WorldWideScience

Sample records for underserved area ranged

  1. FHFA Underserved Areas

    Data.gov (United States)

    Department of Housing and Urban Development — Federal Housing Finance Agency's (FHFA) Underserved Areas establishes underserved area designations for census tracts in Metropolitan Areas (MSAs), nonmetropolitan...

  2. 5 CFR 894.801 - Will benefits be available in underserved areas?

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Will benefits be available in underserved... Underserved Areas § 894.801 Will benefits be available in underserved areas? (a) Dental and vision plans under FEDVIP will include underserved areas in their service areas and provide benefits to enrollees in...

  3. Financial incentives for return of service in underserved areas: a systematic review

    Directory of Open Access Journals (Sweden)

    Bärnighausen Till

    2009-05-01

    . Results Of the 43 reviewed studies 34 investigated financial-incentive programs in the US. The remaining studies evaluated programs in Japan (five studies, Canada (two, New Zealand (one and South Africa (one. The programs started between 1930 and 1998. We identified five different types of programs (service-requiring scholarships, educational loans with service requirements, service-option educational loans, loan repayment programs, and direct financial incentives. Financial incentives to serve for one year in an underserved area ranged from year-2000 United States dollars 1,358 to 28,470. All reviewed studies were observational. The random-effects estimate of the pooled proportion of all eligible program participants who had either fulfilled their obligation or were fulfilling it at the time of the study was 71% (95% confidence interval 60–80%. Seven studies compared retention in the same (underserved area between program participants and non-participants. Six studies found that participants were less likely than non-participants to remain in the same area (five studies reported the difference to be statistically significant, while one study did not report a significance level; one study did not find a significant difference in retention in the same area. Thirteen studies compared provision of care or retention in any underserved area between participants and non-participants. Eleven studies found that participants were more likely to (continue to practice in any underserved area (nine studies reported the difference to be statistically significant, while two studies did not provide the results of a significance test; two studies found that program participants were significantly less likely than non-participants to remain in any underserved area. Seven studies investigated the satisfaction of participants with their work and personal lives in underserved areas. Conclusion Financial-incentive programs for return of service are one of the few health policy interventions

  4. 77 FR 43127 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2013

    Science.gov (United States)

    2012-07-23

    ... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... determination of the States that qualify as Medically Underserved Areas under the Federal Employees Health... law that mandates special consideration for enrollees of certain FEHB plans who receive covered health...

  5. 78 FR 50119 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2014

    Science.gov (United States)

    2013-08-16

    ... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... determination of the states that qualify as Medically Underserved Areas under the Federal Employees Health... law that mandates special consideration for enrollees of certain FEHB plans who receive covered health...

  6. 76 FR 31998 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2012

    Science.gov (United States)

    2011-06-02

    ... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar year 2012. This is... certain FEHB plans who receive covered health services in States with critical shortages of primary care...

  7. 75 FR 32972 - Federal Employees Health Benefits Program; Medically Underserved Areas for 2011

    Science.gov (United States)

    2010-06-10

    ... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program; Medically Underserved... Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar year 2011. This is... certain FEHB plans who receive covered health services in States with critical shortages of primary care...

  8. Telemed: Ehealth applications applied to underserved areas in Latin America

    International Nuclear Information System (INIS)

    Sachpazidis, Ilias; Ohl, Roland; Binotto, Alecio Pedro Delazari; Torres, Marcio Soares; Messina, Luiz Ary; Sales, Alexandre; Gomes, Ricardo; Sakas, Georgios

    2006-01-01

    Access to medical care is sometimes very difficult to be reached from people living in rural and underserved areas. This problem is very well known in rural areas in Brazil. Citizens have no access to health care. They have to travel hundreds of kilometres to receive medical care. In this paper, we will propose a medical network based on state-of-the-art medical imaging application that addresses the problems of providing health care from a distance. Additionally, we are going to show preliminarily results of the first year of the system deployment and utilization in undeserved regions in Brazil. The total number of patients submitted to ultrasound examinations, during the 10 months of projects' medical trials, is 321. The exams have begun with the elderly people (hypertension and diabetes cases) with 90% above 50-years-old. Fifty-four percent were male and 46% were female. From those exams, 67 exams (21%) needed a second medical opinion and were transmitted to Santa Casa hospital in Porto Alegre, Brazil, one of the referral medical centres. From those second opinions of Santa Casa, 12 exams had to be repeated since the acquired images were not sufficient to give a correct diagnosis. The Lagoa Tres Cantos medical doctor performed also preventive exams with patients who had not presented any symptoms (70%)

  9. Telemed: Ehealth applications applied to underserved areas in Latin America

    Energy Technology Data Exchange (ETDEWEB)

    Sachpazidis, Ilias [Fraunhofer Institute for Computer Graphics, Fraunhoferstr. 5, D-64283, Darmstadt (Germany)]. E-mail: Ilias.Sachpazidis@igd.fraunhofer.de; Ohl, Roland [MedCom Gesellschaft fuer medizinische Bildverarbeitung mbH, Rundeturmstr. 12, D-64283, Darmstadt (Germany); Binotto, Alecio Pedro Delazari [Centro de Excelencia em Tecnologias Avancadas Av. Assis Brasil, 8450, 91, 140-000 Porto Alegre (Brazil); Torres, Marcio Soares [Centro de Excelencia em Tecnologias Avancadas Av. Assis Brasil, 8450, 91, 140-000 Porto Alegre (Brazil); Messina, Luiz Ary [Messina Informatica e Comercio Ltda., Rua Castelo Branco 330, 29100-040 Praia da Costa, Vila Velha (Brazil); Sales, Alexandre [Fundacao de Apoio ao Hospital Universitario da UFES-Fahucam, Av. Marechal Campos 1355, 29042-715 Santos Dumont, Vitoria (Brazil); Gomes, Ricardo [Complexo Hospitalar Santa Casa de Porto Alegre Rua Prof. Annes Dias 285, Porto Alegre (Brazil); Sakas, Georgios [Fraunhofer Institute for Computer Graphics, Fraunhoferstr. 5, D-64283, Darmstadt (Germany)

    2006-12-20

    Access to medical care is sometimes very difficult to be reached from people living in rural and underserved areas. This problem is very well known in rural areas in Brazil. Citizens have no access to health care. They have to travel hundreds of kilometres to receive medical care. In this paper, we will propose a medical network based on state-of-the-art medical imaging application that addresses the problems of providing health care from a distance. Additionally, we are going to show preliminarily results of the first year of the system deployment and utilization in undeserved regions in Brazil. The total number of patients submitted to ultrasound examinations, during the 10 months of projects' medical trials, is 321. The exams have begun with the elderly people (hypertension and diabetes cases) with 90% above 50-years-old. Fifty-four percent were male and 46% were female. From those exams, 67 exams (21%) needed a second medical opinion and were transmitted to Santa Casa hospital in Porto Alegre, Brazil, one of the referral medical centres. From those second opinions of Santa Casa, 12 exams had to be repeated since the acquired images were not sufficient to give a correct diagnosis. The Lagoa Tres Cantos medical doctor performed also preventive exams with patients who had not presented any symptoms (70%)

  10. Underserved Areas and Pediatric Resident Characteristics: Is There Reason for Optimism?

    Science.gov (United States)

    Laraque-Arena, Danielle; Frintner, Mary Pat; Cull, William L

    2016-01-01

    To examine whether resident characteristics and experiences are related to practice in underserved areas. Cross-sectional survey of a national random sample of pediatric residents (n = 1000) and additional sample of minority residents (n = 223) who were graduating in 2009 was conducted. Using weighted logistic regression, we examined relationships between resident characteristics (background, values, residency experiences, and practice goals) and reported 1) expectation to practice in underserved area and 2) postresidency position in underserved area. Response rate was 57%. Forty-one percent of the residents reported that they had an expectation of practicing in an underserved area. Of those who had already accepted postresidency positions, 38% reported positions in underserved areas. Service obligation in exchange for loans/scholarships and primary care/academic pediatrics practice goals were the strongest predictors of expectation of practicing in underserved areas (respectively, adjusted odds ratio 4.74, 95% confidence interval 1.87-12.01; adjusted odds ratio 3.48, 95% confidence interval 1.99-6.10). Other significant predictors include hospitalist practice goals, primary care practice goals, importance of racial/ethnic diversity of patient population in residency selection, early plan (before medical school) to care for underserved families, mother with a graduate or medical degree, and higher score on the Universalism value scale. Service obligation and primary care/academic pediatrics practice goal were also the strongest predictors for taking a postresidency job in underserved area. Trainee characteristics such as service obligations, values of humanism, and desire to serve underserved populations offer the hope that policies and public funding can be directed to support physicians with these characteristics to redress the maldistribution of physicians caring for children. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All

  11. Designing financial-incentive programmes for return of medical service in underserved areas: seven management functions

    Directory of Open Access Journals (Sweden)

    Bärnighausen Till

    2009-06-01

    Full Text Available Abstract In many countries worldwide, health worker shortages are one of the main constraints in achieving population health goals. Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practise for a period of time in a medically underserved area, can alleviate local and regional health worker shortages through a number of mechanisms. First, they can redirect the flow of those health workers who would have been educated without financial incentives from well-served to underserved areas. Second, they can add health workers to the pool of workers who would have been educated without financial incentives and place them in underserved areas. Third, financial-incentive programmes may improve the retention in underserved areas of those health workers who participate in a programme, but who would have worked in an underserved area without any financial incentives. Fourth, the programmes may increase the retention of all health workers in underserved areas by reducing the strength of some of the reasons why health workers leave such areas, including social isolation, lack of contact with colleagues, lack of support from medical specialists and heavy workload. We draw on studies of financial-incentive programmes and other initiatives with similar objectives to discuss seven management functions that are essential for the long-term success of financial-incentive programmes: financing (programmes may benefit from innovative donor financing schemes, such as endowment funds, international financing facilities or compensation payments; promotion (programmes should use tested communication channels in order to reach secondary school graduates and health workers; selection (programmes may use selection criteria to ensure programme success and to achieve supplementary policy goals; placement (programmes should match participants to areas in order to maximize participant satisfaction and

  12. Designing financial-incentive programmes for return of medical service in underserved areas: seven management functions.

    Science.gov (United States)

    Bärnighausen, Till; Bloom, David E

    2009-06-26

    In many countries worldwide, health worker shortages are one of the main constraints in achieving population health goals. Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practise for a period of time in a medically underserved area, can alleviate local and regional health worker shortages through a number of mechanisms. First, they can redirect the flow of those health workers who would have been educated without financial incentives from well-served to underserved areas. Second, they can add health workers to the pool of workers who would have been educated without financial incentives and place them in underserved areas. Third, financial-incentive programmes may improve the retention in underserved areas of those health workers who participate in a programme, but who would have worked in an underserved area without any financial incentives. Fourth, the programmes may increase the retention of all health workers in underserved areas by reducing the strength of some of the reasons why health workers leave such areas, including social isolation, lack of contact with colleagues, lack of support from medical specialists and heavy workload. We draw on studies of financial-incentive programmes and other initiatives with similar objectives to discuss seven management functions that are essential for the long-term success of financial-incentive programmes: financing (programmes may benefit from innovative donor financing schemes, such as endowment funds, international financing facilities or compensation payments); promotion (programmes should use tested communication channels in order to reach secondary school graduates and health workers); selection (programmes may use selection criteria to ensure programme success and to achieve supplementary policy goals); placement (programmes should match participants to areas in order to maximize participant satisfaction and retention); support (programmes

  13. Continuing interprofessional education in geriatrics and gerontology in medically underserved areas.

    Science.gov (United States)

    Toner, John A; Ferguson, K Della; Sokal, Regina Davis

    2009-01-01

    There is a widening gap between the health care needs of older persons and the treatment skills of the health care professionals who serve them. This gap is especially severe in rural areas, where there is a shortage of and inadequate collaboration between health care professionals and poor access to services for older persons. There is also a special opportunity in rural areas, particularly those designated as "medically underserved," for continuing interprofessional education as a vehicle for retaining health care professionals who tend to leave medically underserved areas for more lucrative professional opportunities elsewhere. In collaboration with the Consortium of New York Geriatric Education Centers, the Columbia-New York Geriatric Education Center at the Stroud Center of Columbia University has developed the Program for Outreach to Interprofessional Services and Education (POISE). The purpose of POISE is to develop, implement, evaluate, and sustain interprofessional education and training for health care learners, while emphasizing improved access to health services for the geriatric population in medically underserved areas. The POISE model was designed as an effective approach to teaching the core geriatrics and gerontology curriculum endorsed by the national (U.S. Department of Health and Human Services) network of Geriatric Education Centers to health care learners in medically underserved areas of upstate New York. This article describes the adaptation and implementation of the POISE model.

  14. Increasing access to health workers in underserved areas: a conceptual framework for measuring results

    NARCIS (Netherlands)

    Huicho, L.; Dieleman, M.; Campbell, J.; Codjia, L.; Balabanova, D.; Dussault, G.; Dolea, C.

    2010-01-01

    Many countries have developed strategies to attract and retain qualified health workers in underserved areas, but there is only scarce and weak evidence on their successes or failures. It is difficult to compare lessons and measure results from the few evaluations that are available. Evaluation

  15. Increasing access to health workers in underserved areas : a conceptual framework for measuring results

    NARCIS (Netherlands)

    Huicho, Luis; Dieleman, Marjolein; Campbell, James; Codjia, Laurence; Balabanova, Dina; Dussault, Gilles; Dolea, Carmen

    Many countries have developed strategies to attract and retain qualified health workers in underserved areas, but there is only scarce and weak evidence on their successes or failures. It is difficult to compare lessons and measure results from the few evaluations that are available. Evaluation

  16. Teaching Health Center Graduate Medical Education Locations Predominantly Located in Federally Designated Underserved Areas.

    Science.gov (United States)

    Barclift, Songhai C; Brown, Elizabeth J; Finnegan, Sean C; Cohen, Elena R; Klink, Kathleen

    2016-05-01

    Background The Teaching Health Center Graduate Medical Education (THCGME) program is an Affordable Care Act funding initiative designed to expand primary care residency training in community-based ambulatory settings. Statute suggests, but does not require, training in underserved settings. Residents who train in underserved settings are more likely to go on to practice in similar settings, and graduates more often than not practice near where they have trained. Objective The objective of this study was to describe and quantify federally designated clinical continuity training sites of the THCGME program. Methods Geographic locations of the training sites were collected and characterized as Health Professional Shortage Area, Medically Underserved Area, Population, or rural areas, and were compared with the distribution of Centers for Medicare and Medicaid Services (CMS)-funded training positions. Results More than half of the teaching health centers (57%) are located in states that are in the 4 quintiles with the lowest CMS-funded resident-to-population ratio. Of the 109 training sites identified, more than 70% are located in federally designated high-need areas. Conclusions The THCGME program is a model that funds residency training in community-based ambulatory settings. Statute suggests, but does not explicitly require, that training take place in underserved settings. Because the majority of the 109 clinical training sites of the 60 funded programs in 2014-2015 are located in federally designated underserved locations, the THCGME program deserves further study as a model to improve primary care distribution into high-need communities.

  17. A national study on nurses' retention in healthcare facilities in underserved areas in Lebanon.

    Science.gov (United States)

    El-Jardali, Fadi; Alameddine, Mohamad; Jamal, Diana; Dimassi, Hani; Dumit, Nuhad Y; McEwen, Mary K; Jaafar, Maha; Murray, Susan F

    2013-09-30

    Nursing shortages and maldistribution are priority issues for healthcare systems around the globe. Such imbalances are often aggravated in underserved areas, especially in developing countries. Despite the centrality of this issue, there is a dearth of studies that examine the retention of nurses in underserved areas in the Middle East Region. This study investigates the characteristic and the factors associated with the retention of nurses working in rural areas in Lebanon. This study uses a non-experimental cross-sectional design to survey nurses working in underserved areas of Lebanon. Underserved areas in Lebanon were identified using WHO definition. A total of 103 health facilities (hospitals and primary healthcare centers) located in these areas were identified and all nurses working at these facilities received a copy of the survey questionnaire. The questionnaire included five sections: demographic, work-life, career plan, job satisfaction, and assessment of work environment. Analysis included univariate and bivariate (chi-square, Student's t-test and ANOVA) tests to describe the respondents and examine the significance between nurses' characteristics and their intent to stay. A logistic regression model was constructed to identify factors associated with nurses' intent to stay in underserved areas. A total of 857 nurses from 63 Primary Healthcare (PHC) centers and hospitals responded to the questionnaire (75.5% response rate). Only 35.1% of nurses indicated their intent to stay in their current job over the coming one to three years. Surveyed nurses were most satisfied with relationship with co-workers and least satisfied with extrinsic rewards. Rural nurses working in PHC centers were more satisfied than their hospital counterparts on all aspects of work and had significantly higher intention to stay (62.5% compared to 31.5% in hospitals, P job satisfaction and their intent to stay. This study reveals poor retention of nurses in rural and underserved

  18. Workplace physical violence among hospital nurses and physicians in underserved areas in Jordan.

    Science.gov (United States)

    AbuAlRub, Raeda Fawzi; Al Khawaldeh, Abdullah Talal

    2014-07-01

    To: (1) examine the incidence, frequency and contributing factors to workplace violence among nurses and physicians in underserved areas in Jordan, and (2) identify the existing policies and the management modalities to tackle workplace violence. Workplace violence is a major problem in healthcare organisations. An understanding of the nature of violence is essential to implementing successful management. A descriptive exploratory research design. The questionnaire that was developed in 2003 by the International Labor Office, the International Council of Nurses, the World Health Organization, and the Public Services International was used to collect data from a convenience sample of 521 Jordanian physicians and nurses (396 nurses, 125 physicians) who worked in hospitals located in underserved areas. Around 15% of the participants were exposed to physical violence. The factors that contributed to workplace violence were related to absence of policies, inadequate staffing and lack of communication skills. Only 16·9% of participants indicated that there were specific policies available for dealing with physical workplace violence. Strengthening security and providing training were some of the important factors indicated by participants for decreasing violence in the workplace. Workplace violence is a problem in underserved areas that needs attention from administrators. Most participants were very dissatisfied with the way the administrators dealt with the incidents. Instituting firm policies against perpetrators and developing protective violence guidelines to support healthcare staff in managing workplace violence are paramount to tackle the problem of workplace violence. © 2013 John Wiley & Sons Ltd.

  19. The challenges of working in underserved areas: a qualitative exploratory study of views of policy makers and professionals.

    Science.gov (United States)

    AbuAlRub, Raeda F; El-Jardali, Fadi; Jamal, Diana; Iblasi, Abdulkareem S; Murray, Susan F

    2013-01-01

    The inadequate number of health care providers, particularly nurses, in underserved areas is one of the biggest challenges for health policymakers. There is a scarcity of research in Jordan about factors that affect nurse staffing and retention in underserved areas. To elucidate the views of staff nurses working in underserved areas, directors of health facilities in underserved areas and key informants from the policy and education arena on issues of staffing and retention of nurses in underserved areas. An exploratory study using a qualitative approach with semi-structured interviews was utilized to elucidate the views of 22 key informants from the policy and education arena, 11 directors of health centers, and 19 staff nurses on issues that contribute to low staffing and retention of nurses in underserved areas. The five stage 'framework approach' proposed by Bryman et al. (1993) was utilized for data analysis. Nursing shortage in underserved areas in Jordan are exacerbated by a lack of financial incentives, poor transportation and remoteness of these areas, bad working conditions, and lack of health education institutions in these areas, as well as by opportunities for internal and external migration. Young Jordanian male nurses usually grab any opportunity to migrate and work outside the country to improve their financial conditions; whereas, female nurses are more restricted and not encouraged to travel abroad to work. Several strategies are suggested to enhance retention in these areas, such as promoting financial incentives for staff to work there, enhancing the transportation system, and promoting continuous and academic education. Nurses' administrators and health care policy makers could utilize the findings of the present study to design and implement comprehensive interventions to enhance retention of staff in underserved areas. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Clinical medical education in rural and underserved areas and eventual practice outcomes: A systematic review and meta-analysis.

    Science.gov (United States)

    Raymond Guilbault, Ryan William; Vinson, Joseph Alexander

    2017-01-01

    Undergraduate medical students are enrolled in clinical education programs in rural and underserved urban areas to increase the likelihood that they will eventually practice in those areas and train in a primary care specialty to best serve those patient populations. MEDLINE and Cochrane Library online databases were searched to identify articles that provide a detailed description of the exposure and outcome of interest. A qualitative review of articles reporting outcome data without comparison or control groups was completed using the Medical Education Research Study Quality Instrument (MERSQI). A meta-analysis of articles reporting outcome data with comparison or control groups was completed with statistical and graphical summary estimates. Seven hundred and nine articles were retrieved from the initial search and reviewed based on inclusion and exclusion criteria. Of those, ten articles were identified for qualitative analysis and five articles included control groups and thus were included in the quantitative analysis. Results indicated that medical students with clinical training in underserved areas are almost three times as likely to practice in underserved areas than students who do not train in those areas (relative risk [RR] = 2.94; 95% confidence interval [CI]: 2.17, 4.00). Furthermore, medical students training in underserved areas are about four times as likely to practice primary care in underserved areas than students who do not train in those locations (RR = 4.35; 95% CI: 1.56, 12.10). These estimates may help guide medical school administrators and policymakers to expand underserved clinical training programs to help relieve some of the problems associated with access to medical care among underserved populations.

  1. Innovative Educational Initiatives to Train Psychodynamic Psychiatrists in Underserved Areas of the World.

    Science.gov (United States)

    Alfonso, César A; Michael, Marco Christian; Elvira, Sylvia Detri; Zakaria, Hazli; Kalayasiri, Rasmon; Adlan, Aida Syarinaz A; Moinalghorabaei, Mahdieh; Lukman, Petrin Redayani; San'ati, Mohammad; Duchonova, Katerina; Sullivan, Timothy B

    2018-06-01

    Psychodynamic psychiatry remains a challenging subject to teach in underserved areas, where enthusiasm to learn is substantial. Besides logistical and psychiatric workforce shortcomings, sensible cultural adaptations to make psychodynamic psychiatry relevant outside of high-income countries require creative effort. Innovative pedagogical methods that include carefully crafted mentoring and incorporate videoconferencing in combination with site visits can be implemented through international collaborations. Emphasis on mentoring is essential to adequately train future psychodynamic psychotherapy supervisors. Examples of World Psychiatric Association initiatives in countries such as Indonesia, Iran, Malaysia, and Thailand are presented as possible models to emulate elsewhere. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. T@lemed: Ehealth applications applied to underserved areas in Latin America

    Science.gov (United States)

    Sachpazidis, Ilias; Ohl, Roland; Binotto, Alécio Pedro Delazari; Torres, Márcio Soares; Messina, Luiz Ary; Sales, Alexandre; Gomes, Ricardo; Sakas, Georgios

    2006-12-01

    Access to medical care is sometimes very difficult to be reached from people living in rural and underserved areas. This problem is very well known in rural areas in Brazil. Citizens have no access to health care. They have to travel hundreds of kilometres to receive medical care. In this paper, we will propose a medical network based on state-of-the-art medical imaging application that addresses the problems of providing health care from a distance. Additionally, we are going to show preliminarily results of the first year of the system deployment and utilization in undeserved regions in Brazil. The total number of patients submitted to ultrasound examinations, during the 10 months of projects' medical trials, is 321. The exams have begun with the elderly people (hypertension and diabetes cases) with 90% above 50-years-old. Fifty-four percent were male and 46% were female. From those exams, 67 exams (21%) needed a second medical opinion and were transmitted to Santa Casa hospital in Porto Alegre, Brazil, one of the referral medical centres. From those second opinions of Santa Casa, 12 exams had to be repeated since the acquired images were not sufficient to give a correct diagnosis. The Lagoa Tres Cantos medical doctor performed also preventive exams with patients who had not presented any symptoms (70%).

  3. An early stage evaluation of the Supporting Program for Obstetric Care Underserved Areas in Korea.

    Science.gov (United States)

    Na, Baeg Ju; Kim, Hyun Joo; Lee, Jin Yong

    2014-06-01

    "The Supporting Program for Obstetric Care Underserved Areas (SPOU)" provides financial aids to rural community (or district) hospitals to reopen prenatal care and delivery services for regions without obstetrics and gynecology clinics or hospitals. The purpose of this study was to evaluate the early stage effect of the SPOU program. The proportion of the number of birth through SPOU was calculated by each region. Also survey was conducted to investigate the extent of overall satisfaction, elements of dissatisfaction, and suggestions for improvement of the program; 209 subjects participated from 7 to 12 December, 2012. Overall, 20% of pregnant women in Youngdong (71 cases) and Gangjin (106 cases) used their community (or district) hospitals through the SPOU whereas Yecheon (23 cases) was 8%; their satisfaction rates were high. Short distance and easy accessibility was the main reason among women choosing community (or district) hospital whereas the reasons of not selecting the community (or district) hospital were favor of the outside hospital's facility, system, and trust in the medical staffs. The SPOU seems to be currently effective at an early stage. However, to successfully implement this program, the government should make continuous efforts to recruit highly qualified medical staffs and improve medical facility and equipment.

  4. Understanding the performance of community health volunteers involved in the delivery of health programmes in underserved areas: a realist synthesis

    OpenAIRE

    Vareilles, Ga?lle; Pommier, Jeanine; Marchal, Bruno; Kane, Sumit

    2017-01-01

    Background The recruitment of community health volunteers (CHVs) to support the delivery of health programmes is an established approach in underserved areas and in particular where there are health inequalities due to the scarcity of trained human resources. However, there is a dearth of evidence about what works to improve CHVs? performance. This review aimed to synthesise existing literature to explain why, how and under which circumstances intervention approaches to improve the performanc...

  5. BENTON RANGE ROADLESS AREA, CALIFORNIA.

    Science.gov (United States)

    McKee, Edwin H.; Rains, Richard L.

    1984-01-01

    On the basis of a mineral survey, two parts of the Benton Range Roadless Area, California are considered to have mineral-resource potential. The central and southern part of the roadless area, near several nonoperating mines, has a probable potential for tungsten and gold-silver mineralization in tactite zones. The central part of the area has a substantiated resource potential for gold and silver in quartz veins. Detailed mapping and geochemical sampling for tungsten, gold, and silver in the central and southern part of the roadless area might indicate targets for shallow drilling exploration.

  6. Educational and individual factors associated with positive change in and reaffirmation of medical students' intention to practice in underserved areas.

    Science.gov (United States)

    Boscardin, Christy K; Grbic, Douglas; Grumbach, Kevin; O'Sullivan, Patricia

    2014-11-01

    The projected U.S. physician shortage will disproportionately affect underserved areas. This study examined the impact of medical school educational experiences on positive changes in and reaffirmation of students' intention to practice in underserved areas (practice intention). Medical students (n = 7,361) from 113 U.S. MD-granting medical schools who graduated in 2009-2010 and responded to both the Association of American Medical Colleges' 2006 Matriculating Student Questionnaire and 2010 Graduation Questionnaire were included. Multilevel logistic regression analyses were conducted to determine factors associated with change in and reaffirmation of practice intention. After controlling for individual characteristics, community health field experience (adjusted odds ratio [OR]: 1.36; 95% CI: 1.18, 1.57), learning another language (OR: 1.41; 95% CI: 1.22, 1.63), cultural competence/awareness experience (OR: 1.38; 95% CI: 1.21, 1.58), becoming more aware of perspectives of individuals from different backgrounds (OR: 1.24; 95% CI: 1.04, 1.48), and attending schools with higher social mission scores (OR: 1.66; 95% CI: 1.28, 2.16) were all significantly associated with positive changes in practice intention from matriculation to graduation. Field experience in community health (OR: 1.24; 95% CI: 0.99, 1.53), learning another language (OR: 1.29; 95% CI: 1.01, 1.65), and attending schools with higher social mission scores (OR: 1.62; 95% CI: 1.09, 2.43) were all significantly associated with reaffirmation of practice intention at graduation. Multifaceted factors are associated with practice intention. This study suggests medical schools can play active roles in alleviating the physician shortage in underserved areas through targeted curricular interventions and recruitment.

