for refugees and refugee claimants, generating concerns among key stakeholders. In 2014, a new IFHP temporarily reinstated access to some health services; however, little is known about these changes, and more information is needed to map the IFHP's impact. This study explores barriers occurring during the time period of the IFHP reforms to health care access and provision for refugees. A stakeholder analysis, using 23 semi-structured interviews, was conducted to obtain insight into stakeholder perceptions of the 2014 reforms, as well as stakeholders' position and their influence to assess the acceptability of the IFHP changes. The majority of stakeholders expressed concerns about the 2014 IFHP changes as a result of the continuing barriers posed by the 2012 retrenchments and the emergence of new barriers to health care access and provision for refugees. Key barriers identified included lack of communication and awareness, lack of continuity and comprehensive care, negative political discourse and increased costs. A few stakeholders supported the reforms as they represented some, but limited, access to health care. Overall, the reforms to the IFHP in 2014 generated barriers to health care access and provision that contributed to confusion among stakeholders, the transfer of refugee health responsibility to provincial authorities and the likelihood of increased health outcome disparities, as refugees and refugee claimants chose to delay seeking health care. The study recommends that policy-makers engage with refugee health stakeholders to formulate a policy that improves health care provision and access for refugee populations.

  12. 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.

  13. Access Customized Forms

    OpenAIRE

    Cosma Emil; Jeflea Victor

    2010-01-01

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

  14. Investigation of Two Prototypes of Novel Noncontact Technologies for Automated Real-Time Capture of Incremental Drug Administration Data From Syringes.

    Science.gov (United States)

    Eagle, Benjamin; Williams, David J; Dingley, John

    2017-08-01

    An ideal electronic anesthesia recording system would be capable of not only recording physiological data but also injectable drug doses given, including those given incrementally from one syringe, without recourse to manual data entry. We compared 2 prototype devices which wirelessly recognized individual syringes and measured changes in their plunger positions via 2 different optical noncontact means, allowing calculation of incremental drug doses given. Both devices incorporated a radio-frequency identification reader, which wirelessly read a unique code from a radio-frequency identification tag within syringe drug labels. A custom-designed cradle oriented any inserted 1-mL to 20-mL syringe in a repeatable position. The "laser" device had a moving laser beam broken by the end of the syringe plunger. The infrared (IR) device measured time of travel of IR light from a sender to a syringe plunger and back to a receiver. Both devices could therefore determine the drug and volume administered since the previous occasion when any syringe had been used. For each syringe size of 1, 2, 5, 10, and 20 mL, 121 plunger-length measurements were made over their full range, with each machine against a reference method of water filling and weighing using a randomized de Bruijn sequence. For every syringe size, the laser device showed greater accuracy and precision, lower bias, and narrower limits of agreement (95% confidence intervals = bias ± 1.96 SD) than the IR device when compared to the reference method. For all syringe sizes, the range of bias was -0.05 to 0.32 mL for the laser and -2.42 to 1.38 mL for the IR. Lin concordance correlation coefficient values for the IR versus reference methods ranged from 0.6259 to 0.9255, with the lowest coefficients seen in syringes with the shortest distance of plunger travel (2 and 5 mL), while in laser versus reference comparisons, these coefficients were similar (0.9641-0.9981) over all syringe lengths. Both devices measured syringe

  15. An Analysis of Officer Accession Programs and the Career Development of U.S. Marine Corps Officers

    National Research Council Canada - National Science Library

    Ergun, Levent

    2003-01-01

    .... The performance models assume that commissioning programs that provide longer and more intensive pre-commissioning acculturation, or that credit enlisted service experience, will be associated...

  16. Evaluating the Influence of the Revised Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Food Allocation Package on Healthy Food Availability, Accessibility, and Affordability in Texas.

    Science.gov (United States)

    Lu, Wenhua; McKyer, E Lisako J; Dowdy, Diane; Evans, Alexandra; Ory, Marcia; Hoelscher, Deanna M; Wang, Suojin; Miao, Jingang

    2016-02-01

    The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was implemented to improve the health of pregnant women and children of low socioeconomic status. In 2009, the program was revised to provide a wider variety of healthy food choices (eg, fresh fruits, vegetables, and whole-grain items). The purpose of this study was to evaluate (1) the impact of the revised WIC Nutrition Program's food allocation package on the availability, accessibility, and affordability of healthy foods in WIC-authorized grocery stores in Texas; and (2) how the impact of the policy change differed by store types and between rural and urban regions. WIC-approved stores (n=105) across Texas were assessed using a validated instrument (88 items). Pre- (June-September 2009) and post-new WIC package implementation (June-September 2012) audits were conducted. Paired-sample t tests were conducted to compare the differences between pre- and post-implementation audits on shelf width and number of varieties (ie, availability), visibility (ie, accessibility), and inflation-adjusted price (ie, affordability). Across the 105 stores, post-implementation audits showed increased availability in terms of shelf space for most key healthy food options, including fruit (PFood visibility increased for fresh juices (Pfoods such as fruits (Pbread (Pbread (Pfood availability and visibility were observed in stores of different types and in different locations, although smaller or fewer effects were noted in small stores and stores in rural regions. Implementation of the revised WIC food package has generally improved availability and accessibility, but not affordability, of healthy foods in WIC-authorized stores in Texas. Future studies are needed to explore the impact of the revised program on healthy food option purchases and consumption patterns among Texas WIC participants. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  17. Failure mode and effects analysis applied to the administration of liquid medication by oral syringes

    Directory of Open Access Journals (Sweden)

    Eva María Guerra-Alia

    2017-11-01

    Full Text Available To carry out a Failure Mode and Effects Analysis (FMEA to the use of oral syringes. Methods: A multidisciplinary team was assembled within the Safety Committee. The stages of oral administration process of liquid medication were analysed, identifying the most critical and establishing the potential modes of failure that can cause errors. The impact associated with each mode of failure was calculated using the Risk Priority Number (RPN. Preventive actions were proposed. Results: Five failure modes were identified, all classified as high risk (RPN> 100. Seven of the eight preventive actions were implemented. Conclusions: The FMEA methodology was a useful tool. It has allowed to know the risks, analyse the causes that cause them, their effects on patient safety and the measures to reduce them

  18. A rapid and economic in-house DNA purification method using glass syringe filters.

    Directory of Open Access Journals (Sweden)

    Yun-Cheol Kim

    Full Text Available BACKGROUND: Purity, yield, speed and cost are important considerations in plasmid purification, but it is difficult to achieve all of these at the same time. Currently, there are many protocols and kits for DNA purification, however none maximize all four considerations. METHODOLOGY/PRINCIPAL FINDINGS: We now describe a fast, efficient and economic in-house protocol for plasmid preparation using glass syringe filters. Plasmid yield and quality as determined by enzyme digestion and transfection efficiency were equivalent to the expensive commercial kits. Importantly, the time required for purification was much less than that required using a commercial kit. CONCLUSIONS/SIGNIFICANCE: This method provides DNA yield and quality similar to that obtained with commercial kits, but is more rapid and less costly.

  19. Portable system of programmable syringe pump with potentiometer for determination of promethazine in pharmaceutical applications.

    Science.gov (United States)

    Saleh, Tawfik A; Abulkibash, A M; Ibrahim, Atta E

    2012-04-01

    A simple and fast-automated method was developed and validated for the assay of promethazine hydrochloride in pharmaceutical formulations, based on the oxidation of promethazine by cerium in an acidic medium. A portable system, consisting of a programmable syringe pump connected to a potentiometer, was constructed. The developed change in potential during promethazine oxidation was monitored. The related optimum working conditions, such as supporting electrolyte concentration, cerium(IV) concentration and flow rate were optimized. The proposed method was successfully applied to pharmaceutical samples as well as synthetic ones. The obtained results were realized by the official British pharmacopoeia (BP) method and comparable results were obtained. The obtained t-value indicates no significant differences between the results of the proposed and BP methods, with the advantages of the proposed method being simple, sensitive and cost effective.

  20. A computer-controlled syringe driver for use during anaesthesia. A modification of the Graseby MS16A.

    Science.gov (United States)

    Cohen, A T

    1986-06-01

    The requirements of a drug infusion device for use in theatre are discussed. A modification of the Graseby MS16A syringe pump and an interface circuit permitting its remote control by microcomputer are described. The pump is controlled via a standard computer interface (RS232) which makes it a unique and powerful research tool. Aspects of safety are considered.

  1. Using Program Data to Improve Access to Family Planning and Enhance the Method Mix in Conflict-Affected Areas of the Democratic Republic of the Congo

    Science.gov (United States)

    Ho, Lara S; Wheeler, Erin

    2018-01-01

    Unmet need for family planning in the conflict-affected area of eastern Democratic Republic of the Congo (DRC) has been reported to be as high as 38%, and women in such conflict settings are often the most at risk for maternal mortality. The International Rescue Committee implements the Family Planning and Post-Abortion Care in Emergencies program in 3 provinces of eastern DRC to provide women and couples access to family planning, including long-acting reversible contraceptives (LARCs). This article presents routine program data from June 2011 through December 2013 from 2 health zones as well as results from a qualitative assessment of family planning clients and of male and female non-users, conducted in 2013. It then describes how these findings were used to make program adjustments to improve access to family planning services and client informed choice and assesses the effects of the program design changes on family planning uptake and method mix using routine program data from January 2014 through December 2016. Between 2011 and 2013, 8,985 clients adopted family planning, with an average 14 clients adopting a method per facility, per month. The method mix remained stable during this period, with implants dominating at 48%. Barriers to uptake identified from the qualitative research were both supply- and demand-related, including misconceptions about certain modern contraceptive methods on the part of providers, users, and other community members. The program implemented several program changes based on the assessment findings, including clinical coaching and supportive supervision to improve provider skills and attitudes, introduction of immediate postpartum insertion of the intrauterine device (IUD) and the levonorgestrel-releasing intrauterine system (LNG-IUS), and behavior change communication campaigns to raise awareness about family planning. After these program changes, the mean number of clients adopting modern family planning per facility, per month

  2. Using Program Data to Improve Access to Family Planning and Enhance the Method Mix in Conflict-Affected Areas of the Democratic Republic of the Congo.

    Science.gov (United States)

    Ho, Lara S; Wheeler, Erin

    2018-03-21

    Unmet need for family planning in the conflict-affected area of eastern Democratic Republic of the Congo (DRC) has been reported to be as high as 38%, and women in such conflict settings are often the most at risk for maternal mortality. The International Rescue Committee implements the Family Planning and Post-Abortion Care in Emergencies program in 3 provinces of eastern DRC to provide women and couples access to family planning, including long-acting reversible contraceptives (LARCs). This article presents routine program data from June 2011 through December 2013 from 2 health zones as well as results from a qualitative assessment of family planning clients and of male and female non-users, conducted in 2013. It then describes how these findings were used to make program adjustments to improve access to family planning services and client informed choice and assesses the effects of the program design changes on family planning uptake and method mix using routine program data from January 2014 through December 2016. Between 2011 and 2013, 8,985 clients adopted family planning, with an average 14 clients adopting a method per facility, per month. The method mix remained stable during this period, with implants dominating at 48%. Barriers to uptake identified from the qualitative research were both supply- and demand-related, including misconceptions about certain modern contraceptive methods on the part of providers, users, and other community members. The program implemented several program changes based on the assessment findings, including clinical coaching and supportive supervision to improve provider skills and attitudes, introduction of immediate postpartum insertion of the intrauterine device (IUD) and the levonorgestrel-releasing intrauterine system (LNG-IUS), and behavior change communication campaigns to raise awareness about family planning. After these program changes, the mean number of clients adopting modern family planning per facility, per month

  3. Anterior and middle superior alveolar nerve block for anesthesia of maxillary teeth using conventional syringe

    Directory of Open Access Journals (Sweden)

    Ignacio Velasco

    2012-01-01

    Full Text Available Background: Dental procedures in the maxilla typically require multiple injections and may inadvertently anesthetize facial structures and affect the smile line. To minimize these inconveniences and reduce the number of total injections, a relatively new injection technique has been proposed for maxillary procedures, the anterior and middle superior alveolar (AMSA nerve block, which achieves pulpal anesthesia from the central incisor to second premolar through palatal approach with a single injection. The purpose of this article is to provide background information on the anterior and middle superior alveolar nerve block and demonstrate its success rates of pulpal anesthesia using the conventional syringe. Materials and Methods: Thirty Caucasian patients (16 men and 14 women with an average age of 22 years-old, belonging to the School of Dentistry of Los Andes University, were selected. All the patients received an AMSA nerve block on one side of the maxilla using the conventional syringe, 1 ml of lidocaine 2% with epinephrine 1:100.000 was injected to all the patients. Results: The AMSA nerve block obtained a 66% anesthetic success in the second premolar, 40% in the first premolar, 60% in the canine, 23.3% in the lateral incisor, and 16.7% in the central incisor. Conclusions: Because of the unpredictable anesthetic success of the experimental teeth and variable anesthesia duration, the technique is disadvantageous for clinical application as the first choice, counting with other techniques that have greater efficacy in the maxilla. Although, anesthetizing the teeth without numbing the facial muscles may be useful in restorative dentistry.

  4. Syringe-Injectable Electronics with a Plug-and-Play Input/Output Interface.

    Science.gov (United States)

    Schuhmann, Thomas G; Yao, Jun; Hong, Guosong; Fu, Tian-Ming; Lieber, Charles M

    2017-09-13

    Syringe-injectable mesh electronics represent a new paradigm for brain science and neural prosthetics by virtue of the stable seamless integration of the electronics with neural tissues, a consequence of the macroporous mesh electronics structure with all size features similar to or less than individual neurons and tissue-like flexibility. These same properties, however, make input/output (I/O) connection to measurement electronics challenging, and work to-date has required methods that could be difficult to implement by the life sciences community. Here we present a new syringe-injectable mesh electronics design with plug-and-play I/O interfacing that is rapid, scalable, and user-friendly to nonexperts. The basic design tapers the ultraflexible mesh electronics to a narrow stem that routes all of the device/electrode interconnects to I/O pads that are inserted into a standard zero insertion force (ZIF) connector. Studies show that the entire plug-and-play mesh electronics can be delivered through capillary needles with precise targeting using microliter-scale injection volumes similar to the standard mesh electronics design. Electrical characterization of mesh electronics containing platinum (Pt) electrodes and silicon (Si) nanowire field-effect transistors (NW-FETs) demonstrates the ability to interface arbitrary devices with a contact resistance of only 3 Ω. Finally, in vivo injection into mice required only minutes for I/O connection and yielded expected local field potential (LFP) recordings from a compact head-stage compatible with chronic studies. Our results substantially lower barriers for use by new investigators and open the door for increasingly sophisticated and multifunctional mesh electronics designs for both basic and translational studies.

  5. Syringe needle skull penetration reduces brain injuries and secondary inflammation following intracerebral neural stem cell transplantation.

    Science.gov (United States)

    Gao, Mou; Dong, Qin; Zhang, Hongtian; Yang, Yang; Zhu, Jianwei; Yang, Zhijun; Xu, Minhui; Xu, Ruxiang

    2017-03-01

    Intracerebral neural stem cell (NSC) transplantation is beneficial for delivering stem cell grafts effectively, however, this approach may subsequently result in brain injury and secondary inflammation. To reduce the risk of promoting brain injury and secondary inflammation, two methods were compared in the present study. Murine skulls were penetrated using a drill on the left side and a syringe needle on the right. Mice were randomly divided into three groups (n=84/group): Group A, receiving NSCs in the left hemisphere and PBS in the right; group B, receiving NSCs in the right hemisphere and PBS in the left; and group C, receiving equal NSCs in both hemispheres. Murine brains were stained for morphological analysis and subsequent evaluation of infiltrated immune cells. ELISA was performed to detect neurotrophic and immunomodulatory factors in the brain. The findings indicated that brain injury and secondary inflammation in the left hemisphere were more severe than those in the right hemisphere, following NSC transplantation. In contrast to the left hemisphere, more neurotrophic factors but less pro-inflammatory cytokines were detected in the right hemisphere. In addition, increased levels of neurotrophic factors and interleukin (IL)-10 were observed in the NSC transplantation side when compared with the PBS-treated hemispheres, although lower levels of IL-6 and tumor necrosis factor-α were detected. In conclusion, the present study indicated that syringe needle skull penetration vs. drill penetration is an improved method that reduces the risk of brain injury and secondary inflammation following intracerebral NSC transplantation. Furthermore, NSCs have the potential to modulate inflammation secondary to brain injuries.

  6. Syringeal specialization of frequency control during song production in the Bengalese finch (Lonchura striata domestica.

    Directory of Open Access Journals (Sweden)

    Kristen R Secora

    Full Text Available Singing in songbirds is a complex, learned behavior which shares many parallels with human speech. The avian vocal organ (syrinx has two potential sound sources, and each sound generator is under unilateral, ipsilateral neural control. Different songbird species vary in their use of bilateral or unilateral phonation (lateralized sound production and rapid switching between left and right sound generation (interhemispheric switching of motor control. Bengalese finches (Lonchura striata domestica have received considerable attention, because they rapidly modify their song in response to manipulations of auditory feedback. However, how the left and right sides of the syrinx contribute to acoustic control of song has not been studied.Three manipulations of lateralized syringeal control of sound production were conducted. First, unilateral syringeal muscular control was eliminated by resection of the left or right tracheosyringeal portion of the hypoglossal nerve, which provides neuromuscular innervation of the syrinx. Spectral and temporal features of song were compared before and after lateralized nerve injury. In a second experiment, either the left or right sound source was devoiced to confirm the role of each sound generator in the control of acoustic phonology. Third, air pressure was recorded before and after unilateral denervation to enable quantification of acoustic change within individual syllables following lateralized nerve resection.These experiments demonstrate that the left sound source produces louder, higher frequency, lower entropy sounds, and the right sound generator produces lower amplitude, lower frequency, higher entropy sounds. The bilateral division of labor is complex and the frequency specialization is the opposite pattern observed in most songbirds. Further, there is evidence for rapid interhemispheric switching during song production. Lateralized control of song production in Bengalese finches may enhance acoustic

  7. Contact with hospital syringes containing body fluids: implications for medical waste management regulation Jeringas en contacto con sangre y fluidos corporales utilizadas en el hospital: implicaciones para el manejo de desechos hospitalarios

    OpenAIRE

    Patricia Volkow; Bénédicte Jacquemin; Diana Vilar-Compte; José Ramón Castillo

    2003-01-01

    OBJECTIVE: To determine amount of syringes used in the hospital and extent of contact with blood and body fluids of these syringes. MATERIAL AND METHODS: Syringe use was surveyed at a tertiary care center for one week; syringes were classified into the following four categories according to use: a) contained blood; b) contained other body fluids (urine, gastric secretion, cerebrospinal fluid, wound drainage); c) used exclusively for drug dilution and application in plastic intravenous (IV) tu...

  8. Project Baiterek: A Patient Access Program to Improve Clinical Outcomes and Quality of Life in Children with Type 1 Diabetes in Kazakhstan.

    Science.gov (United States)

    Muratalina, Aigul; Smith-Palmer, Jayne; Nurbekova, Akmaral; Abduakhassova, Gulmira; Zhubandykova, Leila; Roze, Stéphane; Karamalis, Manolis; Shamshatova, Gulzhakhan; Demessinov, Adi; D'Agostino, Nicola Dunne; Lynch, Peter; Yedigarova, Larisa; Klots, Motty; Valentine, William; Welsh, John; Kaufman, Francine

    2015-09-01

    Diabetes is a key driver in the rise of noncommunicable diseases globally. It causes expensive and burdensome short- and long-term complications, with both an economic and social impact. In many countries, however, access to care and disease management in type 1 diabetes is suboptimal, increasing the risk for complications. In 2011, Project Baiterek was initiated as a collaborative effort between the Kazakhstan Ministry of Health, industry (Medtronic Plc), local physicians, and the Diabetes Association of the Republic of Kazakhstan to enhance patient access to continuous subcutaneous insulin infusion (CSII) therapy. It was the first countrywide project to provide equity and universal access to insulin pump therapy among children with type 1 diabetes, increasing pump use from zero to two-thirds of this population in less than 3 years. The project also involved instigating longitudinal data collection, and long-term clinical outcomes continue to be monitored. Here, we provide an overview of the clinical, quality-of-life, and economic outcomes to date associated with providing CSII therapy to children with type 1 diabetes in Kazakhstan. Initial clinical data show that CSII therapy improved clinical outcomes and quality of life for patients entered into the program and that CSII therapy was cost-effective relative to multiple daily injection therapy. The positive outcomes of Project Baiterek provide a template for similar patient access programs in other settings, and its framework could be adapted to initiatives to change health care infrastructures and standards of care for other noncommunicable diseases. Copyright © 2015. Published by Elsevier Inc.

  9. Sediment toxicity data from the NOAA National Status and Trends Program, March 1991 to July 1996 (NODC Accession 9800146)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — As part of its bioeffects assessment program. NOAA has begun a series of surveys of the toxicity and other biological effects of toxicants in selected bays and...

  10. Hawaii Coral Reef Assessment and Monitoring Program (CRAMP) from 07 June 1999 to 16 September 1999 (NODC Accession 0000513)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset consists of Coral Reef Assessment and Monitoring Program (CRAMP) surveys taken in 1999 and include quantitative estimates of substrate type, rugosity,...

  11. Developing a strategic marketing plan for physical and occupational therapy services: a collaborative project between a critical access hospital and a graduate program in health care management.

    Science.gov (United States)

    Kash, Bita A; Deshmukh, A A

    2013-01-01

    The purpose of this study was to develop a marketing plan for the Physical and Occupational Therapy (PT/OT) department at a Critical Access Hospital (CAH). We took the approach of understanding and analyzing the rural community and health care environment, problems faced by the PT/OT department, and developing a strategic marketing plan to resolve those problems. We used hospital admissions data, public and physician surveys, a SWOT analysis, and tools to evaluate alternative strategies. Lack of awareness and negative perception were key issues. Recommended strategies included building relationships with physicians, partnering with the school district, and enhancing the wellness program.

  12. Evaluation of clot formation in blood-contrast agent mixture: experimental study on ionic/nonionic contrast agents and plastic/ glass syringes

    International Nuclear Information System (INIS)

    Shim, Hyung Jin; Lee, Jong Beum; Lee, Yong Chul; Lee, Kwan Seh; Kim, Kun Sang

    1991-01-01

    Recent introduction of low-osmolar nonionic contrast agents has allowed the performance of angiography with certain advantages such as reduced pain, reduced osmotic load and other potential advantages, over high osmolar ionic contrast agents. But the potential thrombogenic risk of nonionic contrast agent has been debate because of their weak anticoagulation effect. Several reports have recently documented the formation of thrombi in catheters and syringes containing nonionic contrast agent, and thromboembolic episodes have been noted during angiographic procedures. We have also been experienced blood clotting within blood mixed contrast agent syringe during angiography. Thus, we have studied with blood mixed ionic (Diatrizoate, Ioglicate) agents and nonionic (Iopamidol, Iopromide) agents, that used usually in our hospital, and saline in plastic and glass syringes. Each syringes were checked the clot formation on 10,30,60,90 minutes. Total 340 samples were obtained from 8 adults before angiography. Our data showed that nonionic contrast agents had significantly lesser anticoagulation effect than ionic contrast agents (ρ < 0.0001) on Chi-square test), both in plastic and glass syringes. And formation of clotting in glass syringes were significantly greater than that in plastic syringes (ρ < 0.0001). Thus meticulous technique is required to prevent thrombosis during angiographic procedure using nonionic contrast agents

  13. Internet access is NOT restricted globally to high income countries: so why are evidenced based prevention and treatment programs for mental disorders so rare?