  7. The prevalence of visual impairment and blindness in underserved rural areas: a crucial issue for future.

    Science.gov (United States)

    Hashemi, H; Yekta, A; Jafarzadehpur, E; Doostdar, A; Ostadimoghaddam, H; Khabazkhoob, M

    2017-08-01

    PurposeTo determine the prevalence of visual impairment and blindness in underserved Iranian villages and to identify the most common cause of visual impairment and blindness.Patients and methodsMultistage cluster sampling was used to select the participants who were then invited to undergo complete examinations. Optometric examinations including visual acuity, and refraction were performed for all individuals. Ophthalmic examinations included slit-lamp biomicroscopy and ophthalmoscopy. Visual impairment was determined according to the definitions of the WHO and presenting vision.ResultsOf 3851 selected individuals, 3314 (86.5%) participated in the study. After using the exclusion criteria, the present report was prepared based on the data of 3095 participants. The mean age of the participants was 37.6±20.7 years (3-93 years). The prevalence of visual impairment and blindness was 6.43% (95% confidence interval (CI): 3.71-9.14) and 1.18% (95% CI: 0.56-1.79), respectively. The prevalence of visual impairment varied from 0.75% in participants aged less than 5 years to 38.36% in individuals above the age of 70 years. Uncorrected refractive errors and cataract were the first and second leading causes of visual impairment; moreover, cataract and refractive errors were responsible for 35.90 and 20.51% of the cases of blindness, respectively.ConclusionThe prevalence of visual impairment was markedly high in this study. Lack of access to health services was the main reason for the high prevalence of visual impairment in this study. Cataract and refractive errors are responsible for 80% of visual impairments which can be due to poverty in underserved villages.

  8. Medical School Outcomes, Primary Care Specialty Choice, and Practice in Medically Underserved Areas by Physician Alumni of MEDPREP, a Postbaccalaureate Premedical Program for Underrepresented and Disadvantaged Students.

    Science.gov (United States)

    Metz, Anneke M

    2017-01-01

    Minorities continue to be underrepresented as physicians in medicine, and the United States currently has a number of medically underserved communities. MEDPREP, a postbaccalaureate medical school preparatory program for socioeconomically disadvantaged or underrepresented in medicine students, has a stated mission to increase the numbers of physicians from minority or disadvantaged backgrounds and physicians working with underserved populations. This study aims to determine how MEDPREP enhances U.S. physician diversity and practice within underserved communities. MEDPREP recruits disadvantaged and underrepresented in medicine students to complete a 2-year academic enhancement program that includes science coursework, standardized test preparation, study/time management training, and emphasis on professional development. Five hundred twenty-five disadvantaged or underrepresented students over 15 years completed MEDPREP and were tracked through entry into medical practice. MEDPREP accepts up to 36 students per year, with two thirds coming from the Midwest region and another 20% from nearby states in the South. Students complete science, test preparation, academic enhancement, and professionalism coursework taught predominantly by MEDPREP faculty on the Southern Illinois University Carbondale campus. Students apply broadly to medical schools in the region and nation but are also offered direct entry into our School of Medicine upon meeting articulation program requirements. Seventy-nine percent of students completing MEDPREP became practicing physicians. Fifty-eight percent attended public medical schools, and 62% attended medical schools in the Midwest. Fifty-three percent of program alumni chose primary care specialties compared to 34% of U.S. physicians, and MEDPREP alumni were 2.7 times more likely to work in medically underserved areas than physicians nationally. MEDPREP increases the number of disadvantaged and underrepresented students entering and graduating

  9. 75 FR 26167 - Designation of Medically Underserved Populations and Health Professions Shortage Areas; Intent To...

    Science.gov (United States)

    2010-05-11

    ...) representing a range of States in terms of size, rural/urban, and different regions of the country, including... unusually high needs, as indicated by high poverty, infant mortality or fertility rates, overutilization, or... being: percent of the population with incomes below the poverty level; primary care physician-to...

  10. 7 CFR Exhibit C to Subpart L of... - Housing in Underserved Areas

    Science.gov (United States)

    2010-01-01

    ... metropolitan statistical area that has a population exceeding 1 million; 3. Is designated by the State or... percent or more of their population at, or below, poverty level and 13 percent or more of their occupied... concentrations of poverty and substandard housing and have severe, unmet rural housing needs. B. To provide for...

  11. Factors affecting willingness to practice medicine in underserved areas: a survey of Argentine medical students.

    Science.gov (United States)

    Borracci, Raul A; Arribalzaga, Eduardo B; Couto, Juan L; Dvorkin, Mario; Ahuad Guerrero, Rodolfo A; Fernandez, Carmen; Ferreira, Luis N; Cerezo, Leticia

    2015-01-01

    Previous research has explored the effect of motivations, incentives and working conditions on willingness to accept jobs in rural and remote areas. These studies demonstrated that difficult working conditions, low job satisfaction and remuneration, and poor security, predisposed new medical graduates to select cities instead of rural districts. Since Argentina has a critical shortage of health staff in rural and low-income marginal suburban settings, and limited qualitative and quantitative local research has been done to address this issue, the present study was developed to assess the factors associated with the willingness of medical students to work in low-resource underprivileged areas of the country after graduation. A cross-sectional descriptive design was used with data collected from a self-administered questionnaire and using quantitative analysis methods. A total of 400 eligible second-year medical students were invited to participate in a survey focused on sociodemographic characteristics, incentives and working conditions expected in deprived areas, extrinsic and intrinsic motivations, university medical education and government promotion policies. Twenty-one per cent of medical students showed a strong willingness to work in a deprived area, 57.3% manifested weak willingness and 21.5% unwillingness to work in a low-resource setting. Being female, of older age, not having a university-trained professional parent, previous exposure or service in a poor area, choice of pediatrics as a specialty and strong altruistic motivations were highly associated with the willingness to practice medicine in rural or underprivileged areas. Only 21.5% of respondents considered that medical schools encourage the practice of medicine in poor deprived regions. Likewise, only 6.2% of students considered that national public health authorities suitably stimulate physician distribution in poorer districts. One-third of students expressed high altruistic motivations and

  12. Enhancing Maternal and Perinatal Health in Under-Served Remote Areas in Sub-Saharan Africa: A Tanzanian Model.

    Directory of Open Access Journals (Sweden)

    Angelo S Nyamtema

    Full Text Available In Tanzania, maternal mortality ratio (MMR, unmet need for emergency obstetric care and health inequities across the country are in a critical state, particularly in rural areas. This study was established to determine the feasibility and impact of decentralizing comprehensive emergency obstetric and neonatal care (CEmONC services in underserved rural areas using associate clinicians.Ten health centres (HCs were upgraded by constructing and equipping maternity blocks, operating rooms, laboratories, staff houses and installing solar panels, standby generators and water supply systems. Twenty-three assistant medical officers (advanced level associate clinicians, and forty-four nurse-midwives and clinical officers (associate clinicians were trained in CEmONC and anaesthesia respectively. CEmONC services were launched between 2009 and 2012. Monthly supportive supervision and clinical audits of adverse pregnancy outcomes were introduced in 2011 in these HCs and their respective district hospitals.After launching CEmONC services from 2009 to 2014 institutional deliveries increased in all upgraded rural HCs. Mean numbers of monthly deliveries increased by 151% and obstetric referrals decreased from 9% to 3% (p = 0.03 in HCs. A total of 43,846 deliveries and 2,890 caesarean sections (CS were performed in these HCs making the mean proportion of all births in EmONC facilities of 128% and mean population-based CS rate of 9%. There were 190 maternal deaths and 1,198 intrapartum and very early neonatal deaths (IVEND in all health facilities. Generally, health centres had statistically significantly lower maternal mortality ratios and IVEND rates than district hospitals (p < 0.00 and < 0.02 respectively. Of all deaths (maternal and IVEND 84% to 96% were considered avoidable.These findings strongly indicate that remotely located health centres in resource limited settings hold a great potential to increase accessibility to CEmONC services and to improve

  13. Enhancing Maternal and Perinatal Health in Under-Served Remote Areas in Sub-Saharan Africa: A Tanzanian Model.

    Science.gov (United States)

    Nyamtema, Angelo S; Mwakatundu, Nguke; Dominico, Sunday; Mohamed, Hamed; Pemba, Senga; Rumanyika, Richard; Kairuki, Clementina; Kassiga, Irene; Shayo, Allan; Issa, Omary; Nzabuhakwa, Calist; Lyimo, Chagi; van Roosmalen, Jos

    2016-01-01

    In Tanzania, maternal mortality ratio (MMR), unmet need for emergency obstetric care and health inequities across the country are in a critical state, particularly in rural areas. This study was established to determine the feasibility and impact of decentralizing comprehensive emergency obstetric and neonatal care (CEmONC) services in underserved rural areas using associate clinicians. Ten health centres (HCs) were upgraded by constructing and equipping maternity blocks, operating rooms, laboratories, staff houses and installing solar panels, standby generators and water supply systems. Twenty-three assistant medical officers (advanced level associate clinicians), and forty-four nurse-midwives and clinical officers (associate clinicians) were trained in CEmONC and anaesthesia respectively. CEmONC services were launched between 2009 and 2012. Monthly supportive supervision and clinical audits of adverse pregnancy outcomes were introduced in 2011 in these HCs and their respective district hospitals. After launching CEmONC services from 2009 to 2014 institutional deliveries increased in all upgraded rural HCs. Mean numbers of monthly deliveries increased by 151% and obstetric referrals decreased from 9% to 3% (p = 0.03) in HCs. A total of 43,846 deliveries and 2,890 caesarean sections (CS) were performed in these HCs making the mean proportion of all births in EmONC facilities of 128% and mean population-based CS rate of 9%. There were 190 maternal deaths and 1,198 intrapartum and very early neonatal deaths (IVEND) in all health facilities. Generally, health centres had statistically significantly lower maternal mortality ratios and IVEND rates than district hospitals (p < 0.00 and < 0.02 respectively). Of all deaths (maternal and IVEND) 84% to 96% were considered avoidable. These findings strongly indicate that remotely located health centres in resource limited settings hold a great potential to increase accessibility to CEmONC services and to improve maternal and

  14. Spatial Accessibility to Health Care Services: Identifying under-Serviced Neighbourhoods in Canadian Urban Areas.

    Directory of Open Access Journals (Sweden)

    Tayyab Ikram Shah

    Full Text Available Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods.This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population, was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons. An integrated geocoding approach was used to establish PHC locations.The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs.The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood

  15. A National Longitudinal Survey of Medical Students' Intentions to Practice Among the Underserved.

    Science.gov (United States)

    O'Connell, Thomas F; Ham, Sandra A; Hart, Theodore G; Curlin, Farr A; Yoon, John D

    2018-01-01

    To explore students' intentions to practice in medically underserved areas. In January 2011, 960 third-year medical students from 24 MD-granting U.S. medical schools were invited to participate in a survey on their intention to practice in a medically underserved area. A follow-up survey was sent to participants in September 2011. Covariates included student demographics, medical school characteristics, environmental exposures, work experiences, sense of calling, and religious characteristics. Adjusted response rates were 564/919 (61.4%, first survey) and 474/564 (84.0%, follow-up survey). Among fourth-year medical students, an estimated 34.3% had an intention to practice among the underserved. In multivariate logistic regression modeling, predictors for intentions to practice among the underserved included growing up in an underserved setting (odds ratio [OR] range: 2.96-4.81), very strong sense of calling (OR range: 1.86-3.89), and high medical school social mission score (in fourth year: OR = 2.34 [95% confidence interval (CI), 1.31-4.21]). International experience was associated with favorable change of mind in the fourth year (OR = 2.86 [95% CI, 1.13-7.24]). High intrinsic religiosity was associated with intentions to practice primary care in underserved settings (in fourth year: OR = 2.29 [95% CI = 1.13-4.64]). Growing up in medically underserved settings, work experience in religiously affiliated organizations, very strong sense of calling, and high medical school social mission score were associated with intentions to practice in underserved areas. Lack of formative educational experiences may dissuade students from considering underserved practice.

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

    Science.gov (United States)

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

    2018-03-01

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

  17. 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.

  18. Assessing predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan: results of a cross-sectional baseline survey.

    Science.gov (United States)

    Azmat, Syed Khurram; Ali, Moazzam; Ishaque, Muhammad; Mustafa, Ghulam; Hameed, Waqas; Khan, Omar Farooq; Abbas, Ghazunfer; Temmerman, Marleen; Munroe, Erik

    2015-03-28

    Although Pakistan was one of the first countries in Asia to launch national family planning programs, current modern contraceptive use stands at only 26% with a method mix skewed toward short-acting and permanent methods. As part of a multiyear operational research study, a baseline survey was conducted to understand the predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan. This paper presents the baseline survey results; the outcomes of the intervention will be presented in a separate paper after the study has been completed. A cross-sectional baseline household survey was conducted with randomly selected 3,998 married women of reproductive age (MWRA) in the Chakwal, Mianwali, and Bhakkar districts of Punjab. The data were analyzed on SPSS 17.0 using simple descriptive and logistic regression. Most of the women had low socio-economic status and were younger than 30 years of age. Four-fifths of the women consulted private sector health facilities for reproductive health services; proximity, availability of services, and good reputation of the provider were the main predicators for choosing the facilities. Husbands were reported as the key decision maker regarding health-seeking and family planning uptake. Overall, the current contraceptive use ranged from 17% to 21% across the districts: condoms and female sterilization were widely used methods. Woman's age, husband's education, wealth quintiles, spousal communication, location of last delivery, and favorable attitude toward contraception have an association with current contraceptive use. Unmet need for contraception was 40.6%, 36.6%, and 31.9% in Chakwal, Mianwali, and Bhakkar, respectively. Notably, more than one fifth of the women across the districts expressed willingness to use quality, affordable long-term family planning services in the future. The baseline results highlight the need for quality, affordable long-term family planning

  19. "We can see a future here": Place attachment, professional identity, and forms of capital mobilized to deliver medical education in an underserviced area.

    Science.gov (United States)

    Hanlon, Neil; Halseth, Greg; Snadden, David

    2010-09-01

    Community-integrated undergraduate medical education is becoming a more common option for students predisposed to practice in rural and small town places. One such initiative, the Northern Medical Program, has been operating since 2004 in the northern interior of British Columbia, Canada. The NMP's curriculum relies heavily on the involvement of practicing physicians in its host community, Prince George. Drawing on Bourdieu's conceptualization of capital in its different forms, the commitment of the local physician community is understood as social capital derived from cultural capital centred on a collective sense of professional identity forged by conditions of practice in an underserviced area. The findings of this study are discussed with respect to the long-term operation and success of community-integrated medical education programs. Copyright 2010 Elsevier Ltd. All rights reserved.

  20. Precommitting to Serve the Underserved

    Science.gov (United States)

    Eyal, Nir; Bärnighausen, Till

    2014-01-01

    In many countries worldwide, especially in Sub-Saharan Africa, a shortage of physicians limits the provision of lifesaving interventions. One existing strategy to increase the number of physicians in areas of critical shortage is conditioning medical school scholarships on a precommitment to work in medically underserved areas later. Current practice is usually to demand only one year of service for each year of funded studies. We show the effectiveness of scholarships conditional on such precommitment for increasing physician supplies in underserved areas. Then we defend these scholarships against ethical worries that they constitute slavery contracts; rely on involuntary, biased, or unauthorized early consent by a young signatory; put excessive strains on signed commitments; give rise to domination; and raise suspicion of slavery contracts. Importantly, we find that scholarships involving far longer commitment than current practice allows would also withstand these worries. Policymakers should consider introducing conditional scholarships, including long-term versions, as a means to increasing the supply of physicians to medically underserved areas. PMID:22548519

  1. Precommitting to serve the underserved.

    Science.gov (United States)

    Eyal, Nir; Bärnighausen, Till

    2012-01-01

    In many countries worldwide, especially in sub-Saharan Africa, a shortage of physicians limits the provision of lifesaving interventions. One existing strategy to increase the number of physicians in areas of critical shortage is conditioning medical school scholarships on a precommitment to work in medically underserved areas later. Current practice is usually to demand only one year of service for each year of funded studies. We show the effectiveness of scholarships conditional on such precommitment for increasing physician supplies in underserved areas. Then we defend these scholarships against ethical worries that they constitute slavery contracts; rely on involuntary, biased, or unauthorized early consent by a young signatory; put excessive strains on signed commitments; give rise to domination; and raise suspicion of slavery contracts. Importantly, we find that scholarships involving far longer commitment than current practice allows would also withstand these worries. Policymakers should consider introducing conditional scholarships, including long-term versions, as a means to increasing the supply of physicians to medically underserved areas.

  2. Retaining health workforce in rural and underserved areas of India: What works and what doesn't? A critical interpretative synthesis.

    Science.gov (United States)

    Goel, Sonu; Angeli, Federica; Bhatnagar, Nidhi; Singla, Neetu; Grover, Manoj; Maarse, Hans

    2016-01-01

    Human resource for health is critical in quality healthcare delivery. India, with a large rural population (68.8%), needs to urgently bridge the gaps in health workforce deployment between urban and rural areas. We did a critical interpretative synthesis of the existing literature by using a predefined selection criteria to assess relevant manuscripts to identify the reasons for retaining the health workforce in rural and underserved areas. We discuss different strategies for retention of health workforce in rural areas on the basis of four major retention interventions, viz. education, regulation, financial incentives, and personal and professional support recommended by WHO in 2010. This review focuses on the English-language material published during 2005-14 on human resources in health across low- and middle-income countries. Healthcare in India is delivered through a diverse set of providers. Inequity exists in health manpower distribution across states, area (urban-rural), gender and category of health personnel. India is deficient in health system development and financing where health workforce education and training occupy a low priority. Poor governance, insufficient salary and allowances, along with inability of employers to provide safe, satisfying and rewarding work conditions-are causing health worker attrition in rural India. The review suggests that the retention of health workers in rural areas can be ensured by multiplicity of interventions such as medical schools in rural areas, rural orientation of medical education, introducing compulsory rural service in lieu of incentives providing better pay packages and special allowances, and providing better living and working conditions in rural areas. A complex interplay of factors that impact on attraction and retention of health workforce necessitates bundling of interventions. In low-income countries, evidence- based strategies are needed to ensure context-specific, field- tested and cost

  3. Impact of a Plant-Based Diet and Support on Mitigating Type 2 Diabetes Mellitus in Latinos Living in Medically Underserved Areas.

    Science.gov (United States)

    Ramal, Edelweiss; Champlin, Andrea; Bahjri, Khaled

    2018-03-01

    To determine the impact that a high-fiber, low-fat diet, derived from mostly plant-based sources, when coupled with support has upon self-management of type 2 diabetes mellitus in Latinos from medically underserved areas (MUAs). Experimental randomized controlled community pilot study. Three community clinics in MUAs located within San Bernardino County, California. Thirty-two randomly assigned Latinos with A1 C greater than 6.4: 15 control and 17 experimental. Participants completed a 5-week education program. Researchers provided follow-up support for 17 randomly assigned experimental group participants through focus groups held at participating clinics-1, 3, and 6 months posteducation. Changes in fat and fiber consumption were measured using a modified Dietary Screener for Mexican Americans. Self-management was measured through the Self-Efficacy for Exercise Scale and Diabetes Quality of Life Measure. Baseline characteristics for both groups were analyzed using independent t tests and χ 2 tests. A 2-way repeated-measures analysis of variance was used to analyze biometric data between baseline and 6 months for both groups. Mean A1 C levels decreased from baseline to 6 months for both groups: control, μ 1 = 9.57, μ 2 = 9.49; experimental, μ 1 = 8.53, μ 2 = 7.31. The experimental group demonstrated a statistically significant reduction in mean A1 C levels ( P = .002) when compared to the control group.

  4. Providing Specialty Care for the Poor and Underserved at Student-Run Free Clinics in the San Francisco Bay Area.

    Science.gov (United States)

    Liu, Max Bolun; Xiong, Grace; Boggiano, Victoria Lynn; Ye, Patrick Peiyong; Lin, Steven

    2017-01-01

    This report describes the model of specialty clinics implemented at Stanford University's two student-run free clinics, Arbor Free Clinic and Pacific Free Clinic, in the San Francisco Bay Area. We describe our patient demographic characteristics and the specialty services provided. We discuss challenges in implementing specialty care at student-run free clinics.

  5. Potential use of mobile phones in improving animal health service delivery in underserved rural areas: experience from Kilosa and Gairo districts in Tanzania.

    Science.gov (United States)

    Karimuribo, Esron D; Batamuzi, Emmanuel K; Massawe, Lucas B; Silayo, Richard S; Mgongo, Frederick O K; Kimbita, Elikira; Wambura, Raphael M

    2016-10-07

    Sub-optimal performance of the animal health delivery system in rural areas is common in developing countries including Tanzania. However, penetration of mobile phones and availability of good road network and public transport systems offer opportunities for improving the access of rural communities to diagnostic and advisory services from facilities and expertise located in urban areas. A questionnaire survey on possession and use of mobile phones by pastoral and agro-pastoral communities in Kilosa and Gairo districts was carried out between November and December 2015. A total number of 138 livestock keepers from three villages of Chakwale (54), Mvumi (41) and Parakuyo (43) participated in the study. An e-based system was designed and tested to link rural communities with urban diagnostic facilities. It was observed that the average number of phones possessed by individuals interviewed and household families was 1.1 ± 0.26 (1-2) and 3.5 ± 2.23 (1-10), respectively. It was further observed that out of 138 livestock keepers interviewed, 133 (96.4 %) had feature phones while 10 (7.2 %) of them possessed smartphones. Mobile phone is currently used to support livestock production by communicating on animal health in Parakuyo (18, 41.9 %), Mvumi (18, 43.9 %) and Chakwale (14, 25.9 %). Other contributions of mobile phones in livestock and crop agriculture observed in the study area include: exchange of livestock price information, crop price information, communicating on plant health/diseases, livestock extension and advisory services as well as crop farming extension and advisory services. We also designed and tested an e-based SUAVetDiag® system to support timely diagnosis of infectious disease conditions and prompt advice on case management in veterinary underserved areas. Availability of mobile phones in rural areas, in combination with supporting infrastructure and facilities in urban areas, has potential to stimulate local development and improving

  6. Integrated model of primary and secondary eye care for underserved rural areas: The L V Prasad Eye Institute experience

    Directory of Open Access Journals (Sweden)

    Gullapalli N Rao

    2012-01-01

    Full Text Available Blindness is a major global public health problem and recent estimates from World Health Organization (WHO showed that in India there were 62 million visually impaired, of whom 8 million are blind. The Andhra Pradesh Eye Disease Study (APEDS provided a comprehensive estimate for prevalence and causes of blindness for the state of Andhra Pradesh (AP. It also highlighted that uptake of services was also an issue, predominantly among lower socio-economic groups, women, and rural populations. On the basis of this analysis, L V Prasad Eye Institute (LVPEI developed a pyramidal model of eye care delivery. This article describes the LVPEI eye care delivery model. The article discusses infrastructure development, human resource development, and service delivery (including prevention and promotion in the context of primary and secondary care service delivery in rural areas. The article also alludes to opportunities for research at these levels of service delivery and the amenability of the evidence generated at these levels of the LVPEI eye health pyramid for advocacy and policy planning. In addition, management issues related to the sustainability of service delivery in rural areas are discussed. The article highlights the key factors required for the success of the LVPEI rural service delivery model and discusses challenges that need to be overcome to replicate the model. The article concludes by noting the potential to convert these challenges into opportunities by integrating certain aspects of the existing healthcare system into the model. Examples include screening of diabetes and diabetic retinopathy in order to promote higher community participation. The results of such integration can serve as evidence for advocacy and policy.

  7. Williamsport Area Community College Long Range Planning: The Long Range Plan, Update 1987.

    Science.gov (United States)

    Williamsport Area Community Coll., PA.

    This update to Williamsport Area Community College's (WACC's) 1984-89 long-range plan offers a status report on each of the plan's 78 objectives, reassigns responsibility for specific objectives to make the plan responsive to the current organizational structure of the college, and offers 11 new objectives for the 1986-87 academic year. After…

  8. Autonomous long-range open area fire detection and reporting

    Science.gov (United States)

    Engelhaupt, Darell E.; Reardon, Patrick J.; Blackwell, Lisa; Warden, Lance; Ramsey, Brian D.

    2005-03-01

    Approximately 5 billion dollars in US revenue was lost in 2003 due to open area fires. In addition many lives are lost annually. Early detection of open area fires is typically performed by manned observatories, random reporting and aerial surveillance. Optical IR flame detectors have been developed previously. They typically have experienced high false alarms and low flame detection sensitivity due to interference from solar and other causes. Recently a combination of IR detectors has been used in a two or three color mode to reduce false alarms from solar, or background sources. A combination of ultra-violet C (UVC) and near infra-red (NIR) detectors has also been developed recently for flame discrimination. Relatively solar-blind basic detectors are now available but typically detect at only a few tens of meters at ~ 1 square meter fuel flame. We quantify the range and solar issues for IR and visible detectors and qualitatively define UV sensor requirements in terms of the mode of operation, collection area issues and flame signal output by combustion photochemistry. We describe innovative flame signal collection optics for multiple wavelengths using UV and IR as low false alarm detection of open area fires at long range (8-10 km/m2) in daylight (or darkness). A circular array detector and UV-IR reflective and refractive devices including cylindrical or toroidal lens elements for the IR are described. The dispersion in a refractive cylindrical IR lens characterizes the fire and allows a stationary line or circle generator to locate the direction and different flame IR "colors" from a wide FOV. The line generator will produce spots along the line corresponding to the fire which can be discriminated with a linear detector. We demonstrate prototype autonomous sensors with RF digital reporting from various sites.

  9. Test Area C-64 Range Environmental Assessment, Revision 1

    Science.gov (United States)

    2010-10-01

    interstitial area to the southwest of TA C-64. However, that area is part of Management Unit 9B which is only accessible during weekends and holidays ...Columbia, Puerto Rico, and the Virgin Islands. Emission estimates for individual points or major sources (facilities), as well as county level estimates

  10. Perceptions of cardiovascular health in underserved communities.

    Science.gov (United States)

    Bryant, Lucinda L; Chin, Nancy P; Cottrell, Lesley A; Duckles, Joyce M; Fernandez, I Diana; Garces, D Marcela; Keyserling, Thomas C; McMilin, Colleen R; Peters, Karen E; Samuel-Hodge, Carmen D; Tu, Shin-Ping; Vu, Maihan B; Fitzpatrick, Annette L

    2010-03-01

    Cardiovascular disease is the leading cause of deaths and illnesses in US adults, and the prevalence is disproportionately high in underserved populations. In this study, we assessed respondents' understanding of context-specific differences in knowledge and perceptions of disease, risk, and prevention in 6 underserved communities, with the longer-term goal of developing appropriate interventions. Thirty-nine small-group sessions and 14 interviews yielded data from 318 adults. Each site's researchers coded, analyzed, and extracted key themes from local data. Investigators from all sites synthesized results and identified common themes and differences. Themes clustered in 3 areas (barriers to cardiovascular health, constraints related to multiple roles, and suggestions for effective communications and programs). Barriers spanned individual, social and cultural, and environmental levels; women in particular cited multiple roles (eg, competing demands, lack of self-care). Programmatic suggestions included the following: personal, interactive, social context; information in language that people use; activities built around cultural values and interests; and community orientation. In addition, respondents preferred health-related information from trusted groups (eg, AARP), health care providers (but with noticeable differences of opinion), family and friends, and printed materials. Interventions to decrease barriers to cardiovascular health are needed; these strategies should include family and community context, small groups, interactive methods, culturally sensitive materials, and trusted information sources. New-immigrant communities need culturally and linguistically tailored education before receiving more substantive interventions.

  11. A simple and low-cost Internet-based teleconsultation system that could effectively solve the health care access problems in underserved areas of developing countries.

    Science.gov (United States)

    Kuntalp, Mehmet; Akar, Orkun

    2004-08-01

    In many developing countries including Turkey, telemedicine systems are not in wide use due to the high cost and complexity of the required technology. Lack of these systems however has serious implications on patients who live in rural areas. The objective of this paper is to present a simple and economically affordable alternative to the current systems that would allow experts to easily access the medical data of their remote patients over the Internet. The system is developed in client-server architecture with a user-friendly graphical interface and various services are implemented as dynamic web pages based on PHP. The other key features of the system are its powerful security features and platform independency. An academic prototype is implemented and presented to the evaluation of a group of physicians. The results reveal that the system could find acceptance from the medical community and it could be an effective means of providing quality health care in developing countries.

  12. The KIDROP model of combining strategies for providing retinopathy of prematurity screening in underserved areas in India using wide-field imaging, tele-medicine, non-physician graders and smart phone reporting

    Directory of Open Access Journals (Sweden)

    Anand Vinekar

    2014-01-01

    Full Text Available Aim: To report the Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity (KIDROP program for retinopathy of prematurity (ROP screening in underserved rural areas using an indigenously developed tele-ROP model. Materials and Methods: KIDROP currently provides ROP screening and treatment services in three zones and 81 neonatal units in Karnataka, India. Technicians were trained to use a portable Retcam Shuttle (Clarity, USA and validated against ROP experts performing indirect ophthalmoscopy. An indigenously developed 20-point score (STAT score graded their ability (Level I to III to image and decide follow-up based on a three-way algorithm. Images were also uploaded on a secure tele-ROP platform and accessed and reported by remote experts on their smart phones (iPhone, Apple. Results: 6339 imaging sessions of 1601 infants were analyzed. A level III technician agreed with 94.3% of all expert decisions. The sensitivity, specificity, positive predictive value and negative predictive value for treatment grade disease were 95.7, 93.2, 81.5 and 98.6 respectively. The kappa for technicians to decide discharge of babies was 0.94 (P < 0.001. Only 0.4% of infants needing treatment were missed.The kappa agreement of experts reporting on the iPhone vs Retcam for treatment requiring and mild ROP were 0.96 and 0.94 (P < 0.001 respectively. Conclusions: This is the first and largest real-world program to employ accredited non-physicians to grade and report ROP. The KIDROP tele-ROP model demonstrates that ROP services can be delivered to the outreach despite lack of specialists and may be useful in other middle-income countries with similar demographics.

  13. Corrective action investigation plan for CAU Number 453: Area 9 Landfill, Tonopah Test Range

    International Nuclear Information System (INIS)

    1997-01-01

    This Corrective Action Investigation Plan (CAIP) contains the environmental sample collection objectives and criteria for conducting site investigation activities at the Area 9 Landfill, Corrective Action Unit (CAU) 453/Corrective Action (CAS) 09-55-001-0952, which is located at the Tonopah Test Range (TTR). The TTR, included in the Nellis Air Force Range, is approximately 255 kilometers (140 miles) northwest of Las Vegas, Nevada. The Area 9 Landfill is located northwest of Area 9 on the TTR. The landfill cells associated with CAU 453 were excavated to receive waste generated from the daily operations conducted at Area 9 and from range cleanup which occurred after test activities

  14. Seasonal variation in the range areas of the diurnal rodent Octodon degus.

    Science.gov (United States)

    Quirici, Verónica; Castro, Rodrigo A; Ortiz-Tolhuysen, Liliana; Chesh, Adrian S; Burger, Joseph Robert; Miranda, Eduardo; Cortés, Arturo; Hayes, Loren D; Ebensperger, Luis A

    2010-01-01

    Both breeding activity and abundance and quality of available food are expected to influence daily movements of animals. Animals are predicted to range over large areas to meet high energy demands associated with reproduction (females) or to increase mating success (males). However, animals should expand their range areas whenever food conditions deteriorate. To examine the extent to which breeding activity versus food availability influence space use, we compared the size and location of range areas (home ranges) of the degu (Octodon degus), a diurnal rodent from semiarid environments of north-central Chile, during the austral winter and summer seasons. Degus produce young during the austral spring (September-October) when high-quality food is readily available. In contrast, degus do not breed during the austral summer (January-March) when food is scarce and of low quality. We predicted that degus would range over smaller areas in winter if the availability of food has a greater influence on space than breeding activity. Individuals were radiotracked in winter and the following summer over a 3-year period. Surveys of herbaceous cover were conducted during winter and summer to determine seasonal changes in the abundance and quality of primary food. In summer degus expanded and moved the location of their range areas to locations with available food. Given that preferred food was less abundant in summer than winter, we suggest that degu range areas are strongly influenced by food conditions.

  15. Linking home ranges to protected area size: The case study of the Mediterranean Sea

    DEFF Research Database (Denmark)

    Di Franco, Antonio; Plass-Johnson, Jeremiah Grahm; Di Lorenzo, Manfredi

    2018-01-01

    in the Mediterranean Sea, and related this to the size of 184 Mediterranean fully protected areas. We also investigated the influence of fully protected areas size on fish density in contrast to fished areas with respect to home ranges. Home range estimations were available for 11 species (10 fishes and 1 lobster......). The European spiny lobster Palinurus elephas had the smallest home range (0.0039 ± 0.0014 km2; mean ± 1 SE), while the painted comber Serranus scriba (1.1075 ± 0.2040 km2) had the largest. Approximately 25% of Mediterranean fully protected areas are larger than 2 times the size of the largest home range...

  16. International Comparisons in Underserved Health: Issues, Policies, Needs and Projections.

    Science.gov (United States)

    Hutchinson, Paul; Morelli, Vincent

    2017-03-01

    Health care globally has made great strides; for example, there are lower rates of infant and maternal mortality. Increased incomes have led to lower rates of diseases accompanying poverty and hunger. There has been a shift away from the infectious diseases so deadly in developing nations toward first-world conditions. This article presents health care statistics across age groups and geographic areas to help the primary care physician understand these changes. There is a special focus on underserved populations. New technologies in health and health care spending internationally are addressed, emphasizing universal health care. The article concludes with recommendations for the future. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. A Detailed Study of Debris Flow Source Areas in the Northern Colorado Front Range.

    Science.gov (United States)

    Arana-Morales, A.; Baum, R. L.; Godt, J.

    2014-12-01

    Nearly continuous, heavy rainfall occurred during 9-13 September 2013 causing flooding and widespread landslides and debris flows in the northern Colorado Front Range. Whereas many recent studies have identified erosion as the most common process leading to debris flows in the mountains of Colorado, nearly all of the debris flows mapped in this event began as small, shallow landslides. We mapped the boundaries of 415 September 2013 debris flows in the Eldorado Springs and Boulder 7.5-minute quadrangles using 0.5-m-resolution satellite imagery. We characterized the landslide source areas of six debris flows in the field as part of an effort to identify what factors controlled their locations. Four were on a dip slope in sedimentary rocks in the Pinebrook Hills area, near Boulder, and the other two were in granitic rocks near Gross Reservoir. Although we observed no obvious geomorphic differences between the source areas and surrounding non-landslide areas, we noted several characteristics that the source areas all had in common. Slopes of the source areas ranged from 28° to 35° and most occurred on planar or slightly concave slopes that were vegetated with grass, small shrubs, and sparse trees. The source areas were shallow, irregularly shaped, and elongated downslope: widths ranged from 4 to 9 m, lengths from 6 to 40 m and depths ranged from 0.7 to 1.2 m. Colluvium was the source material for all of the debris flows and bedrock was exposed in the basal surface of all of the source areas. We observed no evidence for concentrated surface runoff upslope from the sources. Local curvature and roughness of bedrock and surface topography, and depth distribution and heterogeneity of the colluvium appear to have controlled the specific locations of these shallow debris-flow source areas. The observed distribution and characteristics of the source areas help guide ongoing efforts to model initiation of the debris flows.

  18. Corrective Action Plan for Corrective Action Unit 490: Station 44 Burn Area, Tonopah Test Range, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    K. B. Campbell

    2002-04-01

    Corrective Action Unit (CAU) 490, Station 44 Burn Area is located on the Tonopah Test Range (TTR). CAU 490 is listed in the Federal Facility Agreement and Consent Order (FFACO, 1996) and includes for Corrective Action Sites (CASs): (1) Fire Training Area (CAS 03-56-001-03BA); (2) Station 44 Burn Area (CAS RG-56-001-RGBA); (3) Sandia Service Yard (CAS 03-58-001-03FN); and (4) Gun Propellant Burn Area (CAS 09-54-001-09L2).

  19. Implementing academic detailing for breast cancer screening in underserved communities

    Directory of Open Access Journals (Sweden)

    Ashford Alfred R

    2007-12-01

    Full Text Available Abstract Background African American and Hispanic women, such as those living in the northern Manhattan and the South Bronx neighborhoods of New York City, are generally underserved with regard to breast cancer prevention and screening practices, even though they are more likely to die of breast cancer than are other women. Primary care physicians (PCPs are critical for the recommendation of breast cancer screening to their patients. Academic detailing is a promising strategy for improving PCP performance in recommending breast cancer screening, yet little is known about the effects of academic detailing on breast cancer screening among physicians who practice in medically underserved areas. We assessed the effectiveness of an enhanced, multi-component academic detailing intervention in increasing recommendations for breast cancer screening within a sample of community-based urban physicians. Methods Two medically underserved communities were matched and randomized to intervention and control arms. Ninety-four primary care community (i.e., not hospital based physicians in northern Manhattan were compared to 74 physicians in the South Bronx neighborhoods of the New York City metropolitan area. Intervention participants received enhanced physician-directed academic detailing, using the American Cancer Society guidelines for the early detection of breast cancer. Control group physicians received no intervention. We conducted interviews to measure primary care physicians' self-reported recommendation of mammography and Clinical Breast Examination (CBE, and whether PCPs taught women how to perform breast self examination (BSE. Results Using multivariate analyses, we found a statistically significant intervention effect on the recommendation of CBE to women patients age 40 and over; mammography and breast self examination reports increased across both arms from baseline to follow-up, according to physician self-report. At post-test, physician

  20. Heavy-metal contamination on training ranges at the Grafenwoehr Training Area, Germany

    Energy Technology Data Exchange (ETDEWEB)

    Zellmer, S.D.; Schneider, J.F.

    1993-05-01

    Large quantities of lead and other heavy metals are deposited in the environment of weapons ranges during training exercises. This study was conducted to determine the type, degree, and extent of heavy-metal contamination on selected handgun, rifle, and hand-grenade ranges at Grafenwoehr Training Area, Germany. Soil, vegetation, and surface-water samples were collected and analyzed using the inductively-coupled plasma atomic-emission spectroscopy (ICP-AES) method and the toxic characterization leaching procedure (TCLP). The ICP-AES results show that above-normal levels of lead and copper are in the surface soil at the handgun range, high concentrations of lead and copper are in the berm and soil surface at the rifle range, and elevated levels of cadmium and above-normal concentrations of arsenic, copper, and zinc are present in the surface soil at the hand-grenade range. The TCLP results show that surface soils can be considered hazardous waste because of lead content at the rifle range and because of cadmium concentration at the hand-grenade range. Vegetation at the handgun and rifle ranges has above-normal concentrations of lead. At the hand-grenade range, both vegetation and surface water have high levels of cadmium. A hand-held X-ray fluorescence (XRF) spectrum analyzer was used to measure lead concentrations in soils in a field test of the method. Comparison of XRF readings with ICP-AES results for lead indicate that the accuracy and precision of the hand-held XRF unit must improve before the unit can be used as more than a screening tool. Results of this study show that heavy-metal contamination at all three ranges is limited to the surface soil; heavy metals are not being leached into the soil profile or transported into adjacent areas.

  1. Hydrogeochemical and stream sediment detailed geochemical survey for Thomas Range-Wasatch, Utah. Farmington Project area

    International Nuclear Information System (INIS)

    Butz, T.R.; Bard, C.S.; Witt, D.A.; Helgerson, R.N.; Grimes, J.G.; Pritz, P.M.

    1980-01-01

    Results of the Farmington project area of the Thomas Range-Wasatch detailed geochemical survey are reported. Field and laboratory data are presented for 71 groundwater samples, 345 stream sediment samples, and 178 radiometric readings. Statistical and areal distributions of uranium and possible uranium-related variables are given. A generalized geologic map of the project area is provided, and pertinent geologic factors which may be of significance in evaluating the potential for uranium mineralization are briefly discussed. Uranium concentrations in groundwater range from <0.20 to 21.77 ppB. The highest values are from groundwaters producing from areas in or near the Norwood Tuff and Wasatch, Evanston, and/or Echo Canyon Formations, and the Farmington Canyon Complex. The uranium:boron ratio delineates an anomalous trend associated with the Farmington Canyon Complex. Variables associated with uranium in groundwaters producing from the Norwood Tuff and Wasatch, Evanston, and/or Echo Canyon Formations include the uranium:sulfate ratio, boron, barium, potassium, lithium, silicon, chloride, selenium, and vanadium. Soluble uranium concentrations (U-FL) in stream sediments range from 0.99 to 86.41 ppM. Total uranium concentrations (U-NT) range from 1.60 to 92.40 ppM. Thorium concentrations range from <2 to 47 ppM. Anomalous concentrations of these variables are associated with the Farmington Canyon Complex. Variables which are associated with uranium include cerium, sodium, niobium, phosphorus, titanium, and yttrium

  2. Recruiting and retaining primary care physicians in urban underserved communities: the importance of having a mission to serve.

    Science.gov (United States)

    Odom Walker, Kara; Ryan, Gery; Ramey, Robin; Nunez, Felix L; Beltran, Robert; Splawn, Robert G; Brown, Arleen F

    2010-11-01

    We examined factors influencing physician practice decisions that may increase primary care supply in underserved areas. We conducted in-depth interviews with 42 primary care physicians from Los Angeles County, California, stratified by race/ethnicity (African American, Latino, and non-Latino White) and practice location (underserved vs nonunderserved area). We reviewed transcriptions and coded them into themes by using standard qualitative methods. Three major themes emerged in relation to selecting geographic- and population-based practice decisions: (1) personal motivators, (2) career motivators, and (3) clinic support. We found that subthemes describing personal motivators (e.g., personal mission and self-identity) for choosing a practice were more common in responses among physicians who worked in underserved areas than among those who did not. By contrast, physicians in nonunderserved areas were more likely to cite work hours and lifestyle as reasons for selecting their current practice location or for leaving an underserved area. Medical schools and shortage-area clinical practices may enhance strategies for recruiting primary care physicians to underserved areas by identifying key personal motivators and may promote long-term retention through work-life balance.

  3. Mineral resource potential map of the Benton Range Roadless Area, Mono County, California

    Science.gov (United States)

    Donahoe, James L.; McKee, Edwin D.; Rains, Richard L.; Barnes, Donald J.; Campbell, Harry W.; Denton, David K.; Iverson, Stephen R.; Jeske, Rodney E.; Stebbins, Scott A.

    1983-01-01

    Tungsten-bearing rocks in the Benton Range Roadless Area occur in tactite lenses within the Paleozoic metasedimentary units that surround and are intruded by Triassic granodiorite of the Benton Range. High anomalous tungsten values were found in the southern part of the study area. Quartz-vein deposits with copper, lead, zinc, and silver may occur within the Jurassic granitic rock in the northwestern part of the area. Stream-sediment and panned-concentrate samples from the northwestern part of the roadless area, reveal anomalous values in a number of elements. Some of these elements are indicative of mineral suites that form by hydrothermal alteration and are potential metallic-ore producers. Metals having anomalous values are antimony, copper, lead, molybdenum, tin, and zinc; their presence suggests the potential for deposits of the lead-zinc-silver or copper-molybdenum type. Molybdenum and lead were identified by geochemical sampling as having low to moderate potential in the roadless area. An estimated 190,000 tons (172,000 t) of subeconomic gold and silver resources are inside the roadless area at the Gold Crown, Gold Webb, and Gold Wedge mines; another 60,000 tons (54,000 t) of subeconomic gold and silver resources are just outside the area at the Tower, Gold Webb, and Gold Wedge mines (table 1). Most of the lode gold and silver deposits are in quartz veins and shear zones. Minor amounts of copper, lead, and zinc occur in some gold deposits. About 2,240 oz (70 kg) of gold, 8,450 oz (260 kg) of silver, and 4,600 lb of lead (2,090 kg) have been produced from the roadless area. In addition, 7,257 oz (226 kg) of gold and 350 oz (11 kg) silver were produced at the Tower mine, near the area.

  4. Intercultural health and ethnobotany: how to improve healthcare for underserved and minority communities?

    Science.gov (United States)

    Vandebroek, Ina

    2013-07-30

    The present conceptual review explores intercultural healthcare--defined as the integration of traditional medicine and biomedicine as complementary healthcare systems--in minority and underserved communities. This integration can take place at different levels: individuals (patients, healers, biomedical healthcare providers), institutions (health centers, hospitals) or society (government policy). Contemporary ethnobotany research of traditional medicine has primarily dealt with the botanical identification of plants commonly used by local communities, and the identification of health conditions treated with these plants, whereas ethnopharmacology has focused on the bioactivity of traditional remedies. On the other hand, medical anthropology seems to be the scholarship more involved with research into patients' healthcare-seeking itineraries and their interaction with traditional versus biomedical healthcare systems. The direct impact of these studies on public health of local communities can be contested. To compare and discuss the body of scholarly work that deals with different aspects of traditional medicine in underserved and minority communities, and to reflect on how gaps identified in research can be bridged to help improve healthcare in these communities. The literature covers a broad range of information of relevance to intercultural healthcare. This information is fragmented across different scientific and clinical disciplines. A conceptual review of these studies identifies a clear need to devote more attention to ways in which research on traditional medicine can be more effectively applied to improve local public health in biomedical resource-poor settings, or in geographic areas that have disparities in access to healthcare. Scholars studying traditional medicine should prioritize a more interdisciplinary and applied perspective to their work in order to forge a more direct social impact on public health in local communities most in need of

  5. Closure Report for Corrective Action Unit 425: Area 9 Main Lake Construction Debris Disposal Area, Tonopah Test Range, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    K. B. Campbell

    2003-03-01

    Corrective Action Unit (CAU) 425 is located on the Tonopah Test Range, approximately 386 kilometers (240 miles) northwest of Las Vegas, Nevada. CAU 425 is listed in the Federal Facility Agreement and Consent Order (FFACO, 1996) and is comprised of one Corrective Action Site (CAS). CAS 09-08-001-TA09 consisted of a large pile of concrete rubble from the original Hard Target and construction debris associated with the Tornado Rocket Sled Tests. CAU 425 was closed in accordance with the FFACO and the Nevada Division of Environmental Protection-approved Streamlined Approach for Environmental Restoration Plan for CAU 425: Area 9 Main Lake Construction Debris Disposal Area, Tonopah Test Range, Nevada (U.S. Department of Energy, Nevada Operations Office, 2002). CAU 425 was closed by implementing the following corrective actions: The approved corrective action for this unit was clean closure. Closure activities included: (1) Removal of all the debris from the site. (2) Weighing each load of debris leaving the job site. (3) Transporting the debris to the U.S. Air Force Construction Landfill for disposal. (4) Placing the radioactive material in a U.S. Department of Transportation approved container for proper transport and disposal. (5) Transporting the radioactive material to the Nevada Test Site for disposal. (6) Regrading the job site to its approximate original contours/elevation.

  6. Corrective action investigation plan for CAU No. 424: Area 3 Landfill Complex, Tonopah Test Range, Nevada

    International Nuclear Information System (INIS)

    1997-04-01

    This Correction Action Investigation Plan contains the environmental sample collection objectives and the criteria for conducting site investigation activities at the Area 3 Landfill Complex, CAU No. 424, which is located at the Tonopah Test Range (TTR). The TTR, included in the Nellis Air Force Range, is approximately 255 kilometers (140 miles) northwest of Las Vegas, nevada. The CAU 424 is comprised of eight individual landfill sites that are located around and within the perimeter of the Area 3 Compound. Due to the unregulated disposal activities commonly associated with early landfill operations, an investigation will be conducted at each CAS to complete the following tasks: identify the presence and nature of possible contaminant migration from the landfills; determine the vertical and lateral extent of possible contaminant migration; ascertain the potential impact to human health and the environment; and provide sufficient information and data to develop and evaluate appropriate corrective action strategies for each CAS

  7. Late cretaceous to early eocene foraminiferal biostratigraphy of the Rakhi Nala area, Sulaiman Range, Pakistan

    International Nuclear Information System (INIS)

    Afzal, J.

    1996-01-01

    Shaly intervals from late cretaceous to early eocene sediments of the Rakhi Nala Section (Sulaiman Range) were analysed for the foraminiferal micro fauna (Planktons, smaller and larger benthics). The faunal record is interpreted for the precise age and paleo environments. These fresh results, in the light of modern bio stratigraphic knowledge, are compared with the previous bio stratigraphic information available about this area. Several discrepancies regarding the litho and biostratigraphy from the previous literature were addressed and tried to remove. (author)

  8. Hydrogeochemical and stream sediment detailed geochemical survey for Thomas Range-Wasatch, Utah. Cottonwood project area

    International Nuclear Information System (INIS)

    Butz, T.R.; Bard, C.S.; Witt, D.A.; Helgerson, R.N.; Grimes, J.G.; Pritz, P.M.

    1980-01-01

    Results of Cottonwood project area of the Thomas Range-Wasatch detailed geochemical survey are reported. Field and laboratory data are presented for 15 groundwater samples, 79 stream sediment samples, and 85 radiometric readings. Statistical and areal distributions of uranium and possible uranium-related variables are given. A generalized geologic map of the project area is provided, and pertinent geologic factors which may be of significance in evaluating the potential for uranium mineralization are briefly discussed. Uranium concentrations in groundwater range from 0.25 to 3.89 ppB. The highest concentrations are from groundwaters from the Little Cottonwood and Ferguson Stocks. Variables that appear to be associated with uranium in groundwater include cobalt, iron, potassium, manganese, nickel, sulfate, and to a lesser extent, molybdenum and strontium. This association is attributed to the Monzonitic Little Cottonwood Stock, granodioritic to granitic and lamprophyric dikes, and known sulfide deposits. Soluble uranium concentrations (U-FL) in stream sediments range from 0.31 to 72.64 ppM. Total uranium concentrations (U-NT) range from 1.80 to 75.20 ppM. Thorium concentrations range from <2 to 48 ppM. Anomalous values for uranium and thorium are concentrated within the area of outcrop of the Little Cottonwood and Ferguson Stocks. Variables which are areally associated with high values of uranium, thorium, and the U-FL:U-NT ratio within the Little Cottonwood Stock are barium, copper, molybdenum, and zinc. High concentrations of these variables are located near sulfide deposits within the Little Cottonwood Stock

  9. 78 FR 51176 - Record of Decision for the Modernization and Enhancement of Ranges, Airspace, and Training Areas...

    Science.gov (United States)

    2013-08-20

    ... Enhancement of Ranges, Airspace, and Training Areas in the Joint Pacific Alaska Range Complex in Alaska ACTION... Enhancement of Ranges, Airspace, and Training Areas in the Joint Pacific Alaska Range Complex (JPARC) in... the EIS, including technical considerations, public review and Tribal and agency input. The Final EIS...

  10. Air defense planning for an area with the use of very short range air defense sets

    Directory of Open Access Journals (Sweden)

    Tadeusz Pietkiewicz

    2017-12-01

    Full Text Available This paper presents a heuristic method of planning the deployment of very short-range anti-air missile and artillery sets (VSHORAD around an area (‘protected area’ in order to protect it. A function dependent on the distance between the earliest feasible points of destroying targets and the centre of the protected area was taken as an objective function. This is a different indicator from those commonly used in the literature, and based on the likelihood of a defense zone penetration by means of an air attack (MAA: the kill probability of the MAA and the probability of area losses. The model constraints resulted directly from the restrictions imposed by real air defense systems and the nature of the area being defended. This paper assumes that the VSHORAD system operates as a part of a general, superordinate air defense command and control system based on the idea of network-centric warfare, which provides the VSHORAD system with a recognized air picture, air defense plans, and combat mission specifications. The presented method has been implemented. The final part of the paper presents the computational results. Keywords: optimal planning, air defense system, area installation protection, deployment of very short range anti-air missile and artillery sets (VSHORAD

  11. Closure Report for Corrective Action Unit 407: Roller Coaster RADSAFE Area, Tonopah Test Range, Nevada

    International Nuclear Information System (INIS)

    Fitzmaurice, T. M.

    2001-01-01

    This closure report (CR) provides documentation for the closure of the Roller Coaster RADSAFE Area (RCRSA) Corrective Action Unit (CAU) 407 identified in the Federal Facility Agreement and Consent Order (FFACO) (Nevada Division of Environmental Protection [NDEP] et al., 1996). CAU 407 is located at the Tonopah Test Range (TTR), Nevada. The TTR is approximately 225 kilometers (km) (140 miles [mi]) northwest of Las Vegas, Nevada (Figure 1). The RCRSA is located on the northeast comer of the intersection of Main Road and Browne's Lake Road, which is approximately 8 km (5 mi) south of Area 3 (Figure 1). The RCRSA was used during May and June of 1963 to decontaminate vehicles, equipment, and personnel from the Double Tracks and Clean Slate tests. Investigation of the RCRSA was conducted from June through November of 1998. A Corrective Action Decision Document (CADD) (U.S. Department of Energy, Nevada Operations Office [DOEN], 1999) was approved in October of 1999. The purpose of this CR is to: Document the closure activities as proposed in the Corrective Action Plan (CAP) (DOEM, 2000). Obtain a Notice of Completion from the NDEP. Recommend the movement of CAU 407 from Appendix III to Appendix IV of the FFACO. The following is the scope of the closure actions implemented for CAU 407: Removal and disposal of surface soils which were over three times background for the area. Soils identified for removal were disposed of at the Area 5 Radioactive Waste Management Site (RWMS) at the Nevada Test Site (NTS). Excavated areas were backfilled with clean borrow soil located near the site. A soil cover was constructed over the waste disposal pit area, where subsurface constituents of concern remain. The site was fenced and posted as an ''Underground Radioactive Material'' area

  12. High-resolution surface analysis for extended-range downscaling with limited-area atmospheric models

    Science.gov (United States)

    Separovic, Leo; Husain, Syed Zahid; Yu, Wei; Fernig, David

    2014-12-01

    High-resolution limited-area model (LAM) simulations are frequently employed to downscale coarse-resolution objective analyses over a specified area of the globe using high-resolution computational grids. When LAMs are integrated over extended time frames, from months to years, they are prone to deviations in land surface variables that can be harmful to the quality of the simulated near-surface fields. Nudging of the prognostic surface fields toward a reference-gridded data set is therefore devised in order to prevent the atmospheric model from diverging from the expected values. This paper presents a method to generate high-resolution analyses of land-surface variables, such as surface canopy temperature, soil moisture, and snow conditions, to be used for the relaxation of lower boundary conditions in extended-range LAM simulations. The proposed method is based on performing offline simulations with an external surface model, forced with the near-surface meteorological fields derived from short-range forecast, operational analyses, and observed temperatures and humidity. Results show that the outputs of the surface model obtained in the present study have potential to improve the near-surface atmospheric fields in extended-range LAM integrations.