    Science.gov (United States)

    Watts, Sarah E; Andrews, Gavin

    2014-08-01

    Mental disorders are widespread and universal. They are frequently accompanied by considerable harmful consequences for the individual and come at a significant economic cost to a community. Yet while effective evidence based prevention and treatment exists, there are a number of barriers to access, implement and disseminate. Cognitive behavior therapy programs, such as those available at www.thiswayup.com.au are widely available using the Internet in high income countries, such as Australia. With the ubiquitous uptake of Internet users globally, it is suggested that low and middle income countries should consider ways to embrace and scale up these cost effective programs. An explanation of why and some suggestions as to how this can be done are presented. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

  14. Stability of children's insurance coverage and implications for access to care: evidence from the Survey of Income and Program Participation.

    Science.gov (United States)

    Buchmueller, Thomas; Orzol, Sean M; Shore-Sheppard, Lara

    2014-06-01

    Even as the number of children with health insurance has increased, coverage transitions--movement into and out of coverage and between public and private insurance--have become more common. Using data from 1996 to 2005, we examine whether insurance instability has implications for access to primary care. Because unobserved factors related to parental behavior and child health may affect both the stability of coverage and utilization, we estimate the relationship between insurance and the probability that a child has at least one physician visit per year using a model that includes child fixed effects to account for unobserved heterogeneity. Although we find that unobserved heterogeneity is an important factor influencing cross-sectional correlations, conditioning on child fixed effects we find a statistically and economically significant relationship between insurance coverage stability and access to care. Children who have part-year public or private insurance are more likely to have at least one doctor's visit than children who are uninsured for a full year, but less likely than children with full-year coverage. We find comparable effects for public and private insurance. Although cross-sectional analyses suggest that transitions directly between public and private insurance are associated with lower rates of utilization, the evidence of such an effect is much weaker when we condition on child fixed effects.

  15. 12 CFR Appendix B to Part 748 - Guidance on Response Programs for Unauthorized Access to Member Information and Member Notice

    Science.gov (United States)

    2010-01-01

    ..., SUSPICIOUS TRANSACTIONS, CATASTROPHIC ACTS AND BANK SECRECY ACT COMPLIANCE Pt. 748, App. B Appendix B to Part... Catastrophic Act and Bank Secrecy Act Compliance regulation, 29 interprets section 501(b) of the Gramm-Leach... response program. 38 See FFIEC Information Technology Examination Handbook, Outsourcing Technology Services...

  16. Broadband Access

    Indian Academy of Sciences (India)

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

  17. The effect of a Lean quality improvement implementation program on surgical pathology specimen accessioning and gross preparation error frequency.

    Science.gov (United States)

    Smith, Maxwell L; Wilkerson, Trent; Grzybicki, Dana M; Raab, Stephen S

    2012-09-01

    Few reports have documented the effectiveness of Lean quality improvement in changing anatomic pathology patient safety. We used Lean methods of education; hoshin kanri goal setting and culture change; kaizen events; observation of work activities, hand-offs, and pathways; A3-problem solving, metric development, and measurement; and frontline work redesign in the accessioning and gross examination areas of an anatomic pathology laboratory. We compared the pre- and post-Lean implementation proportion of near-miss events and changes made in specific work processes. In the implementation phase, we documented 29 individual A3-root cause analyses. The pre- and postimplementation proportions of process- and operator-dependent near-miss events were 5.5 and 1.8 (P < .002) and 0.6 and 0.6, respectively. We conclude that through culture change and implementation of specific work process changes, Lean implementation may improve pathology patient safety.

  18. The Relationship Between Exclusions from Gambling Arcades and Accessibility: Evidence from a Newly Introduced Exclusion Program in Hesse, Germany.

    Science.gov (United States)

    Strohäker, Tanja; Becker, Tilman

    2018-02-28

    An exclusion system for gambling arcades has been introduced recently in the state of Hesse. The aim of this paper is to identify significant predictors that are useful in explaining the variation of exclusions between different Hessian communities. Next to socio-demographic factors, we control for three different accessibility variables in two models: the number of electronic gambling machines (EGMs) in model I, and the number of locations and density of gambling machines at a location in model II. We disentangle the association between EGMs and exclusions of model I into a location and a clustering effect. Considering the socio-demographic variables, the explanatory power of our cross-sectional models is rather low. Only the age group of the 30-39 years old and those who are not in a partnership (in model I) yield significant results. As self-exclusion systems reduce availability for the group of vulnerable players, this analysis provides evidence for the assumption that the two groups-pathological gamblers and vulnerable players-seem to have little overlap concerning sociodemographic characteristics. The accessibility variables, on the other hand, turn out to be significantly associated with the number of exclusions. All three of them are statistically significant and their association is positive. The results of model II show that the location effect is more pronounced then the clustering effect of EGMs, i.e. the effect of an additional single-licensed arcade on the number of exclusions is stronger than the increase in the number of license at one location.

  19. An Open-Source Sandbox for Increasing the Accessibility of Functional Programming to the Bioinformatics and Scientific Communities

    Science.gov (United States)

    Fenwick, Matthew; Sesanker, Colbert; Schiller, Martin R.; Ellis, Heidi JC; Hinman, M. Lee; Vyas, Jay; Gryk, Michael R.

    2012-01-01

    Scientists are continually faced with the need to express complex mathematical notions in code. The renaissance of functional languages such as LISP and Haskell is often credited to their ability to implement complex data operations and mathematical constructs in an expressive and natural idiom. The slow adoption of functional computing in the scientific community does not, however, reflect the congeniality of these fields. Unfortunately, the learning curve for adoption of functional programming techniques is steeper than that for more traditional languages in the scientific community, such as Python and Java, and this is partially due to the relative sparseness of available learning resources. To fill this gap, we demonstrate and provide applied, scientifically substantial examples of functional programming, We present a multi-language source-code repository for software integration and algorithm development, which generally focuses on the fields of machine learning, data processing, bioinformatics. We encourage scientists who are interested in learning the basics of functional programming to adopt, reuse, and learn from these examples. The source code is available at: https://github.com/CONNJUR/CONNJUR-Sandbox (see also http://www.connjur.org). PMID:25328913

  20. Strategies of Building a Stronger Sense of Community for Sustainable Neighborhoods: Comparing Neighborhood Accessibility with Community Empowerment Programs

    Directory of Open Access Journals (Sweden)

    Te-I Albert Tsai

    2014-05-01

    Full Text Available New Urbanist development in the U.S. aims at enhancing a sense of community and seeks to return to the design of early transitional neighborhoods which have pedestrian-oriented environments with retail shops and services within walking distances of housing. Meanwhile, 6000 of Taiwan’s community associations have been running community empowerment programs supported by the Council for Cultural Affairs that have helped many neighborhoods to rebuild so-called community cohesion. This research attempts to evaluate whether neighborhoods with facilities near housing and shorter travel distances within a neighborhood would promote stronger social interactions and form a better community attachment than neighborhoods that have various opportunities for residents to participate in either formal or informal social gatherings. After interviewing and surveying residents from 19 neighborhoods in Taipei’s Beitou District, and correlating the psychological sense of community with inner neighborhood’s daily travel distances and numbers of participatory activities held by community organizations under empowerment programs together with frequencies of regular individual visits and casual meetings, statistical evidence yielded that placing public facilities near residential locations is more effective than providing various programs for elevating a sense of community.

  1. An Open-Source Sandbox for Increasing the Accessibility of Functional Programming to the Bioinformatics and Scientific Communities.

    Science.gov (United States)

    Fenwick, Matthew; Sesanker, Colbert; Schiller, Martin R; Ellis, Heidi Jc; Hinman, M Lee; Vyas, Jay; Gryk, Michael R

    2012-01-01

    Scientists are continually faced with the need to express complex mathematical notions in code. The renaissance of functional languages such as LISP and Haskell is often credited to their ability to implement complex data operations and mathematical constructs in an expressive and natural idiom. The slow adoption of functional computing in the scientific community does not, however, reflect the congeniality of these fields. Unfortunately, the learning curve for adoption of functional programming techniques is steeper than that for more traditional languages in the scientific community, such as Python and Java, and this is partially due to the relative sparseness of available learning resources. To fill this gap, we demonstrate and provide applied, scientifically substantial examples of functional programming, We present a multi-language source-code repository for software integration and algorithm development, which generally focuses on the fields of machine learning, data processing, bioinformatics. We encourage scientists who are interested in learning the basics of functional programming to adopt, reuse, and learn from these examples. The source code is available at: https://github.com/CONNJUR/CONNJUR-Sandbox (see also http://www.connjur.org).

  2. A novel tantalum-based sol-gel packed microextraction syringe for highly specific enrichment of phosphopeptides in MALDI-MS applications.

    Science.gov (United States)

    Çelikbıçak, Ömür; Atakay, Mehmet; Güler, Ülkü; Salih, Bekir

    2013-08-07

    A new tantalum-based sol-gel material was synthesized using a unique sol-gel synthesis pathway by PEG incorporation into the sol-gel structure without performing a calcination step. This improved its chemical and physical properties for the high capacity and selective enrichment of phosphopeptides from protein digests in complex biological media. The specificity of the tantalum-based sol-gel material for phosphopeptides was evaluated and compared with tantalum(V) oxide (Ta2O5) in different phosphopeptide enrichment applications. The tantalum-based sol-gel and tantalum(V) oxide were characterized in detail using FT-IR spectroscopy, X-ray diffraction (XRD) and scanning electron microscopy (SEM), and also using a surface area and pore size analyzer. In the characterization studies, the surface morphology, pore volume, crystallinity of the materials and PEG incorporation into the sol-gel structure to produce a more hydrophilic material were successfully demonstrated. The X-ray diffractograms of the two different materials were compared and it was noted that the broad signals of the tantalum-based sol-gel clearly represented the amorphous structure of the sol-gel material, which was more likely to create enough surface area and to provide more accessible tantalum atoms for phosphopeptides to be easily adsorbed when compared with the neat and more crystalline structure of Ta2O5. Therefore, the phosphopeptide enrichment performance of the tantalum-based sol-gels was found to be remarkably higher than the more crystalline Ta2O5 in our studies. Phosphopeptides at femtomole levels could be selectively enriched using the tantalum-based sol-gel and detected with a higher signal-to-noise ratio by matrix-assisted laser desorption/ionization-mass spectrometer (MALDI-MS). Moreover, phosphopeptides in a tryptic digest of non-fat bovine milk as a complex real-world biological sample were retained with higher yield using a tantalum-based sol-gel. Additionally, the sol-gel material

  3. A two-stage procedure for determining unsaturated hydraulic characteristics using a syringe pump and outflow observations

    DEFF Research Database (Denmark)

    Wildenschild, Dorthe; Jensen, Karsten Høgh; Hollenbeck, Karl-Josef

    1997-01-01

    A fast two-stage methodology for determining unsaturated flow characteristics is presented. The procedure builds on direct measurement of the retention characteristic using a syringe pump technique, combined with inverse estimation of the hydraulic conductivity characteristic based on one......-step outflow experiments. The direct measurements are obtained with a commercial syringe pump, which continuously withdraws fluid from a soil sample at a very low and accurate how rate, thus providing the water content in the soil sample. The retention curve is then established by simultaneously monitoring......-step outflow data and the independently measured retention data are included in the objective function of a traditional least-squares minimization routine, providing unique estimates of the unsaturated hydraulic characteristics by means of numerical inversion of Richards equation. As opposed to what is often...

  4. Direct Evidence of Egestion and Salivation of Xylella fastidiosa Suggests Sharpshooters Can Be "Flying Syringes".

    Science.gov (United States)

    Backus, Elaine A; Shugart, Holly J; Rogers, Elizabeth E; Morgan, J Kent; Shatters, Robert

    2015-05-01

    Xylella fastidiosa is unique among insect-transmitted plant pathogens because it is propagative but noncirculative, adhering to and multiplying on the cuticular lining of the anterior foregut. Any inoculation mechanism for X. fastidiosa must explain how bacterial cells exit the vector's stylets via the food canal and directly enter the plant. A combined egestion-salivation mechanism has been proposed to explain these unique features. Egestion is the putative outward flow of fluid from the foregut via hypothesized bidirectional pumping of the cibarium. The present study traced green fluorescent protein-expressing X. fastidiosa or fluorescent nanoparticles acquired from artificial diets by glassy-winged sharpshooters, Homalodisca vitripennis, as they were egested into simultaneously secreted saliva. X. fastidiosa or nanoparticles were shown to mix with gelling saliva to form fluorescent deposits and salivary sheaths on artificial diets, providing the first direct, conclusive evidence of egestion by any hemipteran insect. Therefore, the present results strongly support an egestion-salivation mechanism of X. fastidiosa inoculation. Results also support that a column of fluid is transiently held in the foregut without being swallowed. Evidence also supports (but does not definitively prove) that bacteria were suspended in the column of fluid during the vector's transit from diet to diet, and were egested with the held fluid. Thus, we hypothesize that sharpshooters could be true "flying syringes," especially when inoculation occurs very soon after uptake of bacteria, suggesting the new paradigm of a nonpersistent X. fastidiosa transmission mechanism.

  5. A portable multi-syringe flow system for spectrofluorimetric determination of iodide in seawater.

    Science.gov (United States)

    Frizzarin, Rejane M; Aguado, Enrique; Portugal, Lindomar A; Moreno, Daniel; Estela, José M; Rocha, Fábio R P; Cerdà, Victor

    2015-11-01

    A miniaturized analyzer encompassing a poly(methyl methacrylate) chip with integrated spectrofluorimetric detection and solutions propelling by a multi-syringe module is proposed. Iodide was determined through its catalytic effect on the reaction between Ce(IV) and As(III). Matrix isopotential synchronous fluorescence was explored to set the excitation and emission wavelengths. A two-level full factorial design allowed to evaluate the significance of variables (Ce(IV), As(III) and H2SO4 concentrations) and their interaction effects in the experimental domain. A Doehlert Matrix was applied to identify the critical values. The optimized procedure showed a linear response from 1 to 100 μg L(-1) (S=53.7+2.61C, in which S is the net fluorescence and C is iodide concentration in μg L(-1)). Detection limit, coefficient of variation (n=6) and sampling rate were estimated at 0.3 μg L(-1), 0.8% and 20 h(-1), respectively. Recoveries within 90-117% were estimated for iodide spiked to seawater samples. The proposed procedure stands out because of the portability, robustness, and simplicity for in-field analysis of iodide in seawater. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Performance of a restrictive flow device and an electronic syringe driver for continuous subcutaneous infusion.

    Science.gov (United States)

    Capes, D; Martin, K; Underwood, R

    1997-10-01

    The aim of this study was to investigate the flow performance of the mechanical Springfusor 30 short model and the electronic Graseby MS16A. Flow rate was measured gravimetrically in a temperature-controlled cabinet. There was no statistically significant difference between the Graseby and Springfusor syringe drivers in the flow rate error at 25 degrees C. The percentage of flow rates within +/-20% accuracy during a 35-min periods at 25 degrees C was significantly less with the Graseby, being 91.9% compared with 100% for the Springfusor. Only 58.2% of flow rates with the Graseby were within the manufacturer claimed accuracy of +/-5%. The flow rate of the Springfusor was affected by temperature; at 30 degrees C the mean flow rate was 10.8% greater than at 25 degrees C. These results indicate that the Springfusor 30 had less flow rate variation than the Graseby MS16A. However, this would not be expected to cause noticeable clinical effects when used for opioid infusion in palliative care.

  7. A laser syringe aimed at delivering drug into the outer layer of human skin

    Science.gov (United States)

    Yoh, Jack J.; Jang, Hun-jae; Park, Mi-ae; Han, Tae-hee; Hah, Jung-moo

    2012-07-01

    A desire to eliminate hypodermic needle in transdermal drug delivery may now be realized. Imaging of the skin after injection of fluorescent probe and biotin via the bio-ballistic technique revealed the epidermal and dermal layers which were stained well below 60 μm underneath the abdominal skin of the guinea-pig. An extensive network of cells are shown in the deeper layer of the stained dermis as the distributed fluorescein isothiocyanate (FITC) dose is administered by repeated injection via the laser-based microjet. Here, we show our method of laser-based microjet drug delivery is capable of breaching guinea-pig's skin tissue and then delivering controlled dose of drug to the targeted region between 10 to 400 μm underneath the outermost layer of the skin. While minimizing pain and tissue damage by reducing the injection volume to ˜100 nl per pulse and the microjet diameter of half the conventional syringe needle in 100 μm, the optimally controlled delivery of liquid drug by the irradiated laser pulse is shown possible.

  8. Syringic Acid Extracted from Herba dendrobii Prevents Diabetic Cataract Pathogenesis by Inhibiting Aldose Reductase Activity

    Directory of Open Access Journals (Sweden)

    Xiaoyong Wei

    2012-01-01

    Full Text Available Objective. Effects of Syringic acid (SA extracted from dendrobii on diabetic cataract (DC pathogenesis were explored. Methods. Both in vitro and in vivo DC lens models were established using D-gal, and proliferation of HLEC exposed to SA was determined by MMT assay. After 60-day treatment with SA, rat lens transparency was observed by anatomical microscopy using a slit lamp. SA protein targets were extracted and isolated using 2-DE and MALDI TOF/TOF. AR gene expression was investigated using qRT-PCR. Interaction sites and binding characteristics were determined by molecule-docking techniques and dynamic models. Results. Targeting AR, SA provided protection from D-gal-induced damage by consistently maintaining lens transparency and delaying lens turbidity development. Inhibition of AR gene expression by SA was confirmed by qRT-PCR. IC50 of SA for inhibition of AR activity was 213.17 μg/mL. AR-SA binding sites were Trp111, His110, Tyr48, Trp20, Trp79, Leu300, and Phe122. The main binding modes involved hydrophobic interactions and hydrogen bonding. The stoichiometric ratio of non-covalent bonding between SA and AR was 1.0 to 13.3. Conclusion. SA acts to prevent DC in rat lenses by inhibiting AR activity and gene expression, which has potential to be developed into a novel drug for therapeutic management of DC.

  9. Exploring the Unknown: Selected Documents in the History of the U.S. Civil Space Program. Volume 4; Accessing Space

    Science.gov (United States)

    Logsdon, John M. (Editor); Williamson, Ray A. (Editor); Launius, Roger D. (Editor); Acker, Russell J. (Editor); Garber, Stephen J. (Editor); Friedman, Jonathan L. (Editor)

    1999-01-01

    The documents selected for inclusion in this volume are presented in four major chapters, each covering a particular aspect of access to space and the manner in which it has developed over time. These chapters focus on the evolution toward the giant Saturn V rocket, the development of the Space Shuttle, space transportation commercialization, and future space transportation possibilities. Each chapter in this volume is introduced by an overview essay, prepared by individuals who are particularly well qualified to write on the topic. In the main, these essays are intended to introduce and complement the documents in the chapter and to place them, for the most part, in a chronological and substantive context. Each essay contains references to the documents in the chapter it introduces, and many also contain references to documents in other chapters of the collection. These introductory essays are the responsibility of their individual authors, and the views and conclusions contained therein do not necessarily represent the opinions of either George Washington University or NASA.

  10. Program Specificity for Ptf1a in Pancreas versus Neural Tube Development Correlates with Distinct Collaborating Cofactors and Chromatin Accessibility

    Science.gov (United States)

    Meredith, David M.; Borromeo, Mark D.; Deering, Tye G.; Casey, Bradford H.; Savage, Trisha K.; Mayer, Paul R.; Hoang, Chinh; Tung, Kuang-Chi; Kumar, Manonmani; Shen, Chengcheng; Swift, Galvin H.

    2013-01-01

    The lineage-specific basic helix-loop-helix transcription factor Ptf1a is a critical driver for development of both the pancreas and nervous system. How one transcription factor controls diverse programs of gene expression is a fundamental question in developmental biology. To uncover molecular strategies for the program-specific functions of Ptf1a, we identified bound genomic regions in vivo during development of both tissues. Most regions bound by Ptf1a are specific to each tissue, lie near genes needed for proper formation of each tissue, and coincide with regions of open chromatin. The specificity of Ptf1a binding is encoded in the DNA surrounding the Ptf1a-bound sites, because these regions are sufficient to direct tissue-restricted reporter expression in transgenic mice. Fox and Sox factors were identified as potential lineage-specific modifiers of Ptf1a binding, since binding motifs for these factors are enriched in Ptf1a-bound regions in pancreas and neural tube, respectively. Of the Fox factors expressed during pancreatic development, Foxa2 plays a major role. Indeed, Ptf1a and Foxa2 colocalize in embryonic pancreatic chromatin and can act synergistically in cell transfection assays. Together, these findings indicate that lineage-specific chromatin landscapes likely constrain the DNA binding of Ptf1a, and they identify Fox and Sox gene families as part of this process. PMID:23754747

  11. Treatment of herniated lumbar disc by percutaneous laser disc decompression combined with synchronous suction technique through syringe

    Institute of Scientific and Technical Information of China (English)

    Dhir B. Gurung; Gaojian Tao; Hongyi Lin; Yanning Qian; Jian Lin

    2007-01-01

    Objective: To compare the outcomes of percutaneous laser disc decompression (PLDD) and PLDD with synchronous suction through syringe in the patients with herniated lumbar disc (HLD). Methods: Forty-two patients with HLD on MRI and those who did not respond to conservative treatment for 6 weeks were randomly divided into group A and group B. In group A, the patients were treated with PLDD and those in group B with PLDD and synchronous suction through syringe. GaAIAS diode laser at 810 nm was used for the ablation in both groups. The treatment effect was evaluated by modified MacNab's criteria on the 7th, 30th and 90th day. Results: Evaluated by modified MacNab's criteria, the percentages of the excellent and good cases in total patients treated for group B and A were 80.95% and 57.14% on the 7th follow-up day, 85.71% and 66.67% on the 30th follow-up day, and 95.24% and 71.43% on the 90th follow-up day, respectively. Conclusion: Synchronous suction technique through syringe during PLDD improves the overall outcome in the treatment of herniated lumbar disc.

  12. Organic Extractives from Mentha spp. Honey and the Bee-Stomach: Methyl Syringate, Vomifoliol, Terpenediol I, Hotrienol and Other Compounds

    Directory of Open Access Journals (Sweden)

    Igor Jerković

    2010-04-01

    Full Text Available The GC and GC/MS analyses of the solvent organic extractive from the stomach of the bees, having collected Mentha spp. nectar, revealed the presence of methyl syringate (6.6%, terpendiol I (5.0% and vomifoliol (3.0% that can be attributed to the plant origin. Other major compounds from the bee-stomach were related to the composition of cuticular waxes and less to pheromones. Organic extractivesfrom Mentha spp. honey were obtained by solvent-free headspace solid-phase microextraction (HS-SPME and ultrasonic solvent extraction (USE and analyzed by GC and GC/MS. The major honey headspace compounds were hotrienol (31.1%–38.5%, 2-methoxy-4-methylphenol (0.5–6.0%, cis- and trans-linalool oxides (0.9–2.8%, linalool (1.0–3.1% and neroloxide (0.9–1.9%. Methyl syringate was the most abundant compound (38.3-56.2% in the honey solvent extractives followed by vomifoliol (7.0–26.6%. Comparison of the honey organic extractives with the corresponding bee-stomach extractive indicated that methyl syringate and vomofoliol were transferred to the honey while terpendiol I was partially transformed to hotrienol in ripened honey.