  13. Decision 99-18: Range Petroleum Corporation application for a well licence, Sturgeon Lake Area

    International Nuclear Information System (INIS)

    1999-07-01

    Range Petroleum Corporation (Range) applied to the Alberta Energy and Utilities Board (EUB) pursuant to Section 2.020 of the Oil and Gas Conservation Regulations for a well licence to drill a sour oil well from a surface location in Legal Subdivision 4, Section 34, West of the fifth Meridian, directionally to a bottom-hole location under Sturgeon Lake. The purpose of the proposed well would be to obtain sour oil production from the Leduc Formation. The well would be a Level 1 well because it would have a potential maximum hydrogen sulphide release rate of 0.0412 cubic m/s. The EUB received objections to the application from landowners, cattle ranchers, farmers, residents, and cottage owners in the area of the proposed well. The application and intervention were considered at a public hearing on 26 January 1999 in Grande Prairie, Alberta, and the Board viewed the proposed surface location, the previous Lds 3-2 surface location, and the surrounding area prior to the hearing. Having carefully considered the evidence, the Board believed that it would be possible to drill the proposed well safely and with minimal risk, subject to attached conditions. But in light of the unique setting of the area, including the residences and the road and lake configurations, and the difficulty that would exist preparing an effective environmental review process (ERP), the Board deferred its decision on the well licence application until an approved ERP is in place

  14. Dust Plume Modeling from Ranges and Maneuver Areas on Fort Bliss and the White Sands Missile Range: Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Chapman, Elaine G.; Barnard, James C.; Rutz, Frederick C.; Pekour, Mikhail S.; Rishel, Jeremy P.; Shaw, William J.

    2009-05-04

    The potential for air quality impacts from heavy mechanized vehicles operating on and between the unpaved main supply routes at Fort Bliss and White Sands Missile Range was investigated. This report details efforts by the staff of Pacific Northwest National Laboratory for the Fort Bliss Directorate of Environment in this investigation. Dust emission and dispersion from typical move-out activities occurring on the installations were simulated using the atmospheric modeling system DUSTRAN. Major assumptions associated with designing the modeling scenarios are summarized and results of simulations conducted under these assumptions are presented for four representative meteorological periods.

  15. Diet and Obesity Issues in the Underserved.

    Science.gov (United States)

    Mejia de Grubb, Maria C; Levine, Robert S; Zoorob, Roger J

    2017-03-01

    The goal of this article is to inform new directions for addressing inequalities associated with obesity by reviewing current issues about diet and obesity among socioeconomically vulnerable and underserved populations. It highlights recent interventions in selected high-risk populations, as well as gaps in the knowledge base. It identifies future directions in policy and programmatic interventions to expand the role of primary care providers, with an emphasis on those aimed at preventing obesity and promoting healthy weight. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Increased genetic divergence between two closely related fir species in areas of range overlap

    Science.gov (United States)

    Wang, Jing; Abbott, Richard J; Ingvarsson, Pär K; Liu, Jianquan

    2014-01-01

    Because of introgressive hybridization, closely related species can be more similar to each other in areas of range overlap (parapatry or sympatry) than in areas where they are geographically isolated from each other (allopatry). Here, we report the reverse situation based on nuclear genetic divergence between two fir species, Abies chensiensis and Abies fargesii, in China, at sites where they are parapatric relative to where they are allopatric. We examined genetic divergence across 126 amplified fragment length polymorphism (AFLP) markers in a set of 172 individuals sampled from both allopatric and parapatric populations of the two species. Our analyses demonstrated that AFLP divergence was much greater between the species when comparisons were made between parapatric populations than between allopatric populations. We suggest that selection in parapatry may have largely contributed to this increased divergence. PMID:24772279

  17. Geologic map of the greater Denver area, Front Range urban corridor, Colorado

    Science.gov (United States)

    Trimble, Donald E.; Machette, Michael N.

    1979-01-01

    This digital map shows the areal extent of surficial deposits and rock stratigraphic units (formations) as compiled by Trimble and Machette from 1973 to 1977 and published in 1979 under the Front Range Urban Corridor Geology Program. Trimble and Machette compiled their geologic map from published geologic maps and unpublished geologic mapping having varied map unit schemes. A convenient feature of the compiled map is its uniform classification of geologic units that mostly matches those of companion maps to the north (USGS I-855-G) and to the south (USGS I-857-F). Published as a color paper map, the Trimble and Machette map was intended for land-use planning in the Front Range Urban Corridor. This map recently (1997-1999) was digitized under the USGS Front Range Infrastructure Resources Project. In general, the mountainous areas in the western part of the map exhibit various igneous and metamorphic bedrock units of Precambrian age, major faults, and fault brecciation zones at the east margin (5-20 km wide) of the Front Range. The eastern and central parts of the map (Colorado Piedmont) depict a mantle of unconsolidated deposits of Quaternary age and interspersed outcroppings of Cretaceous or Tertiary-Cretaceous sedimentary bedrock. The Quaternary mantle comprises eolian deposits (quartz sand and silt), alluvium (gravel, sand, and silt of variable composition), colluvium, and a few landslides. At the mountain front, north-trending, dipping Paleozoic and Mesozoic sandstone, shale, and limestone bedrock formations form hogbacks and intervening valleys.

  18. Range 8C Rehabilitation Demonstration Project, Hohenfels Training Area, Germany: Final report

    International Nuclear Information System (INIS)

    Zellmer, S.D.; Hinchman, R.R.; Johnson, D.O.; Brent, J.J.

    1991-11-01

    More than 30 years of intensive and continual tactical training has caused extensive environmental damage at the US Army Hohenfels Training Area in Germany. The Range 8C Rehabilitation Demonstration Project, followed by a three-year monitoring effort, was conducted to develop and evaluate the environmental and economic effectiveness of seven revegetation and four erosion control prescriptions implemented at a 16-ha site. The point-intercept method was used to measure the types and amounts of vegetation established and the changes in the vegetative community during three years of military use on the seven areas treated with revegetation prescriptions. Field observations were made to determine the suitability and durability of four types of erosion control structures. Soil fertility and a source of seed appeared to be the most limiting factors in establishing vegetation, while seedbed preparation had only a minor influence. Grasses appeared to be more resistant to vehicle traffic than did other types of vegetation. Because grassed waterways were used as roads by military vehicles and a system of graded terraces was expensive, these erosion control prescriptions were unsuitable and uneconomical for use on training areas. Low-cost riprap waterbars and porous check dams slowed the velocity of runoff, trapped sediments, and were durable. Recommendations were formulated to improve the environmental and economic effectiveness of future rehabilitation efforts on tactical training areas

  19. Defining Indicators and Standards for Tourism Impacts in Protected Areas: Cape Range National Park, Australia

    Science.gov (United States)

    Moore, Susan A.; Polley, Amanda

    2007-03-01

    Visitors’ perceptions of impacts and acceptable standards for environmental conditions can provide essential information for the sustainable management of tourist destinations, especially protected areas. To this end, visitor surveys were administered during the peak visitor season in Cape Range National Park, on the northwest coast of Western Australia and adjacent to the iconic Ningaloo Reef. The central focus was visitors’ perceptions regarding environmental conditions and standards for potential indicators. Conditions considered of greatest importance in determining visitors’ quality of experience included litter, inadequate disposal of human waste, presence of wildlife, levels of noise, and access to beach and ocean. Standards were determined, based on visitors’ perceptions, for a range of site-specific and non-site-specific indicators, with standards for facilities (e.g., acceptable number of parking bays, signs) and for negative environmental impacts (e.g., levels of littering, erosion) sought. The proposed standards varied significantly between sites for the facilities indicators; however, there was no significant difference between sites for environmental impacts. For the facilities, the standards proposed by visitors were closely related to the existing situation, suggesting that they were satisfied with the status quo. These results are considered in the context of current research interest in the efficacy of visitor-derived standards as a basis for protected area management.

  20. Defining indicators and standards for tourism impacts in protected areas: Cape Range National Park, Australia.

    Science.gov (United States)

    Moore, Susan A; Polley, Amanda

    2007-03-01

    Visitors' perceptions of impacts and acceptable standards for environmental conditions can provide essential information for the sustainable management of tourist destinations, especially protected areas. To this end, visitor surveys were administered during the peak visitor season in Cape Range National Park, on the northwest coast of Western Australia and adjacent to the iconic Ningaloo Reef. The central focus was visitors' perceptions regarding environmental conditions and standards for potential indicators. Conditions considered of greatest importance in determining visitors' quality of experience included litter, inadequate disposal of human waste, presence of wildlife, levels of noise, and access to beach and ocean. Standards were determined, based on visitors' perceptions, for a range of site-specific and non-site-specific indicators, with standards for facilities (e.g., acceptable number of parking bays, signs) and for negative environmental impacts (e.g., levels of littering, erosion) sought. The proposed standards varied significantly between sites for the facilities indicators; however, there was no significant difference between sites for environmental impacts. For the facilities, the standards proposed by visitors were closely related to the existing situation, suggesting that they were satisfied with the status quo. These results are considered in the context of current research interest in the efficacy of visitor-derived standards as a basis for protected area management.

  1. Re-Presenting Slavery: Underserved Questions in Museum Collections

    Science.gov (United States)

    Levenson, Cyra

    2014-01-01

    This article looks at the notion of what, not who, is underserved in museum education. The importance of looking through, in, and from objects in order to uncover underserved questions and themes is vital. A willingness to consider new ways to approach collections and display is necessary to have a dialogue with our audiences about how museums can…

  2. Impact of selection strategies on representation of underserved populations and intention to practise: international findings.

    Science.gov (United States)

    Larkins, Sarah; Michielsen, Kristien; Iputo, Jehu; Elsanousi, Salwa; Mammen, Marykutty; Graves, Lisa; Willems, Sara; Cristobal, Fortunato L; Samson, Rex; Ellaway, Rachel; Ross, Simone; Johnston, Karen; Derese, Anselme; Neusy, André-Jacques

    2015-01-01

    Socially accountable medical schools aim to reduce health inequalities by training workforces responsive to the priority health needs of underserved communities. One key strategy involves recruiting students from underserved and unequally represented communities on the basis that they may be more likely to return and address local health priorities. This study describes the impacts of different selection strategies of medical schools that aspire to social accountability on the presence of students from underserved communities in their medical education programmes and on student practice intentions. A cross-sectional questionnaire was administered to students starting medical education in five institutions with a social accountability mandate in five different countries. The questionnaire assessed students' background characteristics, rurality of background, and practice intentions (location, discipline of practice and population to be served). The results were compared with the characteristics of students entering medical education in schools with standard selection procedures, and with publicly available socio-economic data. The selection processes of all five schools included strategies that extended beyond the assessment of academic achievement. Four distinct strategies were identified: the quota system; selection based on personal attributes; community involvement, and school marketing strategies. Questionnaire data from 944 students showed that students at the five schools were more likely to be of non-urban origin, of lower socio-economic status and to come from underserved groups. A total of 407 of 810 (50.2%) students indicated an intention to practise in a non-urban area after graduation and the likelihood of this increased with increasing rurality of primary schooling (p = 0.000). Those of rural origin were statistically less likely to express an intention to work abroad (p = 0.003). Selection strategies to ensure that members of underserved communities

  3. HealthATM: personal health cyberinfrastructure for underserved populations.

    Science.gov (United States)

    Botts, Nathan E; Horan, Thomas A; Thoms, Brian P

    2011-05-01

    There is an opportunity for personal health record (PHR) systems to play a vital role in fostering health self-management within underserved populations. If properly designed and promoted, it is possible that patients will use PHRs to become more empowered in taking an active role toward managing their health needs. This research examines the potential of a cyberinfrastructure-based PHR to encourage patient activation in health care, while also having population health implications. A multi-phased, iterative research approach was used to design and evaluate a PHR system called HealthATM, which utilizes services from a cloud computing environment. These services were integrated into an ATM-style interface aimed at providing a broad range of health consumers with the ability to manage health conditions and encourage accomplishment of health goals. Evaluation of the PHR included 115 patients who were clients of several free clinics in Los Angeles County. The majority of patients perceived ease of use (74%) and confidence (73%) in using the HealthATM system, and thought they would like to use it frequently (73%). Patients also indicated a belief in being responsible for their own health. However, fewer felt as though they were able to maintain necessary life changes to improve their health. Findings from the field tests suggest that PHRs can be a beneficial health management tool for underserved populations. In order for these types of tools to be effective within safety-net communities, they must be technically accessible and provide meaningful opportunities to increase patient engagement in their health care. Copyright © 2011. Published by Elsevier Inc.

  4. 33 CFR 334.20 - Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area.

    Science.gov (United States)

    2010-07-01

    ... REGULATIONS § 334.20 Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. (a) The... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Gulf of Maine off Cape Small, Maine; naval aircraft practice mining range area. 334.20 Section 334.20 Navigation and Navigable Waters...

  5. 75 FR 27286 - McKelvie Geographic Area Range Allotment Management Planning on the Samuel R. McKelvie National...

    Science.gov (United States)

    2010-05-14

    ... range allotment management planning on the McKelvie Geographic Area, Samuel R. McKelvie National Forest... DEPARTMENT OF AGRICULTURE Forest Service McKelvie Geographic Area Range Allotment Management Planning on the Samuel R. McKelvie National Forest, Bessey Ranger District in Nebraska AGENCY: Forest...

  6. Mass movements of lowland areas in long range TLS and ALS monitoring

    Science.gov (United States)

    Tyszkowski, Sebastian

    2015-04-01

    The development of geodynamic processes in lowland areas remains an interesting issue for geomorphology and geology as well as civil engineering. Landslides, slumps, slope washes, rills and gully erosion are considered both geomorphological processes and natural hazards. In order to know precisely their origin and development, it is crucial to determine the rate and direction of their change. Previously such studies used geodesy and photogrammetry but the recent progress in the LiDAR technology allows collecting the data in a wider range and comparable or higher precision than most of geodetic methods. Airborne Laser Scanning (ALS) is also a good tool, but high costs and low frequency of the surveys make it difficult to trace the dynamics of the studied phenomena and processes. Nevertheless, this method enables gathering information from large areas, which is useful for the preliminary identification of the research issues and nomination of the areas for subsequent case studies. It is, however, more common to use Terrestrial Laser Scanning (TLS) for the detailed studies of morphology and its change. This method provides mobility and high accuracy, and enables frequent measurements. The problem in the analysis of many geoprocesses lies in the limited range of this method. This study concerns the Lower Vistula Valley located in northern Poland. It presents the results of measurements of landslides located in the escarpment zone of a big river valley. The object of the studies is mass movements developing within the quaternary deposits on the valley slopes. These processes were monitored in previous years with the traditional survey methods, mainly based on the geodesy field observations (benchmark) as well as the analyses of historical maps and archives. The ALS method used during the study enabled gathering the data on the valley with the density of 8 points per sq m, which provided the background for the consecutive monitoring study. In the surveys a terrestrial

  7. Source areas and long-range transport of pollen from continental land to Tenerife (Canary Islands).

    Science.gov (United States)

    Izquierdo, Rebeca; Belmonte, Jordina; Avila, Anna; Alarcón, Marta; Cuevas, Emilio; Alonso-Pérez, Silvia

    2011-01-01

    The Canary Islands, due to their geographical position, constitute an adequate site for the study of long-range pollen transport from the surrounding land masses. In this study, we analyzed airborne pollen counts at two sites: Santa Cruz de Tenerife (SCO), at sea level corresponding to the marine boundary layer (MBL), and Izaña at 2,367 m.a.s.l. corresponding to the free troposphere (FT), for the years 2006 and 2007. We used three approaches to describe pollen transport: (1) a classification of provenances with an ANOVA test to describe pollen count differences between sectors; (2) a study of special events of high pollen concentrations, taking into consideration the corresponding meteorological synoptic pattern responsible for transport and back trajectories; and (3) a source-receptor model applied to a selection of the pollen taxa to show pollen source areas. Our results indicate several extra-regional pollen transport episodes to Tenerife. The main provenances were: (1) the Mediterranean region, especially the southern Iberian Peninsula and Morocco, through the trade winds in the MBL. These episodes were characterized by the presence of pollen from trees (Casuarina, Olea, Quercus perennial and deciduous types) mixed with pollen from herbs (Artemisia, Chenopodiaceae/Amaranthaceae and Poaceae wild type). (2) The Saharan sector, through transport at the MBL level carrying pollen principally from herbs (Chenopodiaceae-Amaranthaceae, Cyperaceae and Poaceae wild type) and, in one case, Casuarina pollen, uplifted to the free troposphere. And (3) the Sahel, characterized by low pollen concentrations of Arecaceae, Chenopodiaceae-Amaranthaceae, Cyperaceae and Poaceae wild type in sporadic episodes. This research shows that sporadic events of long-range pollen transport need to be taken into consideration in Tenerife as possible responsible agents in respiratory allergy episodes. In particular, it is estimated that 89-97% of annual counts of the highly allergenous Olea

  8. Source areas and long-range transport of pollen from continental land to Tenerife (Canary Islands)

    Science.gov (United States)

    Izquierdo, Rebeca; Belmonte, Jordina; Avila, Anna; Alarcón, Marta; Cuevas, Emilio; Alonso-Pérez, Silvia

    2011-01-01

    The Canary Islands, due to their geographical position, constitute an adequate site for the study of long-range pollen transport from the surrounding land masses. In this study, we analyzed airborne pollen counts at two sites: Santa Cruz de Tenerife (SCO), at sea level corresponding to the marine boundary layer (MBL), and Izaña at 2,367 m.a.s.l. corresponding to the free troposphere (FT), for the years 2006 and 2007. We used three approaches to describe pollen transport: (1) a classification of provenances with an ANOVA test to describe pollen count differences between sectors; (2) a study of special events of high pollen concentrations, taking into consideration the corresponding meteorological synoptic pattern responsible for transport and back trajectories; and (3) a source-receptor model applied to a selection of the pollen taxa to show pollen source areas. Our results indicate several extra-regional pollen transport episodes to Tenerife. The main provenances were: (1) the Mediterranean region, especially the southern Iberian Peninsula and Morocco, through the trade winds in the MBL. These episodes were characterized by the presence of pollen from trees ( Casuarina, Olea, Quercus perennial and deciduous types) mixed with pollen from herbs ( Artemisia, Chenopodiaceae/Amaranthaceae and Poaceae wild type). (2) The Saharan sector, through transport at the MBL level carrying pollen principally from herbs (Chenopodiaceae-Amaranthaceae, Cyperaceae and Poaceae wild type) and, in one case, Casuarina pollen, uplifted to the free troposphere. And (3) the Sahel, characterized by low pollen concentrations of Arecaceae, Chenopodiaceae-Amaranthaceae, Cyperaceae and Poaceae wild type in sporadic episodes. This research shows that sporadic events of long-range pollen transport need to be taken into consideration in Tenerife as possible responsible agents in respiratory allergy episodes. In particular, it is estimated that 89-97% of annual counts of the highly allergenous Olea

  9. Limited-area short-range ensemble predictions targeted for heavy rain in Europe

    Directory of Open Access Journals (Sweden)

    K. Sattler

    2005-01-01

    Full Text Available Inherent uncertainties in short-range quantitative precipitation forecasts (QPF from the high-resolution, limited-area numerical weather prediction model DMI-HIRLAM (LAM are addressed using two different approaches to creating a small ensemble of LAM simulations, with focus on prediction of extreme rainfall events over European river basins. The first ensemble type is designed to represent uncertainty in the atmospheric state of the initial condition and at the lateral LAM boundaries. The global ensemble prediction system (EPS from ECMWF serves as host model to the LAM and provides the state perturbations, from which a small set of significant members is selected. The significance is estimated on the basis of accumulated precipitation over a target area of interest, which contains the river basin(s under consideration. The selected members provide the initial and boundary data for the ensemble integration in the LAM. A second ensemble approach tries to address a portion of the model-inherent uncertainty responsible for errors in the forecasted precipitation field by utilising different parameterisation schemes for condensation and convection in the LAM. Three periods around historical heavy rain events that caused or contributed to disastrous river flooding in Europe are used to study the performance of the LAM ensemble designs. The three cases exhibit different dynamic and synoptic characteristics and provide an indication of the ensemble qualities in different weather situations. Precipitation analyses from the Deutsche Wetterdienst (DWD are used as the verifying reference and a comparison of daily rainfall amounts is referred to the respective river basins of the historical cases.

  10. Community mobilisation with women's groups facilitated by Accredited Social Health Activists (ASHAs to improve maternal and newborn health in underserved areas of Jharkhand and Orissa: study protocol for a cluster-randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Sinha Rajesh

    2011-07-01

    Full Text Available Abstract Background Around a quarter of the world's neonatal and maternal deaths occur in India. Morbidity and mortality are highest in rural areas and among the poorest wealth quintiles. Few interventions to improve maternal and newborn health outcomes with government-mandated community health workers have been rigorously evaluated at scale in this setting. The study aims to assess the impact of a community mobilisation intervention with women's groups facilitated by ASHAs to improve maternal and newborn health outcomes among rural tribal communities of Jharkhand and Orissa. Methods/design The study is a cluster-randomised controlled trial and will be implemented in five districts, three in Jharkhand and two in Orissa. The unit of randomisation is a rural cluster of approximately 5000 population. We identified villages within rural, tribal areas of five districts, approached them for participation in the study and enrolled them into 30 clusters, with approximately 10 ASHAs per cluster. Within each district, 6 clusters were randomly allocated to receive the community intervention or to the control group, resulting in 15 intervention and 15 control clusters. Randomisation was carried out in the presence of local stakeholders who selected the cluster numbers and allocated them to intervention or control using a pre-generated random number sequence. The intervention is a participatory learning and action cycle where ASHAs support community women's groups through a four-phase process in which they identify and prioritise local maternal and newborn health problems, implement strategies to address these and evaluate the result. The cycle is designed to fit with the ASHAs' mandate to mobilise communities for health and to complement their other tasks, including increasing institutional delivery rates and providing home visits to mothers and newborns. The trial's primary endpoint is neonatal mortality during 24 months of intervention. Additional

  11. Recruitment practices for U.S. minority and underserved populations in NRG oncology: Results of an online survey

    Directory of Open Access Journals (Sweden)

    Elise D. Cook

    2018-06-01

    Full Text Available Introduction: Cancer clinical trials (CCT provide much of the evidence for clinical guidelines and standards of care. But low levels of CCT participation are well documented, especially for minorities. Methods and materials: We conducted an online survey of 556 recruitment practices across the NRG Oncology network. Survey aims were 1 to learn how sites recruit minority/underserved populations; 2 to better understand the catchment areas of the NRG institutions; and 3 to aid in planning education programs for accrual of minority/underserved populations. Results: The survey response rate was 34.9%. The most effective methods reported for recruiting minority/underserved participants were patient navigators (44.4% and translators (38.9%. All institutions reported using a mechanism for eligibility screening and 71% of institutions reported using a screening/enrollment tracking system. CCT training was required at 78.1% and cultural competency training was required at 47.5% of responding institutions. Only 19.9% of sites used community partners to assist with minority recruitment and just 37.1% of respondents reported a defined catchment area. Sites reported very little race and ethnicity data. Conclusion: This NRG Oncology online survey provides useful data for improvements in trial enrollment and training to recruit minority/underserved populations to CCT. Areas for further investigation include web-based methods for recruitment and tracking, cultural competency training, definition of catchment areas, use of patient navigators, and community partnerships. The survey results will guide recruitment training programs.

  12. Sources and Seasonality of Volatile Organic Compounds in the Northern Front Range Metropolitan Area

    Science.gov (United States)

    Abeleira, A.; Pollack, I. B.; Sive, B. C.; Zaragoza, J.; Lindaas, J.; Fischer, E. V.; Farmer, D.

    2016-12-01

    The Northern Front Range Metropolitan Area (NFRMA) of Colorado, with a growing population of over 3 million, was deemed an ozone (O3) nonattainment area (NAA) in 2008 despite continued work on NOx reductions. Ground-level O3 is produced from photochemical catalytic cycles initiated by the OH oxidation of volatile organic compounds (VOCs), and propagated through reactions involving peroxy (HO2+RO2) and NOx (NO + NO2) radicals. We measured a suite of speciated VOCs during two 8-week deployments (March-May 2015, July-September 2015) at the Boulder Atmospheric Observatory in Erie, CO. The spring deployment overlapped with the NOAA SONGNEX (Shale Oil and Natural Gas Nexus) campaign. The BAO site lies at an urban-rural interface in the NFRMA with multiple urban centers surrounding the site, a major interstate highway within 2 miles, local suburban development in Erie, agricultural operations in the surrounding counties, and recent rapid expansion of oil and gas development in adjacent Weld County. VOCs were measured hourly with a custom-built online gas chromatography system along with measurements of O3, NOx, PAN, CO, and CH4. VOC measurements included C2-C8 hydrocarbons (NMHCs), C1-C5 alkyl nitrates, C1-C2 halocarbons, and several oxygenated species (OVOCs: methyl ethyl ketone, acetone, acetaldehyde). Using Positive Matrix Factorization (PMF) we have identified four distinct VOC sources in the spring and five in the summer: 1) Oil and Natural Gas (ONG, e.g. C2 - C5 alkanes), 2) Traffic (e.g. ethyne & aromatics), 3) Background species (e.g. long-lived halogenated species), 4) Secondary production (e.g. C3-C5 alkyl nitrates & OVOCs), and for summer 5) Biogenic (e.g. isoprene). Using the source factors generated from the PMF analysis we calculated the VOC reactivity (VOCr) of each source. For both seasons, the ONG factor dominates VOCr in the mornings. In spring afternoons, a combination of background species and secondary products make up a large percentage of VOCr as

  13. Effects of a psychological skills training programme for underserved ...

    African Journals Online (AJOL)

    Effects of a psychological skills training programme for underserved rugby ... The development of psychological skills is an important, but often neglected part of ... Repeated measures two-way ANOVAs revealed significant main time effects, ...

  14. NOAA TIFF Image - 4m Bathymetric Depth Range of Red Snapper Research Areas in the South Atlantic Bight, 2010

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset contains unified Bathymetric Depth Range GeoTiffs with 4x4 meter cell resolution describing the topography of 15 areas along the shelf edge off the...

  15. Specific diversity and morphological indices of muriform rodents in some areas of Semipalatinsk test range zone

    International Nuclear Information System (INIS)

    Magda, I.N.; Chernykh, A.B.; Morozov, A.E.; Bushneva, I.A.; Ponyavkina, A.G.

    2002-01-01

    There were presented the results of the preliminary estimation of comparative specific diversity and morphological indices of muriform rodents inhabiting separate areas of the Semipalatinsk test site. (author)

  16. Habitat area and climate stability determine geographical variation in plant species range sizes

    DEFF Research Database (Denmark)

    Morueta-Holme, Naia; Enquist, Brian J.; McGill, Brian J.

    2013-01-01

    Despite being a fundamental aspect of biodiversity, little is known about what controls species range sizes. This is especially the case for hyperdiverse organisms such as plants. We use the largest botanical data set assembled to date to quantify geographical variation in range size for ~85,000 ...

  17. Areas of climate stability of species ranges in the Brazilian Cerrado

    DEFF Research Database (Denmark)

    Terribile, Levi Carina; Lima-Ribeiro, Matheus Souza; Bastos Araujo, Miguel

    2012-01-01

    uncertainties and to identify climatically stable areas, working with Cerrado tree species as a model organism. Ecological niche models were generated for 18 Cerrado tree species and their potential distributions were projected into past and future. Analyses of the sources of uncertainties in ensembles...... continuous climatically stable area was identified, which should be considered as a potential improvement for spatial prioritization for conservation....

  18. Physician assistants as servant leaders: meeting the needs of the underserved.

    Science.gov (United States)

    Huckabee, Michael J; Wheeler, Daniel W

    2011-01-01

    The purpose of this study was to determine if the level of servant leader characteristics in clinically practicing physician assistants (PAs) in underserved populations differed from PAs serving in other locales. Five subscales of servant leadership: altruistic calling, emotional healing, wisdom, persuasive mapping, and organizational stewardship, were measured in a quantitative study of clinically practicing PAs using a self-rating survey and a similar survey by others rating the PA. Of 777 PAs invited, 321 completed the survey. On a scale of 1 to 5, mean PA self-ratings ranged from 3.52 (persuasive mapping) to 4.05 (wisdom). Other raters' scores paired with the self-rated PA scores were comparable in all subscales except wisdom, which was rated higher by the other raters (4.32 by other raters, 4.01 by PAs, P= .002). There was no significant difference in the measures of servant leadership reported by PAs serving the underserved compared to PAs serving in other populations. Servant leader subscales were higher for PAs compared to previous studies of other health care or community leader populations. The results found that the PA population studied had a prominent level of servant leadership characteristics that did not differ between those working with underserved and nonunderserved populations.

  19. Improving Maternal and Child Health in Underserved Rural Areas of ...

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

    Maternal and child health is a priority for Nigeria, but there are significant challenges and opportunities at state levels that influence efforts to reduce deaths. This project will contribute to government efforts in Delta State to improve delivery and use of maternal and child healthcare services in three marginalized rural ...

  20. 77 FR 35245 - Substantially Underserved Trust Areas (SUTA)

    Science.gov (United States)

    2012-06-13

    ... statute (7 U.S.C. 306F (B)(2)) added to the RE Act as part of the Food, Conservation and Energy Act of... governments and is mindful of their sovereignty. The agency engages with tribes on a government to government...

  1. 76 FR 63846 - Substantially Underserved Trust Areas (SUTA)

    Science.gov (United States)

    2011-10-14

    ... Cost Rural Communities; 10.861, Public Television Station Digital Transition Grant Program; 10.862... rule do not impose substantial unreimbursed direct compliance costs on Indian tribal, Alaska native, or native Hawaiian governments and sovereign institutions or have tribal implications that preempt tribal...

  2. Sampling Studies at an Air Force Live-Fire Bombing Range Impact Area

    National Research Council Canada - National Science Library

    Jenkins, Thomas F; Hewitt, Alan D; Ramsey, Charles A; Bjella, Kevin L; Bigl, Susan R; Lambert, Dennis J

    2006-01-01

    .... The main objective was to assess the effectiveness of using a systematic-random, multi-increment sampling strategy for the collection of representative surface soil samples in areas where bombing...

  3. Engaging with Underserved Urban Communities on Climate Resilience

    Science.gov (United States)

    Akerlof, K.; Moser, F. C.; Baja, K.; Dindinger, J. M.; Chanse, V.; Rowan, K. E.; Rohring, B.

    2016-12-01

    Meeting the needs of urban high-risk/low-resource communities is one of the most critical challenges in improving climate resilience nationally, but little tailored information exists to guide community engagement efforts specifically for these contexts. This case study describes a collaboration between universities, local governments, and community members working in underserved neighborhoods of the City of Baltimore and Prince George's County, Maryland. In service of current and developing community programs, the team surveyed residents door-to-door about their perceptions of the socio-environmental risks they face, their priorities for change, and the ways in which communication may build protective social capital. We highlight theoretical, applied, and pedagogical aspects of the study that inform both the promise and limitations of these collaborations. These include: 1) the role of citizen participation in climate adaptation decision-making; 2) the meaning, use, and potential impact of community data; 3) balancing differing organizational priorities, timelines, and cultures within community-based projects; and 4) research participation of undergraduate students. The results of the survey illuminate climate risk perceptions in neighborhoods facing complex stressors with lessons for communication and engagement in other urban areas facing similar adaptation challenges.

  4. Test Areas B-71 and B-82 Range Environmental Assessment, Revision 1

    Science.gov (United States)

    2010-10-01

    areas on weekends and holidays when training missions are seldom conducted. 4.8.3 Alternative 2 Under Alternative 2, the frequency and total quantity...basis. The NEI includes emission estimates for all 50 states, the District of Columbia, Puerto Rico, and the Virgin Islands. Emission estimates for

  5. Fine-scale movements of rural free-ranging dogs in conservation areas in the temperate rainforest of the coastal range of southern Chile

    Science.gov (United States)

    Sepulveda, Maximiliano; Pelican, Katherine; Cross, Paul C.; Eguren, Antonieta; Singer, Randall S.

    2015-01-01

    Domestic dogs can play a variety of important roles for farmers. However, when in proximity to conservation areas, the presence of rural free-ranging dogs can be problematic due to the potential for predation of, competition with, or transmission of infectious disease to local threatened fauna. We used a frequent location radio tracking technology to study rural free-ranging dog movements and habitat use into sensitive conservation habitats. To achieve a better understanding of foray behaviors in dogs we monitored dogs (n = 14) in rural households located in an isolated area between the Valdivian Coastal Reserve and the Alerce Costero National Park in southern Chile. Dogs were mostly located near households (habitat compared to forest habitat including protected lands. Foraying dogs rarely used forest habitat and, when entered, trails and/or roads were selected for movement. Our study provides important information about how dogs interact in a fine-scale with wildlife habitat, and, in particular, protected lands, providing insight into how dog behavior might drive wildlife interactions, and, in turn, how an understanding of dog behavior can be used to manage these interactions.

  6. Test Area C-74 Complex Final Range Environmental Assessment at Eglin Air Force Base, Florida

    Science.gov (United States)

    2015-08-21

    Generally, in riparian areas the fire burns back the aboveground biomass leaving the root systems of riparian woody species such as titi and...such as dense deposits of shell , or clusters of artifacts) are encountered on the ground in the course of any mission activity, Management Practices...addition to chopping plant biomass , this practice created extensive ground disturbance that degraded plant ground cover and exposed soils. Appendix A TA

  7. Phytosociological attributes of plant biodiversity of the Fort Ranikot and adjoining area (Kirthar range)

    International Nuclear Information System (INIS)

    Ishtiaq, M.; Perveen, A.

    2015-01-01

    The plant biodiversity, floristic composition and phytosociological attributes of the vascular plants of Fort Ranikot were analyzed. A total of 107 taxa were collected belonging to 41 families and 78 genera. The largest family was Poaceae containing 9 taxa, while the other major families were Papilionaceae with 6 species; Asclepiadaceae, Mimosaceae, and Solanaceae comprising of 5 species each respectively. Majority of the taxa are common throughout the study area, however, 6 species Viz. Aristolochia bracteolata, Physorrhynchus brahuicus, Plantago ciliata, Polygala erioptera, Salvadora persica and Viola stocksii were found to be very rare. The flora is dominated by Chamaephyte, followed by Therophytes, Phanerophytes, Hemicryptophytes and climbers. The aim of the present study is to provide comprehensive inventory of the study area along with its phytosociology and ecological parameters. Collectively on the basis of important value index six plants communities were recognized from different sites of the study area. The study area was categorized into six ecological sites on the basis of microclimatic conditions and topography. For comparison in these sites similarity index, beta diversity, diversity index, species evenness and maturity index was also calculated. The soil texture classes varied from loam to sandy loam and slit loam with pH of 7.78-8.24, electrical conductivity varied from 687-827 EC micro S/cm, Total dissolved salts varied from 0.36-0.71 mg-1, CaCO/sub 3/ varied from 3.48-4.21% and organic matter varied from 0.39-1.24%. Present study predict that there are certain edaphic factors, altitudinal variation, soil texture and amount of organic matter which are responsible for variation in vegetation. (author)

  8. Corrective Action Plan for Corrective Action Unit 407: Roller Coaster RADSAFE Area, Tonopah Test Range, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    T. M. Fitzmaurice

    2000-05-01

    This Corrective Action Plan (CAP) has been prepared for the Roller Coaster RADSAFE Area Corrective Action Unit 407 in accordance with the Federal Facility and Consent Order (Nevada Division of Environmental Protection [NDEP] et al., 1996). This CAP provides the methodology for implementing the approved Corrective Action Alternative as listed in the Corrective Action Decision Document (U.S. Department of Energy, Nevada Operations Office, 1999). The RCRSA was used during May and June of 1963 to decontaminate vehicles, equipment, and personnel from the Clean Slate tests. The Constituents of Concern (COCs) identified during the site characterization include plutonium, uranium, and americium. No other COCS were identified. The following closure actions will be implemented under this plan: (1) Remove and dispose of surface soils which are over three times background for the area. Soils identified for removal will be disposed of at an approved disposal facility. Excavated areas will be backfilled with clean borrow soil fi-om a nearby location. (2) An engineered cover will be constructed over the waste disposal pit area where subsurface COCS will remain. (3) Upon completion of the closure and approval of the Closure Report by NDEP, administrative controls, use restrictions, and site postings will be used to prevent intrusive activities at the site. Barbed wire fencing will be installed along the perimeter of this unit. Post closure monitoring will consist of site inspections to determine the condition of the engineered cover. Any identified maintenance and repair requirements will be remedied within 90 working days of discovery and documented in writing at the time of repair. Results of all inspections/repairs for a given year will be addressed in a single report submitted annually to the NDEP.

  9. Development of wide area tracking method for augmented reality using multi-range fiducials

    International Nuclear Information System (INIS)

    Ishii, Hirotake; Fujino, Hidenori; Yan, Weida; Yang, Shoufeng; Shimoda, Hiroshi; Izumi, Masanori

    2009-01-01

    A new fiducial marker for augmented reality was designed along with a method that recognizes the markers captured by a camera and calculates the relative position and orientation between the markers and the camera. These markers can be used at both long and short distances without increasing the number of markers pasted in the environment. Results of the experimental evaluation show that the new marker can be used in a larger area than circular markers and more stably than square markers. (author)

  10. Final Range Environmental Assessment for Test Areas C-87 and D-51 at Eglin Air Force Base, Florida

    Science.gov (United States)

    2015-05-01

    TA C-87 consists of one septic tank and associated leach field. There are nine septic tanks and associated leach fields on TA D-51. Under...storage tank , and septic systems, and connecting the test area to the Okaloosa County water and wastewater utility lines. The existing utility systems on T...8840E Water Treatment Plan 8840F Biological/Chemical Training Area 13 (acres) 8840ST Septic Tank at 8840 8840W Well at 8840 8841 Range Support

  11. Creating A Sustainable Model of Spine Care in Underserved Communities

    DEFF Research Database (Denmark)

    Haldeman, Scott; Nordin, Margareta; Outerbridge, Geoff

    2015-01-01

    The world lacks sustainable models of care to manage spinal disorders in poor and underserved communities. The purpose of this article is to: (1) review the rationale and importance of developing a sustainable evidence-based model of care at low cost for people with spinal disorders in underserved...... adequate care, World Spine Care (WSC) was established to "improve lives in underserved communities through sustainable, integrated, evidence-based, spinal care." WSC is comprised of volunteers and institutions from 6 continents and several countries, and incorporates a Board of Directors, an executive...... are adapted to and integrated within each community in collaboration with local decision makers, existing health care workers and traditional healers. Cornerstones of WSC's emphasis on long-term sustainability are (1) education of community partners, governments and local health professionals, and (2...

  12. Birds of two protected areas in the southern range of the Brazilian Araucaria forest

    Directory of Open Access Journals (Sweden)

    Ismael Franz

    2014-01-01

    Full Text Available Over 70% of threatened birds in the state of Rio Grande do Sul, south Brazil, inhabit forest environments. The creation and maintenance of protected areas is one of the most important measures aiming to mitigate these problems. However, the knowledge of the local biodiversity is essential so that these areas can effectively preserve the natural resources. Between 2004 and 2009 we sampled the avifauna in two conservation units in Rio Grande do Sul: Floresta Nacional de Canela (FNC and Parque Natural Municipal da Ronda (PMR, both representative of the Mixed Humid Forest (Araucaria Forest. A total of 224 species was recorded, 116 at FNC and 201 at PMR, ten of which threatened regionally: Pseudastur polionotus, Odontophorus capueira, Patagioenas cayennensis, Amazona pretrei, A. vinacea, Triclaria malachitacea, Campephilus robustus, Grallaria varia, Procnias nudicollis and Sporophila melanogaster. Richness and species composition seem to be related to different stages of forest conservation, to size and connectivity, as well as to the diversity of environments. The better conservation of PMR compared to FNC, allied to its geographic position, results in a richer avifauna, with a larger amount of rare and endangered species, as well as species sensitive to disturbance and endemic to the Atlantic Rainforest. We suggest management actions aiming the conservation and the long-term recovery of natural environments at these sites.

  13. Modeling the potential area of occupancy at fine resolution may reduce uncertainty in species range estimates

    DEFF Research Database (Denmark)

    Jiménez-Alfaro, Borja; Draper, David; Nogues, David Bravo

    2012-01-01

    and maximum entropy modeling to assess whether different sampling (expert versus systematic surveys) may affect AOO estimates based on habitat suitability maps, and the differences between such measurements and traditional coarse-grid methods. Fine-scale models performed robustly and were not influenced...... by survey protocols, providing similar habitat suitability outputs with high spatial agreement. Model-based estimates of potential AOO were significantly smaller than AOO measures obtained from coarse-scale grids, even if the first were obtained from conservative thresholds based on the Minimal Predicted...... permit comparable measures among species. We conclude that estimates of AOO based on fine-resolution distribution models are more robust tools for risk assessment than traditional systems, allowing a better understanding of species ranges at habitat level....

  14. Use of Atlantic Forest protected areas by free-ranging dogs: estimating abundance and persistence of use

    Science.gov (United States)

    Paschoal, Ana Maria; Massara, Rodrigo; Bailey, Larissa L.; Kendall, William L.; Doherty, Paul F.; Hirsch, Andre; Chiarello, Adriano; Paglia, Adriano

    2016-01-01

    Worldwide, domestic dogs (Canis familiaris) are one of the most common carnivoran species in natural areas and their populations are still increasing. Dogs have been shown to impact wildlife populations negatively, and their occurrence can alter the abundance, behavior, and activity patterns of native species. However, little is known about abundance and density of the free-ranging dogs that use protected areas. Here, we used camera trap data with an open-robust design mark–recapture model to estimate the number of dogs that used protected areas in Brazilian Atlantic Forest. We estimated the time period these dogs used the protected areas, and explored factors that influenced the probability of continued use (e.g., season, mammal richness, proportion of forest), while accounting for variation in detection probability. Dogs in the studied system were categorized as rural free-ranging, and their abundance varied widely across protected areas (0–73 individuals). Dogs used protected areas near human houses for longer periods (e.g., >50% of sampling occasions) compared to more distant areas. We found no evidence that their probability of continued use varied with season or mammal richness. Dog detection probability decreased linearly among occasions, possibly due to the owners confining their dogs after becoming aware of our presence. Comparing our estimates to those for native carnivoran, we found that dogs were three to 85 times more abundant than ocelots (Leopardus pardalis), two to 25 times more abundant than puma (Puma concolor), and approximately five times more abundant than the crab-eating fox (Cerdocyon thous). Combining camera trapping data with modern mark–recapture methods provides important demographic information on free-ranging dogs that can guide management strategies to directly control dogs' abundance and ranging behavior.

  15. Occupational safety and health education and training for underserved populations.

    Science.gov (United States)

    O'Connor, Tom; Flynn, Michael; Weinstock, Deborah; Zanoni, Joseph

    2014-01-01

    This article presents an analysis of the essential elements of effective occupational safety and health education and training programs targeting underserved communities. While not an exhaustive review of the literature on occupational safety and health training, the paper provides a guide for practitioners and researchers to the key factors they should consider in the design and implementation of training programs for underserved communities. It also addresses issues of evaluation of such programs, with specific emphasis on considerations for programs involving low-literacy and limited-English-speaking workers.

  16. Natural regeneration of deforested areas dominated by Pteridium aquilinum (L. Kuhn located in the serra da mantiqueira mountain range

    Directory of Open Access Journals (Sweden)

    Selma Cristina Ribeiro

    2013-03-01

    Full Text Available This study was set out with the objective of analyzing successional process in areas which are deforested and dominated by Pteridium aquilinum in the Serra da Mantiqueira mountain range, by researching the natural regeneration of shrub and tree species and evaluating both disturbance history and the edaphic conditions on the natural regeneration community. This research investigated two abandoned pasture areas in Bocaina de Minas county exposed to natural regeneration intervals ranging from six years (area named 6A to twenty years (area named 20A. The inventory occurred from sixty plots of 10 m², where all samples surveyed were between 0.15 m and 3 m high. All samples were identified and both the diameter in ground level and total height of the specimens were measured. The survey totaled 1,159 samples and 53 species. Melastomataceae was registered with the highest species richness and the highest specimen abundance. The two sampled areas showed species composition differences, with Jaccard similarity coefficient equal to 3.7%. The canonical correspondence analysis showed the correlations between natural regeneration stratum and non-labile phosphorus and clay in the 6A area. On the other hand, the 20A area showed correlations between plant regeneration and the K, P, Ca²+, Al³+ levels, with higher pH levels, and with the sum of exchangeable bases. In addition, the vegetation surveyed in area 20A was correlated with higher Pteridium population density. The results showed that the dominance of Pteridium aquilinum leads to successional process under inhibition, in which the ferns act negatively on the richness and abundance of shrub populations. It was also confirmed the Pteridium's affinity to steep areas, mainly in higher altitudes, where the soil is acid, as well as its preference to disturbed areas. Moreover, we highlight the fragilities of the mountain environments and the importance of preserving natural vegetation, as well as the bracken

  17. An aerial radiological survey of the Tonopah Test Range including Clean Slate 1,2,3, Roller Coaster, decontamination area, Cactus Springs Ranch target areas. Central Nevada

    International Nuclear Information System (INIS)

    Proctor, A.E.; Hendricks, T.J.

    1995-08-01

    An aerial radiological survey was conducted of major sections of the Tonopah Test Range (TTR) in central Nevada from August through October 1993. The survey consisted of aerial measurements of both natural and man-made gamma radiation emanating from the terrestrial surface. The initial purpose of the survey was to locate depleted uranium (detecting 238 U) from projectiles which had impacted on the TTR. The examination of areas near Cactus Springs Ranch (located near the western boundary of the TTR) and an animal burial area near the Double Track site were secondary objectives. When more widespread than expected 241 Am contamination was found around the Clean Slates sites, the survey was expanded to cover the area surrounding the Clean Slates and also the Double Track site. Results are reported as radiation isopleths superimposed on aerial photographs of the area

  18. Chronic disease management in rural and underserved populations: innovation and system improvement help lead to success.

    Science.gov (United States)

    Bolin, Jane; Gamm, Larry; Kash, Bita; Peck, Mitchell

    2005-03-01

    Successful implementation of disease management (DM) is based on the ability of an organization to overcome a variety of barriers to deliver timely, appropriate care of chronic illnesses. Such programs initiate DM services to patient populations while initiating self-management education among medication-resistant patients who are chronically ill. Despite formidable challenges, rural health care providers have been successful in initiating DM programs and have discovered several ways in which these programs benefit their organizations. This research reports on six DM programs that serve large rural and underserved populations and have demonstrated that DM can be successfully implemented in such areas.

  19. Smartphone threshold audiometry in underserved primary health-care contexts.

    Science.gov (United States)

    Sandström, Josefin; Swanepoel, De Wet; Carel Myburgh, Hermanus; Laurent, Claude

    2016-01-01

    To validate a calibrated smartphone-based hearing test in a sound booth environment and in primary health-care clinics. A repeated-measure within-subject study design was employed whereby air-conduction hearing thresholds determined by smartphone-based audiometry was compared to conventional audiometry in a sound booth and a primary health-care clinic environment. A total of 94 subjects (mean age 41 years ± 17.6 SD and range 18-88; 64% female) were assessed of whom 64 were tested in the sound booth and 30 within primary health-care clinics without a booth. In the sound booth 63.4% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dB HL corresponded to smartphone thresholds within ≤10 dB in 80.6% of cases with an average threshold difference of -1.6 dB ± 9.9 SD. In primary health-care clinics 13.7% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dBHL corresponded to smartphone thresholds within ≤10 dB in 92.9% of cases with an average threshold difference of -1.0 dB ± 7.1 SD. Accurate air-conduction audiometry can be conducted in a sound booth and without a sound booth in an underserved community health-care clinic using a smartphone.

  20. Rb-Sr geochronolgy of the Jervois Range area in the eastern part of the Arunta Block, NT

    International Nuclear Information System (INIS)

    Black, L.P.

    1980-01-01

    New Rb-Sr isotopic data are presented for the Jervois Range area in the eastern part of the Arunta Block. The post-metamorphic Jinka and Jervois Granites yield an age of about 1750 m.y. An alaskitic granite is dated at about 1460 m.y. Pegmatite formation occurred about 1660 m.y. ago. Mineral ages are generally younger than total-rock ages, but no values significantly less than that of the alaskitic granite were found. This means that the Alice Springs Orogeny, which extensively reset large areas of the Arunta Block to the west, did not effect the Jervois area. In this and other geochronological comparisons, the Jervois area seems more akin to the rocks of the Tennant Creek Block, 400 km to the northwest, than to those of the Arunta Block

  1. Occupational Health and Sleep Issues in Underserved Populations.

    Science.gov (United States)

    Kalliny, Medhat; McKenzie, Judith Green

    2017-03-01

    Sleep disorders and occupational hazards, injuries, and illnesses impact an individual's overall health. In the United States, substantial racial, ethnic, and socioeconomic disparities exist in sleep and occupational health. Primary care physicians working in underserved communities should be aware of this disparity and target these higher-risk populations for focused evaluation and intervention. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. The Online-Counseling Debate: A View toward the Underserved

    Science.gov (United States)

    Sanchez-Page, Delida

    2005-01-01

    This article responds to some important issues that Mallen, Vogel, Rochlen, and Day raise in "Online Counseling: Reviewing the Literature from a Counseling Psychology Framework." This reaction reviews the appropriateness of online counseling for underserved populations. The author provides suggestions for better serving historically undeserved…

  3. Empowering underserved populations through cancer prevention and early detection.

    Science.gov (United States)

    Rivera-Colón, Venessa; Ramos, Roberto; Davis, Jenna L; Escobar, Myriam; Inda, Nikki Ross; Paige, Linda; Palencia, Jeannette; Vives, Maria; Grant, Cathy G; Green, B Lee

    2013-12-01

    It is well documented that cancer is disproportionately distributed in racial/ethnic minority groups and medically underserved communities. In addition, cancer prevention and early detection represent the key defenses to combat cancer. The purpose of this article is to showcase the comprehensive health education and community outreach activities at the H. Lee Moffitt Cancer Center and Research Institute (Moffitt) designed to promote and increase access to and utilization of prevention and early detection services among underserved populations. One of Moffitt's most important conduits for cancer prevention and early detection among underserved populations is through its community education and outreach initiatives, in particular, the Moffitt Program for Outreach Wellness Education and Resources (M-POWER). M-POWER works to empower underserved populations to make positive health choices and increase screening behaviors through strengthening collaboration and partnerships, providing community-based health education/promotion, and increasing access to care. Effective, empowering, and culturally and linguistically competent health education and community outreach, is key to opening the often impenetrable doors of cancer prevention and early detection to this society's most vulnerable populations.

  4. Exercise and Sports Medicine Issues in Underserved Populations.

    Science.gov (United States)

    Morelli, Vincent; Bedney, Daniel L; Eric Dadush, Arie

    2017-03-01

    Primary care providers can make a strong argument for exercise promotion in underserved communities. The benefits are vitally important in adolescent physical, cognitive, and psychological development as well as in adult disease prevention and treatment. In counseling such patients, we should take into account a patient's readiness for change and the barriers to exercise. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Can the soil fauna of boreal forests recover from lead-derived stress in a shooting range area?

    Science.gov (United States)

    Selonen, Salla; Liiri, Mira; Setälä, Heikki

    2014-04-01

    The responses of soil faunal communities to lead (Pb) contamination in a shooting range area and the recovery of these fauna after range abandonment were studied by comparing the communities at an active shotgun shooting range, an abandoned shooting range, and a control site, locating in the same forest. Despite the similar overall Pb pellet load at the shooting ranges, reaching up to 4 kg m(-2), Pb concentrations in the top soil of the abandoned range has decreased due to the accumulation of detritus on the soil surface. As a consequence, soil animal communities were shown to recover from Pb-related disturbances by utilizing the less contaminated soil layer. Microarthropods showed the clearest signs of recovery, their numbers and community composition being close to those detected at the control site. However, in the deepest organic soil layer, the negative effects of Pb were more pronounced at the abandoned than at the active shooting range, which was detected as altered microarthropod and nematode community structures, reduced abundances of several microarthropod taxa, and the total absence of enchytraeid worms. Thus, although the accumulation of fresh litter on soil surface can promote the recovery of decomposer communities in the top soil, the gradual release of Pb from corroding pellets may pose a long-lasting risk for decomposer taxa deeper in the soil.

  6. Using Range-Wide Abundance Modeling to Identify Key Conservation Areas for the Micro-Endemic Bolson Tortoise (Gopherus flavomarginatus.

    Directory of Open Access Journals (Sweden)

    Cinthya A Ureña-Aranda

    Full Text Available A widespread biogeographic pattern in nature is that population abundance is not uniform across the geographic range of species: most occurrence sites have relatively low numbers, whereas a few places contain orders of magnitude more individuals. The Bolson tortoise Gopherus flavomarginatus is endemic to a small region of the Chihuahuan Desert in Mexico, where habitat deterioration threatens this species with extinction. In this study we combined field burrows counts and the approach for modeling species abundance based on calculating the distance to the niche centroid to obtain range-wide abundance estimates. For the Bolson tortoise, we found a robust, negative relationship between observed burrows abundance and distance to the niche centroid, with a predictive capacity of 71%. Based on these results we identified four priority areas for the conservation of this microendemic and threatened tortoise. We conclude that this approach may be a useful approximation for identifying key areas for sampling and conservation efforts in elusive and rare species.