  13. Analysis of Hypodermic Needles and Syringes for the Presence of Blood and Polydimethylsiloxane (Silicone) Utilizing Microchemical Tests and Infrared Spectroscopy.

    Science.gov (United States)

    Crowe, John B; Lanzarotta, Adam; Witkowski, Mark R; Andria, Sara E

    2015-07-01

    Suspect hypodermic needles and syringes were seized from an unlicensed individual who was allegedly injecting patients with silicone (polydimethylsiloxane [PDMS]) for cosmetic enhancement. Since control syringe barrels and needles often contain an interfering PDMS lubricant, a risk for false positives of foreign PDMS exists. The focus of this report was to minimize this risk and determine a quick and reliable test for the presence of blood in PDMS matrices. Using ATR-FT-IR spectroscopy, the risk for false-positive identification of foreign PDMS was reduced by (i) overfilling the sampling aperture to prevent spectral distortions and (ii) sampling a region of the suspect syringe/needle assembly where manufacturer-applied PDMS is not typically located. Analysis for blood indicated that the Teichman microchemical test was effective for detecting blood in the presence of PDMS. Overall, detecting PDMS established intent and detecting blood established that the needle containing the PDMS had been used for injection. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  14. Phase I - Smart Grid Data Access Pilot Program: Utilizing STEM Education as a Catalyst for Residential Consumer Decision Making and Change

    Energy Technology Data Exchange (ETDEWEB)

    Lishness, Alan [Gulf Of Maine Research Inst., Portland, ME (United States); Peake, Leigh [Gulf Of Maine Research Inst., Portland, ME (United States)

    2014-11-19

    Under Phase I of the Smart Grid Data Access Pilot Program, the Gulf of Maine Research Institute (GMRI) partnered with Central Maine Power (CMP), and the Maine Mathematics and Science Alliance (MMSA) and engaged key vendors Tilson Government Services, LLC (Tilson), and Image Works to demonstrate the efficacy of PowerHouse, an interactive online learning environment linking middle school students with their home electricity consumption data provided through CMP’s Advanced Metering Infrastructure (AMI). The goal of the program is to harness the power of youth to alter home energy consumption behaviors using AMI data. Successful programs aimed at smoking cessation, recycling, and seat belt use have demonstrated the power of young people to influence household behaviors. In an era of increasing concern about energy costs, availability, and human impacts on global climate, GMRI sought to demonstrate the effectiveness of a student-focused approach to understanding and managing household energy use. We also sought to contribute to a solid foundation of science-literate students who can analyze evidence to find solutions to increasingly complex energy challenges.

  15. Utilizing Public Access Data and Open Source Statistical Programs to Teach Climate Science to Interdisciplinary Undergraduate Students

    Science.gov (United States)

    Collins, L.

    2014-12-01

    Students in the Environmental Studies major at the University of Southern California fulfill their curriculum requirements by taking a broad range of courses in the social and natural sciences. Climate change is often taught in 1-2 lectures in these courses with limited examination of this complex topic. Several upper division elective courses focus on the science, policy, and social impacts of climate change. In an upper division course focused on the scientific tools used to determine paleoclimate and predict future climate, I have developed a project where students download, manipulate, and analyze data from the National Climatic Data Center. Students are required to download 100 or more years of daily temperature records and use the statistical program R to analyze that data, calculating daily, monthly, and yearly temperature averages along with changes in the number of extreme hot or cold days (≥90˚F and ≤30˚F, respectively). In parallel, they examine population growth, city expansion, and changes in transportation looking for correlations between the social data and trends observed in the temperature data. Students examine trends over time to determine correlations to urban heat island effect. This project exposes students to "real" data, giving them the tools necessary to critically analyze scientific studies without being experts in the field. Utilizing the existing, public, online databases provides almost unlimited, free data. Open source statistical programs provide a cost-free platform for examining the data although some in-class time is required to help students navigate initial data importation and analysis. Results presented will highlight data compiled over three years of course projects.

  16. In-syringe magnetic-stirring-assisted liquid-liquid microextraction for the spectrophotometric determination of Cr(VI) in waters.

    Science.gov (United States)

    Henríquez, Camelia; Horstkotte, Burkhard; Solich, Petr; Cerdà, Víctor

    2013-08-01

    A fully automated method for the determination of chromate is described. It is based on the selective reaction of Cr(VI) with diphenylcarbazide in acidic media to form a colored complex of Cr(III) with the oxidation product diphenylcarbazone. The reaction was performed within the syringe of an automatic burette containing a magnetic stirrer for homogenization of the sample and the required reagents. In-syringe stirring was made possible using a specially designed driving device placed around the syringe barrel to achieve a rotating magnetic field in the syringe, forcing the stirrer to spin. In a second step, the reaction mixture in the syringe was neutralized to allow in-syringe magnetic-stirring-assisted dispersive liquid-liquid microextraction of the complex into 125 μL of n-hexanol. After phase separation by droplet flotation over 30 s, the organic phase was propelled into a coupled spectrophotometric detection cell. The entire multistep procedure including in-system standard preparation was done within 270 s. The method was used for the analysis of natural waters, achieving average analyte recovery of 103%, a limit of detection of 0.26 μg L(-1), and a repeatability of less than 4% relative standard deviation.

  17. Physical stability of 20% lipid injectable emulsions via simulated syringe infusion: effects of glass vs plastic product packaging.

    Science.gov (United States)

    Driscoll, David F; Ling, Pei-Ra; Bistrian, Bruce R

    2007-01-01

    The United States Pharmacopeia (USP) has proposed large-globule-size limits to ensure the physical stability of lipid injectable emulsions, expressed as the percent fat >5 microm, or PFAT(5), not exceeding 0.05%. Visibly obvious phase separation as free oil has been shown to occur in some samples if PFAT(5) is >0.4%. We recently found that lipids, newly packaged in plastic (P), exceed the proposed USP limits and seem to produce less stable total nutrient admixtures compared with those made from conventional glass (G), which do meet proposed USP standards. We tested the possible stability differences between 20% lipid injectable emulsions in either P or G in a simulated neonatal syringe infusion study. Eighteen individual syringes were prepared from each 20% lipid injectable emulsion product (n = 36) and attached to a syringe pump set at an infusion rate of 0.5 mL/hour. The starting PFAT(5) levels were measured at time 0 and after 24 hours of infusion, using a laser-based light obscuration technique as described by the USP Chapter . The data were assessed by a 2-way analysis of variance (ANOVA) with Container (G vs P) and Time as the independent variables and PFAT as the dependent variable. At time 0, the starting PFAT(5) level for lipids packaged in G was 0.006% +/- 0.001% vs 0.162% +/- 0.026% for P, whereas at the end of the infusion they were 0.013% +/- 0.003% and 0.328% +/- 0.046%, respectively. Significant differences were noted overall between groups for Container, Time, and Container-Time interaction (all p emulsions packaged in newly introduced plastic containers exceed the proposed USP PFAT(5) limits and subsequently become significantly less stable during a simulated syringe-based infusion. Although modest growth (p = NS) in large-diameter fat globules was observed for the glass-based lipids, they remained within proposed USP globule size limits throughout the study. Glass-based lipids seem to be a more stable dosage form and potentially a safer way to

  18. Data Portal for the Library of Integrated Network-based Cellular Signatures (LINCS) program: integrated access to diverse large-scale cellular perturbation response data

    Science.gov (United States)

    Koleti, Amar; Terryn, Raymond; Stathias, Vasileios; Chung, Caty; Cooper, Daniel J; Turner, John P; Vidović, Dušica; Forlin, Michele; Kelley, Tanya T; D’Urso, Alessandro; Allen, Bryce K; Torre, Denis; Jagodnik, Kathleen M; Wang, Lily; Jenkins, Sherry L; Mader, Christopher; Niu, Wen; Fazel, Mehdi; Mahi, Naim; Pilarczyk, Marcin; Clark, Nicholas; Shamsaei, Behrouz; Meller, Jarek; Vasiliauskas, Juozas; Reichard, John; Medvedovic, Mario; Ma’ayan, Avi; Pillai, Ajay

    2018-01-01

    Abstract The Library of Integrated Network-based Cellular Signatures (LINCS) program is a national consortium funded by the NIH to generate a diverse and extensive reference library of cell-based perturbation-response signatures, along with novel data analytics tools to improve our understanding of human diseases at the systems level. In contrast to other large-scale data generation efforts, LINCS Data and Signature Generation Centers (DSGCs) employ a wide range of assay technologies cataloging diverse cellular responses. Integration of, and unified access to LINCS data has therefore been particularly challenging. The Big Data to Knowledge (BD2K) LINCS Data Coordination and Integration Center (DCIC) has developed data standards specifications, data processing pipelines, and a suite of end-user software tools to integrate and annotate LINCS-generated data, to make LINCS signatures searchable and usable for different types of users. Here, we describe the LINCS Data Portal (LDP) (http://lincsportal.ccs.miami.edu/), a unified web interface to access datasets generated by the LINCS DSGCs, and its underlying database, LINCS Data Registry (LDR). LINCS data served on the LDP contains extensive metadata and curated annotations. We highlight the features of the LDP user interface that is designed to enable search, browsing, exploration, download and analysis of LINCS data and related curated content. PMID:29140462

  19. On-line lab-in-syringe cloud point extraction for the spectrophotometric determination of antimony.

    Science.gov (United States)

    Frizzarin, Rejane M; Portugal, Lindomar A; Estela, José M; Rocha, Fábio R P; Cerdà, Victor

    2016-02-01

    Most of the procedures for antimony determination require time-consuming sample preparation (e.g. liquid-liquid extraction with organic solvents), which are harmful to the environment. Because of the high antimony toxicity, a rapid, sensitive and greener procedure for its determination becomes necessary. The goal of this work was to develop an analytical procedure exploiting for the first time the cloud point extraction on a lab-in-syringe flow system aiming at the spectrophotometric determination of antimony. The procedure was based on formation of an ion-pair between the antimony-iodide complex and H(+) followed by extraction with Triton X-114. The factorial design showed that the concentrations of ascorbic acid, H2SO4 and Triton X-114, as well as second and third order interactions were significant at the 95% confidence level. A Box-Behnken design was applied to obtain the response surfaces and to identify the critical values. System is robust at the 95% confidence level. A linear response was observed from 5 to 50 µg L(-1), described by the equation A=0.137+0.050C(Sb) (r=0.998). The detection limit (99.7% confidence level), the coefficient of variation (n=5; 15 µg L(-1)) and the sampling rate was estimated at 1.8 µg L(-1), 1.6% and 16 h(-1), respectively. The procedure allows quantification of antimony in the concentrations established by environmental legislation (6 µg L(-1)) and it was successfully applied to the determination of antimony in freshwater samples and antileishmanial drugs, yielding results in agreement with those obtained by HGFAAS at the 95% confidence level. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. 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.

  1. Environmental implications of Universal Rural Road Access Program (URRAP roads in Southwestern Ethiopia: The case of Jimma and Buno Bedelle zones

    Directory of Open Access Journals (Sweden)

    Hassen Negesso

    2018-03-01

    Full Text Available Ethiopia has been undertaking numerous development programs and projects with the objective of taking a country to the middle-income countries in the near future. Universal Rural Road Access Program (URRAP roads being constructed in Jimma and Bunno Bedele zones are among the projects in Ethiopia. Although these projects are assumed to bring desirable positive change, there are sometimes negative consequences on environmental issues. Accordingly, the objective of this study was to investigate the negative sides of these projects on environmental elements. Household survey with randomly selected household heads and in-depth interview, focus group discussion (FGD and observation for purposively selected samples were used to collect relevant and required data. Thereby, data were analyzed quantitatively by using Statistical Package for Social Sciences (SPSS and qualitatively through thematic method. The findings from the analyzed data show that rural roads being constructed by URRAP have both positive and negative impacts on plant species, bird species, reptile species, mammal’s species, amphibians’ species, soil, and climate. Finally, URRAP is in dilemma and needs an extensive and frequent supervision, monitoring, inclusive, interdisciplinary and sound strategies and policies by responsible bodies at all expected levels and contexts.

  2. 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

  3. Single patient doses of {sup 99m}Tc-HDP: Assessment of radiochemical purity, sterility and extractables from a polypropylene syringe over six hours

    Energy Technology Data Exchange (ETDEWEB)

    Parkes, S.L.; Varelis, P. [St George Hospital, Kogarah, NSW (Australia). Department of Nuclear Medicine

    1997-12-01

    Full text: The purpose of this investigation was to determine the radiochemical purity (RCP), sterility and extractables for {sup 99m}Tc oxidronate ({sup 99m}Tc-HDP) stored in polypropylene syringes over < six-hour period. The radiochemical purity was determined using a two-strip ITLC procedure, performed at time 0, 1, 2, 4, 6 hours. The sterility and endotoxin levels were tested by a NATA accredited laboratory, after allowing the radiopharmaceutical to stand at room temperature for six hours in the syringes. Plasticisers and other likely compounds that could be extracted from the syringes into the aqueous solution were determined by high pressure liquid chromatography (HPLC) diode array detection. This analysis involved shaking normal saline in a syringe over night and then injecting an aliquot of this solution onto a C18 analytical column and monitoring the effluent at 200 and 253 nm. The radiochemical purity of {sup 99m}Tc-HDP did not significantly change over the course of the study and remained above the recommended RCP for this radiopharmaceutical. Furthermore, at six hours the RCP of {sup 99m}Tc-HDP stored in both the manufacturer`s vial and a syringe were identical. Sterility testing of {sup 99m}Tc-HDP stored in syringes showed no microbial growth and less than 10 endotoxin units/mL (pass). The HPLC analysis did not show the presence of any extraneous compounds in the aqueous solution. Single patient doses of {sup 99m}Tc-HDP stored in polypropylene syringes over a six-hour period fulfill all the quality control requirements for administration to humans.

  4. The awareness of patients with non - muscle invasive bladder cancer regarding the importance of smoking cessation and their access to smoking cessation programs

    Directory of Open Access Journals (Sweden)

    Emrah Yuruk

    Full Text Available ABSTRACT Objectives Smoking is the most important risk factor for bladder cancer and smoking cessation is associated with reduced risk of tumor recurrence and progression. The aim of this study is to assess the awareness of non-muscle invasive bladder cancer (NMIBC patients regarding the importance of smoking cessation, determine their access to smoking cessation programs and the effects of smoking cessation on recurrence rates of NMIBC. Materials and Methods NMIBC patients who were followed with cystoscopy were included in the study. Their demographic properties were recorded, along with their smoking habits, awareness regarding the effects of smoking on bladder cancer and previous attempts for smoking cessation. Moreover, the patients were asked whether they applied for a smoking cessation program. Recurrence of bladder cancer during the follow-up period was also noted. Results A total of 187 patients were included in the study. The mean age was 64.68±12.05 (range: 15-90 and the male to female ratio was 167/20. At the time of diagnosis, 114 patients (61.0% were active smokers, 35 patients (18.7% were ex-smokers and 38 patients (20.3% had never smoked before. After the diagnosis, 83.3% of the actively smoking patients were advised to quit smoking and 57.9% of them quit smoking. At the time of the study, 46.52% of the NMIBC patients were aware of the link between smoking and bladder cancer, whereas only 4.1% of the smoking patients were referred to smoking cessation programs. After a mean follow-up of 32.28±11.42 months, 84 patients (44.91% had recurrence; however, current smoking status or awareness of the causative role of smoking on NMIBC did not affect the recurrence. Conclusion In our study group, the majority of the NMIBC patients were not aware of the association between smoking and bladder cancer. Although most of the physicians advised patients to quit smoking, a significant amount of the patients were still active smokers during

  5. Protocole of a controlled before-after evaluation of a national health information technology-based program to improve healthcare coordination and access to information.

    Science.gov (United States)

    Saillour-Glénisson, Florence; Duhamel, Sylvie; Fourneyron, Emmanuelle; Huiart, Laetitia; Joseph, Jean Philippe; Langlois, Emmanuel; Pincemail, Stephane; Ramel, Viviane; Renaud, Thomas; Roberts, Tamara; Sibé, Matthieu; Thiessard, Frantz; Wittwer, Jerome; Salmi, Louis Rachid

    2017-04-21

    Improvement of coordination of all health and social care actors in the patient pathways is an important issue in many countries. Health Information (HI) technology has been considered as a potentially effective answer to this issue. The French Health Ministry first funded the development of five TSN ("Territoire de Soins Numérique"/Digital health territories) projects, aiming at improving healthcare coordination and access to information for healthcare providers, patients and the population, and at improving healthcare professionals work organization. The French Health Ministry then launched a call for grant to fund one research project consisting in evaluating the TSN projects implementation and impact and in developing a model for HI technology evaluation. EvaTSN is mainly based on a controlled before-after study design. Data collection covers three periods: before TSN program implementation, during early TSN program implementation and at late TSN program implementation, in the five TSN projects' territories and in five comparison territories. Three populations will be considered: "TSN-targeted people" (healthcare system users and people having characteristics targeted by the TSN projects), "TSN patient users" (people included in TSN experimentations or using particular services) and "TSN professional users" (healthcare professionals involved in TSN projects). Several samples will be made in each population depending on the objective, axis and stage of the study. Four types of data sources are considered: 1) extractions from the French National Heath Insurance Database (SNIIRAM) and the French Autonomy Personalized Allowance database, 2) Ad hoc surveys collecting information on knowledge of TSN projects, TSN program use, ease of use, satisfaction and understanding, TSN pathway experience and appropriateness of hospital admissions, 3) qualitative analyses using semi-directive interviews and focus groups and document analyses and 4) extractions of TSN

  6. Stability of Hydromorphone-Ketamine Solutions in Glass Bottles, Plastic Syringes, and IV Bags for Pediatric Use.

    Science.gov (United States)

    Ensom, Mary H H; Decarie, Diane; Leung, Karen; Montgomery, Carolyne

    2009-03-01

    To evaluate the stability of mixtures of hydromorphone and ketamine in 0.9% sodium chloride (normal saline [NS]) after storage for up to 7 days at room temperature (25°C). The stability of 3 standard mixtures of hydromorphone and ketamine (hydromorphone 0.2 mg/mL + ketamine 0.2 mg/mL, hydromorphone 0.2 mg/mL + ketamine 0.6 mg/mL, and hydromorphone 0.2 mg/mL + ketamine 1.0 mg/mL) in NS was studied. Portions of each mixture were transferred to 3 brown glass bottles (100 mL), 3 plastic syringes (50 mL), and 3 IV bags (50 mL), which were then stored at room temperature (25°C). Physical characteristics, including pH, colour, and precipitation, were evaluated daily. Three 1.5-mL samples were collected from each bottle, syringe, and IV bag at baseline, at 24, 48, and 72 hours, and on day 7. Samples were analyzed in triplicate by a stability-indicating high-performance liquid chromatography method. Solutions were considered stable if they maintained 90% of the initial concentration of each drug. Samples from syringes and IV bags were subjected to standard sterility testing by incubation for 5 days in an enriched culture media. No notable changes in pH or colour were observed, and no precipitation occurred in any of the solutions. All formulations maintained more than 90% of the initial concentration of each drug on day 7. No bacterial growth was observed in any of the samples tested. Mixtures of hydromorphone and ketamine were stable for up 7 days at 25°C, and the sterility of the preparations was maintained. Because stability alone does not guarantee efficacy, it is recommended that clinical studies be conducted to evaluate the pharmacokinetics and pharmacodynamics of these formulations.

  7. Stability of sodium bicarbonate injection 8.4% in syringes over a six-week period in refrigerated temperature.

    Science.gov (United States)

    Seki, Jack T; Wang, Tian Q; Yip, Paul M; Mazzulli, Tony; Minden, Mark D

    2018-04-01

    Background Dysfunctional central venous catheter prohibits the administration of potential life-saving chemotherapy and the delivery of essential supportive care needs to patients. Sodium bicarbonate injection has been shown to impede against fibrin clot formation and prolong prothrombin time and thrombin clotting time. Sodium bicarbonate injection has been tried as a second-line agent with good results in a small number of patients (internal data not published) when alteplase failed. We assessed whether the pre-filled sodium bicarbonate injection in 5 mL syringes would not only preserve sterility and retain its pH and concentration but also amount to the potential cost savings for future use when stored in a refrigerated environment. Methodology Twelve pre-filled 5 mL syringes were prepared aseptically, of which four each were tested for pH, sodium bicarbonate injection concentration and sterility when stored in refrigerated temperature over a six-week period. A standard pH meter, enzymatic carbon dioxide analyzer, and a 14-day incubation for microbial detection were employed for this study. Results Sodium bicarbonate concentration measured in the form of carbon dioxide ranged from 923 mmol/L or (1846 mosol/L) to 1006 mmol/L or (2012 mosmol/L), and pH ranged from (7.88 to 8.05) were reported over the duration of the study period. The 14-day incubation period resulted in no microbial growth. Conclusion Our study results have indicated that the pH and sodium bicarbonate injection concentration values were stable and within range, comparable to those reported by the manufacturer within the study period. The contents of the subdivided sodium bicarbonate injection 5 mL syringes retained sterility over a 14-day incubation period.

  8. Intrathecal catheter-syringe adaptor for short-term intrathecal analgesia with an externalized pump: a case report.

    Science.gov (United States)

    Wilkes, Denise; Cook, Michael; Solanki, Daneshvari

    2010-01-01

    In most patients, cancer pain is effectively treated with conservative medical management consisting of oral and/or transdermal analgesics. Cancer patients tend to fail conservative medical management near the end of their life expectancy, thus requiring alternative routes of analgesia such as intravenous, epidural, or intrathecal. The intrathecal route provides the most effective analgesia due to the close proximity of the opioid receptors in the spinal cord. Though there are many techniques that exist for intrathecal drug delivery, complications can limit effectiveness such as infection, bleeding, cerebrospinal fluid (CSF) leaks, post-dural puncture headaches (PDPH), pump and/or catheter malfunctions, or limitations of technical expertise. Therefore, an important goal in palliative cancer pain therapy is to use equipment that is going to have the fewest number of complications and will be the most familiar to the health care providers. We describe the combination of the Medtronic Indura 1P catheter, which has the least catheter-related complications and can be used with any external drug infusion pump. These are regular infusion pumps that the health care workers are familiar with so they can provide excellent and efficient service to the patient. In an operating room, the intrathecal catheter was placed using sterile technique under fluoroscopic guidance. The epidural space was identified with loss of resistance technique. Then the introducer needle (supplied in the Indura 1P catheter kit) was advanced until free-flowing CSF was obtained. The spinal catheter was advanced into the intrathecal space through the introducer needle to lumbar 2-3 level. The catheter was tunneled subcutaneously 10 cm lateral to the catheter exit site. A syringe filling device was inserted into the catheter opening and was secured with silk suture. A luer lock syringe was attached to the syringe filling device and CSF was aspirated. The syringe filling device was capped and later

  9. Italian Nivolumab Expanded Access Program in Nonsquamous Non-Small Cell Lung Cancer Patients: Results in Never-Smokers and EGFR-Mutant Patients.