  7. Streamlined Approach for Environmental Restoration Plan for Corrective Action Unit 425: Area 9 Main Lake Construction Debris Disposal Area, Tonopah Test Range, Nevada; TOPICAL

    International Nuclear Information System (INIS)

    K. B. Campbell

    2002-01-01

    This Streamlined Approach for Environmental Restoration (SAFER) Plan addresses the action necessary for the closure of Corrective Action Unit (CAU) 425, Area 9 Main Lake Construction Debris Disposal Area. This CAU is currently listed in Appendix III of the Federal Facility Agreement and Consent Order (FFACO, 1996). This site will be cleaned up under the SAFER process since the volume of waste exceeds the 23 cubic meters (m(sup 3)) (30 cubic yards[yd(sup 3)]) limit established for housekeeping sites. CAU 425 is located on the Tonopah Test Range (TTR) and consists of one Corrective Action Site (CAS) 09-08-001-TA09, Construction Debris Disposal Area (Figure 1). CAS 09-08-001-TA09 is an area that was used to collect debris from various projects in and around Area 9. The site is located approximately 81 meters (m) (265 feet[ft]) north of Edwards Freeway northeast of Main Lake on the TTR. The site is composed of concrete slabs with metal infrastructure, metal rebar, wooden telephone poles, and concrete rubble from the Hard Target and early Tornado Rocket sled tests. Other items such as wood scraps, plastic pipes, soil, and miscellaneous nonhazardous items have also been identified in the debris pile. It is estimated that this site contains approximately 2280 m(sup 3) (3000 yd(sup 3)) of construction-related debris

  8. DEM ASSESSMENT DERIVED FROM CLOSE RANGE PHOTOGRAMMETRY: A CASE STUDY FROM KADAVUR AREA, KARUR DISTRICT, TAMIL NADU, INDIA

    Directory of Open Access Journals (Sweden)

    S. Anbarasan

    2012-07-01

    Full Text Available Close-Range Photogrammetry is an accurate, cost effective technique of collecting measurements of real world objects and conditions, directly from photographs. Photogrammetry utilizes digital images to obtain accurate measurements and geometric data of the object or area of interest, in order to provide spatial information for Engineering design, spatial surveys or 3D modeling. The benefits of close-range Photogrammetry over other field procedures are purported to be: Increased accuracy; complete as-built information; reduced costs; reduced on-site time; and effective for small and large projects. The same basic principle of traditional Aerial Photogrammetry can be applied to stereoscopic pictures taken from lower altitudes or from the ground. Terrestrial, ground-based, and close-range are all descriptive terms that refer to photos taken with an object-to-camera distance less than 300m (1000 feet. (Matthews, N.A, 2008. Close range Photogrammetry is a technique for obtaining the geometric information (e.g. position, distance, size and shape of any object in 3D space that was imaged on the two dimensional (2D photos, (Wolf, P.R, et.al, 2000 DEM Generation requires many processing and computation, such as camera calibration, stereo matching, editing, and interpolation. All the mentioned steps contribute to the quality of DEM. Image on close range Photogrammetry can be captured using three kind of camera: metric camera, semi-metric camera, and non-metric camera (Hanke, K., et.al, 2002. In this paper DEM quality assessed at Kadavur area, Karur district, Tamil Naudu, India using Close Range Photogrammetry technique, Commercial Digital Camera and Leica Photogrammetry Suite.

  9. Factors Associated With Medical School Graduates' Intention to Work With Underserved Populations: Policy Implications for Advancing Workforce Diversity.

    Science.gov (United States)

    Garcia, Andrea N; Kuo, Tony; Arangua, Lisa; Pérez-Stable, Eliseo J

    2018-01-01

    Given projected U.S. physician shortages across all specialties that will likely impact underserved areas disproportionately, the authors sought to explore factors most correlated with medical school graduates' intention to work with underserved populations (IWUP). Data from the 2010-2012 Association of American Medical Colleges Medical School Graduation Questionnaire (n = 40,846) were analyzed. Variables (demographics, career preference, debt burden, intention to enter loan forgiveness programs) were examined using chi-square tests and logistic regression models. Respondents included 49.5% (20,228/40,846) women, 16.6% (6,771/40,837) underrepresented minorities (URMs), and 32.4% (13,034/37,342) with primary care intent. The median educational debt was $160,000. Respondents who were women (adjusted odds ratio [aOR] 1.59, 95% confidence interval [CI] 1.49, 1.70), URMs (aOR 2.50, 95% CI 2.30, 2.72), intended to enter loan forgiveness programs (aOR 2.44, 95% CI 2.26, 2.63), intended to practice primary care (aOR 1.65, 95% CI 1.54, 1.76), and intended to emphasize nonclinical careers (aOR 1.23, 95% CI 1.11, 1.37) had greater odds of reporting IWUP. Among those who chose specialties and careers with a nonclinical emphasis, and among those with greater burdens of educational and consumer debt, URMs were nearly twice as likely as other minorities and whites to report IWUP. Findings suggest physician characteristics that may be associated with filling workforce gaps in underserved areas. Restructuring financial incentive programs to support physician leaders and specialists with characteristics associated with IWUP may complement similar policies in primary care and could have key impacts on health equity in underserved areas.

  10. Risks of avian influenza transmission in areas of intensive free-ranging duck production with wild waterfowl

    Science.gov (United States)

    Cappelle, Julien; Zhao, Delong; Gilbert, Marius; Newman, Scott H.; Takekawa, John Y.; Gaidet, Nicolas; Prosser, Diann J.; Liu, Ying; Li, Peng; Shu, Yuelong; Xiao, Xiangming

    2014-01-01

    For decades, southern China has been considered to be an important source for emerging influenza viruses since key hosts live together in high densities in areas with intensive agriculture. However, the underlying conditions of emergence and spread of avian influenza viruses (AIV) have not been studied in detail, particularly the complex spatiotemporal interplay of viral transmission between wild and domestic ducks, two major actors of AIV epidemiology. In this synthesis, we examine the risks of avian influenza spread in Poyang Lake, an area of intensive free-ranging duck production and large numbers of wild waterfowl. Our synthesis shows that farming of free-grazing domestic ducks is intensive in this area and synchronized with wild duck migration. The presence of juvenile domestic ducks in harvested paddy fields prior to the arrival and departure of migrant ducks in the same fields may amplify the risk of AIV circulation and facilitate the transmission between wild and domestic populations. We provide evidence associating wild ducks migration with the spread of H5N1 in the spring of 2008 from southern China to South Korea, Russia, and Japan, supported by documented wild duck movements and phylogenetic analyses of highly pathogenic avian influenza H5N1 sequences. We suggest that prevention measures based on a modification of agricultural practices may be implemented in these areas to reduce the intensity of AIV transmission between wild and domestic ducks. This would require involving all local stakeholders to discuss feasible and acceptable solutions.

  11. Leadership Advocacy: Bringing Nursing to the Homeless and Underserved.

    Science.gov (United States)

    Porter-OʼGrady, Tim

    Nurses have historically played a key role in advocacy and service for all members of the community, including those who are traditionally underserved by other providers or the health system. Nurses from a local Atlanta community health system, both clinical and administrative, have continued this tradition by developing an advocacy and service program for the downtown homeless of Atlanta. From its beginnings as a highly informal volunteer program to its current structure as a strongly integrated community health center for the underserved and homeless of Atlanta, local nurses have demonstrated their strong value of service advocacy. Their leadership, insight, discipline, and strategic development have facilitated the growth of a focused, viable health service network for marginalized people of the city of Atlanta.

  12. Impact of a regional distributed medical education program on an underserved community: perceptions of community leaders.

    Science.gov (United States)

    Toomey, Patricia; Lovato, Chris Y; Hanlon, Neil; Poole, Gary; Bates, Joanna

    2013-06-01

    To describe community leaders' perceptions regarding the impact of a fully distributed undergraduate medical education program on a small, medically underserved host community. The authors conducted semistructured interviews in 2007 with 23 community leaders representing, collectively, the education, health, economic, media, and political sectors. They reinterviewed six participants from a pilot study (2005) and recruited new participants using purposeful and snowball sampling. The authors employed analytic induction to organize content thematically, using the sectors as a framework, and they used open coding to identify new themes. The authors reanalyzed transcripts to identify program outcomes (e.g., increased research capacity) and construct a list of quantifiable indicators (e.g., number of grants and publications). Participants reported their perspectives on the current and anticipated impact of the program on education, health services, the economy, media, and politics. Perceptions of impact were overwhelmingly positive (e.g., increased physician recruitment), though some were negative (e.g., strains on health resources). The authors identified new outcomes and confirmed outcomes described in 2005. They identified 16 quantifiable indicators of impact, which they judged to be plausible and measureable. Participants perceive that the regional undergraduate medical education program in their community has broad, local impacts. Findings suggest that early observed outcomes have been maintained and may be expanding. Results may be applicable to medical education programs with distributed or regional sites in similar rural, remote, and/or underserved regions. The areas of impact, outcomes, and quantifiable indicators identified will be of interest to future researchers and evaluators.

  13. Subpixel Snow-covered Area Including Differentiated Grain Size from AVIRIS Data Over the Sierra Nevada Mountain Range

    Science.gov (United States)

    Hill, R.; Calvin, W. M.; Harpold, A. A.

    2016-12-01

    Mountain snow storage is the dominant source of water for humans and ecosystems in western North America. Consequently, the spatial distribution of snow-covered area is fundamental to both hydrological, ecological, and climate models. Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) data were collected along the entire Sierra Nevada mountain range extending from north of Lake Tahoe to south of Mt. Whitney during the 2015 and 2016 snow-covered season. The AVIRIS dataset used in this experiment consists of 224 contiguous spectral channels with wavelengths ranging 400-2500 nanometers at a 15-meter spatial pixel size. Data from the Sierras were acquired on four days: 2/24/15 during a very low snow year, 3/24/16 near maximum snow accumulation, and 5/12/16 and 5/18/16 during snow ablation and snow loss. Previous retrieval of subpixel snow-covered area in alpine regions used multiple snow endmembers due to the sensitivity of snow spectral reflectance to grain size. We will present a model that analyzes multiple endmembers of varying snow grain size, vegetation, rock, and soil in segmented regions along the Sierra Nevada to determine snow-cover spatial extent, snow sub-pixel fraction and approximate grain size or melt state. The root mean squared error will provide a spectrum-wide assessment of the mixture model's goodness-of-fit. Analysis will compare snow-covered area and snow-cover depletion in the 2016 year, and annual variation from the 2015 year. Field data were also acquired on three days concurrent with the 2016 flights in the Sagehen Experimental Forest and will support ground validation of the airborne data set.

  14. Entanglement contour perspective for "strong area-law violation" in a disordered long-range hopping model

    Science.gov (United States)

    Roy, Nilanjan; Sharma, Auditya

    2018-03-01

    We numerically investigate the link between the delocalization-localization transition and entanglement in a disordered long-range hopping model of spinless fermions by studying various static and dynamical quantities. This includes the inverse participation ratio, level statistics, entanglement entropy, and number fluctuations in the subsystem along with quench and wave-packet dynamics. Finite systems show delocalized, quasilocalized, and localized phases. The delocalized phase shows strong area-law violation, whereas the (quasi)localized phase adheres to (for large subsystems) the strict area law. The idea of "entanglement contour" nicely explains the violation of area law and its relationship with "fluctuation contour" reveals a signature at the transition point. The relationship between entanglement entropy and number fluctuations in the subsystem also carries signatures for the transition in the model. Results from the Aubry-Andre-Harper model are compared in this context. The propagation of charge and entanglement are contrasted by studying quench and wave-packet dynamics at the single-particle and many-particle levels.

  15. Find Shortage Areas: HPSA & MUA/P by Address

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Find Shortage Areas: Health Professional Shortage Area (HPSA) and Medically Underserved Area/Population (MUA/P) by Address tool helps you determine if a specific...

  16. A spatial database of bedding attitudes to accompany Geologic map of the greater Denver area, Front Range Urban Corridor, Colorado

    Science.gov (United States)

    Trimble, Donald E.; Machette, Michael N.; Brandt, Theodore R.; Moore, David W.; Murray, Kyle E.

    2003-01-01

    This digital map shows bedding attitude symbols display over the geographic extent of surficial deposits and rock stratigraphic units (formations) as compiled by Trimble and Machette 1973-1977 and published in 1979 (U.S. Geological Survey Map I-856-H) under the Front Range Urban Corridor Geology Program. Trimble and Machette compiled their geologic map from published geologic maps and unpublished geologic mapping having varied map unit schemes. A convenient feature of the compiled map is its uniform classification of geologic units that mostly matches those of companion maps to the north (USGS I-855-G) and to the south (USGS I-857-F). Published as a color paper map, the Trimble and Machette map was intended for land-use planning in the Front Range Urban Corridor. This map recently (1997-1999), was digitized under the USGS Front Range Infrastructure Resources Project (see cross-reference). In general, the mountainous areas in the west part of the map exhibit various igneous and metamorphic bedrock units of Precambrian age, major faults, and fault brecciation zones at the east margin (5-20 km wide) of the Front Range. The eastern and central parts of the map (Colorado Piedmont) depict a mantle of unconsolidated deposits of Quaternary age and interspersed outcroppings of Cretaceous or Tertiary-Cretaceous sedimentary bedrock. The Quaternary mantle is comprised of eolian deposits (quartz sand and silt), alluvium (gravel, sand, and silt of variable composition), colluvium, and few landslides. At the mountain front, north-trending, dipping Paleozoic and Mesozoic sandstone, shale, and limestone bedrock formations form hogbacks and intervening valleys.

  17. The Inwood Astronomy Project: 100 Nights in Manhattan---An Outreach Initiative to Underserved Communities

    Science.gov (United States)

    Kendall, J. S.

    2008-11-01

    Observing the night sky in New York City is a challenge. However, there is a popular, and even club-going, interest in science in New York City. On the edges of that interest, most people that live in New York City have never had the opportunity to look through a telescope, particularly in underserved areas such as Northern Manhattan. The presenter discusses plans for frequent observing sessions utilizing the parks in New York City combined with public classes at the New York Public Library. Both observing sessions and classes will be held in the ethnically, racially and economically diverse Bronx and Manhattan neighborhoods of Washington Heights, Marble Hill and Inwood. Integration with area middle, elementary and high schools is also discussed. Particular issues surrounding publicity and the need for showmanship in an image-driven community with numerous entertainment opportunities are also discussed.

  18. Corrective Action Plan for Corrective Action Unit 428: Area 3 Septic Waste Systems 1 and 5 Tonopah Test Range, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    D. S. Tobiason

    2000-08-01

    Area 3 Septic Waste Systems 1 and 5 are located in Area 3 of the Tonopah Test Range (TTR) (Figure 1). The site is listed in the Federal Facility Agreement and Consent Order (FFACO, 1996) as Corrective Action Unit (CAU) 428 and includes Corrective Action Sites 03-05-002-SW01 (Septic Waste System 1 [SWS 1]), and 03-05-002-SW05 (Septic Waste System 5 [SWS 5]). The site history for the CAU is provided in the Corrective Action Investigation Plan (U.S. Department of Energy, Nevada Operations Office [DOE/NV], 1999). SWS 1 consists of two leachfields and associated septic tanks. SWS 1 received effluent from both sanitary and industrial sources from various buildings in Area 3 of the TTR (Figure 2). SWS 5 is comprised of one leachfield and outfall with an associated septic tank. SWS 5 received effluent from sources in Building 03-50 in Area 3 of the TTR (Figure 2). Both systems were active until 1990 when a consolidated sewer system was installed. The purpose of this Corrective Action Plan (CAP) is to provide the strategy and methodology to close the Area 3 SWS 1 and 5. The CAU will be closed following state and federal regulations and the FFACO (1996). Site characterization was done during May and June 1999. Samples of the tank contents, leachfield soil, and soil under the tanks and pipes were collected. The results of the characterization were reported in the Corrective Action Decision Document (CADD) (DOE/NV, 2000). Additional sampling was done in May 2000, the results of which are presented in this plan. Soil sample results indicated that two constituents of concern were detected above Preliminary Action Levels (PALs). Total arsenic was detected at a concentration of 68.7 milligrams per kilogram (mg/kg). The arsenic was found under the center distribution line at the proximal end of the SWS 5 Leachfield (Figure 3). Total benzo(a)pyrene was detected at a concentration of 480 micrograms per kilogram ({micro}g/kg). The benzo(a)pyrene was found in the soil under the

  19. Closure Report for Corrective Action Unit 408: Bomblet Target Area Tonopah Test Range (TTR), Nevada, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Mark Krauss

    2010-09-01

    This Closure Report (CR) presents information supporting the closure of Corrective Action Unit (CAU) 408: Bomblet Target Area (TTR), Tonopah Test Range, Nevada. This CR complies with the requirements of the Federal Facility Agreement and Consent Order that was agreed to by the State of Nevada; U.S. Department of Energy (DOE), Environmental Management; U.S. Department of Defense; and DOE, Legacy Management. Corrective Action Unit 408 is located at the Tonopah Test Range, Nevada, and consists of Corrective Action Site (CAS) TA-55-002-TAB2, Bomblet Target Areas. This CAS includes the following seven target areas: • Mid Target • Flightline Bomblet Location • Strategic Air Command (SAC) Target Location 1 • SAC Target Location 2 • South Antelope Lake • Tomahawk Location 1 • Tomahawk Location 2 The purpose of this CR is to provide documentation supporting the completed corrective actions and data confirming that the closure objectives for the CAS within CAU 408 were met. To achieve this, the following actions were performed: • Review the current site conditions, including the concentration and extent of contamination. • Implement any corrective actions necessary to protect human health and the environment. • Properly dispose of corrective action and investigation wastes. • Document Notice of Completion and closure of CAU 408 issued by the Nevada Division of Environmental Protection. From July 2009 through August 2010, closure activities were performed as set forth in the Streamlined Approach for Environmental Restoration Plan for CAU 408: Bomblet Target Area, Tonopah Test Range (TTR), Nevada. The purposes of the activities as defined during the data quality objectives process were as follows: • Identify and remove munitions of explosive concern (MEC) associated with DOE activities. • Investigate potential disposal pit locations. • Remove depleted uranium-contaminated fragments and soil. • Determine whether contaminants of concern (COCs) are

  20. Spatial‑temporal variability of water balance components in the North area of the Zailiisky Alatau Range

    Directory of Open Access Journals (Sweden)

    V. G. Konovalov

    2016-01-01

    Full Text Available Analysis of changes in WB components (precipitation, evaporation, glacier runoff, dynamical water resources on the Northern slope of the Zailiisky Alatau was performed for the 1946–2005 time divided into two periods: 1946–1975 and 1976–2005. The territory under investigation included basins of the following rivers: Bolshaya Almatinka, Malaya Almatinka, Talgar, Turgen, Issyk, Chemolgan, Kaskelen, Kargalinka, Prohodnaya, and Uzunkargaly. Their total area down to the closing gauge points amounts to 2644 km2. Summarized glacier areas in these basins and annual runoff were equal, respectively, to: 306.6 km2 and 39.05 km3in 1946–1975, and 253.0 km2 and 38.35 km3 in 1975–2005. In 1946–2005, typical features of regional glaciation dynamics were increasing area of the moraine cover on glaciers and reducing area of bare ice that results in decreasing of the glacial runoff volume, all other factors being the same. The method to calculate the WB components consists of the following constituents: model of seasonal runoff from melted snow and ice in the areas of accumulation and ablation of glaciers; complex of formulas to calculate precipitation, air temperature and humidity, intensity of ice melting under the moraine, bare ice and evaporation within the height intervals corresponding to the main types of surfaces on the glaciers. On the basis of our method, we could reconstruct for the 1876–2015 period long‑term series of data on a runoff, separately annual values and sums for the vegetation periods. They can be used for regional scientific and applied analyses of the river stream discharges. The data on runoff in the Malaya Almatinka River basin and observational data on the meteorological station Almaty (Hydrometeorological Observatory had been quantitatively substantiated as the representative information for modeling and calculation of water resources on the Northern slope of the Zailiisky Alatau Range.

  1. Streamlined Approach for Environmental Restoration Plan for Corrective Action Unit 408: Bomblet Target Area, Tonopah Test Range, Nevada

    International Nuclear Information System (INIS)

    NSTec Environmental Management

    2006-01-01

    This Streamlined Approach for Environmental Restoration Plan provides the details for the closure of Corrective Action Unit (CAU) 408, Bomblet Target Area. CAU 408 is located at the Tonopah Test Range and is currently listed in Appendix III of the Federal Facility Agreement and Consent Order of 1996. One Corrective Action Site (CAS) is included in CAU 408: (lg b ullet) CAS TA-55-002-TAB2, Bomblet Target Areas Based on historical documentation, personnel interviews, process knowledge, site visits, aerial photography, multispectral data, preliminary geophysical surveys, and the results of data quality objectives process (Section 3.0), clean closure will be implemented for CAU 408. CAU 408 closure activities will consist of identification and clearance of bomblet target areas, identification and removal of depleted uranium (DU) fragments on South Antelope Lake, and collection of verification samples. Any soil containing contaminants at concentrations above the action levels will be excavated and transported to an appropriate disposal facility. Based on existing information, contaminants of potential concern at CAU 408 include explosives. In addition, at South Antelope Lake, bomblets containing DU were tested. None of these contaminants is expected to be present in the soil at concentrations above the action levels; however, this will be determined by radiological surveys and verification sample results. The corrective action investigation and closure activities have been planned to include data collection and hold points throughout the process. Hold points are designed to allow decision makers to review the existing data and decide which of the available options are most suitable. Hold points include the review of radiological, geophysical, and analytical data and field observations

  2. Crowdsourced Microfinance for Energy Efficiency in Underserved Communities

    Energy Technology Data Exchange (ETDEWEB)

    Baird, Donnel [BlocPower LLC, New York, NY (United States); Cox, Morris [BlocPower LLC, New York, NY (United States); Harmarneh, Sarey [BlocPower LLC, New York, NY (United States); Zheng, Chen [BlocPower LLC, New York, NY (United States)

    2017-06-21

    BlocPower’s mission is to provide access to energy efficiency financing for underserved communities across the United States. This project, “Crowdsourced Microfinance for Energy Efficiency in Underserved Communities,” is an extension of that goal and is grounded in the principles of providing engineering and financing services to those in need. The project is based on the creation of a BlocPower Marketplace as a central hub for connecting shovel-ready green buildings to institutional investors. This ‘connection’ entails using online crowdfunding to aggregate debt and equity capital from institutional investors to connect to customers (building owners) across various financial portfolios. BlocPower Marketplace is intended to bring social, environmental, and financial returns to investors while also decreasing investor risk by loaning out funds for energy installations in individual buildings. In detail, the intended benefits of crowdsourcing are two-sided. Firstly, for building owners, clean energy retrofit installations improve building operations, reduce utility costs, and reduce harmful impacts to their surrounding environment. Secondly, for institutional investors, they gain access to a new market of energy efficiency and are able to provide debt or equity capital with high financial returns. This gives investors the opportunity to create social and environmental impact in communities around the country as well. With this in mind, BlocPower designed the marketplace to specifically answer exploratory research questions with respect to the pricing of energy financing. Institutional investors typically charge high rates on project financing solutions in the energy space, particularly in low and middle-income communities, because of fears that required debt service will not be made. This makes access to energy capital exorbitantly difficult for those that need it the most. Through this project, BlocPower tested investor appetite to determine if

  3. Corrective action investigation plan for the Roller Coaster RADSAFE Area, Corrective Action Unit 407, Tonopah Test Range, Nevada

    International Nuclear Information System (INIS)

    1998-04-01

    This Corrective Action Investigation Plan (CAIP) has been developed in accordance with the Federal Facility Agreement and Consent Order (FFACO) that was agreed to by the US Department of Energy, Nevada Operations Office (DOE/NV); the State of Nevada Division of Environmental Protection (NDEP); and the US Department of Defense (FFACO, 1996). The CAIP is a document that provides or references all of the specific information for investigation activities associated with Corrective Action Units (CAUs) or Corrective Action Sites (CASs). According to the FFACO (1996), CASs are sites potentially requiring corrective action(s) and may include solid waste management units or individual disposal or release sites. CAUs consist of one or more CASs grouped together based on geography, technical similarity, or agency responsibility for the purpose of determining corrective actions. This CAIP contains the environmental sample collection objectives and the criteria for conducting site investigation activities at CAU No. 407, the Roller Coaster RADSAFE Area (RCRSA) which is located on the Tonopah Test Range (TTR). The TTR, included in the Nellis Air Force Range Complex, is approximately 255 km (140 mi) northwest of Las Vegas, Nevada. CAU No. 407 is comprised of only one CAS (TA-23-001-TARC). The RCRSA was used during May and June 1963 to decontaminate vehicles, equipment, and personnel from the Clean Slate tests. The surface and subsurface soils are likely to have been impacted by plutonium and other contaminants of potential concern (COPCs) associated with decontamination activities at this site. The purpose of the corrective action investigation described in this CAIP is to: identify the presence and nature of COPCs; determine the vertical and lateral extent of COPCs; and provide sufficient information and data to develop and evaluate appropriate corrective actions for the CAS

  4. Stakeholder collaboration in a prospective World Heritage Area: The case of Kokoda and the Owen Stanley Ranges

    Directory of Open Access Journals (Sweden)

    Amy Louise Bott

    2011-05-01

    Full Text Available The process of listing a World Heritage Area (WHAc in developing countries is often much more complex than in the West. Often all stakeholders are not taken into consideration and there is a lack of understanding of the concept of World Heritage and what it entails. This is particularly true for stakeholders who live in or adjacent to the proposed WHA, such as local communities. This paper presents a case study of Kokoda and the Owen Stanley Ranges, currently a tentative World Heritage site, to show the complexities in stakeholder collaboration and attribution in the process of World Heritage designation. Six key stakeholders were identified in the study. Upon examination of four attributes of stakeholders: power; legitimacy; urgency; and proximity, it was found that all stakeholders in this case study have a high legitimacy in the listing process however only the local community holds high levels of power, urgency and proximity. Additionally it was found that several stakeholders, like the private sector, have too many weak relationships with other stakeholders, resulting in a lack of communication. These findings present the first step in understanding how it might be possible to improve the listing process of World Heritage Sites in developing countries through effective stakeholder collaboration.

  5. Leveraging Telehealth to Bring Volunteer Physicians Into Underserved Communities.

    Science.gov (United States)

    Uscher-Pines, Lori; Rudin, Robert; Mehrotra, Ateev

    2017-06-01

    Many disadvantaged communities lack sufficient numbers of local primary care and specialty physicians. Yet tens of thousands of physicians, in particular those who are retired or semiretired, desire meaningful volunteer opportunities. Multiple programs have begun to use telehealth to bridge the gap between volunteer physicians and underserved patients. In this brief, we describe programs that are using this model and discuss the promise and pitfalls. Physician volunteers in these programs report that the work can be fulfilling and exciting, a cutting-edge yet convenient way to remain engaged and contribute. Given the projected shortfall of physicians in the United States, recruiting retired and semiretired physicians to provide care through telehealth increases the total supply of active physicians and the capacity of the existing workforce. However, programs typically use volunteers in a limited capacity because of uncertainty about the level and duration of commitment. Acknowledging this reality, most programs only use volunteer physicians for curbside consults rather than fully integrating them into longitudinal patient care. The part-time availability of volunteers may also be difficult to incorporate into the workflow of busy safety net clinics. As more physicians volunteer in a growing number of telehealth programs, the dual benefits of enriching the professional lives of volunteers and improving care for underserved communities will make further development of these programs worthwhile.

  6. Physical Activity in an Underserved Population: Identifying Technology Preferences.

    Science.gov (United States)

    Medairos, Robert; Kang, Vicky; Aboubakare, Carissa; Kramer, Matthew; Dugan, Sheila Ann

    2017-01-01

    This study aims to identify patterns of use and preferences related to technology platforms that could support physical activity (PA) programs in an underserved population. A 29-item questionnaire was administered at 5 health and wellness sites targeting low income communities in Chicago. Frequency tables were generated for Internet, cell phone, and social media use and preferences. Chi-squared analysis was used to evaluate differences across age and income groups. A total of 291 individuals participated and were predominantly female (69.0%). Majority reported incomes less than $30,000 (72.9%) and identified as African American/Black/Caribbean (49.3%) or Mexican/Mexican American (34.3%). Most participants regularly used smartphones (63.2%) and the Internet (75.9%). Respondents frequently used Facebook (84.8%), and less commonly used Instagram (43.6%), and Twitter (20.0%). Free Internet-based exercise programs were the most preferred method to increase PA levels (31.6%), while some respondents (21.0%) thought none of the surveyed technology applications would help. Cell phone, Internet, and social media use is common among the surveyed underserved population. Technology preferences to increase PA levels varied, with a considerable number of respondents not preferring the surveyed technology platforms. Creating educational opportunities to increase awareness may maximize the effectiveness of technology-based PA interventions.

  7. Sleep duration of underserved minority children in a cross-sectional study

    Science.gov (United States)

    Short sleep duration has been shown to associate with increased risk of obesity. Childhood obesity is more prevalent among underserved minority children. The study measured the sleep duration of underserved minority children living in a large US urban environment using accelerometry and its relation...

  8. Three-dimensional polarization characteristics of magnetic variations in the Pc 5 frequency range at conjugate areas near L=4

    International Nuclear Information System (INIS)

    Fukunishi, H.; Lanzerotti, L.J.; MaClennan, C.G.

    1975-01-01

    By using magnetic data measured at a network of stations extending from L approx. 3.2 to L approx. 4.4 and at a station in the conjugate area, ellipticities in the three orthogonal planes (H-D, H-Z, and D-Z) for the frequency range 2-5 mHz were computed continuously by the cross-spectral matrix method over 10 days with various levels of magnetic activity. The ellipticity diagrams in the H-D plane show that, except for the time interval during the main phase of a major magnetic storm, the sense of polarization reverses every day across local noon, with a left-hand polarization observed during local morning hours and a right-hand polarization observed during local evening hours, regardless of the level of magnetic activity. The second reversal of the sense of polarization occurs generally around approx. 2000 LT. The ellipticity diagrams in the H-Z plane show a predominantly clockwise polarization throughout the day, while the diurnal variation of the ellipticity in the D-Z plane tends to be confused. As to the latitude dependence of the wave phase, it is found that the D component oscillations are almost in phase at all latitudes, while the H component oscillations have advanced phase shifts at the lower-latitude stations. As to the conjugate dependence of wave phase, it is found that the D component oscillations are almost out of phase, while the H component oscillations are almost in phase atthe conjugate pair stations. These polarization characteristics are discussed in terms of external driving sources coupling to the shear Alfven waves of the local resonant field lines. Possible energy sources of Pc 5 waves are also discussed on the basis of the local time dependence of the sense of polarization

  9. Prevalence and spectrum of helminths in free-ranging African buffaloes (Syncerus caffer in wildlife protected areas, Tanzania

    Directory of Open Access Journals (Sweden)

    Emanuel Senyael Swai

    2013-09-01

    Full Text Available Objective: To determine the prevalence and spectrum of helminths in free-ranging African buffaloes in Tanzania by a cross-sectional study. Methods: Faecal samples (n=1 23 from Arusha National Park and Ngorongoro Crater were examined for helminth eggs using sedimentation and floatation techniques during the period of March to June 2012. Results: Coprological examination revealed that 34.1% (n=42 of the buffaloes excreted nematodes and trematodes eggs and protozoan oocyst in their faces. The pattern of infection was either single or mixed. Single (52.4% and concurrent infections with two, three, four and five parasites were recorded in 19.0%, 11.9%, 14.3% and 2.3% respectively of the cases. The nematode eggs encountered were those of Trichostrongylus sp. (20.3%, Oesophagostomum sp. (7.3%, Strongyle sp. (4.1%, Bunostomum sp. (4.1%, Ostertegia sp. (3.3% and Toxocara sp. (2.4%. The trematode eggs encountered were those of Fasciola sp. (9.8%, Paramphistomum sp. (4.9%, Gastrothylax sp. (1.6%, Ornithobilharzia sp. (0.81% and Fischoederius sp (0.81%. The protozoan oocyst recorded was that of Eimeria sp. (8.1%. Geographical location of buffaloes had significant influence on the prevalence of infection with Trichostrongylus (P=0.046 and Fasciola (P=0.001, and the mean prevalances in Arusha National Park are significantly higher than those in Ngorongoro Crater. Age had significant influence on infection with Fasciola (P=0.036, and juvenile recorded higher levels of infection than sub-adults. Health status, body condition score and sex-wise prevalence of helminths were not significant (P>0.05. Conclusions: This study indicates that helminths species are numerous and highly prevalent in the two protected areas and may be one of the contributing factors to lower buffalo productivity.

  10. The influence of band sum area, domain extent, and range sizes on the latitudinal mid-domain effect

    DEFF Research Database (Denmark)

    Romdal, Tom Skovlund; Colwell, Robert K.; Rahbek, Carsten

    2005-01-01

    of latitudinal distributions of New World birds (3706 species) on a 1° scale. Two previously published data sets for other taxa are also considered. We adjusted band sums (number of species per latitudinal band) for longitudinal area by constructing species-area curves for each band. Area-corrected richness...... patterns differed substantially from raw band sums, although both confirmed a strong, mid-tropical peak in richness. An MDE model accounted for 47% of the adjusted pattern, whereas area alone explained 13% of variation. Area-adjusted band sum data proved preferable to coastal transect data from the same...

  11. Caregiver's depressive symptoms and asthma control in children from an underserved community.

    Science.gov (United States)

    Rioseco, Andrea; Serrano, Carolina; Celedón, Juan C; Padilla, Oslando; Puschel, Klaus; Castro-Rodriguez, Jose A

    2017-12-01

    Caregiver's or maternal depression has been associated with increased asthma morbidity in children from prosperous nations, but little is known about this link in low and middle-income countries. To examine if caregiver's depressive symptoms are associated with poor asthma control and abnormal immune responses in school-aged children. Case-control study of 87 asthmatic children (aged 4-11 years) attending a primary care clinic in an underserved area of Santiago (Chile). Cases were children with poor asthma control (Child Asthma Control Test [cACT] asthma control (cACT ≥20 points). The Beck Depression Inventory-II (BDI) and a locally validated family health vulnerability test (SALUFAM) were used to assess caregivers' depression and family health vulnerability. Serum from participating children was assayed for IFN-γ, IL-4, IL-13, TGF-β, cortisol, and total IgE. The mean (SD) age of study participants was 8.23 (2.15 years), and 55.2% were females. Use of inhaled corticosteroids (ICS), family health vulnerability, and caregiver's depressive symptoms were significantly more common in cases than in controls (65.4% vs. 34.6%, p = 0.003; 41.3% vs. 24.8%, p = 0.07; and 39.1% vs. 19.5%, p = 0.04, respectively). There was no significant difference in the level of any serum biomarkers between groups. In a multivariate analysis, only ICS use was significantly associated with better asthma control (OR = 3.56 [1.34-9.48], p = 0.01). Presence of caregiver's depressive symptoms is associated with poor asthma control among children from an underserved community, but this association was no longer significant after accounting for ICS use.

  12. Preliminary study of the favorability for uranium in selected areas in the Basin and Range Province, Nevada

    International Nuclear Information System (INIS)

    Cupp, G.M.; Leedom, S.H.; Mitchell, T.P.; Kiloh, K.D.; Horton, R.C.

    1977-10-01

    Six uranium areas in Nevada were examined in a reconnaissance fashion to determine their favorability for uranium deposits. The favorable areas are: Virgin Valley, Humboldt County; northern Reese River Valley, Lander County; East Walker River, Lyon County; and Coaldale, Esmeralda County. Areas judged to be unfavorable are: Carol ''R'' prospect, Garfield Hills, Mineral County; and Meadow Valley (Panaca), Lincoln County. In the Virgin Valley area, the Canyon Rhyolite Formation contains as much as 27 ppM U 3 O 8 and is an excellent source rock. Uranium deposits in the underlying Virgin Valley Formation are small, but larger deposits may exist. The northern portion of the Reese River Valley contains several small uranium deposits but none of mineable grade or size. Rhyolitic volcanic rocks in the area contain above-average amounts of uranium, and larger deposits may lie beneath these potential source rocks. The East Walker River area may be part of a larger uranium province. Intrusive and extrusive rocks in the area contain above-average amounts of uranium, and low-grade supergene deposits were found. Large areas of potential source rocks and host rocks, and two small uranium deposits, were found in the Coaldale area. Many rhyolite plugs were also found. The Carol ''R'' prospect is an isolated uranium occurrence in Tertiary lacustrine rocks. Uranium deposits in Meadow Valley are in the Panaca Formation, a Pliocene lacustrine formation of varied lithology. The uranium deposits are small and low grade. It is unlikely that large-grade deposits will be found in this area

  13. Recruiting Underserved Mothers to Medical Research: Findings from North Carolina

    Science.gov (United States)

    Spears, Chaya R.; Sandberg, Joanne C.; O’Neill, Jenna L.; Grzywacz, Joseph G.; Howard, Timothy D.; Feldman, Steven R.; Arcury, Thomas A.

    2014-01-01

    Representative samples are required for ethical, valid, and useful health research. Yet, recruiting participants, especially from historically underserved communities, can be challenging. This paper presents findings from in-depth interviews with 40 mothers about factors that might influence their willingness to participate or allow their children to participate in medical research. Saliency analysis organizes the findings. Frequent and important salient themes about research participation included concerns that it might cause participants harm, hope that participants might gain a health benefit, and recognition that time and transportation resources could limit participation. Ultimately, we propose that a theoretical model, such as the Theory of Planned Behavior (TPB), will facilitate more systematic evaluation of effective methods for recruitment and retention of participants in medical research. Future research should explore the utility of such a model for development of effective recruitment and retention strategies. PMID:24185171

  14. Foraging range, habitat use and minimum flight distances of East Atlantic Light-bellied Brent Geese Branta bernicla hrota in their spring staging areas

    DEFF Research Database (Denmark)

    Clausen, Kevin Kuhlmann; Clausen, Preben; Hounisen, Jens Peder

    2013-01-01

    Global Positioning System (GPS) satellite telemetry was used to determine the foraging range, habitat use and minimum flight distances for individual East Atlantic Light-bellied Brent Geese Branta bernicla hrota at two spring staging areas in Denmark. Foraging ranges (mean ± s.d. = 53.0 ± 23.4 km...

  15. Enrolling Minority and Underserved Populations in Cancer Clinical Research.

    Science.gov (United States)

    Wallington, Sherrie F; Dash, Chiranjeev; Sheppard, Vanessa B; Goode, Tawara D; Oppong, Bridget A; Dodson, Everett E; Hamilton, Rhonda N; Adams-Campbell, Lucile L

    2016-01-01

    Research suggests that community involvement is integral to solving public health problems, including involvement in clinical trials-a gold standard. Significant racial/ethnic disparities exist in the accrual of participants for clinical trials. Location and cultural aspects of clinical trials influence recruitment and accrual to clinical trials. It is increasingly necessary to be aware of defining characteristics, such as location and culture of the populations from which research participants are enrolled. Little research has examined the effect of location and cultural competency in adapting clinical trial research for minority and underserved communities on accrual for clinical trials. Utilizing embedded community academic sites, the authors applied cultural competency frameworks to adapt clinical trial research in order to increase minority participation in nontherapeutic cancer clinical trials. This strategy resulted in successful accrual of participants to new clinical research trials, specifically targeting participation from minority and underserved communities in metropolitan Washington, DC. From 2012 to 2014, a total of 559 participants enrolled across six nontherapeutic clinical trials, representing a 62% increase in the enrollment of blacks in clinical research. Embedding cancer prevention programs and research in the community was shown to be yet another important strategy in the arsenal of approaches that can potentially enhance clinical research enrollment and capacity. The analyses showed that the capacity to acquire cultural knowledge about patients-their physical locales, cultural values, and environments in which they live-is essential to recruiting culturally and ethnically diverse population samples. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  16. Examining e-Health literacy and the digital divide in an underserved population in Hawai'i.

    Science.gov (United States)

    Connolly, Kathleen Kihmm; Crosby, Martha E

    2014-02-01

    Seeking health information is one of the leading uses for the Internet and World Wide Web (WWW). Research has found the amount one benefits from e-Health information (health information from electronic sources) is directly related to the level of e-Health literacy. e-Health literacy is defined as "the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem." In order to gain a further understanding of the effects and use of technology, the digital divide, and the relationship between technology utilization and health outcomes, focus group interviews were conducted with participants diagnosed with diabetes and currently residing in a Medically Underserved Area. Overall, 25 volunteers participated in the four focus group meetings. Based on the focus group discussions, a general low e-Health literacy rate was identified. This was demonstrated by the lack of access to the Internet and the skills needed to retrieve health information. Of the 25 participants, 64% reported having Internet access at some level, but, only one reported going on the Internet every day. When the barriers to using the Internet were discussed, many participants expressed a lack of knowledge in how to retrieve information. Results of this study further show that having access to technology is not necessarily associated with usage. This dynamic is evolving into a new form of digital divide, gap in information retrieval and usage, versus gap in access. This is the first known study to examine e-Health literacy in an underserved population in Hawai'i. With the proliferation of information and communication technology and the transformation of information retrieval to be mobile and "on demand", a multi-pronged communication and education strategy is needed to explore how technology can improve e-Health literacy and health outcomes among underserved populations.

  17. Examining e-Health Literacy and the Digital Divide in an Underserved Population in Hawai‘i

    Science.gov (United States)

    Crosby, Martha E

    2014-01-01

    Seeking health information is one of the leading uses for the Internet and World Wide Web (WWW). Research has found the amount one benefits from e-Health information (health information from electronic sources) is directly related to the level of e-Health literacy. e-Health literacy is defined as “the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem.” In order to gain a further understanding of the effects and use of technology, the digital divide, and the relationship between technology utilization and health outcomes, focus group interviews were conducted with participants diagnosed with diabetes and currently residing in a Medically Underserved Area. Overall, 25 volunteers participated in the four focus group meetings. Based on the focus group discussions, a general low e-Health literacy rate was identified. This was demonstrated by the lack of access to the Internet and the skills needed to retrieve health information. Of the 25 participants, 64% reported having Internet access at some level, but, only one reported going on the Internet every day. When the barriers to using the Internet were discussed, many participants expressed a lack of knowledge in how to retrieve information. Results of this study further show that having access to technology is not necessarily associated with usage. This dynamic is evolving into a new form of digital divide, gap in information retrieval and usage, versus gap in access. This is the first known study to examine e-Health literacy in an underserved population in Hawai‘i. With the proliferation of information and communication technology and the transformation of information retrieval to be mobile and “on demand”, a multi-pronged communication and education strategy is needed to explore how technology can improve e-Health literacy and health outcomes among underserved populations. PMID:24567867

  18. LTP in Hippocampal Area CA1 Is Induced by Burst Stimulation over a Broad Frequency Range Centered around Delta

    Science.gov (United States)

    Grover, Lawrence M.; Kim, Eunyoung; Cooke, Jennifer D.; Holmes, William R.

    2009-01-01

    Long-term potentiation (LTP) is typically studied using either continuous high-frequency stimulation or theta burst stimulation. Previous studies emphasized the physiological relevance of theta frequency; however, synchronized hippocampal activity occurs over a broader frequency range. We therefore tested burst stimulation at intervals from 100…

  19. Research publications of the Cascade Head Experimental Forest and Scenic Research Area, Oregon Coast Range, 1934 to 1990.

    Science.gov (United States)

    Sarah E. Greene; Tawny Blinn

    1991-01-01

    A list of publications resulting from research at the Cascade Head Experimental Forest and Scenic Research Area, Siuslaw National Forest, Oregon, from 1934 to 1990 is presented. Over 200 publications are listed, including papers, theses, and reports. An index is provided that cross-references the listings under appropriate keywords.

  20. Step-by-step variability of swing phase trajectory area during steady state walking at a range of speeds

    Science.gov (United States)

    Hurt, Christopher P.; Brown, David A.

    2018-01-01

    Background Step kinematic variability has been characterized during gait using spatial and temporal kinematic characteristics. However, people can adopt different trajectory paths both between individuals and even within individuals at different speeds. Single point measures such as minimum toe clearance (MTC) and step length (SL) do not necessarily account for the multiple paths that the foot may take during the swing phase to reach the same foot fall endpoint. The purpose of this study was to test a step-by-step foot trajectory area (SBS-FTA) variability measure that is able to characterize sagittal plane foot trajectories of varying areas, and compare this measure against MTC and SL variability at different speeds. We hypothesize that the SBS-FTA variability would demonstrate increased variability with speed. Second, we hypothesize that SBS-FTA would have a stronger curvilinear fit compared with the CV and SD of SL and MTC. Third, we hypothesize SBS-FTA would be more responsive to change in the foot trajectory at a given speed compared to SL and MTC. Fourth, SBS-FTA variability would not strongly co-vary with SL and MTC variability measures since it represents a different construct related to foot trajectory area variability. Methods We studied 15 nonimpaired individuals during walking at progressively faster speeds. We calculated SL, MTC, and SBS-FTA area. Results SBS-FTA variability increased with speed, had a stronger curvilinear fit compared with the CV and SD of SL and MTC, was more responsive at a given speed, and did not strongly co-vary with SL and MTC variability measures. Conclusion SBS foot trajectory area variability was sensitive to change with faster speeds, captured a relationship that the majority of the other measures did not demonstrate, and did not co-vary strongly with other measures that are also components of the trajectory. PMID:29370202

  1. Examining the Influence of Cost Concern and Awareness of Low-cost Health Care on Cancer Screening among the Medically Underserved.

    Science.gov (United States)

    Best, Alicia L; Strane, Alcha; Christie, Omari; Bynum, Shalanda; Wiltshire, Jaqueline

    2017-01-01

    African Americans suffer a greater burden of mortality from breast, cervical, and colorectal cancers than other groups in the United States. Early detection through timely screening can improve survival outcomes; however, cost is frequently reported as a barrier to screening. Federally qualified health centers (FQHCs) provide preventive and primary care to underserved populations regardless of ability to pay, positioning them to improve cancer screening rates. The purpose of this study was to examine the influence of concern about health care cost (cost concern) and awareness of low-cost health care (awareness) on cancer screening among 236 African Americans within an FQHC service area using self-report surveys. Multiple logistic regression indicated that awareness was positively associated with cervical and colorectal cancer screening, while cost concern was negatively associated with mammography screening. Results indicate that improving awareness and understanding of low-cost health care could increase cancer screening among underserved African Americans.

  2. Tourism-induced disturbance of wildlife in protected areas: A case study of free ranging elephants in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Eranga Ranaweerage

    2015-07-01

    Full Text Available Tourism-induced disturbance is a growing concern in wildlife conservation worldwide. This case study in a key protected area in Sri Lanka, examined the behavioral changes of Asian elephants in the context of elephant watching tourism activities. Observations of different age–sex-group classes of elephants were conducted focusing on the feeding activity of elephants in the presence vs. absence of tourists. Frequency and duration of alert, fear, stress and aggressive behaviors of elephants were significantly high in the presence of tourists and these behaviors occurred at a cost of feeding time. Tourist behavior, vehicle noise, close distances and time of the tours were closely associated with the behavioral changes of elephants. It is important to monitor tourism effects on endangered species such as Asian elephants and to take proper measures including controlled tourist behavior and vehicle activity in protected areas in order to reduce disturbance of wildlife behavior.

  3. With Educational Benefits for All: Campus Inclusion through Learning Communities Designed for Underserved Student Populations

    Science.gov (United States)

    Fink, John E.; Hummel, Mary L.

    2015-01-01

    This chapter explores the practices of learning communities designed for specific, underserved student populations, highlighting on-campus examples and culminating with a synthesized list of core practices from these "inclusive" learning communities.

  4. Lack of Quality Primary Health Services: The Problems of the Underserved.

    Science.gov (United States)

    Hall, Daniel A.

    1978-01-01

    Major political and economic forces, which affect the provision of primary health services, particularly to underserved populations, are reviewed. Technological, professional, governmental, fiscal, and societal solutions are proposed. (GC)

  5. Breast Cancer Outreach for Underserved Women: A Randomized Trial and Cost-Effectiveness Analysis

    National Research Council Canada - National Science Library

    Pasick, Rena

    1999-01-01

    The current study, BACCIS-II, is a randomized controlled trial of an outreach intervention model designed to increase the rate of periodic mammography and clinical breast exam among underserved women...

  6. Designing for Underserved Populations: Constraints and Requirements of Personal Health Record Systems

    Centers for Disease Control (CDC) Podcasts

    In this podcast, Dr. Thomas Horan discusses how language, literacy, and access barriers can be overcome with electronic Personal Health Record (PHR) systems to improve health among the most vulnerable, isolated, and underserved populations.

  7. Seasonality in cholera dynamics: A rainfall-driven model explains the wide range of patterns in endemic areas

    Science.gov (United States)

    Baracchini, Theo; King, Aaron A.; Bouma, Menno J.; Rodó, Xavier; Bertuzzo, Enrico; Pascual, Mercedes

    2017-10-01

    Seasonal patterns in cholera dynamics exhibit pronounced variability across geographical regions, showing single or multiple peaks at different times of the year. Although multiple hypotheses related to local climate variables have been proposed, an understanding of this seasonal variation remains incomplete. The historical Bengal region, which encompasses the full range of cholera's seasonality observed worldwide, provides a unique opportunity to gain insights on underlying environmental drivers. Here, we propose a mechanistic, rainfall-temperature driven, stochastic epidemiological model which explicitly accounts for the fluctuations of the aquatic reservoir, and analyze with this model the historical dataset of cholera mortality in the Bengal region. Parameters are inferred with a recently developed sequential Monte Carlo method for likelihood maximization in partially observed Markov processes. Results indicate that the hydrological regime is a major driver of the seasonal dynamics of cholera. Rainfall tends to buffer the propagation of the disease in wet regions due to the longer residence times of water in the environment and an associated dilution effect, whereas it enhances cholera resurgence in dry regions. Moreover, the dynamics of the environmental water reservoir determine whether the seasonality is unimodal or bimodal, as well as its phase relative to the monsoon. Thus, the full range of seasonal patterns can be explained based solely on the local variation of rainfall and temperature. Given the close connection between cholera seasonality and environmental conditions, a deeper understanding of the underlying mechanisms would allow the better management and planning of public health policies with respect to climate variability and climate change.

  8. LifeSteps: An Evidence-based Health Promotion Program for Underserved Populations – A Community Service Learning Approach

    Directory of Open Access Journals (Sweden)

    Melanie Austin-McCain

    2015-04-01

    Full Text Available Chronic diseases are the most common, costly, and preventable of all health problems in the United States. Chronic diseases represent the leading causes of death and are experienced at higher rates by minority populations (CDC, 2012. Innovative community-based health promotion programs are recommended that meet the diverse needs of underserved populations (Yeary, et al., 2011. LifeSteps is being developed as an evidence-based health promotion program focusing on health and wellness, a domain area defined within the Occupational Therapy Practice Framework (OTPF, 2008. LifeSteps will utilize a client-centered approach to coach individuals in making health behavior changes. Fieldwork and service-learning components are incorporated integrating clinical practice, academic study, and collaboration with community providers. Program evaluation measures based on the Transtheoretical Model (TTM have been identified to address all phases of program planning. The LifeSteps health promotion program aligns with local, national, and international objectives and addresses the need for programs that meet the diverse needs of underserved populations. Occupational therapists are in a unique position for implementing community-based interventions that promote health and contribute to a healthier society.

  9. Range-wide network of priority areas for greater sage-grouse - a design for conserving connected distributions or isolating individual zoos?

    Science.gov (United States)

    Crist, Michele R.; Knick, Steven T.; Hanser, Steven E.

    2015-09-08

    The network of areas delineated in 11 Western States for prioritizing management of greater sage-grouse (Centrocercus urophasianus) represents a grand experiment in conservation biology and reserve design. We used centrality metrics from social network theory to gain insights into how this priority area network might function. The network was highly centralized. Twenty of 188 priority areas accounted for 80 percent of the total centrality scores. These priority areas, characterized by large size and a central location in the range-wide distribution, are strongholds for greater sage-grouse populations and also might function as sources. Mid-ranking priority areas may serve as stepping stones because of their location between large central and smaller peripheral priority areas. The current network design and conservation strategy has risks. The contribution of almost one-half (n = 93) of the priority areas combined for less than 1 percent of the cumulative centrality scores for the network. These priority areas individually are likely too small to support viable sage-grouse populations within their boundary. Without habitat corridors to connect small priority areas either to larger priority areas or as a clustered group within the network, their isolation could lead to loss of sage-grouse within these regions of the network. 

  10. Large area double p-i-n heterostructure for signal multiplexing and demultiplexing in the visible range

    International Nuclear Information System (INIS)

    Vieira, M.; Louro, P.; Fernandes, M.; Vieira, M.A.; Fantoni, A.; Barata, M.

    2009-01-01

    Results on the use of a double a-SiC:H p-i-n heterostructure for signal multiplexing and demultiplexing applications in the visible range, are presented. Modulated monochromatic beams together (multiplexing mode), or a single polychromatic beam (demultiplexing mode) impinge in the device and are absorbed, accordingly to their wavelength, giving rise to a time and wavelength dependent electrical field modulation. Red, green and blue pulsed input channels are transmitted together, each one with a specific transmission rate. The combined optical signal is analyzed by reading out, under different applied voltages, the generated photocurrent. Results show that in the multiplexing mode the output signal is balanced by the wavelength and transmission rate of each input channel, keeping the memory of the incoming optical carriers. In the demultiplexing mode the photocurrent is controlled by the applied voltage allowing regaining the transmitted information. An electrical model gives insight into the device operation.

  11. An automatic high precision registration method between large area aerial images and aerial light detection and ranging data

    Science.gov (United States)

    Du, Q.; Xie, D.; Sun, Y.

    2015-06-01

    The integration of digital aerial photogrammetry and Light Detetion And Ranging (LiDAR) is an inevitable trend in Surveying and Mapping field. We calculate the external orientation elements of images which identical with LiDAR coordinate to realize automatic high precision registration between aerial images and LiDAR data. There are two ways to calculate orientation elements. One is single image spatial resection using image matching 3D points that registered to LiDAR. The other one is Position and Orientation System (POS) data supported aerotriangulation. The high precision registration points are selected as Ground Control Points (GCPs) instead of measuring GCPs manually during aerotriangulation. The registration experiments indicate that the method which registering aerial images and LiDAR points has a great advantage in higher automation and precision compare with manual registration.