    Science.gov (United States)

    Garassino, Marina Chiara; Gelibter, Alain Jonathan; Grossi, Francesco; Chiari, Rita; Soto Parra, Hector; Cascinu, Stefano; Cognetti, Francesco; Turci, Daniele; Blasi, Livio; Bengala, Carmelo; Mini, Enrico; Baldini, Editta; Quadrini, Silvia; Ceresoli, Giovanni Luca; Antonelli, Paola; Vasile, Enrico; Pinto, Carmine; Fasola, Gianpiero; Galetta, Domenico; Macerelli, Marianna; Giannarelli, Diana; Lo Russo, Giuseppe; de Marinis, Filippo

    2018-05-03

    Nivolumab is the first checkpoint inhibitor approved for the treatment of nonsquamous NSCLC. We report results from the nivolumab Italian expanded access program focusing on never-smokers and patients with EGFR-mutant nonsqamous NSCLC. Nivolumab (3 mg/kg intravenously every 2 weeks) was administered upon physicians' request to patients who had relapsed after one or more prior systemic treatments for stage IIIB/IV nonsquamous NSCLC. Efficacy and safety were evaluated in patients who received at least one dose of nivolumab. Of 1588 patients with nonsquamous NSCLC, 305 (19.2%) were never-smokers. EGFR status was available for 1395 patients. Of the 102 patients (6.4%) with EGFR mutation-positive tumors, 51 (50%) were never-smokers. The objective response rate was significantly higher in patients with wild-type EGFR than patients with EGFR-mutant tumors (19.6% versus 8.8% [p = 0.007]), in former and current smokers than in never-smokers (21.5% versus 9.2% [p = 0.0001]), and in never-smokers with wild-type EGFR than in never-smokers with mutant EGFR (11.0% versus 1.9% [p = 0.04]). There was no significant difference in objective response rate between smokers with wild-type EGFR and smokers with mutant EGFR (22.0% versus 20.6%). There was no statistically significant difference in median progression-free survival or in median overall survival. The median overall survival times were 11 months in patients with EGFR wild-type tumors versus 8.3 months in patients with EGFR-mutant tumors, 11.6 months in smokers versus 10.0 months in never-smokers, 11.0 months in never-smokers with EGFR wild-type tumors versus 5.6 months in never-smokers with EGFR-mutant tumors, and 14.1 months in smokers with EGFR-mutant tumors versus 11.3 months in smokers with EGFR wild-type tumors. The data on the Italian expanded access program in populations with nonsquamous NSCLC suggest that subgroups of patients could benefit differently from nivolumab according to their EGFR mutational status and

  10. The American Geological Institute Minority Participation Program (MPP): Thirty Years of Improving Access to Opportunities in the Geosciences Through Undergraduate and Graduate Scholarships for Underrepresented Minorities

    Science.gov (United States)

    Callahan, C. N.; Byerly, G. R.; Smith, M. J.

    2001-05-01

    are used to gauge the needs of the scholar, and to access the success of the overall program. The MPP Advisory Committee aims to match the profession of the mentor with the scholar's academic interest. Throughout the year, mentors and scholars communicate about possible opportunities in the geosciences such as internships, participation in symposia, professional society meetings, and job openings. Mentors have also been active in helping younger students cope with the major changes involved in relocating to a new region of the country or a new college culture. We believe that AGI is well positioned to advance diversity in the geosciences through its unique standing as the major professional organization in the geosciences. AGI maintains strong links to its professional Member Societies, state and federal agencies and funding programs, many with distinctive programs in the geoscience education. AGI Corporate Associates have consistently pledged to support diversity issues in geoscience education. Current plans include seeking funding for 48 undergraduate awards at \\2500 each and \\24,000 to support undergraduate travel to professional meetings. We also expect to increase the size of our graduate scholarship program to 30 students and raise an additional \\$30,000 to support graduate travel to professional meetings.

  11. Barriers to antiretroviral treatment access for injecting drug users living with HIV in Chennai, South India.

    Science.gov (United States)

    Chakrapani, Venkatesan; Velayudham, Jaikumar; Shunmugam, Murali; Newman, Peter A; Dubrow, Robert

    2014-01-01

    India's National AIDS Control Organization provides free antiretroviral treatment (ART) to people living with HIV (PLHIV), including members of marginalized groups such as injecting drug users (IDUs). To help inform development of interventions to enhance ART access, we explored barriers to free ART access at government ART centers for IDUs living with HIV in Chennai by conducting three focus groups (n = 19 IDUs) and four key informant interviews. Data were explored using framework analysis to identify categories and derive themes. We found interrelated barriers at the family and social, health-care system, and individual levels. Family and social level barriers included lack of family support and fear of societal discrimination, as well as unmet basic needs, including food and shelter. Health-care system barriers included actual or perceived unfriendly hospital environment and procedures such as requiring proof of address and identity from PLHIV, including homeless IDUs; provider perception that IDUs will not adhere to ART, resulting in ART not being initiated; actual or perceived inadequate counseling services and lack of confidentiality; and lack of effective linkages between ART centers, needle/syringe programs, and drug dependence treatment centers. Individual-level barriers included active drug use, lack of self-efficacy in ART adherence, low motivation to initiate ART stemming from a fatalistic attitude, and inadequate knowledge about ART. These findings indicate that to facilitate IDUs gaining access to ART, systemic changes are needed, including steps to make the environment and procedures at government ART centers more IDU-friendly and steps to decrease HIV- and drug use-related stigma and discrimination faced by IDUs from the general public and health-care providers. Housing support for homeless IDUs and linkage of IDUs with drug dependence treatment are also essential.

  12. Simultaneous extraction and determination of albendazole and triclabendazole by a novel syringe to syringe dispersive liquid phase microextraction-solidified floating organic drop combined with high performance liquid chromatography.

    Science.gov (United States)

    Asadi, Mohammad; Dadfarnia, Shayessteh; Haji Shabani, Ali Mohammad

    2016-08-17

    A syringe to syringe dispersive liquid phase microextraction-solidified floating organic drop was introduced and used for the simultaneous extraction of trace amounts of albendazole and triclabendazole from different matrices. The extracted analytes were determined by high performance liquid chromatography along with fluorescence detection. The analytical parameters affecting the microextraction efficiency including the nature and volume of the extraction solvent, sample volume, sample pH, ionic strength and the cycles of extraction were optimized. The calibration curves were linear in the range of 0.1-30.0 μg L(-1) and 0.2-30.0 μg L(-1) with determination coefficients of 0.9999 and 0.9998 for albendazole and triclabendazole respectively. The detection limits defined as three folds of the signal to noise ratio were found to be 0.02 μg L(-1) for albendazole and 0.06 μg L(-1) for triclabendazole. The inter-day and intra-day precision (RSD%) for both analytes at three concentration levels (0.5, 2.0 and 10.0 μg L(-1)) were in the range of 6.3-10.1% and 5.0-7.5% respectively. The developed method was successfully applied to determine albendazole and triclabendazole in water, cow milk, honey, and urine samples. Copyright © 2016. Published by Elsevier B.V.

  13. Eye Care Quality and Accessibility Improvement in the Community (EQUALITY): impact of an eye health education program on patient knowledge about glaucoma and attitudes about eye care.

    Science.gov (United States)

    Rhodes, Lindsay A; Huisingh, Carrie E; McGwin, Gerald; Mennemeyer, Stephen T; Bregantini, Mary; Patel, Nita; Saaddine, Jinan; Crews, John E; Girkin, Christopher A; Owsley, Cynthia

    2016-01-01

    To assess the impact of the education program of the Eye Care Quality and Accessibility Improvement in the Community (EQUALITY) telemedicine program on at-risk patients' knowledge about glaucoma and attitudes about eye care as well as to assess patient satisfaction with EQUALITY. New or existing patients presenting for a comprehensive eye exam (CEE) at one of two retail-based primary eye clinics were enrolled based on ≥1 of the following at-risk criteria for glaucoma: African Americans ≥40 years of age, Whites ≥50 years of age, diabetes, family history of glaucoma, and/or preexisting diagnosis of glaucoma. A total of 651 patients were enrolled. A questionnaire was administered prior to the patients' CEE and prior to the patients receiving any of the evidence-based eye health education program; a follow-up questionnaire was administered 2-4 weeks later by phone. Baseline and follow-up patient responses regarding knowledge about glaucoma and attitudes about eye care were compared using McNemar's test. Logistic regression models were used to assess the association of patient-level characteristics with improvement in knowledge and attitudes. Overall patient satisfaction was summarized. At follow-up, all patient responses in the knowledge and attitude domains significantly improved from baseline (P≤0.01 for all questions). Those who were unemployed (odds ratio =0.63, 95% confidence interval =0.42-0.95, P=0.026) or had lower education (odds ratio =0.55, 95% confidence interval =0.29-1.02, P=0.058) were less likely to improve their knowledge after adjusting for age, sex, race, and prior glaucoma diagnosis. This association was attenuated after further adjustment for other patient-level characteristics. Ninety-eight percent (n=501) of patients reported being likely to have a CEE within the next 2 years, whereas 63% (n=326) had a CEE in the previous 2 years. Patient satisfaction with EQUALITY was high (99%). Improved knowledge about glaucoma and a high intent to

  14. A Pilot Randomized Controlled Trial of the ACCESS Program: A Group Intervention to Improve Social, Adaptive Functioning, Stress Coping, and Self-Determination Outcomes in Young Adults with Autism Spectrum Disorder

    Science.gov (United States)

    Oswald, Tasha M.; Winder-Patel, Breanna; Ruder, Steven; Xing, Guibo; Stahmer, Aubyn; Solomon, Marjorie

    2018-01-01

    The purpose of this pilot randomized controlled trial was to investigate the acceptability and efficacy of the Acquiring Career, Coping, Executive control, Social Skills (ACCESS) Program, a group intervention tailored for young adults with autism spectrum disorder (ASD) to enhance critical skills and beliefs that promote adult functioning,…

  15. 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…

  16. Open access

    African Journals Online (AJOL)

    Prof. Dennis Ocholla

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

  17. Effect of liposomes on rheological and syringeability properties of hyaluronic acid hydrogels intended for local injection of drugs.

    Science.gov (United States)

    El Kechai, Naila; Bochot, Amélie; Huang, Nicolas; Nguyen, Yann; Ferrary, Evelyne; Agnely, Florence

    2015-06-20

    The aim of this work was to thoroughly study the effect of liposomes on the rheological and the syringeability properties of hyaluronic acid (HA) hydrogels intended for the local administration of drugs by injection. Whatever the characteristics of the liposomes added (neutral, positively or negatively charged, with a corona of polyethylene glycol chains, size), the viscosity and the elasticity of HA gels increased in a lipid concentration-dependent manner. Indeed, liposomes strengthened the network formed by HA chains due to their interactions with this polymer. The nature and the resulting effects of these interactions depended on liposome composition and concentration. The highest viscosity and elasticity were observed with liposomes covered by polyethylene glycol chains while neutral liposomes displayed the lowest effect. Despite their high viscosity at rest, all the formulations remained easily injectable through needles commonly used for local injections thanks to the shear-thinning behavior of HA gels. The present study demonstrates that rheological and syringeability tests are both necessary to elucidate the behavior of such systems during and post injection. In conclusion, HA liposomal gels appear to be a promising and versatile formulation platform for a wide range of applications in local drug delivery when an injection is required. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. In-syringe dispersive liquid-liquid microextraction with liquid chromatographic determination of synthetic pyrethroids in surface water

    Directory of Open Access Journals (Sweden)

    Saeed S. Albaseer

    2012-03-01

    Full Text Available An indigenously fabricated in laboratory glass syringe was used for in-syringe dispersive liquid-liquid microextraction (is-DLLME and preconcentration of synthetic pyrethroids (SPs from surface waters suitable for their determination by high performance liquid chromatography. In contrast to classical DLLME, is-DLLME allows the use of lighter-than-water organic solvents and the analysis of environmental contaminants’ samples without prior filtration, which is of great importance due to the high affinity of pyrethroids to adsorb to solid particulates present in environmental samples. The effects of various parameters on the extraction efficiency were evaluated and optimized systemically using one-factor-at-a-time method (OFAT and statistically using full factorial design (24. Three SPs (viz.; cypermethrin, resmethrin and permethrin were analyzed. The method showed good accuracy with RSD% in the range of of 4.8–6.9%. The method detection limits of the three pesticides ranged from 0.14 to 0.16 ng mL-1. The proposed method was applied for the determination of synthetic pyrethroids in lake water

  19. Extraction of mandibular premolars and molars: comparison between local infiltration via pressure syringe and inferior alveolar nerve block anesthesia.

    Science.gov (United States)

    Thiem, Daniel G E; Schnaith, Florian; Van Aken, Caroline M E; Köntges, Anne; Kumar, Vinay V; Al-Nawas, Bilal; Kämmerer, Peer W

    2018-04-01

    The purpose of this study was to evaluate the anesthetic efficiency of local infiltration anesthesia administered with a pressure syringe (P-INF) via a special technique versus direct block anesthesia of the inferior alveolar nerve (IANB) for tooth extraction in the posterior mandible. In a prospective randomized study, 101 teeth in 101 patients were extracted in the posterior mandible under local anesthesia whereby two different administration techniques were used (P-INF n = 48; IANB n = 53). Primary objectives were comparisons of anesthetic success rate (yes/no) and efficacy (full/sufficient vs. insufficient). Secondary objectives were patients' pain perception during treatment, pain of injection (numerical rating scale), need for second injections (always IANB), time until onset of anesthetic action (min), and duration of local numbness (min). IANB was successful in all cases, whereas initial P-INF achieved 35% of success only. Furthermore, IANB reached significant higher values of anesthetic efficacy compared to P-INF (P block anesthesia of the inferior alveolar nerve (IANB) turned out to be more proficient to local infiltration via special delivering system with a special technique. Infiltration, even when performed with 4% articaine and a pressure syringe system, is not a suitable method of anesthesia in the posterior mandible.

  20. Stability of Fentanyl Citrate, Hydromorphone Hydrochloride, Ketamine Hydrochloride, Midazolam, Morphine Sulfate, and Pentobarbital Sodium in Polypropylene Syringes.

    Science.gov (United States)

    Anderson, Collin; MacKay, Mark

    2015-12-16

    Determine the stability of fentanyl 10 mcg/mL in 0.9% sodium chloride, fentanyl 10 mcg/mL in 5% dextrose, fentanyl 50 mcg/mL, hydromorphone 100 mcg/mL in 0.9% sodium chloride, ketamine 10 mg/mL, midazolam 0.4 mg/mL in 5% dextrose, midazolam 5 mg/mL, morphine 1 mg/mL in 0.9% sodium chloride, morphine 1 mg/mL in 5% dextrose, and pentobarbital 50 mg/mL when stored as single drug entities at room temperature in polypropylene syringes. Four 5 mL samples of each drug and concentration were prepared in 10 mL polypropylene syringes. The samples were stored at ambient room temperature in a locked cabinet. Triplicate determinations of drug concentration for each sample were performed initially, on day 50 or 51, and on day 100 using high-performance liquid chromatography with diode-array detection. With the exception of the hydromorphone 100 mcg/mL dilution, all compounds were found to contain greater than 95% of their initial concentration remaining at 100 days. Each sample remained clear and colorless when visually inspected.

  1. [2000-year history of the ear syringe and its relationship to the enema. Images from the history of otorhinolaryngology, represented by instruments from the collection of the Ingolstadt Medical History Museum].

    Science.gov (United States)

    Feldmann, H

    1999-08-01

    SYRINGES WITH A PISTON AND THEIR USE AS "CLYSTER ORICULARIUS" IN THE ANCIENT ROME: Syringes with a piston were already known in ancient times and have been mentioned as a device for spraying rose water (Philon of Byzantium, about 230 BC), and for fighting fires (Heron of Alexandria about 110 AD). Celsus mentions it several times in his grand opus "De Medicina" (1st century AD) in the treatment of purulent discharge from the ear and for removing foreign bodies from the external ear canal. He always calls it "clyster oricularius", i.e. ear syringe, even when he describes its use in applications other than otological, such as in urology. Later the ear syringe fell from favor for a very long time and was reinvented only at the beginning of the 19th century. IRRIGATION OF THE BOWELS, FROM THE BAG SYRINGE TO THE PISTON SYRINGE: Irrigations of the bowels, clysters, were performed from ancient times to the 18th century with a baglike syringe using the bladder of animals as a pouch. Syringes with a piston were used by barbers and surgeons only for cleansing wounds or irrigating natural cavities of the body. Irrigation of the external ear canal had completely fallen from favor. In France in the 18th century large syringes with a piston made of tin oder brass came into use for enemas and replaced the old baglike devices. THE REINVENTION OF THE EAR SYRINGE AFTER THE PROTOTYPE OF THE ENEMA SYRINGE: Itard, an otologist in France in 1821, was the first to describe irrigating the ear with a syringe to remove hard wax. He recommended using an enema syringe ("seringue à lavement") for the procedure. Soon after his publication special ear syringes of appropriate size were developed and described by Beck in Freiburg, Germany, in 1827; by Fabrizi in Modena, Italy, 1839; and Schmalz in Dresden, Germany, 1846, who also introduced the kidney-shaped bowel for catching the water. Apart from that, small baglike syringes made of rubber were devised especially for use by the patient himself

  2. Media-fill simulation tests in manual and robotic aseptic preparation of injection solutions in syringes.

    Science.gov (United States)

    Krämer, Irene; Federici, Matteo; Kaiser, Vanessa; Thiesen, Judith

    2016-04-01

    The purpose of this study was to evaluate the contamination rate of media-fill products either prepared automated with a robotic system (APOTECAchemo™) or prepared manually at cytotoxic workbenches in the same cleanroom environment and by experienced operators. Media fills were completed by microbiological environmental control in the critical zones and used to validate the cleaning and disinfection procedures of the robotic system. The aseptic preparation of patient individual ready-to-use injection solutions was simulated by using double concentrated tryptic soy broth as growth medium, water for injection and plastic syringes as primary packaging materials. Media fills were either prepared automated (500 units) in the robot or manually (500 units) in cytotoxic workbenches in the same cleanroom over a period of 18 working days. The test solutions were incubated at room temperature (22℃) over 4 weeks. Products were visually inspected for turbidity after a 2-week and 4-week period. Following incubation, growth promotion tests were performed with Staphylococcus epidermidis. During the media-fill procedures, passive air monitoring was performed with settle plates and surface monitoring with contact plates on predefined locations as well as fingerprints. The plates got incubated for 5-7 days at room temperature, followed by 2-3 days at 30-35℃ and the colony forming units (cfu) counted after both periods. The robot was cleaned and disinfected according to the established standard operating procedure on two working days prior to the media-fill session, while on six other working days only six critical components were sanitized at the end of the media-fill sessions. Every day UV irradiation was operated for 4 h after finishing work. None of the 1000 media-fill products prepared in the two different settings showed turbidity after the incubation period thereby indicating no contamination with microorganisms. All products remained uniform, clear, and light

  3. Vascular Access in Children

    International Nuclear Information System (INIS)

    Krishnamurthy, Ganesh; Keller, Marc S.

    2011-01-01

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

  4. Final Results of the Telaprevir Access Program: FibroScan Values Predict Safety and Efficacy in Hepatitis C Patients with Advanced Fibrosis or Cirrhosis.

    Directory of Open Access Journals (Sweden)

    Antonia Lepida

    Full Text Available Liver stiffness determined by transient elastography is correlated with hepatic fibrosis stage and has high accuracy for detecting severe fibrosis and cirrhosis in chronic hepatitis C patients. We evaluated the clinical value of baseline FibroScan values for the prediction of safety and efficacy of telaprevir-based therapy in patients with advanced fibrosis and cirrhosis in the telaprevir Early Access Program HEP3002.1,772 patients with HCV-1 and bridging fibrosis or cirrhosis were treated with telaprevir plus pegylated interferon-α and ribavirin (PR for 12 weeks followed by PR alone, the total treatment duration depending on virological response and previous response type. Liver fibrosis stage was determined either by liver biopsy or by non-invasive markers. 1,282 patients (72% had disease stage assessed by FibroScan; among those 46% were classified as Metavir F3 at baseline and 54% as F4.Overall, 1,139 patients (64% achieved a sustained virological response (SVR by intention-to-treat analysis. Baseline FibroScan values were tested for association with SVR and the occurrence of adverse events. By univariate analysis, higher baseline FibroScan values were predictive of lower sustained virological response rates and treatment-related anemia. By multivariate analysis, FibroScan was no longer statistically significant as an independent predictor, but higher FibroScan values were correlated with the occurrence of infections and serious adverse events.FibroScan has a limited utility as a predictor of safety and efficacy in patients treated with telaprevir-based triple therapy. Nevertheless it can be used in association with other clinical and biological parameters to help determine patients who will benefit from the triple regiments.ClinicalTrials.gov NCT01508286.

  5. Depression and post-traumatic stress disorder among Haitian immigrant students: implications for access to mental health services and educational programming

    Directory of Open Access Journals (Sweden)

    Muriel Anna C

    2009-12-01

    Full Text Available Abstract Background Previous studies of Haitian immigrant and refugee youth have emphasized "externalizing" behaviors, such as substance use, high risk sexual behavior, and delinquency, with very little information available on "internalizing" symptoms, such as depression and anxiety. Analyzing stressors and "internalizing" symptoms offers a more balanced picture of the type of social and mental health services that may be needed for this population. The present study aims to: 1 estimate the prevalence of depression and post-traumatic stress disorder (PTSD among Haitian immigrant students; and 2 examine factors associated with depression and PTSD to identify potential areas of intervention that may enhance psychosocial health outcomes among immigrant youth from Haiti in the U.S. Methods A stratified random sample of Haitian immigrant students enrolled in Boston public high schools was selected for participation; 84% agreed to be interviewed with a standardized questionnaire. Diagnosis of depression and PTSD was ascertained using the best estimate diagnosis method. Results The prevalence estimates of depression and PTSD were 14.0% and 11.6%; 7.9% suffered from comorbid PTSD and depression. Multivariate logistic regression demonstrated factors most strongly associated with depression (history of father's death, self-report of schoolwork not going well, not spending time with friends and PTSD (concern for physical safety, having many arguments with parents, history of physical abuse, and lack of safety of neighborhood. Conclusions A significant level of depression and PTSD was observed. Stressors subsequent to immigration, such as living in an unsafe neighborhood and concern for physical safety, were associated with an increased risk of PTSD and should be considered when developing programs to assist this population. Reducing exposure to these stressors and enhancing access to social support and appropriate school-based and mental health services

  6. Access Contested

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

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

  7. Accessing memory

    Science.gov (United States)

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

    2017-09-26

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

  8. Forbidden Access

    CERN Multimedia

    C. Colloca TS/FM

    2004-01-01

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

  9. Printing and Curing of Conductive Ink Track on Fabric using Syringe Deposition System with DLP Projector and Hot Plate

    Directory of Open Access Journals (Sweden)

    Khirotdin Rd. Khairilhijra

    2017-01-01

    Full Text Available Printing is a technique to transfer ink onto substrates to create pattern and syringe deposition system has shown some great potential in printing due to its ability to produce filamentary bead tracks which is important concerning conductivity and easily adopted on conformal surfaces which could not be realized by conventional technique. Fabrics with integrated electrical features able to create intelligent articles and may potentially open up new perspective areas of application in textile printing. However, the applicability of this technique on fabrics remains unknown which the ink used has to meet certain requirements including high electrical conductivity, resistance to oxidation, dry out without clogging, good adhesion with suitable viscosity and surface tension. Thus, there is a need to do this study which is to determine the feasibility of syringe deposition system to print a conductive ink tracks using silver epoxy-based conductive ink on fabric substrate via lycra material. This study is also aim to investigate the feasibility of using DLP projector with hot plate as another source of heat to be used in curing the ink tracks on fabric. The effect of printing and curing parameters to the characteristics and conductivity of the ink track is investigated. Several mechanical and electrical tests were also administered to determine the cure, hardness, adhesion and resistance level of the ink tracks. The results obtained were as expected which higher printing speed and lower deposition height used, a narrower and thinner ink tracks were produced. Sample with 4 mm/s of printing speed and deposition height of 1 mm resulted in dimension closer to the targeted dimension. The longer curing time and higher temperature used, a lower resistance is produced. The lowest resistance achieved is 0.9 Ω cured at 150°C for 60 minutes. The conductivity of the ink track was affected by curing process and cross-sectional area of the ink track. It is proven

  10. Eye Care Quality and Accessibility Improvement in the Community (EQUALITY: impact of an eye health education program on patient knowledge about glaucoma and attitudes about eye care

    Directory of Open Access Journals (Sweden)

    Rhodes LA

    2016-05-01

    Full Text Available Lindsay A Rhodes,1 Carrie E Huisingh,1 Gerald McGwin Jr,1,2 Stephen T Mennemeyer,3 Mary Bregantini,4 Nita Patel,4 Jinan Saaddine,5 John E Crews,5 Christopher A Girkin,1 Cynthia Owsley11Department of Ophthalmology, School of Medicine, 2Department of Epidemiology, 3Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, 4Prevent Blindness, Chicago, IL, USA; 5Vision Health Initiative, Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USAPurpose: To assess the impact of the education program of the Eye Care Quality and Accessibility Improvement in the Community (EQUALITY telemedicine program on at-risk patients’ knowledge about glaucoma and attitudes about eye care as well as to assess patient satisfaction with EQUALITY.Patients and methods: New or existing patients presenting for a comprehensive eye exam (CEE at one of two retail-based primary eye clinics were enrolled based on ≥1 of the following at-risk criteria for glaucoma: African Americans ≥40 years of age, Whites ≥50 years of age, diabetes, family history of glaucoma, and/or preexisting diagnosis of glaucoma. A total of 651 patients were enrolled. A questionnaire was administered prior to the patients’ CEE and prior to the patients receiving any of the evidence-based eye health education program; a follow-up questionnaire was administered 2–4 weeks later by phone. Baseline and follow-up patient responses regarding knowledge about glaucoma and attitudes about eye care were compared using McNemar’s test. Logistic regression models were used to assess the association of patient-level characteristics with improvement in knowledge and attitudes. Overall patient satisfaction was summarized.Results: At follow-up, all patient responses in the knowledge and attitude domains significantly improved from baseline (P≤0.01 for all questions. Those who were unemployed (odds

  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. Stability of Fentanyl Citrate, Hydromorphone Hydrochloride, Ketamine Hydrochloride, Midazolam, Morphine Sulfate, and Pentobarbital Sodium in Polypropylene Syringes

    OpenAIRE

    Anderson, Collin; MacKay, Mark

    2015-01-01

    Purpose: Determine the stability of fentanyl 10 mcg/mL in 0.9% sodium chloride, fentanyl 10 mcg/mL in 5% dextrose, fentanyl 50 mcg/mL, hydromorphone 100 mcg/mL in 0.9% sodium chloride, ketamine 10 mg/mL, midazolam 0.4 mg/mL in 5% dextrose, midazolam 5 mg/mL, morphine 1 mg/mL in 0.9% sodium chloride, morphine 1 mg/mL in 5% dextrose, and pentobarbital 50 mg/mL when stored as single drug entities at room temperature in polypropylene syringes. Methods: Four 5 mL samples of each drug and concentra...

  13. Identification of Catechin, Syringic Acid, and Procyanidin B2 in Wine as Stimulants of Gastric Acid Secretion.

    Science.gov (United States)

    Liszt, Kathrin Ingrid; Eder, Reinhard; Wendelin, Sylvia; Somoza, Veronika

    2015-09-09

    Organic acids of wine, in addition to ethanol, have been identified as stimulants of gastric acid secretion. This study characterized the influence of other wine compounds, particularly phenolic compounds, on proton secretion. Forty wine parameters were determined in four red wines and six white wines, including the contents of organic acids and phenolic compounds. The secretory activity of the wines was determined in a gastric cell culture model (HGT-1 cells) by means of a pH-sensitive fluorescent dye. Red wines stimulated proton secretion more than white wines. Lactic acid and the phenolic compounds syringic acid, catechin, and procyanidin B2 stimulated proton secretion and correlated with the pro-secretory effect of the wines. Addition of the phenolic compounds to the least active white wine sample enhanced its proton secretory effect by 65 ± 21% (p astringent tasting phenolic compounds in wine contribute to its stimulatory effect on gastric acid secretion.

  14. 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...

  15. Cultivation and Differentiation of Encapsulated hMSC-TERT in a Disposable Small-Scale Syringe-Like Fixed Bed Reactor

    DEFF Research Database (Denmark)

    Weber, Christian; Pohl, Sebastian; Pörtner, Ralf

    2007-01-01

    The use of commercially available plastic syringes is introduced as disposable small-scale fixed bed bioreactors for the cultivation of implantable therapeutic cell systems on the basis of an alginate-encapsulated human mesenchymal stem cell line. The system introduced is fitted with a noninvasiv...

  16. In-syringe extraction using dissolvable layered double hydroxide-polymer sponges templated from hierarchically porous coordination polymers.

    Science.gov (United States)

    Ghani, Milad; Frizzarin, Rejane M; Maya, Fernando; Cerdà, Víctor

    2016-07-01

    Herein we report the use of cobalt porous coordination polymers (PCP) as intermediates to prepare advanced extraction media based on layered double hydroxides (LDH) supported on melamine polymer foam. The obtained dissolvable Ni-Co LDH composite sponges can be molded and used as sorbent for the in-syringe solid-phase extraction (SPE) of phenolic acids from fruit juices. The proposed sorbent is obtained due to the surfactant-assisted self-assembly of Co(II)/imidazolate PCPs on commercially available melamine foam, followed by the in situ conversion of the PCP into the final dissolvable LDH coating. Advantageous features for SPE are obtained by using PCPs with hierarchical porosity (HPCPs). The LDH-sponge prepared using intermediate HPCPs (HLDH-sponge) is placed in the headspace of a glass syringe, enabling flow-through extraction followed by analyte elution by the dissolution of the LDH coating in acidic conditions. Three phenolic acids (gallic acid, p-hydroxybenzoic acid and caffeic acid) were extracted and quantified using high performance liquid chromatography. Using a 5mL sample volume, the obtained detection limits were 0.15-0.35μgL(-1). The proposed method for the preparation of HLDH-sponges showed a good reproducibility as observed from the intra- and inter-day RSD's, which were <10% for all analytes. The batch-to-batch reproducibility for three different batches of HLDH-sponges was 10.6-11.2%. Enrichment factors of 15-21 were obtained. The HLDH-sponges were applied satisfactorily to the determination of phenolic acids in natural and commercial fruit juices, obtaining relative recoveries among 89.7-95.3%. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Needle syringe programmes and opioid substitution therapy for preventing hepatitis C transmission in people who inject drugs

    Science.gov (United States)

    Platt, Lucy; Minozzi, Silvia; Reed, Jennifer; Vickerman, Peter; Hagan, Holly; French, Clare; Jordan, Ashly; Degenhardt, Louisa; Hope, Vivian; Hutchinson, Sharon; Maher, Lisa; Palmateer, Norah; Taylor, Avril; Bruneau, Julie; Hickman, Matthew

    2017-01-01

    Background Needle syringe programmes and opioid substitution therapy for preventing hepatitis C transmission in people who inject drugs Needle syringe programmes (NSP) and opioid substitution therapy (OST) are the primary interventions to reduce hepatitis C (HCV) transmission in people who inject drugs. There is good evidence for the effectiveness of NSP and OST in reducing injecting risk behaviour and increasing evidence for the effectiveness of OST and NSP in reducing HIV acquisition risk, but the evidence on the effectiveness of NSP and OST for preventing HCV acquisition is weak. Objectives To assess the effects of needle syringe programmes and opioid substitution therapy, alone or in combination, for preventing acquisition of HCV in people who inject drugs. Search methods We searched the Cochrane Drug and Alcohol Register, CENTRAL, the Cochrane Database of Systematic Reviews (CDSR), the Database of Abstracts of Reviews of Effects (DARE), the Health Technology Assessment Database (HTA), the NHS Economic Evaluation Database (NHSEED), MEDLINE, Embase, PsycINFO, Global Health, CINAHL, and the Web of Science up to 16 November 2015. We updated this search in March 2017, but we have not incorporated these results into the review yet. Where observational studies did not report any outcome measure, we asked authors to provide unpublished data. We searched publications of key international agencies and conference abstracts. We reviewed reference lists of all included articles and topic-related systematic reviews for eligible papers. Selection criteria We included prospective and retrospective cohort studies, cross-sectional surveys, case-control studies and randomised controlled trials that measured exposure to NSP and/or OST against no intervention or a reduced exposure and reported HCV incidence as an outcome in people who inject drugs. We defined interventions as current OST (within previous 6 months), lifetime use of OST and high NSP coverage (regular attendance at

  18. Apical negative pressure irrigation versus syringe irrigation: a systematic review of cleaning and disinfection of the root canal system.

    Science.gov (United States)

    Konstantinidi, E; Psimma, Z; Chávez de Paz, L E; Boutsioukis, C

    2017-11-01

    The aim of this study was to systematically review and critically analyse the published data on the treatment outcome (primary outcome) and on the cleaning and disinfection of root canals (secondary outcomes) achieved by negative pressure irrigation as compared to syringe irrigation. An electronic search was conducted in EMBASE, LILACS, PubMed, SciELO, Scopus and Web of Knowledge using both free-text keywords and controlled vocabulary. Additional studies were sought through hand searching of endodontic journals and of the relevant chapters of endodontic textbooks. No language restriction was imposed. The retrieved studies were screened by two reviewers according to predefined criteria. Included studies were critically appraised and the extracted data were arranged in tables. The electronic search and hand search retrieved 489 titles. One clinical study and 14 in vitro studies were finally included in the review; none of these studies assessed treatment outcome, four studies assessed the antimicrobial effect, seven studies evaluated the removal of pulp tissue remnants, and four studies investigated the removal of hard tissue debris or both hard tissue debris and pulp tissue remnants. Poor standardization and description of the protocols was evident. Inconclusive results were reported about the cleaning and disinfection accomplished by the two irrigation methods. Negative pressure irrigation was more effective under certain conditions when compared to suboptimal syringe irrigation; however, the variability of the protocols hindered quantitative synthesis. There is insufficient evidence to claim general superiority of any one of these methods. The level of the available evidence is low, and the conclusions should be interpreted with caution. © 2016 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  19. Assessment of an in vitro whole cigarette smoke exposure system: The Borgwaldt RM20S 8-syringe smoking machine

    Directory of Open Access Journals (Sweden)

    McAughey John

    2011-08-01

    Full Text Available Abstract Background There have been many recent developments of in vitro cigarette smoke systems closely replicating in vivo exposures. The Borgwaldt RM20S smoking machine (RM20S enables the serial dilution and delivery of cigarette smoke to exposure chambers for in vitro analyses. In this study we have demonstrated reliability and robustness testing of the RM20S in delivering smoke to in vitro cultures using an in-house designed whole smoke exposure chamber. Results The syringe precision and accuracy of smoke dose generated by the RM20S was assessed using a methane gas standard and resulted in a repeatability error of ≤9%. Differential electrical mobility particle spectrometry (DMS measured smoke particles generated from reference 3R4F cigarettes at points along the RM20S. 53% ± 5.9% of particles by mass reached the chamber, the remainder deposited in the syringe or connecting tubing and ~16% deposited in the chamber. Spectrofluorometric quantification of particle deposition within chambers indicated a positive correlation between smoke concentration and particle deposition. In vitro air-liquid interface (ALI cultures (H292 lung epithelial cells, exposed to whole smoke (1:60 dilution (smoke:air, equivalent to ~5 μg/cm2 demonstrated uniform smoke delivery within the chamber. Conclusions These results suggest this smoke exposure system is a reliable and repeatable method of generating and exposing ALI in vitro cultures to cigarette smoke. This system will enable the evaluation of future tobacco products and individual components of cigarette smoke and may be used as an alternative in vitro tool for evaluating other aerosols and gaseous mixtures such as air pollutants, inhaled pharmaceuticals and cosmetics.

  20. 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

  1. Topical ocular 0.1% cyclosporine A cationic emulsion in dry eye disease patients with severe keratitis: experience through the French early-access program

    Directory of Open Access Journals (Sweden)

    Pisella P

    2018-02-01

    Full Text Available Pierre-Jean Pisella,1 Marc Labetoulle,2 Serge Doan,3 Beatrice Cochener-Lamard,4 Mourad Amrane,5 Dahlia Ismail,5 Catherine Creuzot-Garcher,6,7 Christophe Baudouin8–10 1Department of Ophthalmology, Tours University Hospital, University François Rabelais, Bretonneau Hospital, Tours, 2Department of Ophthalmology, Bicêtre Hospital, APHP, Paris-Sud University, Le Kremlin-Bicêtre, 3Department of Ophthalmology, Bichat Hospital and Fondation A de Rothschild, Paris, 4Brest University Medical School, Morvan Hospital, Brest, 5Santen SAS, Evry, 6Department of Ophthalmology, University Hospital, 7Department of Ophthalmology III, Eye and Nutrition Research Group, Burgundy, Dijon, 8Research Team S12, Quinze-Vingts National Ophthalmology Hospital, 9Department of Ophthalmology, Ambroise-Paré Hospital, APHP, UPMC University, Paris 6, Vision Institute, INSERM UMRS968, CNRS UMR7210, Paris, 10University of Versailles Saint-Quentin en Yvelines, Versailles, France Purpose: The objective of this study was to report the evaluation of efficacy and safety of cyclosporine A cationic emulsion (CsA CE 0.1% for the treatment of severe keratitis in adults with dry eye disease (DED in a French early-access program. Methods: Patients with DED and severe keratitis (corneal fluorescein staining [CFS] score of 3–5 on the Oxford scale and/or the presence of corneal lesions [filaments or ulcers] were enrolled in a compassionate use program (Authorization for Temporary Use [ATU] for once-daily CsA CE, which was approved by French health authorities prior to its registration. Efficacy and safety at 1, 3, 6, and 12-month follow-up visits were evaluated. Results: The ATU cohort (n=1,212; mean age =60.5 years; 79.5% female; 98.1% with severe keratitis; 74.5% with corneal lesions consisted of 601 CsA-naïve patients and 611 patients treated previously with other CsA formulations. The primary DED etiology was Sjögren’s syndrome (48.7%. Clinical benefit could be discerned among

  2. Gaining Access.

    Science.gov (United States)

    Wand, Sean; Thermos, Adam C.

    1998-01-01

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

  3. Programming

    International Nuclear Information System (INIS)

    Jackson, M.A.

    1982-01-01

    The programmer's task is often taken to be the construction of algorithms, expressed in hierarchical structures of procedures: this view underlies the majority of traditional programming languages, such as Fortran. A different view is appropriate to a wide class of problem, perhaps including some problems in High Energy Physics. The programmer's task is regarded as having three main stages: first, an explicit model is constructed of the reality with which the program is concerned; second, this model is elaborated to produce the required program outputs; third, the resulting program is transformed to run efficiently in the execution environment. The first two stages deal in network structures of sequential processes; only the third is concerned with procedure hierarchies. (orig.)

  4. Programming

    OpenAIRE

    Jackson, M A

    1982-01-01

    The programmer's task is often taken to be the construction of algorithms, expressed in hierarchical structures of procedures: this view underlies the majority of traditional programming languages, such as Fortran. A different view is appropriate to a wide class of problem, perhaps including some problems in High Energy Physics. The programmer's task is regarded as having three main stages: first, an explicit model is constructed of the reality with which the program is concerned; second, thi...

  5. Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and Children's Health Insurance Program Reauthorization Act and Alternative Payment Models in dermatology.

    Science.gov (United States)

    Barbieri, John S; Miller, Jeffrey J; Nguyen, Harrison P; Forman, Howard P; Bolognia, Jean L; VanBeek, Marta J

    2017-06-01

    With the introduction of the Medicare Access and Children's Health Insurance Program Reauthorization Act, clinicians who are not eligible for an exemption must choose to participate in 1 of 2 new reimbursement models: the Merit-based Incentive Payment System or Alternative Payment Models (APMs). Although most dermatologists are expected to default into the Merit-based Incentive Payment System, some may have an interest in exploring APMs, which have associated financial incentives. However, for dermatologists interested in the APM pathway, there are currently no options other than joining a qualifying Accountable Care Organization, which make up only a small subset of Accountable Care Organizations overall. As a result, additional APMs relevant to dermatologists are needed to allow those interested in the APMs to explore this pathway. Fortunately, the Medicare Access and Children's Health Insurance Program Reauthorization Act establishes a process for new APMs to be approved and the creation of bundled payments for skin diseases may represent an opportunity to increase the number of APMs available to dermatologists. In this article, we will provide a detailed review of APMs under the Medicare Access and Children's Health Insurance Program Reauthorization Act and discuss the development and introduction of APMs as they pertain to dermatology. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  6. e-Learning Programs Come in All Shapes and Sizes: From Alaska to Arkansas, Districts Are Experimenting with Online Learning to Solve Access Problems

    Science.gov (United States)

    Coyle, Shawn; Jones, Thea; Pickle, Shirley Kirk

    2009-01-01

    This article presents a sample of online learning programs serving very different populations: a small district spread over a vast area, a large inner school district, and a statewide program serving numerous districts. It describes how these districts successfully implemented e-learning programs in their schools and discusses the positive impact…

  7. A clinical comparative study between conventional and camouflaged syringes to evaluate behavior and anxiety in 6-11-year-old children during local anesthesia administration-a novel approach.

    Science.gov (United States)

    Melwani, Anjana M; Srinivasan, Ila; Setty, Jyothsna V; D R, Murali Krishna; Pamnani, Sunaina S; Lalitya, Dandamudi

    2018-02-01

    The sight of dental injection can bring about severe anxiety in children. Therefore, an alternative method that is convenient, effective, and keeps the needle hidden making it child friendly is necessary. The objective of the study was to compare the efficacy of a camouflaged syringe and conventional syringe on behavior and anxiety in 6-11-year-old children during local anesthesia administration. The study was a randomized, crossover clinical study including 30 children. Children were separated into two groups. Group 1 consisted of 15 children aged 6-8 years while group 2 consisted of 15 children aged 9-11 years. This study involved two sessions wherein all the children were injected using conventional and camouflaged syringes in separate sessions. Their behavior was assessed using the Faces, Legs, Activity, Cry, Consolability (FLACC) behavior pain scale and anxiety was assessed by measuring changes in pulse rate. Patient and operator preferences were compared. The results showed a lower mean change in pulse rate and FLACC scores in the camouflaged group, suggesting a positive behavior and lesser anxiety with camouflaged syringes than with conventional syringes. The use of camouflaged syringes for anesthesia was demonstrated to be effective in improving the behavior of children and decreasing their anxiety, and is therefore recommended as an alternative to the use of conventional syringes for local anesthesia.

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

    Directory of Open Access Journals (Sweden)

    Littrell Megan

    2011-10-01

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

  9. Nuclear information access system

    International Nuclear Information System (INIS)

    Ham, C. H.; Yang, M. H.; Yoon, S. W.

    1998-01-01

    The energy supply in the countries, which have abundant energy resources, may not be affected by accepting the assertion of anti-nuclear and environment groups. Anti-nuclear movements in the countries which have little energy resources may cause serious problem in securing energy supply. Especially, it is distinct in Korea because she heavily depends on nuclear energy in electricity supply(nuclear share in total electricity supply is about 40%).The cause of social trouble surrounding nuclear energy is being involved with various circumstances. However, it is very important that we are not aware of the importance of information access and prepared for such a situation from the early stage of nuclear energy's development. In those matter, this paper analyzes the contents of nuclear information access system in France and Japan which have dynamic nuclear development program and presents the direction of the nuclear access regime through comparing Korean status and referring to progresses of the regime

  10. Accessing Programs for Infants, Toddlers, and Preschoolers with Disabilities: A Parent's Guide = Programas para Infantes y Ninos Pre-escolares con Discapacidades: Guia para Padres de Familia. Update.

    Science.gov (United States)

    Kupper, Lisa, Ed.

    This parent's guide (presented in both English and Spanish) is intended to help families access services for young children with special needs. It is presented in the form of questions and answers arranged in three parts. Part I presents 12 questions and answers about early intervention services for infants and toddlers (ages birth through 2…

  11. Access to Experimental Cancer Drugs

    Science.gov (United States)

    An experimental drug has been tested in the lab and with animals and approved for testing in people by the FDA, but can’t yet be advertised, sold, or prescribed. Experimental drugs may be available through clinical trials or expanded access programs - learn more about these programs and how to talk to your doctor.

  12. Doses rate in contact with plastic syringes of 1, 2 and 5 mL for different beta and gamma emitting radionuclides

    International Nuclear Information System (INIS)

    Torres Berdeguez, Mirta; Ayra Pardo, Enrique; Falcon, Lazaro

    2008-01-01

    The objective of this paper is to calculate the dose rate in contact with plastic syringes of 1, 2 and 5 m L volume, unshielded and the dose rate in the same syringes after a lead or a Lucite shield of various thickness has been installed, depending on the emission of the radionuclide used. The radionuclides involved in the assessment were 32 P, 51 Cr, 90 Y, 99m Tc, 125 I, 131 I, 153 Sm, 186 Re, 188 Re, 169 Er and 177 Lu. The code used was the MCNP4C. The results are intended to be used by a Radiation Protection Officer wherever the radionuclides in question are handled to rapidly assess the dose in hands of the operators. (author)

  13. Fully-automated in-syringe dispersive liquid-liquid microextraction for the determination of caffeine in coffee beverages.

    Science.gov (United States)

    Frizzarin, Rejane M; Maya, Fernando; Estela, José M; Cerdà, Víctor

    2016-12-01

    A novel fully-automated magnetic stirring-assisted lab-in-syringe analytical procedure has been developed for the fast and efficient dispersive liquid-liquid microextraction (DLLME) of caffeine in coffee beverages. The procedure is based on the microextraction of caffeine with a minute amount of dichloromethane, isolating caffeine from the sample matrix with no further sample pretreatment. Selection of the relevant extraction parameters such as the dispersive solvent, proportion of aqueous/organic phase, pH and flow rates have been carefully evaluated. Caffeine quantification was linear from 2 to 75mgL(-1), with detection and quantification limits of 0.46mgL(-1) and 1.54mgL(-1), respectively. A coefficient of variation (n=8; 5mgL(-1)) of a 2.1% and a sampling rate of 16h(-1), were obtained. The procedure was satisfactorily applied to the determination of caffeine in brewed, instant and decaf coffee samples, being the results for the sample analysis validated using high-performance liquid chromatography. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Stability of Diphenhydramine Hydrochloride, Lorazepam, and Dexamethasone Sodium Phosphate in 0.9% Sodium Chloride Stored in Polypropylene Syringes.

    Science.gov (United States)

    Anderson, Collin R; Halford, Zachery; MacKay, Mark

    2015-01-01

    Chemotherapy induced nausea and vomiting is problematic for many patients undergoing chemotherapy. Multiple-drug treatments have been developed to mitigate chemotherapy induced nausea and vomiting. A patient-controlled infusion of diphenhydramine hydrochloride, lorazepam, and dexamethasone sodium phosphate has been studied in patients who are refractory to first-line therapy. Unfortunately, the physical and chemical compatibility of this three-drug combination is not available in the published literature. Chemical compatibility was evaluated using high-performance liquid chromatography with ultraviolet detection. Visual observation was employed to detect change in color, clarity, or gas evolution. Turbidity and pH measurements were performed in conjunction with visual observation at hours 0, 24, and 48. Results showed that diphenhydramine hydrochloride 4 mg/mL, lorazepam 0.16 mg/mL, and dexamethasone sodium phosphate 0.27 mg/mL in 0.9% sodium chloride stored in polypropylene syringes were compatible, and components retained greater than 95% of their original concentration over 48 hours when stored at room temperature.

  15. α-TCP cements prepared by syringe-foaming: Influence of Na2HPO4 and surfactant concentration.

    Science.gov (United States)

    Vásquez, A F; Domínguez, S; Loureiro Dos Santos, L A

    2017-12-01

    The lack of intrinsic open porosity in calcium phosphate cements slows down the resorption rate and bone ingrowth when implanted In Vivo. In this study, macroporous structures were obtained by mixing α-TCP cement with a foamed liquid phase containing different concentrations of sodium hydrogen phosphate and a nonionic surfactant. The cement paste was prepared by hand mixing in a novel system of two syringes connected by a tube. Two different liquid to powder (L/P) ratios were used to prepare the cement paste. The cement samples showed open macropores with diameters>100μm. The specimens prepared with lower L/P ratio showed smaller porosity, macroporosity and pore size distribution. The cohesion of the cement paste in liquid solutions was assessed by adding 2wt% sodium alginate to the liquid phase. This study suggests that the final macrostructure of the foamed cements can be controlled by varying the phosphate and surfactant concentrations in the liquid phase and the L/P ratio. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Vanillic and syringic acids from biomass burning: Behaviour during Fenton-like oxidation in atmospheric aqueous phase and in the absence of light

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Gabriela T.A.D.; Santos, Patrícia S.M., E-mail: patricia.santos@ua.pt; Duarte, Armando C.

    2016-08-05

    Highlights: • The rate of oxidation of small aromatic acids increase with the pH decrease. • With the oxidation of aromatic acids are formed new small aromatic compounds. • The initial and formed compounds are not totally degraded during the night period. • The substituents and their positions in ring affect the oxidation of aromatic acids. • The OH radical attack to vanillic and syringic acids is different in atmospheric waters. - Abstract: Biomass combustion is a threat to the environment since it emits to the atmosphere organic compounds, which may react and originate others more aggressive. This work studied the behaviours of vanillic and syringic acids, small aromatic tracers of biomass burning, during Fenton-like oxidation in aqueous phase and absence of light. For both compounds, the extent of oxidation increased with pH decrease from neutral to acid in atmospheric waters, but for vanillic acid the neutral pH was not able of promoting the oxidation. With the oxidation of both acids were formed chromophoric compounds, and the formation rate increased with the degree of electron-donator substituents in benzene ring. The initial and produced compounds were not totally degraded up to 24 h of reaction at pH 4.5, suggesting that the night period may be not sufficient for their full degradation in atmospheric waters. The major compounds formed were the 3,4-dihydroxybenzoic acid for vanillic acid, and the 1,4-dihydroxy-2,6-dimethoxybenzene for syringic acid. These findings suggest the occurrence of an ipso attack by the hydroxyl radical preferential to the methoxy and carboxyl groups of vanillic and syringic acids, respectively. It is important to highlight that for both aromatic acids the main compounds produced are also small aromatic compounds.

  17. Determination of ammonium in aqueous samples using new headspace dynamic in-syringe liquid-phase microextraction with in situ derivitazation coupled with liquid chromatography-fluorescence detection.

    Science.gov (United States)

    Muniraj, Sarangapani; Yan, Cheing-Tong; Shih, Hou-Kung; Ponnusamy, Vinoth Kumar; Jen, Jen-Fon

    2012-11-19

    A new simultaneous derivatization and extraction method for the preconcentration of ammonia using new one-step headspace dynamic in-syringe liquid-phase microextraction with in situ derivatization was developed for the trace determination of ammonium in aqueous samples by liquid chromatography with fluorescence detection (LC-FLD). The acceptor phase (as derivatization reagent) containing o-phthaldehyde and sodium sulfite was held within a syringe barrel and immersed in the headspace of sample container. The gaseous ammonia from the alkalized aqueous sample formed a stable isoindole derivative with the acceptor phase inside the syringe barrel through the reciprocated movements of plunger. After derivatization-cum-extraction, the acceptor phase was directly injected into LC-FLD for analysis. Parameters affecting the ammonia evolution and the extraction/derivatization efficiency such as sample matrix, pH, temperature, sampling time, and the composition of derivatization reagent, reaction temperature, and frequency of reciprocated plunger, were studied thoroughly. Results indicated that the maximum extraction efficiency was obtained by using 100μL derivatization reagent in a 1-mL gastight syringe under 8 reciprocated movements of plunger per min to extract ammonia evolved from a 20mL alkalized aqueous solution at 70°C (preheated 4min) with 380rpm stirring for 8min. The detection was linear in the concentration range of 0.625-10μM with the correlation coefficient of 0.9967 and detection limit of 0.33μM (5.6ng mL(-1)) based on SN(-1)=3. The method was applied successfully to determine ammonium in real water samples without any prior cleanup of the samples, and has been proved to be a simple, sensitive, efficient and cost-effective procedure for trace ammonium determination in aqueous samples. Copyright © 2012 Elsevier B.V. All rights reserved.

  18. Contemporary programs in support of traditional ways: Inuit perspectives on community freezers as a mechanism to alleviate pressures of wild food access in Nain, Nunatsiavut.

    Science.gov (United States)

    Organ, Jennifer; Castleden, Heather; Furgal, Chris; Sheldon, Tom; Hart, Catherine

    2014-11-01

    Rapid socio-cultural, economic, and environmental changes are challenging wild food access and thus food security for Inuit in the Canadian Arctic. In response to the continued value and practice of harvesting wild foods, communities are establishing "wild food support" initiatives. This study evaluated how one such initiative, a community freezer, in Nain, Nunatsiavut supported wild food access for community members. Data were collected through: interviews and focus groups with users, freezer managers, and active harvesters; participant observation; and document analysis. Results indicated that the community freezer supported socio-cultural, economic and local access to wild foods. However, there were issues associated with supply, dependency, social exclusion, and tension between feasibility and traditional values and practices. Communities, governments, and policymakers are urged to consider social and physical location as factors when investing in and monitoring such initiatives. The Nunatsiavut Government and the Nain Inuit Community Government have since worked together to modify this early freezer initiative due, in part, to this study's findings. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Zooplankton biomass data collected from net tows from the Eltanin in the Antarctic in support of the US Antarctic Research Program (USARP) from 1963 - 1967 (NODC Accession 0068171)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Zooplankton biomass data (displacement volume, settled volume) sampled aboard the R/V ELTANIN during the U.S. Antarctic Research Program (USARP) from Apr 5 1963 to...

  20. Groundtruthing Notes and Miscellaneous Biological Datasets from Coral Ecosystems Surveys from the Northwestern Hawaiian Islands Rapid Reef Assessment and Monitoring Program of 2000-2002 (NODC Accession 0001448)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Northwestern Hawaiian Islands Coral Reef Assessment and Monitoring Program (NOWRAMP) began in 2000 with the mission to rapidly evaluate and map the shallow water...

  1. National Coral Reef Monitoring Program: Assessment of coral reef benthic communities in Puerto Rico from 2014-05-19 to 2014-12-03 (NCEI Accession 0151729)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Benthic data collection for the National Coral Reef Ecosystem Monitoring Program (NCRMP) consists of two survey types: the Line Point-Intercept (LPI) method and the...

  2. Water quality data collected by the the National Estuarine Research Reserve System's System-wide Monitoring Program (NERRS SWMP), 1996 - 1998 (NODC Accession 0000789)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Estuarine Research Reserve System's System-wide Monitoring Program (NERRS SWMP) collected water quality data in 22 reserves in the United States and...

  3. National Coral Reef Monitoring Program: Stratified Random Surveys (StRS) of Reef Fish, including Benthic Estimate Data of the Mariana Archipelago in 2014 (NCEI Accession 0157596)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Data provided in this data set were collected as part of the NOAA Pacific Islands Fisheries Science Center (PIFSC), Coral Reef Ecosystem Program (CREP) led NCRMP...

  4. Water quality, meteorological, and nutrient data collected by the the National Estuarine Research Reserve System's System-wide Monitoring Program (NERRS SWMP), 1994 - 2005 (NODC Accession 0019215)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Estuarine Research Reserve System's System-wide Monitoring Program (NERRS SWMP) collected water quality, meteorological, and nutrient data in 25...

  5. Temperature and salinity collected for MMS 'Deepwater Program: Northern Gulf of Mexico Continental Slope Habitat and Benthic Ecology' from the Gulf of Mexico, 1999 - 2002 (NODC Accession 0002185)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data collection includes profile data containing temperature and salinity collected in support of this research program to gain better knowledge of the benthic...

  6. NOAA's Coastal Change Analysis Program (C-CAP) 1985 to 2010 Regional Land Cover Change Data - Coastal United States (NODC Accession 0121254)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Coastal Change Analysis Program (C-CAP) produces national standardized land cover and change products for the coastal regions of the U.S. C-CAP products...

  7. Hawaii Coral Reef Assessment and Monitoring Program (CRAMP): digital still images from transects on Kauai, Oahu, Molokai, Maui, and Hawaii 2011-2012 (NCEI Accession 0119360)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset consists of digital still images from the Hawaii Coral Reef Assessment and Monitoring Program (CRAMP) taken 2011-2012 from 29 sites within 5 main...

  8. Hawaii Coral Reef Assessment and Monitoring Program (CRAMP): digital still images from transects on Kauai, Oahu, Molokai, Maui, and Hawaii 2008-2010 (NCEI Accession 0104357)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset consists of digital still images from the Hawaii Coral Reef Assessment and Monitoring Program (CRAMP) taken 2008-2010 from 24 sites within 5 main...

  9. Two syringe spinal anesthesia technique for cesarean section: A controlled randomized study of a simple way to achieve more satisfactory block and less hypotension.

    Science.gov (United States)

    Keera, Amr Aly Ismail; Elnabtity, Ali Mohamed Ali

    2016-01-01

    Multiple trials have been tried to prevent hypotension during spinal anesthesia. However, the drug choice and mode of administration is still a matter of debate. To compare the outcome of spinal injection of hyperbaric bupivacaine and fentanyl separately to standard injection of mixed fentanyl with hyperbaric bupivacaine. A randomized, controlled clinical trial. One hundred twenty-four parturient scheduled for elective cesarean section were randomly allocated into two groups, each 62 parturient: Group M received spinal anesthesia using 10 mg bupivacaine 0.5% premixed with 25 μg fentanyl in the same syringe and Group S received 25 μg fentanyl in one syringe and 10 mg bupivacaine 0.5% without barbotage in a second syringe. Patients with intraoperative pain that was controllable without the need for a shift to general anesthesia was significantly lower in Group S (3.2%) than in Group M (16.1%). The frequency of hypotension was significantly lower in Group S compared to Group M (P 0.05). There was no significant difference in the time till occurrence of hypotension, duration of hypotension, mean dose of ephedrine used for the treatment of hypotension and frequency of patients developed itching between the groups (P > 0.05). Separate intrathecal injection of fentanyl and hyperbaric bupivacaine provided a significant improvement in the quality of sensory block and significant reduction of the frequency of hypotension compared to injection of mixed medications.

  10. Particle Characterization for a Protein Drug Product Stored in Pre-Filled Syringes Using Micro-Flow Imaging, Archimedes, and Quartz Crystal Microbalance with Dissipation.

    Science.gov (United States)

    Zheng, Songyan; Puri, Aastha; Li, Jinjiang; Jaiswal, Archana; Adams, Monica

    2017-01-01

    Micro-flow imaging (MFI) has been used for formulation development for analyzing sub-visible particles. Archimedes, a novel technique for analyzing sub-micron particles, has been considered as an orthogonal method to currently existing techniques. This study utilized these two techniques to investigate the effectiveness of polysorbate (PS-80) in mitigating the particle formation of a therapeutic protein formulation stored in silicone oil-coated pre-filled syringes. The results indicated that PS-80 prevented the formation of both protein and silicone oil particles. In the case of protein particles, PS-80 might involve in the interactions with the hydrophobic patches of protein, air bubbles, and the stressed surfaces of silicone oil-coated pre-filled syringes. Such interactions played a role in mitigating the formation of protein particles. Subsequently, quartz crystal microbalance with dissipation (QCM-D) was utilized to characterize the interactions associated with silicone oil, protein, and PS-80 in the solutions. Based on QCM-D results, we proposed that PS-80 likely formed a layer on the interior surfaces of syringes. As a result, the adsorbed PS-80 might block the leakage of silicone oil from the surfaces to solution so that the silicone oil particles were mitigated at the presence of PS-80. Overall, this study demonstrated the necessary of utilizing these three techniques cooperatively in order to better understand the interfacial role of PS-80 in mitigating the formation of protein and silicone oil particles.

  11. Correlates of Access to Business Research Databases

    Science.gov (United States)

    Gottfried, John C.

    2010-01-01

    This study examines potential correlates of business research database access through academic libraries serving top business programs in the United States. Results indicate that greater access to research databases is related to enrollment in graduate business programs, but not to overall enrollment or status as a public or private institution.…

  12. Non-destructive vacuum decay method for pre-filled syringe closure integrity testing compared with dye ingress testing and high-voltage leak detection.

    Science.gov (United States)

    Simonetti, Andrea; Amari, Filippo

    2015-01-01

    In reaction to the limitations of the traditional sterility test methods, in 2008, the U.S. Food and Drug Administration issued the guidance "Container and Closure System Integrity Testing in Lieu of Sterility Testing as a Component of the Stability Protocol for Sterile Products" encouraging sterile drug manufacturers to use properly validated physical methods, apart from conventional microbial challenge testing, to confirm container closure integrity as part of the stability protocol. The case study presented in this article investigated the capability of four container closure integrity testing methods to detect simulated defects of different sizes and types on glass syringes, prefilled both with drug product intended for parenteral administration and sterile water. The drug product was a flu vaccine (Agrippal, Novartis Vaccines, Siena, Italy). Vacuum decay, pharmacopoeial dye ingress test, Novartis specific dye ingress test, and high-voltage leak detection were, in succession, the methods involved in the comparative studies. The case study execution was preceded by the preparation of two independent sets of reference prefilled syringes, classified, respectively, as examples of conforming to closure integrity requirements (negative controls) and as defective (positive controls). Positive controls were, in turn, split in six groups, three of with holes laser-drilled through the prefilled syringe glass barrel, while the other three with capillary tubes embedded in the prefilled syringe plunger. These reference populations were then investigated by means of validated equipment used for container closure integrity testing of prefilled syringe commercial production; data were collected and analyzed to determine the detection rate and the percentage of false results. Results showed that the vacuum decay method had the highest performance in terms of detection sensitivity and also ensured the best reliability and repeatability of measurements. An innovative technical

  13. Assessing the Effectiveness of a School-Based Dental Clinic on the Oral Health of Children Who Lack Access to Dental Care: A Program Evaluation

    Science.gov (United States)

    Carpino, Rachel; Walker, Mary P.; Liu, Ying; Simmer-Beck, Melanie

    2017-01-01

    This program evaluation examines the effectiveness of a school-based dental clinic. A repeated-measures design was used to longitudinally examine secondary data from participants (N = 293). Encounter intensity was developed to normalize data. Multivariate analysis of variance and Kruskal-Wallis test were used to investigate the effect of encounter…

  14. Beyond Access and Supply: Youth-Led Strategies to Captivate Young People's Interest in and Demand for Youth Programs and Opportunities

    Science.gov (United States)

    Saito, Rebecca N.

    2006-01-01

    Most people would probably agree that participation in quality youth programs and neighborhood-based, informal relationships and opportunities is a good thing for young people. The problem is that not nearly enough children and youth are engaged in these growth-enhancing opportunities. What can educators learn from young people about designing…

  15. Antioxidant Activity of Syringic Acid Prevents Oxidative Stress in l-arginine–Induced Acute Pancreatitis: An Experimental Study on Rats

    Science.gov (United States)

    Cikman, Oztekin; Soylemez, Omer; Ozkan, Omer Faruk; Kiraz, Hasan Ali; Sayar, Ilyas; Ademoglu, Serkan; Taysi, Seyithan; Karaayvaz, Muammer

    2015-01-01

    The aim of this study was to investigate the possible protective role of antioxidant treatment with syringic acid (SA) on l-arginine–induced acute pancreatitis (AP) using biochemical and histopathologic approaches. A total of 30 rats were divided into 3 groups. The control group received normal saline intraperitoneally. The AP group was induced by 3.2 g/kg body weight l-arginine intraperitoneally, administered twice with an interval of 1 hour between administrations. The AP plus SA group, after having AP induced by 3.2 g/kg body weight l-arginine, was given SA (50 mg kg−1) in 2 parts within 24 hours. The rats were killed, and pancreatic tissue was removed and used in biochemical and histopathologic examinations. Compared with the control group, the mean pancreatic tissue total oxidant status level, oxidative stress index, and lipid hydroperoxide levels were significantly increased in the AP group, being 30.97 ± 7.13 (P < 0.05), 1.76 ± 0.34 (P < 0.0001), and 19.18 ± 4.91 (P < 0.01), respectively. However, mean total antioxidant status and sulfhydryl group levels were significantly decreased in the AP group compared with the control group, being 1.765 ± 0.21 (P < 0.0001) and 0.21 ± 0.04 (P < 0.0001), respectively. SA reduces oxidative stress markers and has antioxidant effects. It also augments antioxidant capacity in l-arginine–induced acute toxicity of pancreas in rats. PMID:26011211

  16. Antioxidant Activity of Syringic Acid Prevents Oxidative Stress in l-arginine-Induced Acute Pancreatitis: An Experimental Study on Rats.

    Science.gov (United States)

    Cikman, Oztekin; Soylemez, Omer; Ozkan, Omer Faruk; Kiraz, Hasan Ali; Sayar, Ilyas; Ademoglu, Serkan; Taysi, Seyithan; Karaayvaz, Muammer

    2015-05-01

    The aim of this study was to investigate the possible protective role of antioxidant treatment with syringic acid (SA) on l-arginine-induced acute pancreatitis (AP) using biochemical and histopathologic approaches. A total of 30 rats were divided into 3 groups. The control group received normal saline intraperitoneally. The AP group was induced by 3.2 g/kg body weight l-arginine intraperitoneally, administered twice with an interval of 1 hour between administrations. The AP plus SA group, after having AP induced by 3.2 g/kg body weight l-arginine, was given SA (50 mg kg(-1)) in 2 parts within 24 hours. The rats were killed, and pancreatic tissue was removed and used in biochemical and histopathologic examinations. Compared with the control group, the mean pancreatic tissue total oxidant status level, oxidative stress index, and lipid hydroperoxide levels were significantly increased in the AP group, being 30.97 ± 7.13 (P < 0.05), 1.76 ± 0.34 (P < 0.0001), and 19.18 ± 4.91 (P < 0.01), respectively. However, mean total antioxidant status and sulfhydryl group levels were significantly decreased in the AP group compared with the control group, being 1.765 ± 0.21 (P < 0.0001) and 0.21 ± 0.04 (P < 0.0001), respectively. SA reduces oxidative stress markers and has antioxidant effects. It also augments antioxidant capacity in l-arginine-induced acute toxicity of pancreas in rats.

  17. Syringic acid from Tamarix aucheriana possesses antimitogenic and chemo-sensitizing activities in human colorectal cancer cells.

    Science.gov (United States)

    Abaza, Mohamed-Salah; Al-Attiyah, Raja'a; Bhardwaj, Radhika; Abbadi, Ghaneim; Koyippally, Mathew; Afzal, Mohammad

    2013-09-01

    For its variety of biological activities, Tamarix aucheriana (Decne.) Baum. (Tamaricaceae) has an extensive history as a traditional Arab medicine. Antimitogenic and chemo-sensitizing activities of syringic acid (SA) were studied against human colorectal cancer. Chromatographic and spectral data were used for the isolation and identification of SA. MTT, flow cytometry, in vitro invasion and angiogenesis assays, fluoremetry, ELISA and Real Time qPCR were used to test antimitogenic and chemo-sensitizing activities of SA, cell cycle, apoptosis, proteasome and NFκB-DNA-binding activities, cancer cell invasion and angiogenesis, and expression of cell cycle/apoptosis-related genes. SA showed a time- and dose-dependent (IC₅₀ = 0.95-1.2 mg mL⁻¹) antimitogenic effect against cancer cells with little cytotoxicity on normal fibroblasts (≤20%). SA-altered cell cycle (S/G2-M or G1/G2-M phases) in a time-dependent manner, induced apoptosis, inhibited DNA-binding activity of NFκB (p ≤ 0.0001), chymotrypsin-like/PGPH (peptidyl-glutamyl peptide-hydrolyzing) (p ≤ 0.0001) and the trypsin-like (p ≤ 0.002) activities of 26S proteasome and angiogenesis. SA also differentially sensitized cancer cells to standard chemotherapies with a marked increase in their sensitivity to camptothecin (500-fold), 5FU (20,000-fold), doxorubicin (210-fold), taxol (3134-fold), vinblastine (1000-fold), vincristine (130-fold) and amsacrine (107-fold) compared to standard drugs alone. SA exerted its chemotherapeutic and chemo-sensitizing effects through an array of mechanisms including cell-cycle arrest, apoptosis induction, inhibition of cell proliferation, cell migration, angiogenesis, NFκB DNA-binding and proteasome activities. These results demonstrate the potential of SA as an antimitogenic and chemo-sensitizing agent for human colorectal cancer.

  18. 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

  19. Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and Children's Health Insurance Program Reauthorization Act and the Merit-based Incentive Payment System.

    Science.gov (United States)

    Barbieri, John S; Miller, Jeffrey J; Nguyen, Harrison P; Forman, Howard P; Bolognia, Jean L; VanBeek, Marta J

    2017-06-01

    As the implementation of the Medicare Access and Children's Health Insurance Program Reauthorization Act begins, many dermatologists who provide Medicare Part B services will be subject to the reporting requirements of the Merit-based Incentive Payment System (MIPS). Clinicians subject to MIPS will receive a composite score based on performance across 4 categories: quality, advancing care information, improvement activities, and cost. Depending on their overall MIPS score, clinicians will be eligible for a positive or negative payment adjustment. Quality will replace the Physician Quality Reporting System and clinicians will report on 6 measures from a list of over 250 options. Advancing care information will replace meaningful use and will assess clinicians on activities related to integration of electronic health record technology into their practice. Improvement activities will require clinicians to attest to completion of activities focused on improvements in care coordination, beneficiary engagement, and patient safety. Finally, cost will be determined automatically from Medicare claims data. In this article, we will provide a detailed review of the Medicare Access and Children's Health Insurance Program Reauthorization Act with a focus on MIPS and briefly discuss the potential implications for dermatologists. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  20. Increasing Community Access to Fresh Fruits and Vegetables: A Case Study of the Farm Fresh Market Pilot Program in Cobb County, Georgia, 2014.

    Science.gov (United States)

    Woodruff, Rebecca C; Coleman, Anne-Marie; Hermstad, April K; Honeycutt, Sally; Munoz, Jennifer; Loh, Lorna; Brown, Agnes F; Shipley, Rebecca; Kegler, Michelle C

    2016-03-10

    Ecological models of health suggest that to effectively prevent chronic disease, community food environments must support healthy eating behaviors. However, disparities in access to healthy foods persist in the United States. The Farm Fresh Market (FFM) was a fruit and vegetable market that sold low-cost fresh produce in Cobb County, Georgia in 2014. This case study describes the development of the FFM through a community engagement process and presents evaluation results from the project's pilot implementation. Community engagement strategies included forming a community advisory board, conducting a needs assessment, and contracting with a community-based organization to implement the FFM. In the pilot year, the FFM served an average of 28.7 customers and generated an average of $140.20 in produce sales per market day. Most returning customers lived in the local community and reported a range of socioeconomic backgrounds. Most returning customers strongly agreed that the FFM made it easier (69.0%) and less expensive (79.0%) for them to buy fresh fruits and vegetables, reported that they ate more vegetables (65.0%) and fruit (55.0%) as a result of the FFM, and reported that they were very satisfied with the FFM overall (92.0%). Results from this community case study underscore the importance of engaging communities in the development of community food environment interventions. Results also suggest that the FFM initiative was a feasible and acceptable way to respond to the community-identified public health priority of increasing access to healthy foods.

  1. Lab-In-Syringe automation of stirring-assisted room-temperature headspace extraction coupled online to gas chromatography with flame ionization detection for determination of benzene, toluene, ethylbenzene, and xylenes in surface waters.

    Science.gov (United States)

    Horstkotte, Burkhard; Lopez de Los Mozos Atochero, Natalia; Solich, Petr

    2018-06-22

    Online coupling of Lab-In-Syringe automated headspace extraction to gas chromatography has been studied. The developed methodology was successfully applied to surface water analysis using benzene, toluene, ethylbenzene, and xylenes as model analytes. The extraction system consisted of an automatic syringe pump with a 5 mL syringe into which all solutions and air for headspace formation were aspirated. The syringe piston featured a longitudinal channel, which allowed connecting the syringe void directly to a gas chromatograph with flame ionization detector via a transfer capillary. Gas injection was achieved via opening a computer-controlled pinch valve and compressing the headspace, upon which separation was initialized. Extractions were performed at room temperature; yet sensitivity comparable to previous work was obtained by high headspace to sample ratio V HS /V Sample of 1.6:1 and injection of about 77% of the headspace. Assistance by in-syringe magnetic stirring yielded an about threefold increase in extraction efficiency. Interferences were compensated by using chlorobenzene as an internal standard. Syringe cleaning and extraction lasting over 10 min was carried out in parallel to the chromatographic run enabling a time of analysis of <19 min. Excellent peak area repeatabilities with RSD of <4% when omitting and <2% RSD when using internal standard corrections on 100 μg L -1 level were achieved. An average recovery of 97.7% and limit of detection of 1-2 μg L -1 were obtained in analyses of surface water. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Cardiac EASE (Ensuring Access and Speedy Evaluation) – the impact of a single-point-of-entry multidisciplinary outpatient cardiology consultation program on wait times in Canada

    Science.gov (United States)

    Bungard, Tammy J; Smigorowsky, Marcie J; Lalonde, Lucille D; Hogan, Terry; Doliszny, Katharine M; Gebreyesus, Ghirmay; Garg, Sipi; Archer, Stephen L

    2009-01-01

    BACKGROUND: Universal access to health care is valued in Canada but increasing wait times for services (eg, cardiology consultation) raise safety questions. Observations suggest that deficiencies in the process of care contribute to wait times. Consequently, an outpatient clinic was designed for Ensuring Access and Speedy Evaluation (Cardiac EASE) in a university group practice, providing cardiac consultative services for northern Alberta. Cardiac EASE has two components: a single-point-of-entry intake service (prospective testing using physician-approved algorithms and previsit triage) and a multidisciplinary clinic (staffed by cardiologists, nurse practitioners and doctoral-trained pharmacists). OBJECTIVES: It was hypothesized that Cardiac EASE would reduce the time to initial consultation and a definitive diagnosis, and also increase the referral capacity. METHODS: The primary and secondary outcomes were time from referral to initial consultation, and time to achieve a definitive diagnosis and management plan, respectively. A conventionally managed historical control group (three-month pre-EASE period in 2003) was compared with the EASE group (2004 to 2006). The conventional referral mechanism continued concurrently with EASE. RESULTS: A comparison between pre-EASE (n=311) and EASE (n=3096) revealed no difference in the mean (± SD) age (60±16 years), sex (55% and 52% men, respectively) or reason for referral, including chest pain (31% and 40%, respectively) and arrhythmia (27% and 29%, respectively). Cardiac EASE reduced the time to initial cardiac consultation (from 71±45 days to 33±19 days) and time to a definitive diagnosis (from 120±86 days to 51±58 days) (P<0.0001). The annual number of new referrals increased from 1512 in 2002 to 2574 in 2006 due to growth in the Cardiac EASE clinic. The number of patients seen through the conventional referral mechanism and their wait times remained constant during the study period. CONCLUSIONS: Cardiac EASE reduced

  3. The first ten years: achievements and challenges of the Brazilian program of universal access to HIV/AIDS comprehensive management and care, 1996-2006.

    Science.gov (United States)

    Hacker, Mariana A; Kaida, Angela; Hogg, Robert S; Bastos, Francisco I

    2007-01-01

    A review was carried out of papers published between 1996 and 2006, documenting the introduction of highly active anti-retroviral therapy (HAART) in Brazil. Papers indexed in the MEDLINE and SciELO databases were retrieved using different combinations of keywords related to the management and care of AIDS in the post-HAART era: opportunistic diseases and co-infections, adherence to therapy, survival in the pre- and post-HAART eras, adverse events and side-effects, emergence and possible transmission of resistant viral strains, metabolic and cardiovascular disorders, and issues related to access to care and equity. The review documents the dramatic changes in HIV/AIDS disease progression in the post-HAART era, including an increase in survival and quality of life and a pronounced decrease in the episodes of opportunistic diseases. Notwithstanding such major achievements, new challenges have emerged, including slow evolving co-infections (such as hepatitis C, metabolic and cardiovascular disorders), the emergence of viral resistance, with consequences at the individual level (virological failure) and the community level (primary/secondary resistance at the population level), and impacts on the cost of new therapeutic regimens.

  4. Error free physically unclonable function with programmed resistive random access memory using reliable resistance states by specific identification-generation method

    Science.gov (United States)

    Tseng, Po-Hao; Hsu, Kai-Chieh; Lin, Yu-Yu; Lee, Feng-Min; Lee, Ming-Hsiu; Lung, Hsiang-Lan; Hsieh, Kuang-Yeu; Chung Wang, Keh; Lu, Chih-Yuan

    2018-04-01

    A high performance physically unclonable function (PUF) implemented with WO3 resistive random access memory (ReRAM) is presented in this paper. This robust ReRAM-PUF can eliminated bit flipping problem at very high temperature (up to 250 °C) due to plentiful read margin by using initial resistance state and set resistance state. It is also promised 10 years retention at the temperature range of 210 °C. These two stable resistance states enable stable operation at automotive environments from -40 to 125 °C without need of temperature compensation circuit. The high uniqueness of PUF can be achieved by implementing a proposed identification (ID)-generation method. Optimized forming condition can move 50% of the cells to low resistance state and the remaining 50% remain at initial high resistance state. The inter- and intra-PUF evaluations with unlimited separation of hamming distance (HD) are successfully demonstrated even under the corner condition. The number of reproduction was measured to exceed 107 times with 0% bit error rate (BER) at read voltage from 0.4 to 0.7 V.

  5. [Comparison of two access portals of an employee assistance program at an insurance corporation targeted to reduce stress levels of employees].

    Science.gov (United States)

    Burnus, M; Benner, V; Kirchner, D; Drabik, A; Stock, St

    2012-03-01

    Support programmes for stress reduction were offered independently in two departments (650 employees in total) of an insurance group. Both departments, referred to as comparison group 1 and 2 (CG1 and CG2), offered an Employee Assistance Programme (EAP) featuring individual consultations. The employees were addressed through different channels of communication, such as staff meetings, superiors and email. In CG1, a staff adviser additionally called on all employees at their workplace and showed them a brief relaxing technique in order to raise awareness of stress reduction. By contacting employees personally it was also intended to reduce the inhibition threshold for the following individual talks. In CG2 individual talks were done face-to-face, whereas CG1 used telephone counselling. By using the new access channel with an additional personal contact at the workplace, an above average percentage of employees in CG1 could be motivated to participate in the following talks. The rate of participants was five times as high as in CG1, with lower costs for the consultation in each case.

  6. Assessing the Potential Cost-Effectiveness of Microneedle Patches in Childhood Measles Vaccination Programs: The Case for Further Research and Development.

    Science.gov (United States)

    Adhikari, Bishwa B; Goodson, James L; Chu, Susan Y; Rota, Paul A; Meltzer, Martin I

    2016-12-01

    Currently available measles vaccines are administered by subcutaneous injections and require reconstitution with a diluent and a cold chain, which is resource intensive and challenging to maintain. To overcome these challenges and potentially increase vaccination coverage, microneedle patches are being developed to deliver the measles vaccine. This study compares the cost-effectiveness of using microneedle patches with traditional vaccine delivery by syringe-and-needle (subcutaneous vaccination) in children's measles vaccination programs. We built a simple spreadsheet model to compute the vaccination costs for using microneedle patch and syringe-and-needle technologies. We assumed that microneedle vaccines will be, compared with current vaccines, more heat stable and require less expensive cool chains when used in the field. We used historical data on the incidence of measles among communities with low measles vaccination rates. The cost of microneedle vaccination was estimated at US$0.95 (range US$0.71-US$1.18) for the first dose, compared with US$1.65 (range US$1.24-US$2.06) for the first dose delivered by subcutaneous vaccination. At 95 % vaccination coverage, microneedle patch vaccination was estimated to cost US$1.66 per measles case averted (range US$1.24-US$2.07) compared with an estimated cost of US$2.64 per case averted (range US$1.98-US$3.30) using subcutaneous vaccination. Use of microneedle patches may reduce costs; however, the cost-effectiveness of patches would depend on the vaccine recipients' acceptability and vaccine effectiveness of the patches relative to the existing conventional vaccine-delivery method. This study emphasizes the need to continue research and development of this vaccine-delivery method that could boost measles elimination efforts through improved access to vaccines and increased vaccination coverage.

  7. Dilemas e desafios diante do acesso ao Programa Brasil Quilombola: A realidade vivenciada pela comunidade Marques (Dilemmas and challenges facing access to the Quilombola Brazil Program: The reality experienced by the Marques community

    Directory of Open Access Journals (Sweden)

    Sidimara Cristina Souza

    2017-12-01

    Full Text Available Este artigo tem como objetivo avaliar o acesso aos benefícios ofertados pelo Programa Brasil Quilombola, no interior da comunidade Marques no município de Carlos Chagas, situado no Vale do Mucuri no estado de Minas Gerais, Brasil. Esta comunidade foi certificada em 2005 pela Fundação Cultural Palmares como “remanescente de quilombos”. Para a realização da pesquisa que deu origem a este artigo, utilizou-se como técnica a entrevista individual semiestruturada, bem como a observação de campo. A análise dos dados permite afirmar que o acesso aos benefícios ofertados pelo Programa Brasil Quilombola é extremamente restrito, e que a falta de comunicação entre os executores do programa e os possíveis usuários, assim como as falhas de execução, são os principais responsáveis pela ineficiência e inacessibilidade ao programa. Palavras-chave: Programa Brasil Quilombola. Comunidade Marques. Remanescente de Quilombo.  ABSTRACT This article aims to evaluate the access to the benefits offered by the Brasil Quilombola Program, within the Marques community in the municipality of Carlos Chagas, located in the Mucuri Valley in the State of Minas Gerais, Brazil. This community was certified in 2005 by the Palmares Cultural Foundation as "remnants of quilombos". For the accomplishment of the research that originated this article, it was used as technique the semi-structured individual interview, as well as the field observation. The analysis of the data allows to affirm that the access to the benefits offered by the Brasil Quilombola Program is extremely restricted, and that the lack of communication between the executor of the program and the possible users, as well as the execution failures, are the main ones responsible for the inefficiency and inaccessibility to the program.Keywords: Brazil Quilombola Program. Community Marques. Remnant of Quilombo. 

  8. Metal-organic framework based in-syringe solid-phase extraction for the on-site sampling of polycyclic aromatic hydrocarbons from environmental water samples.

    Science.gov (United States)

    Zhang, Xiaoqiong; Wang, Peiyi; Han, Qiang; Li, Hengzhen; Wang, Tong; Ding, Mingyu

    2018-04-01

    In-syringe solid-phase extraction is a promising sample pretreatment method for the on-site sampling of water samples because of its outstanding advantages of portability, simple operation, short extraction time, and low cost. In this work, a novel in-syringe solid-phase extraction device using metal-organic frameworks as the adsorbent was fabricated for the on-site sampling of polycyclic aromatic hydrocarbons from environmental waters. Trace polycyclic aromatic hydrocarbons were effectively extracted through the self-made device followed by gas chromatography with mass spectrometry analysis. Owing to the excellent adsorption performance of metal-organic frameworks, the analytes could be completely adsorbed during one adsorption cycle, thus effectively shortening the extraction time. Moreover, the adsorbed analytes could remain stable on the device for at least 7 days, revealing the potential of the self-made device for on-site sampling of degradable compounds in remote regions. The limit of detection ranged from 0.20 to 1.9 ng/L under the optimum conditions. Satisfactory recoveries varying from 84.4 to 104.5% and relative standard deviations below 9.7% were obtained in real samples analysis. The results of this study promote the application of metal-organic frameworks in sample preparation and demonstrate the great potential of in-syringe solid-phase extraction for the on-site sampling of trace contaminants in environmental waters. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. Comparison of SDR presumed by AAMI and the radio-resistance distribution of the microbiological populations exist on the Turkish made single use syringes

    International Nuclear Information System (INIS)

    Konac, T.; Siyakus, G.; Basguel, M.; Uenal, Z.

    2001-01-01

    The concept of radiation sterilization of medical devices was introduced in Turkey 10 years ago through the irradiation facilities in Ankara and Istanbul. It has been preferred by international community due to technological advantages,such as freedom from chemical residues, safer sterility assurance, etc.. This technology is regulated by ISO 11137 (1), EN 552 (2) standards and their references. The scope of this study was to compare the radio-resistance distribution of the microbial population on the Turkish single use syringes and SDR

  10. Publishing in Open Access Journals

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

    mbrunet

    While most open access journals are peer‐reviewed and high quality, there are a number of ... Publisher has a negative reputation (e.g., documented examples in Chronicle of Higher Education, ... A key part of Canada's aid program, IDRC supports research in developing countries to promote growth and development.

  11. Availability of herbal medicines and medicinal plants in the primary health facilities of the state of São Paulo, Southeast Brazil: results from the National Program for Access and Quality Improvement in Primary Care.

    Science.gov (United States)

    Caccia-Bava, Maria do Carmo Gullaci Guimarães; Bertoni, Bianca Waléria; Pereira, Ana Maria Soares; Martinez, Edson Zangiacomi

    2017-05-01

    This study aims to describe the availability of herbal medicines and medicinal plants in the primary care facilities in the state of São Paulo, Southeast Brazil, from the results of the first cycle of the National Program for Access and Quality Improvement in Primary Care (PMAQ). The PMAQ uses a national cross-sectional multicenter design, with data from 4,249 health facilities distributed among 645 municipalities of the state of São Paulo. Of these facilities, 467 (11%) had herbal medicines and/or medicinal plants. Among the 645 municipalities, 104 (16.1%) had at least one health facility that provided these drugs. We observed that the availability of herbal medicines is greater in larger cities with better social and economic conditions. Furthermore, we found that use of industrialized herbal medicines prevailed over that of vegetal drugs or compounded herbal medicines.

  12. CONTAMINATION OF ANTI-VEGF DRUGS FOR INTRAVITREAL INJECTION: How Do Repackaging and Newly Developed Syringes Affect the Amount of Silicone Oil Droplets and Protein Aggregates?

    Science.gov (United States)

    Schargus, Marc; Werner, Benjamin P; Geerling, Gerd; Winter, Gerhard

    2017-08-21

    The particle counts and the nature of particles of three different antivascular endothelial growth factor agents (VEGF) in different containers in a laboratory setting were compared. Original prefilled ranibizumab glass syringes, original vials with aflibercept, and repacked ready-to-use plastic syringes with bevacizumab from a compounding pharmacy and a compounding company (CC) were analyzed. Particle counts and size distributions were quantified by different particle characterization methods (nephelometry, light obscuration, Micro-Flow Imaging, nanotracking analysis, resonant mass measurement). Using high-performance size-exclusion chromatography (HP-SEC), levels of protein drug monomer and soluble aggregates were determined. Nearly all samples showed similar product quality. Light obscuration and Micro-Flow Imaging showed a 4-fold to 9-fold higher total particle count in compounding company bevacizumab (other samples up to 42,000 particles/mL). Nanotracking analysis revealed highest values for compounding company bevacizumab (6,375 million particles/mL). All containers showed similar amounts of silicone oil microdroplets. Ranibizumab showed lowest particle count of all tested agents with only one monomer peak in HP-SEC. Repackaged bevacizumab from different suppliers showed varying product quality. All three tested agents are available in similar quality regarding particulate purity and silicone oil microdroplet count. Repackaging can have a major impact on the quality.

  13. Physicochemical stability of carfilzomib (Kyprolis®) containing solutions in glass vials, ready-to-administer plastic syringes and infusion bags over a 28-day storage period.

    Science.gov (United States)

    Kim, Sun Hee; Krämer, Irene

    2017-01-01

    Centralized aseptic preparation of ready-to-administer carfilzomib containing parenteral solutions in plastic syringes and polyolefine (PO) infusion bags needs profound knowledge about the physicochemical stability in order to determine the beyond-use-date of the preparations. Therefore, the purpose of this study was to determine the physicochemical stability of carfilzomib solution marketed as Kyprolis® powder for solution for infusion. Reconstituted solutions and ready-to-administer preparations of Kyprolis® stored under refrigeration (2-8℃) or at room temperature (25℃) were analyzed at predetermined intervals over a maximum storage period of 28 days. Chemical stability of carfilzomib was planned to be determined with a stability-indicating reversed-phase high-performance liquid chromatography assay. Physicochemical stability was planned to be determined by visual inspection of clarity and color as well as pH measurement. The study results show that reconstituted carfilzomib containing parenteral solutions are stable in glass vials as well as diluted solutions in plastic syringes and PO infusion bags over a period of at least 28 days when stored light protected under refrigeration. When stored at room temperature, reconstituted and diluted carfilzomib solutions are physicochemically stable over 14 days and 10 days, respectively. The physicochemical stability of carfilzomib infusion solutions allows cost-saving pharmacy-based centralized preparation of ready-to-administer preparations.

  14. In-coupled syringe assisted octanol-water partition microextraction coupled with high-performance liquid chromatography for simultaneous determination of neonicotinoid insecticide residues in honey.

    Science.gov (United States)

    Vichapong, Jitlada; Burakham, Rodjana; Srijaranai, Supalax

    2015-07-01

    A simple and fast method namely in-coupled syringe assisted octanol-water partition microextraction combined with high performance liquid chromatography (HPLC) has been developed for the extraction, preconcentration and determination of neonicotinoid insecticide residues (e.g. imidacloprid, acetamiprid, clothianidin, thiacloprid, thiamethoxam, dinotefuran, and nitenpyram) in honey. The experimental parameters affected the extraction efficiency, including kind and concentration of salt, kind of disperser solvent and its volume, kind of extraction solvent and its volume, shooting times and extraction time were investigated. The extraction process was carried out by rapid shooting of two syringes. Therefore, rapid dispersion and mass transfer processes was created between phases, and thus affects the extraction efficiency of the proposed method. The optimum extraction conditions were 10.00 mL of aqueous sample, 10% (w/v) Na2SO4, 1-octanol (100µL) as an extraction solvent, shooting 4 times and extraction time 2min. No disperser solvent and centrifugation step was necessary. Linearity was obtained within the range of 0.1-3000 ngmL(-1), with the correlation coefficients greater than 0.99. The high enrichment factor of the target analytes was 100 fold and low limit of detection (0.25-0.50 ngmL(-1)) could be obtained. This proposed method has been successfully applied in the analysis of neonicotinoid residues in honey, and good recoveries in the range of 96.93-107.70% were obtained. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Determination of desipramine in biological samples using liquid-liquid-liquid microextraction combined with in-syringe derivatization, gas chromatography, and nitrogen/phosphorus detection.

    Science.gov (United States)

    Saraji, Mohammad; Mehrafza, Narges; Bidgoli, Ali Akbar Hajialiakbari; Jafari, Mohammad Taghi

    2012-10-01

    A method was established for the determination of desipramine in biological samples using liquid-liquid-liquid microextraction followed by in-syringe derivatization and gas chromatography-nitrogen phosphorus detection. The extraction method was based on the use of two immiscible organic solvents. n-Dodecane was impregnated in the pores of the hollow fiber and methanol was placed inside the lumen of the fiber as the acceptor phase. Acetic anhydride was used as the reagent for the derivatization of the analyte inside the syringe barrel. Parameters that affect the extraction efficiency (composition of donor and acceptor phase, ionic strength, sample temperature, and extraction time) as well as derivatization efficiency (amount of acetic anhydride and reaction time and temperature) were investigated. The limit of detection was 0.02 μg/L with intra and interday RSDs of 2.6 and 7.7%, respectively. The linearity of the method was in the range of 0.2-20 μg/L (r(2) = 0.9986). The method was successfully applied to determine desipramine in human plasma and urine. © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Determination of Three Organochlorine Pesticides in Aqueous Samples by Solid-Phase Extraction Based on Natural Nano Diatomite in Packed Syringe Coupled to Gas Chromatography-Mass Spectrometry.

    Science.gov (United States)

    Taghani, Abdollah; Goudarzi, Nasser; Bagherian, Ghadamali; Chamjangali, Mansour Arab

    2017-01-01

    A rapid, simple, and sensitive technique is proposed based on a miniaturized solid-phase extraction method named mictroextraction in a packed syringe coupled with gas chromatography-mass spectrometry for the preconcentration and determination of three organochlorine pesticides. These include hexachlorobenzene, heptachlor and aldrine in aqueous samples. For the first time, the natural nano diatomite is used a sorbent. Based on this technique, 6.0 mg of the nano sorbent is inserted in a syringe between two polypropylene frits. The analytes would be adsorbed on the solid phase, and would subsequently be eluted using organic solvents. The influence of some important parameters, such as the solution pH, type and volume of the organic desorption solvent, and amount of sorbent on the extraction efficiency of the selected pesticides, is investigated. The proposed method shows good linearity in the range of 0.1 - 40.0 μg L -1 , and at low limits of detection in the range of 0.02 - 0.13 μg L -1 using the selected ion-monitoring mode. The reproducibility of this method was found to be in the range of 3.5 - 11.1% for the understudied pesticides. In order to evaluate the matrix effect, the developed method is also applied to the preconcentration and determination of the selected pesticides in different water samples.

  17. Syringe needle-based sampling coupled with liquid-phase extraction for determination of the three-dimensional distribution of l-ascorbic acid in apples.

    Science.gov (United States)

    Tang, Sheng; Lee, Hian Kee

    2016-05-15

    A novel syringe needle-based sampling approach coupled with liquid-phase extraction (NBS-LPE) was developed and applied to the extraction of l-ascorbic acid (AsA) in apple. In NBS-LPE, only a small amount of apple flesh (ca. 10mg) was sampled directly using a syringe needle and placed in a glass insert for liquid extraction of AsA by 80 μL oxalic acid-acetic acid. The extract was then directly analyzed by liquid chromatography. This new procedure is simple, convenient, almost organic solvent free, and causes far less damage to the fruit. To demonstrate the applicability of NBS-LPE, AsA levels at different sampling points in a single apple were determined to reveal the spatial distribution of the analyte in a three-dimensional model. The results also showed that this method had good sensitivity (limit of detection of 0.0097 mg/100g; limit of quantification of 0.0323 mg/100g), acceptable reproducibility (relative standard deviation of 5.01% (n=6)), a wide linear range of between 0.05 and 50mg/100g, and good linearity (r(2)=0.9921). This interesting extraction technique and modeling approach can be used to measure and monitor a wide range of compounds in various parts of different soft-matrix fruits and vegetables, including single specimens. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Inventário de ciclo de vida da manufatura de seringas odontológicas Life cycle inventory of dental syringes

    Directory of Open Access Journals (Sweden)

    Biagio F. Giannetti

    2008-01-01

    Full Text Available Uma das formas mais integradas, completas e eficazes para a gestão ambiental de atividades produtivas é baseada no ciclo de vida do produto, sendo a Avaliação do Ciclo de Vida sua principal ferramenta. O produto avaliado é a seringa odontológica tipo Carpule. O objetivo é a realização do Inventário de Ciclo de Vida (ICV simplificado da fabricação de seringas odontológicas tipo Carpule, visando quantificar o uso de energia elétrica e a emissão de resíduos sólidos desde a mineração até o descarte do produto. A estrutura metodológica está baseada nas normas da série NBR ISO 14.040 e ISO 14.040. As fronteiras do estudo incluem as etapas de mineração, beneficiamento e manufatura; a produção do polietileno que compõe o tubete e a embalagem da agulha; a produção do aço, utilizado na fabricação da agulha, e o uso do conjunto pelos dentistas. A unidade funcional utilizada é 10(6 (um milhão de anestesias aplicadas. Na avaliação de melhorias, as soluções propostas permitem reduzir o consumo de energia elétrica em aproximadamente 20% na etapa de manufatura. A quantidade de resíduos sólidos pode ser reduzida de 40% na etapa de manufatura, o que corresponde a aproximadamente 6,50% do total de resíduos sólidos no ciclo de vida da seringa odontológica.Among the methods proposed to environmental management of productive activities, Life Cycle Assessment is one of the most integrated, complete and efficacious. The product assessed is the dental carpule syringe. The aim of this work is to to perform a Streamlined Life Cycle Inventory (LCI to quantify the electric energy consumption and the solid waste release from dental carpule syringes manufacture. The methodological structure is based on NBR ISO 14.040 and ISO 14.040 series. The LCI covers the syringe life cycle from mining to disposal. The limits of the system include the stages of copper and zinc mining and ore beneficiation; the production of polyethylene used for

  19. A new solid phase microextraction method using organic ligand in micropipette tip syringe system packed with modified carbon cloth for preconcentration of cadmium in drinking water and blood samples of kidney failure patients

    Science.gov (United States)

    Panhwar, Abdul Haleem; Kazi, Tasneem Gul; Afridi, Hassan Imran; Arain, Salma Aslam; Naeemullah; Brahman, Kapil Dev; Arain, Mariam Shahzadi

    2015-03-01

    A simple and efficient miniaturized solid phase microextraction (M-SPμE) in a syringe system was developed for preconcentration of cadmium (Cd) in environmental and biological samples, followed by flame atomic absorption technique. The syringe system contains the micropipette tip packed with activated carbon cloth, coated with modified magnetic nanoparticles of iron oxide Triton X114 (ACC-NPs). Scanning electron microscopy and energy dispersive spectroscopy used for characterization of the size, morphology and elemental composition of ACC-NPs. The sample solution treated with a complexing reagent 8-hydroxyqunilone (8-HQ), and drawn into the syringe, filled with ACC-MNPs and dispensed manually for 2-10 drawing/discharging cycles. The analyte retained on ACC-NPs in micropipette tip-syringe system were then eluted with different volume of 1.5 mol L-1 HCl by 1-5 drawing/discharging cycles. The syringe system directly couple with FAAS for analysis. The influence of different variables on the extraction efficiency of Cd, including adsorbent dosage, pH, sample volume, eluent volume and drawing/discharging cycles of syringe system were optimized. At optimized extraction conditions, the method showed good linearity in the range of 5-250 μg L-1, with a limit of detection 0.15 μg L-1. Repeatability of the extraction (%RSD) was <5%, n = 5. The validity and accuracy of the method was checked by the certified reference materials. The proposed method was successfully applied for the determination of Cd in different drinking water and biological samples of kidney failure patients and healthy controls.

  20. 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...

  1. Accessibility and sensory experiences

    DEFF Research Database (Denmark)

    Ryhl, Camilla

    2010-01-01

    and accessibility. Sensory accessibility accommodates aspects of a sensory disability and describes architectural design requirements needed to ensure access to architectural experiences. In the context of architecture accessibility has become a design concept of its own. It is generally described as ensuring...... physical access to the built environment by accommodating physical disabilities. While the existing concept of accessibility ensures the physical access of everyone to a given space, sensory accessibility ensures the choice of everyone to stay and be able to participate and experience....

  2. Accessing Safe Deliveries in Tanzania (IMCHA) | IDRC ...

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

    Few healthcare workers are trained to offer emergency obstetrical care, so timely ... With better access to skilled care and emergency services, the project aims to ... training program as it relates to health service delivery and health outcomes.

  3. 45 CFR 98.31 - Parental access.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Parental access. 98.31 Section 98.31 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Parental Rights and Responsibilities § 98.31 Parental access. The...

  4. Teaching Accessibility Standards to Generation Y Students

    Science.gov (United States)

    Klitzing, Sandra

    2011-01-01

    The Americans with Disabilities Act (ADA) of 1990 mandated that facilities and programs are accessible, so people with disabilities can be included in all aspects of community life including recreation (Dattilo, 2002). Understanding accessibility standards is not an easy task. Educators are faced with the challenge of teaching technical content,…

  5. Students' Motivation to Access Academic Advising Services

    Science.gov (United States)

    Henning, Marcus A.

    2009-01-01

    The interrelationships between motivation for choosing a program of study, intention to access academic advisors, academic difficulty, and actual appointments with academic advisors were based on student self-reports of motivation and intentions. In addition, academic achievement measures and data on student access to academic advisors were…

  6. Access to major overseas research facilities

    International Nuclear Information System (INIS)

    Bolderman, J. W.

    1997-01-01

    This paper will describe four schemes which have been established to permit Australian researchers access to some of the most advanced overseas research facilities. These include, access to Major Research Facilities Program, the Australian National Beamline Facility at the Photon Factory, the Australian Synchrotron Research Program and the ISIS Agreement. The details of each of these programs is discussed and the statistics on the scientific output provided. All programs are managed on behalf of the Department of Industry, Science and Tourism by the Australian Nuclear Science and Technology Organisation. One hundred and thirteen senior scientists plus forty, one postgraduate, students were supported through these schemes during the 1996-1997 financial year

  7. JISC Open Access Briefing Paper

    OpenAIRE

    Swan, Alma

    2005-01-01

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

  8. Open versus Controlled-Access Data | Office of Cancer Genomics

    Science.gov (United States)

    OCG employs stringent human subjects’ protection and data access policies to protect the privacy and confidentiality of the research participants. Depending on the risk of patient identification, OCG programs data are available to the scientific community in two tiers: open or controlled access. Both types of data can be accessed through its corresponding OCG program-specific data matrix or portal. Open-access Data

  9. 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.

  10. The state-led large scale public private partnership 'Chiranjeevi Program' to increase access to institutional delivery among poor women in Gujarat, India: How has it done? What can we learn?

    Science.gov (United States)

    De Costa, Ayesha; Vora, Kranti S; Ryan, Kayleigh; Sankara Raman, Parvathy; Santacatterina, Michele; Mavalankar, Dileep

    2014-01-01

    Many low-middle income countries have focused on improving access to and quality of obstetric care, as part of promoting a facility based intra-partum care strategy to reduce maternal mortality. The state of Gujarat in India, implements a facility based intra-partum care program through its large for-profit private obstetric sector, under a state-led public-private-partnership, the Chiranjeevi Yojana (CY), under which the state pays accredited private obstetricians to perform deliveries for poor/tribal women. We examine CY performance, its contribution to overall trends in institutional deliveries in Gujarat over the last decade and its effect on private and public sector deliveries there. District level institutional delivery data (public, private, CY), national surveys, poverty estimates, census data were used. Institutional delivery trends in Gujarat 2000-2010 are presented; including contributions of different sectors and CY. Piece-wise regression was used to study the influence of the CY program on public and private sector institutional delivery. Institutional delivery rose from 40.7% (2001) to 89.3% (2010), driven by sharp increases in private sector deliveries. Public sector and CY contributed 25-29% and 13-16% respectively of all deliveries each year. In 2007, 860 of 2000 private obstetricians participated in CY. Since 2007, >600,000 CY deliveries occurred i.e. one-third of births in the target population. Caesareans under CY were 6%, higher than the 2% reported among poor women by the DLHS survey just before CY. CY did not influence the already rising proportion of private sector deliveries in Gujarat. This paper reports a state-led, fully state-funded, large-scale public-private partnership to improve poor women's access to institutional delivery - there have been >600,000 beneficiaries. While caesarean proportions are higher under CY than before, it is uncertain if all beneficiaries who require sections receive these. Other issues to explore include

  11. The state-led large scale public private partnership 'Chiranjeevi Program' to increase access to institutional delivery among poor women in Gujarat, India: How has it done? What can we learn?

    Directory of Open Access Journals (Sweden)

    Ayesha De Costa

    Full Text Available BACKGROUND: Many low-middle income countries have focused on improving access to and quality of obstetric care, as part of promoting a facility based intra-partum care strategy to reduce maternal mortality. The state of Gujarat in India, implements a facility based intra-partum care program through its large for-profit private obstetric sector, under a state-led public-private-partnership, the Chiranjeevi Yojana (CY, under which the state pays accredited private obstetricians to perform deliveries for poor/tribal women. We examine CY performance, its contribution to overall trends in institutional deliveries in Gujarat over the last decade and its effect on private and public sector deliveries there. METHODS: District level institutional delivery data (public, private, CY, national surveys, poverty estimates, census data were used. Institutional delivery trends in Gujarat 2000-2010 are presented; including contributions of different sectors and CY. Piece-wise regression was used to study the influence of the CY program on public and private sector institutional delivery. RESULTS: Institutional delivery rose from 40.7% (2001 to 89.3% (2010, driven by sharp increases in private sector deliveries. Public sector and CY contributed 25-29% and 13-16% respectively of all deliveries each year. In 2007, 860 of 2000 private obstetricians participated in CY. Since 2007, >600,000 CY deliveries occurred i.e. one-third of births in the target population. Caesareans under CY were 6%, higher than the 2% reported among poor women by the DLHS survey just before CY. CY did not influence the already rising proportion of private sector deliveries in Gujarat. CONCLUSION: This paper reports a state-led, fully state-funded, large-scale public-private partnership to improve poor women's access to institutional delivery - there have been >600,000 beneficiaries. While caesarean proportions are higher under CY than before, it is uncertain if all beneficiaries who require

  12. 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.

  13. 77 FR 29473 - Market Access Program

    Science.gov (United States)

    2012-05-17

    ... 12866 and was not reviewed by the Office of Management and Budget. A cost-benefit assessment of this... contribution levels from Participants as important factors in the overall management of the MAP. Summary and... expenditures are not reimbursable for brand promotion activities. The comments regarding E-ticketing and...

  14. Direct preparation of a graphene oxide modified monolith in a glass syringe as a solid-phase extraction cartridge for the extraction of quaternary ammonium alkaloids from Chinese patent medicine.

    Science.gov (United States)

    Liang, Xiaojing; Wang, Licheng; Wang, Shuai; Li, Yijing; Guo, Yong

    2017-11-01

    Packed cartridges have been widely used in solid-phase extraction. However, there are still some drawbacks, such as they are blocked easily and the method is time-consuming. In view of the advantages of monoliths, a monolithic extraction material has been directly synthesized in a glass syringe without any gap between the monolith and syringe inner wall. The monolithic syringe was modified with graphene oxide by loading graphene oxide dispersion onto it. The content of graphene oxide and the surface topography of the monolith have been evaluated by elemental analysis and scanning electron microscopy, respectively, which confirmed the successful modification. This prepared graphene oxide-modified monolithic syringe was directly used as a traditional solid-phase extraction cartridge. As expected, it shows good permeability and excellent capability for the extraction of quaternary ammonium alkaloids. The sample loading velocity (1-6 mL/min) does not affect the recovery. Under the optimal conditions, good linearities (R = 0.9992-0.9998) were obtained for five quaternary ammonium alkaloids, and the limits of detection and quantification were 0.5-1 and 1-2 μg/L, respectively. The proposed method was successfully applied for the analysis of quaternary ammonium alkaloids in Chinese patent medicine. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  15. Development of new portable miniaturize solid phase microextraction of silver-APDC complex using micropipette tip in-syringe system couple with electrothermal atomic absorption spectrometry

    Science.gov (United States)

    Naeemullah; Kazi, Tasneem Gul; Afridi, Hassan Imran; Shah, Faheem; Arain, Sadaf Sadia; Arain, Salma Aslam; Panhwar, Abdul Haleem; Arain, Mariam Shahzadi; Samoon, Muhammad Kashif

    2016-02-01

    An innovative and simple miniaturized solid phase microextraction (M-SPME) method, was developed for preconcentration and determination of silver(I) in the fresh and waste water samples. For M-SPME, a micropipette tip packed with activated carbon cloth (ACC) as sorbent, in a syringe system. The size, morphology and elemental composition of ACC before and after adsorption of analyte have been characterized by scanning electron microscopy and energy dispersive spectroscopy. The sample solution treated with a complexing reagent, ammonium pyrrolidine dithiocarbamate (APDC), was drawn into the syringe filled with ACC and dispensed manually for 2 to 10 aspirating/dispensing cycle. Then the Ag- complex sorbed on the ACC in micropipette was quantitatively eluted by drawing and dispensing of different concentrations of acids for 2 to 5 aspirating/dispensing cycles. The extracted Ag ions with modifier were injected directly into the electrothermal atomic absorption spectrometry for analysis. The influence of different variables on the extraction efficiency, including the concentration of ligand, pH, sample volume, eluent type, concentration and volume was investigated. Validity and accuracy of the developed method was checked by the standard addition method. Reliability of the proposed methodology was checked by the relative standard deviation (%RSD), which was found to be < 5%. Under the optimized experimental variables, the limits of detection (LOD) and enhancement factors (EF), were obtained to be 0.86 ng L- 1 and 120, respectively. The proposed method was successfully applied for the determination of trace levels of silver ions in fresh and waste water samples.

  16. Deformability measurement of red blood cells using a microfluidic channel array and an air cavity in a driving syringe with high throughput and precise detection of subpopulations.

    Science.gov (United States)

    Kang, Yang Jun; Ha, Young-Ran; Lee, Sang-Joon

    2016-01-07

    Red blood cell (RBC) deformability has been considered a potential biomarker for monitoring pathological disorders. High throughput and detection of subpopulations in RBCs are essential in the measurement of RBC deformability. In this paper, we propose a new method to measure RBC deformability by evaluating temporal variations in the average velocity of blood flow and image intensity of successively clogged RBCs in the microfluidic channel array for specific time durations. In addition, to effectively detect differences in subpopulations of RBCs, an air compliance effect is employed by adding an air cavity into a disposable syringe. The syringe was equally filled with a blood sample (V(blood) = 0.3 mL, hematocrit = 50%) and air (V(air) = 0.3 mL). Owing to the air compliance effect, blood flow in the microfluidic device behaved transiently depending on the fluidic resistance in the microfluidic device. Based on the transient behaviors of blood flows, the deformability of RBCs is quantified by evaluating three representative parameters, namely, minimum value of the average velocity of blood flow, clogging index, and delivered blood volume. The proposed method was applied to measure the deformability of blood samples consisting of homogeneous RBCs fixed with four different concentrations of glutaraldehyde solution (0%-0.23%). The proposed method was also employed to evaluate the deformability of blood samples partially mixed with normal RBCs and hardened RBCs. Thereafter, the deformability of RBCs infected by human malaria parasite Plasmodium falciparum was measured. As a result, the three parameters significantly varied, depending on the degree of deformability. In addition, the deformability measurement of blood samples was successfully completed in a short time (∼10 min). Therefore, the proposed method has significant potential in deformability measurement of blood samples containing hematological diseases with high throughput and precise detection of

  17. Development of new portable miniaturize solid phase microextraction of silver-APDC complex using micropipette tip in-syringe system couple with electrothermal atomic absorption spectrometry.

    Science.gov (United States)

    Naeemullah; Kazi, Tasneem Gul; Afridi, Hassan Imran; Shah, Faheem; Arain, Sadaf Sadia; Arain, Salma Aslam; Panhwar, Abdul Haleem; Arain, Mariam Shahzadi; Samoon, Muhammad Kashif

    2016-02-05

    An innovative and simple miniaturized solid phase microextraction (M-SPME) method, was developed for preconcentration and determination of silver(I) in the fresh and waste water samples. For M-SPME, a micropipette tip packed with activated carbon cloth (ACC) as sorbent, in a syringe system. The size, morphology and elemental composition of ACC before and after adsorption of analyte have been characterized by scanning electron microscopy and energy dispersive spectroscopy. The sample solution treated with a complexing reagent, ammonium pyrrolidine dithiocarbamate (APDC), was drawn into the syringe filled with ACC and dispensed manually for 2 to 10 aspirating/dispensing cycle. Then the Ag- complex sorbed on the ACC in micropipette was quantitatively eluted by drawing and dispensing of different concentrations of acids for 2 to 5 aspirating/dispensing cycles. The extracted Ag ions with modifier were injected directly into the electrothermal atomic absorption spectrometry for analysis. The influence of different variables on the extraction efficiency, including the concentration of ligand, pH, sample volume, eluent type, concentration and volume was investigated. Validity and accuracy of the developed method was checked by the standard addition method. Reliability of the proposed methodology was checked by the relative standard deviation (%RSD), which was found to be <5%. Under the optimized experimental variables, the limits of detection (LOD) and enhancement factors (EF), were obtained to be 0.86 ng L(-1) and 120, respectively. The proposed method was successfully applied for the determination of trace levels of silver ions in fresh and waste water samples. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. A simple and effective approach to prepare injectable macroporous calcium phosphate cement for bone repair: Syringe-foaming using a viscous hydrophilic polymeric solution.

    Science.gov (United States)

    Zhang, Jingtao; Liu, Weizhen; Gauthier, Olivier; Sourice, Sophie; Pilet, Paul; Rethore, Gildas; Khairoun, Khalid; Bouler, Jean-Michel; Tancret, Franck; Weiss, Pierre

    2016-02-01

    In this study, we propose a simple and effective strategy to prepare injectable macroporous calcium phosphate cements (CPCs) by syringe-foaming via hydrophilic viscous polymeric solution, such as using silanized-hydroxypropyl methylcellulose (Si-HPMC) as a foaming agent. The Si-HPMC foamed CPCs demonstrate excellent handling properties such as injectability and cohesion. After hardening the foamed CPCs possess hierarchical macropores and their mechanical properties (Young's modulus and compressive strength) are comparable to those of cancellous bone. Moreover, a preliminary in vivo study in the distal femoral sites of rabbits was conducted to evaluate the biofunctionality of this injectable macroporous CPC. The evidence of newly formed bone in the central zone of implantation site indicates the feasibility and effectiveness of this foaming strategy that will have to be optimized by further extensive animal experiments. A major challenge in the design of biomaterial-based injectable bone substitutes is the development of cohesive, macroporous and self-setting calcium phosphate cement (CPC) that enables rapid cell invasion with adequate initial mechanical properties without the use of complex processing and additives. Thus, we propose a simple and effective strategy to prepare injectable macroporous CPCs through syringe-foaming using a hydrophilic viscous polymeric solution (silanized-hydroxypropyl methylcellulose, Si-HPMC) as a foaming agent, that simultaneously meets all the aforementioned aims. Evidence from our in vivo studies shows the existence of newly formed bone within the implantation site, indicating the feasibility and effectiveness of this foaming strategy, which could be used in various CPC systems using other hydrophilic viscous polymeric solutions. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  19. OPTICA: Our Path Together Initiating Cultural Access. Final Report.

    Science.gov (United States)

    Jackson, Susan, Comp.

    This final report describes the activities and outcomes of OPTICA (Our Path Together Initiating Cultural Access) programs. For each program an information sheet indicates the goal, total participation, status of the goal, and activities of the program. Programs included: (1) Hands On: ASL Creative Story Telling, a program that used children's…

  20. Overview: Routes to Open Access

    OpenAIRE

    Tullney, Marco; van Wezenbeek, Wilma

    2017-01-01

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