  12. Pediatric Asthma Care Coordination in Underserved Communities: A Quasiexperimental Study.

    Science.gov (United States)

    Janevic, Mary R; Stoll, Shelley; Wilkin, Margaret; Song, Peter X K; Baptist, Alan; Lara, Marielena; Ramos-Valencia, Gilberto; Bryant-Stephens, Tyra; Persky, Victoria; Uyeda, Kimberly; Lesch, Julie Kennedy; Wang, Wen; Malveaux, Floyd J

    2016-11-01

    To assess the effect of care coordination on asthma outcomes among children in underserved urban communities. We enrolled children, most of whom had very poorly or not well-controlled asthma, in medical-social care coordination programs in Los Angeles, California; Chicago, Illinois; Philadelphia, Pennsylvania; and San Juan, Puerto Rico in 2011 to 2014. Participants (n = 805; mean age = 7 years) were 60% male, 50% African American, and 42% Latino. We assessed asthma symptoms and health care utilization via parent interview at baseline and 12 months. To prevent overestimation of intervention effects, we constructed a comparison group using bootstrap resampling of matched control cases from previous pediatric asthma trials. At follow-up, intervention participants had 2.2 fewer symptom days per month (SD = 0.3; P < .01) and 1.9 fewer symptom nights per month (SD = 0.35; P < .01) than did the comparison group. The relative risk in the past year associated with the intervention was 0.63 (95% confidence interval [CI] = 0.45, 0.89) for an emergency department visit and 0.69 (95% CI = 0.47, 1.01) for hospitalization. Care coordination may improve pediatric asthma symptom control and reduce emergency department visits. Expanding third-party reimbursement for care coordination services may help reduce pediatric asthma disparities.

  13. NASA and Public Libraries: Enhancing STEM Literacy in Underserved Communities

    Science.gov (United States)

    Dusenbery, P.; LaConte, K.; Harold, J. B.; Randall, C.

    2016-12-01

    NASA research programs are helping humanity understand the origin and evolution of galaxies, stars, and planets, and defining the conditions necessary to support life beyond Earth. The Space Science Institute's (SSI) National Center for Interactive Learning (NCIL) was recently funded by NASA`s Science Mission Directorate (SMD) to develop and implement a project called NASA@ My Library: A National Earth and Space Science Initiative That Connects NASA, Public Libraries and Their Communities. As places that offer their services for free, public libraries have become the "public square" by providing a place where members of a community can gather for information, educational programming, and policy discussions. Libraries are developing new ways to engage their patrons in STEM learning, and NCIL's STAR Library Education Network (STAR_Net) has been supporting their efforts for the last eight years, including through a vibrant community of practice that serves both librarians and STEM professionals. Project stakeholders include public library staff, state libraries, the earth and space science education community at NASA, subject matter experts, and informal science educators. The project will leverage high-impact SMD and library events to catalyze partnerships through dissemination of SMD assets and professional development. It will also develop frameworks for public libraries to increase STEM interest pathways in their communities (with supports for reaching underserved audiences). This presentation will summarize the key activities and expected outcomes of the 5-year project.

  14. Web usability testing with a Hispanic medically underserved population.

    Science.gov (United States)

    Moore, Mary; Bias, Randolph G; Prentice, Katherine; Fletcher, Robin; Vaughn, Terry

    2009-04-01

    Skilled website developers value usability testing to assure user needs are met. When the target audience differs substantially from the developers, it becomes essential to tailor both design and evaluation methods. In this study, researchers carried out a multifaceted usability evaluation of a website (Healthy Texas) designed for Hispanic audiences with lower computer literacy and lower health literacy. METHODS INCLUDED: (1) heuristic evaluation by a usability engineer, (2) remote end-user testing using WebEx software; and (3) face-to-face testing in a community center where use of the website was likely. Researchers found standard usability testing methods needed to be modified to provide interpreters, increased flexibility for time on task, presence of a trusted intermediary such as a librarian, and accommodation for family members who accompanied participants. Participants offered recommendations for website redesign, including simplified language, engaging and relevant graphics, culturally relevant examples, and clear navigation. User-centered design is especially important when website developers are not representative of the target audience. Failure to conduct appropriate usability testing with a representative audience can substantially reduce use and value of the website. This thorough course of usability testing identified improvements that benefit all users but become crucial when trying to reach an underserved audience.

  15. Prevalence, Genetic Characterization, and 18S Small Subunit Ribosomal RNA Diversity of Trypanosoma rangeli in Triatomine and Mammal Hosts in Endemic Areas for Chagas Disease in Ecuador.

    Science.gov (United States)

    Ocaña-Mayorga, Sofia; Aguirre-Villacis, Fernanda; Pinto, C Miguel; Vallejo, Gustavo A; Grijalva, Mario J

    2015-12-01

    Trypanosoma rangeli is a nonpathogenic parasite for humans; however, its medical importance relies in its similarity and overlapping distribution with Trypanosoma cruzi, causal agent of Chagas disease in the Americas. The genetic diversity of T. rangeli and its association with host species (triatomines and mammals) has been identified along Central and the South America; however, it has not included data of isolates from Ecuador. This study reports infection with T. rangeli in 18 genera of mammal hosts and five species of triatomines in three environments (domestic, peridomestic, and sylvatic). Higher infection rates were found in the sylvatic environment, in close association with Rhodnius ecuadoriensis. The results of this study extend the range of hosts infected with this parasite and the geographic range of the T. rangeli genotype KP1(-)/lineage C in South America. It was not possible to detect variation on T. rangeli from the central coastal region and southern Ecuador with the analysis of the small subunit ribosomal RNA (SSU-rRNA) gene, even though these areas are ecologically different and a phenotypic subdivision of R. ecuadoriensis has been found. R. ecuadoriensis is considered one of the most important vectors for Chagas disease transmission in Ecuador due to its wide distribution and adaptability to diverse environments. An extensive knowledge of the trypanosomes circulating in this species of triatomine, and associated mammal hosts, is important for delineating transmission dynamics and preventive measures in the endemic areas of Ecuador and Northern Peru.

  16. Prevalence, Genetic Characterization, and 18S Small Subunit Ribosomal RNA Diversity of Trypanosoma rangeli in Triatomine and Mammal Hosts in Endemic Areas for Chagas Disease in Ecuador

    Science.gov (United States)

    Ocaña-Mayorga, Sofia; Aguirre-Villacis, Fernanda; Pinto, C. Miguel; Vallejo, Gustavo A.

    2015-01-01

    Abstract Trypanosoma rangeli is a nonpathogenic parasite for humans; however, its medical importance relies in its similarity and overlapping distribution with Trypanosoma cruzi, causal agent of Chagas disease in the Americas. The genetic diversity of T. rangeli and its association with host species (triatomines and mammals) has been identified along Central and the South America; however, it has not included data of isolates from Ecuador. This study reports infection with T. rangeli in 18 genera of mammal hosts and five species of triatomines in three environments (domestic, peridomestic, and sylvatic). Higher infection rates were found in the sylvatic environment, in close association with Rhodnius ecuadoriensis. The results of this study extend the range of hosts infected with this parasite and the geographic range of the T. rangeli genotype KP1(−)/lineage C in South America. It was not possible to detect variation on T. rangeli from the central coastal region and southern Ecuador with the analysis of the small subunit ribosomal RNA (SSU-rRNA) gene, even though these areas are ecologically different and a phenotypic subdivision of R. ecuadoriensis has been found. R. ecuadoriensis is considered one of the most important vectors for Chagas disease transmission in Ecuador due to its wide distribution and adaptability to diverse environments. An extensive knowledge of the trypanosomes circulating in this species of triatomine, and associated mammal hosts, is important for delineating transmission dynamics and preventive measures in the endemic areas of Ecuador and Northern Peru. PMID:26645579

  17. Feasibility/treatability studies for removal of heavy metals from training range soils at the Grafenwoehr Training Area, Germany

    Energy Technology Data Exchange (ETDEWEB)

    Peters, R.W.

    1995-05-01

    A feasibility/treatability study was performed to investigate the leaching potential of heavy metals (particularly lead) from soils at the Grafenw6hr Training Area (GTA) in Germany. The study included an evaluation of the effectiveness of chelant extraction to remediate the heavy-metal-contarninated soils. Batch shaker tests indicated that ethylenediaminetetraacetic acid (EDTA) (0.01M) was more effective than citric acid (0.01M) at removing cadmium, copper, lead, and zinc. EDTA and citric acid were equally effective in mobilizing chromium and barium from the soil. The batch shaker technique with chelant extraction offers promise as a remediation technique for heavy-metal-contaninated soil at the GTA. Columnar flooding tests conducted as part of the study revealed that deionized water was the least effective leaching solution for mobilization of the heavy metals; the maximum solubilization obtained was 3.72% for cadmium. EDTA (0.05M) achieved the greatest removal of lead (average removal of 17.6%). The difficulty of extraction using deionized water indicates that all of the heavy metals are very tightly bound to the soil; therefore, they are very stable in the GTA soils and do not pose a serious threat to the groundwater system. Columnar flooding probably does not represent a viable remediation technique for in-situ cleanup of heavy-metal-contaminated soils at the GTA.

  18. Corrective action investigation plan for Corrective Action Unit Number 427: Area 3 septic waste system numbers 2 and 6, Tonopah Test Range, Nevada

    International Nuclear Information System (INIS)

    1997-01-01

    This Corrective Action Investigation Plan (CAIP) contains the environmental sample collection objectives and the criteria for conducting site investigation activities at the Area 3 Compound, specifically Corrective Action Unit (CAU) Number 427, which is located at the Tonopah Test Range (TTR). The TTR, included in the Nellis Air Force Range, is approximately 255 kilometers (140 miles) northwest of Las Vegas, Nevada. The Corrective Action Unit Work Plan, Tonopah Test Range, Nevada divides investigative activities at TTR into Source Groups. The Septic Tanks and Lagoons Group consists of seven CAUs. Corrective Action Unit Number 427 is one of three septic waste system CAUs in TTR Area 3. Corrective Action Unit Numbers 405 and 428 will be investigated at a future data. Corrective Action Unit Number 427 is comprised of Septic Waste Systems Number 2 and 6 with respective CAS Numbers 03-05-002-SW02 and 03-05-002-SW06

  19. Impact of diurnal temperature range on mortality in a high plateau area in southwest China: A time series analysis.

    Science.gov (United States)

    Ding, Zan; Guo, Pi; Xie, Fang; Chu, Huifang; Li, Kun; Pu, Jingbo; Pang, Shaojie; Dong, Hongli; Liu, Yahui; Pi, Fuhua; Zhang, Qingying

    2015-09-01

    Diurnal temperature range (DTR) is an important meteorological indicator that reflects weather stability and is associated with global climate change and urbanization. Previous studies have explored the effect of DTR on human health in coastal cities with small daily temperature variations, but we have little evidence for high plateau regions where large DTRs usually occur. Using daily mortality data (2007-2013), we conducted a time-series analysis to assess the effect of DTR on daily mortality in Yuxi, a high plateau city in southwest China. Poisson regression with distributed lag non-linear model was used to estimate DTR effects on daily mortality, controlling for daily mean temperature, relative humidity, sunshine duration, wind speed, atmospheric pressure, day of the week, and seasonal and long-term trends. The cumulative effects of DTR were J-shaped curves for non-accidental, cardiorespiratory and cardiovascular mortality, with a U-shaped curve for respiratory mortality. Risk assessments showed strong monotonic increases in mortality starting at a DTR of approximately 16 °C. The relative risk of non-accidental morality with extreme high DTR at lag 0 and 0-21 days was 1.03 (95% confidence interval: 0.95-1.11) and 1.33 (0.94-1.89), respectively. The risk of mortality with extreme high DTR was greater for males and age <75 years than females and age ≥75 years. The effect of DTR on mortality was non-linear, with high DTR associated with increased mortality. A DTR of 16 °C may be a cut-off point for mortality prognosis and has implications for developing intervention strategies to address high DTR exposure. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Nature of the Coastal Range Wedge Along the Rupture Area of the 2015, Illapel Chile Earthquake Mw 8.4

    Science.gov (United States)

    Farías, M.; Comte, D.; Roecker, S. W.; Brandon, M. T.

    2017-12-01

    least the Late Cretaceous, before the proposed arrival of the Juan Fernandez ridge at this area and the consequent flat slab that characterize this part of the margin in the Present.

  1. Revealing the distinct habitat ranges and hybrid zone of genetic sub-populations within Pseudo-nitzschia pungens (Bacillariophyceae) in the West Pacific area.

    Science.gov (United States)

    Kim, Jin Ho; Wang, Pengbin; Park, Bum Soo; Kim, Joo-Hwan; Patidar, Shailesh Kumar; Han, Myung-Soo

    2018-03-01

    Genetic sub-populations (clades) of cosmopolitan marine diatom Pseudo-nitzschia pungens might have distinct habitats, and their hybrid zone is suspected in higher latitude area of the West Pacific area, however, it is still unrevealed because of technical difficulties and lack of evidences in natural environments. The aim of this study is to investigate the habitat characteristics of each clade of P. pungens on geographical distribution with the habitat temperature ranges of each clade and to reveal their hybrid zone in the West Pacific area. We employed the 137 number of nucleotide sequences of P. pungens and its sampling data (spatial and temporal scale) originated from the West Pacific area, and used field application of qPCR assay for intra-specific level of P. pungens. Only two genotypes, clade I and III, were identified in the West Pacific area. Clade I was distributed from 39 to 32.3°N, and clade III were from 1.4 to 34.4°N. The estimated habitat temperature for the clade I and clade III ranges were 8.1-26.9 °C and 24.2-31.2 °C, respectively. The latitudinal distributions and temperature ranges of each clade were significantly different. The qPCR assay employed, and results suggested that the hybrid zone for clade I and III has been observed in the southern Korean coasts, and clade III might be introduced from the Southern Pacific area. The cell abundances of clade III were strongly related with the higher seawater temperature and warm current force. This study has defined distinct habitat characteristics of genetically different sub-populations of P. pungens, and revealed its hybrid zone in natural environment for the first time. We also provided strong evidences about dispersion of the population of clade III to higher latitude in the West Pacific area. Copyright © 2018. Published by Elsevier B.V.

  2. Social marketing for a farmer’s market in an underserved community: A needs assessment

    Directory of Open Access Journals (Sweden)

    Meg Skizim

    2018-01-01

    Full Text Available The aim of the present paper is to assess local residents’ awareness of utilizing Supplemental Nutrition Assistance Program (SNAP benefits to purchase fresh produce at local farmers’ markets, and to determine internet use and media preferences of study participants prior to implementation of a social marketing campaign. A needs assessment was conducted to collect baseline data in an underserved neighbourhood in New Orleans (LA, USA. The study was carried out August 2014-May 2015. The assessment revealed that 73% of the respondents were unaware that the SNAP benefits could be used to purchase food in farmers’ markets; 63% of low-income participants never attended a farmers’ market compared to 27% of mid/high-income. Over 50% of the low-income respondents have access to the internet at least once per day. The results show the potential of raising awareness among a wide range of members in the community. This needs assessment will serve as the foundation for a social marketing intervention, which will be disseminated city-wide.

  3. Enrolling Underserved Women in mHealth Programs: Results From Text4baby Outreach Campaigns.

    Science.gov (United States)

    Bushar, Jessica A; Fishman, Jodie; Garfinkel, Danielle; Pirretti, Amy

    2018-03-01

    Public health practitioners have increasingly leveraged technology-based communication to get health information into the hands of hard-to-reach populations; however, best practices for outreach and enrollment into mobile health (mHealth) programs are lacking. This article describes enrollment results from campaigns focused on enrolling underserved pregnant women and mothers in Text4baby-a free, mHealth service-to inform outreach strategies for mHealth programs. Text4baby participants receive health and safety information, interactive surveys, alerts, and appointment reminders through at least three weekly texts and a free app-timed to users' due date or babies' birth date. Text4baby worked with partners to implement national, state, and community-based enrollment campaigns. Descriptive statistics were used to compare baseline enrollment prior to a campaign with enrollment during a campaign to generate enrollment estimates. Enrollment rates were calculated for campaigns for which the number targeted/reached was available. National television campaigns resulted in more than 10,000 estimated enrollments. Campaigns that were integrated with an existing program and text-based recruitment had the highest enrollment rates, ranging from 7% to 24%. Facebook advertisements and traditional media targeting providers and consumers were least effective. mHealth programs should consider text-based recruitment and outreach via existing programs; additional research is needed on return on investment for different outreach strategies and on the effectiveness of different outreach strategies at reaching and enrolling specific target populations.

  4. Study of radon exhalation rates using solid state nuclear track detectors in stone mining area of Aravali range in Pali region, district Faridabad

    International Nuclear Information System (INIS)

    Raj Kumari; Yadav, A.S.; Kant, Krishan; Garg, Maneesha

    2013-01-01

    It is well established that indoor radon-thoron and daughters are the largest contributor to total radiation dose received by populations. They account for more than 50% of the total dose and the radiation exposure beyond permissible levels can lead to deleterious effects on health. This fact necessitates extensive studies of natural radioactivity levels in the stone mining area of Aravali range in Faridabad. The stone mining area of Aravali Range in Pali, District Faridabad bears significant geological features. Radon exhalation from ground plays an important role in enhanced indoor radon levels and can pose grave health hazards to the workers and the residents. Exhalation rates (mass and surface) from stone samples of the area have been studied using LR-115, Type II nuclear track detectors. The mass and surface exhalation rates from crushed stone samples, also called stone dust varied in the range 3.41-9.11 mBq kg -1 h - 1 and 75.9-202.7 mBq m -2 h -1 , respectively. The study has revealed substantial presence of radionuclides in the samples collected from the mining area. (author)

  5. Diversity of bees and their floral resources at altitudinal areas in the Southern Espinhaço Range, Minas Gerais, Brazil.

    Science.gov (United States)

    Araújo, Vinícius A; Antonini, Yasmine; Araújo, Ana P A

    2006-01-01

    The Southern Espinhaço Range consists of large areas covered by quartzitic or metaliferous tropical altitudinal fields. The Espinhaço Range ecosystems are endangered by anthropic high impacts, particularly due to mining and urbanization. We conducted a one-year inventory of the bee flora and fauna at the quartzitic Ouro Branco Mountains and a two-year survey of the metaliferous Ouro Preto fields. The samples were collected twice a month, from 8:00 am to 5:00 pm. The bees (677) belonged to 91 species, five families. The family Apidae was the richest and most abundant, followed by the Halictidae and Megachilidae. The bees visited 46 flowering plant species; the most visited plants were the Asteraceae (n = 220), the Malpighiaceae (n = 95), the Melastomataceae (n = 94), the Fabaceae (n = 78), and the Solanaceae (n = 63). Diversity was higher in Ouro Branco (H = 1.47) than in Ouro Preto (H = 1.17). The low richness and abundance of bees in our research site when compared to other Brazilian "Cerrado" areas can be due to the high altitude, low temperature, and low availability of flowers we found. "Canga" and rupestrian areas house fauna and flora species that are rare and threatened by extinction. The southern Espinhaço areas can, therefore, be given the status of permanent biodiversity preservation area.

  6. Streamlined Approach for Environmental Restoration (SAFER) Plan for Corrective Action Unit 408: Bomblet Target Area Tonopah Test Range (TTR), Nevada, Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Mark Krauss

    2010-03-01

    This Streamlined Approach for Environmental Restoration Plan addresses the actions needed to achieve closure of Corrective Action Unit (CAU) 408, Bomblet Target Area (TTR). Corrective Action Unit 408 is located at the Tonopah Test Range and is currently listed in Appendix III of the Federal Facility Agreement and Consent Order. Corrective Action Unit 408 comprises Corrective Action Site TA-55-002-TAB2, Bomblet Target Areas. Clean closure of CAU 408 will be accomplished by removal of munitions and explosives of concern within seven target areas and potential disposal pits. The target areas were used to perform submunitions related tests for the U.S. Department of Energy (DOE). The scope of CAU 408 is limited to submunitions released from DOE activities. However, it is recognized that the presence of other types of unexploded ordnance and munitions may be present within the target areas due to the activities of other government organizations. The CAU 408 closure activities consist of: • Clearing bomblet target areas within the study area. • Identifying and remediating disposal pits. • Collecting verification samples. • Performing radiological screening of soil. • Removing soil containing contaminants at concentrations above the action levels. Based on existing information, contaminants of potential concern at CAU 408 include unexploded submunitions, explosives, Resource Conservation Recovery Act metals, and depleted uranium. Contaminants are not expected to be present in the soil at concentrations above the action levels; however, this will be determined by radiological surveys and verification sample results.

  7. Streamlined Approach for Environmental Restoration (SAFER) Plan for Corrective Action Unit 408: Bomblet Target Area Tonopah Test Range (TTR), Nevada, Revision 1

    International Nuclear Information System (INIS)

    Krauss, Mark

    2010-01-01

    This Streamlined Approach for Environmental Restoration Plan addresses the actions needed to achieve closure of Corrective Action Unit (CAU) 408, Bomblet Target Area (TTR). Corrective Action Unit 408 is located at the Tonopah Test Range and is currently listed in Appendix III of the Federal Facility Agreement and Consent Order. Corrective Action Unit 408 comprises Corrective Action Site TA-55-002-TAB2, Bomblet Target Areas. Clean closure of CAU 408 will be accomplished by removal of munitions and explosives of concern within seven target areas and potential disposal pits. The target areas were used to perform submunitions related tests for the U.S. Department of Energy (DOE). The scope of CAU 408 is limited to submunitions released from DOE activities. However, it is recognized that the presence of other types of unexploded ordnance and munitions may be present within the target areas due to the activities of other government organizations. The CAU 408 closure activities consist of: (1) Clearing bomblet target areas within the study area. (2) Identifying and remediating disposal pits. (3) Collecting verification samples. (4) Performing radiological screening of soil. (5) Removing soil containing contaminants at concentrations above the action levels. Based on existing information, contaminants of potential concern at CAU 408 include unexploded submunitions, explosives, Resource Conservation Recovery Act metals, and depleted uranium. Contaminants are not expected to be present in the soil at concentrations above the action levels; however, this will be determined by radiological surveys and verification sample results.

  8. Streamlined Approach for Environmental Restoration Plan for Corrective Action Unit 484: Surface Debris, Waste Sites, and Burn Area, Tonopah Test Range, Nevada

    International Nuclear Information System (INIS)

    Bechel Nevada

    2004-01-01

    This Streamlined Approach for Environmental Restoration plan details the activities necessary to close Corrective Action Unit (CAU) 484: Surface Debris, Waste Sites, and Burn Area (Tonopah Test Range). CAU 484 consists of sites located at the Tonopah Test Range, Nevada, and is currently listed in Appendix III of the Federal Facility Agreement and Consent Order. CAU 484 consists of the following six Corrective Action Sites: (1) CAS RG-52-007-TAML, Davis Gun Penetrator Test; (2) CAS TA-52-001-TANL, NEDS Detonation Area; (3) CAS TA-52-004-TAAL, Metal Particle Dispersion Test; (4) CAS TA-52-005-TAAL, Joint Test Assembly DU Sites; (5) CAS TA-52-006-TAPL, Depleted Uranium Site; and (6) CAS TA-54-001-TANL, Containment Tank and Steel Structure

  9. How Much Does it Cost to Expand a Protected Area System? Some Critical Determining Factors and Ranges of Costs for Queensland

    Science.gov (United States)

    Adams, Vanessa M.; Segan, Daniel B.; Pressey, Robert L.

    2011-01-01

    Many governments have recently gone on record promising large-scale expansions of protected areas to meet global commitments such as the Convention on Biological Diversity. As systems of protected areas are expanded to be more comprehensive, they are more likely to be implemented if planners have realistic budget estimates so that appropriate funding can be requested. Estimating financial budgets a priori must acknowledge the inherent uncertainties and assumptions associated with key parameters, so planners should recognize these uncertainties by estimating ranges of potential costs. We explore the challenge of budgeting a priori for protected area expansion in the face of uncertainty, specifically considering the future expansion of protected areas in Queensland, Australia. The government has committed to adding ∼12 million ha to the reserve system, bringing the total area protected to 20 million ha by 2020. We used Marxan to estimate the costs of potential reserve designs with data on actual land value, market value, transaction costs, and land tenure. With scenarios, we explored three sources of budget variability: size of biodiversity objectives; subdivision of properties; and legal acquisition routes varying with tenure. Depending on the assumptions made, our budget estimates ranged from $214 million to $2.9 billion. Estimates were most sensitive to assumptions made about legal acquisition routes for leasehold land. Unexpected costs (costs encountered by planners when real-world costs deviate from assumed costs) responded non-linearly to inability to subdivide and percentage purchase of private land. A financially conservative approach - one that safeguards against large cost increases while allowing for potential financial windfalls - would involve less optimistic assumptions about acquisition and subdivision to allow Marxan to avoid expensive properties where possible while meeting conservation objectives. We demonstrate how a rigorous analysis can inform

  10. Engaging diverse underserved communities to bridge the mammography divide

    Directory of Open Access Journals (Sweden)

    Cully Angelia

    2011-01-01

    Full Text Available Abstract Background Breast cancer screening continues to be underutilized by the population in general, but is particularly underutilized by traditionally underserved minority populations. Two of the most at risk female minority groups are American Indians/Alaska Natives (AI/AN and Latinas. American Indian women have the poorest recorded 5-year cancer survival rates of any ethnic group while breast cancer is the number one cause of cancer mortality among Latina women. Breast cancer screening rates for both minority groups are near or at the lowest among all racial/ethnic groups. As with other health screening behaviors, women may intend to get a mammogram but their intentions may not result in initiation or follow through of the examination process. An accumulating body of research, however, demonstrates the efficacy of developing 'implementation intentions' that define when, where, and how a specific behavior will be performed. The formulation of intended steps in addition to addressing potential barriers to test completion can increase a person's self-efficacy, operationalize and strengthen their intention to act, and close gaps between behavioral intention and completion. To date, an evaluation of the formulation of implementation intentions for breast cancer screening has not been conducted with minority populations. Methods/Design In the proposed program, community health workers will meet with rural-dwelling Latina and American Indian women one-on-one to educate them about breast cancer and screening and guide them through a computerized and culturally tailored "implementation intentions" program, called Healthy Living Kansas - Breast Health, to promote breast cancer screening utilization. We will target Latina and AI/AN women from two distinct rural Kansas communities. Women attending community events will be invited by CHWs to participate and be randomized to either a mammography "implementation intentions" (MI2 intervention or a

  11. Individual Breast Cancer risk assessment in Underserved Populations: Integrating empirical Bioethics and Health Disparities Research

    Science.gov (United States)

    Anderson, Emily E.; Hoskins, Kent

    2013-01-01

    Research suggests that individual breast cancer risk assessment may improve adherence to recommended screening and prevention guidelines, thereby decreasing morbidity and mortality. Further research on the use of risk assessment models in underserved minority populations is critical to informing national public health efforts to eliminate breast cancer disparities. However, implementing individual breast cancer risk assessment in underserved patient populations raises particular ethical issues that require further examination. After reviewing these issues, we will discuss how empirical bioethics research can be integrated with health disparities research to inform the translation of research findings. Our in-progress National Cancer Institute (NCI) funded study, How Do Underserved Minority Women Think About Breast Cancer?, conducted in the context of a larger study on individual breast cancer risk assessment, is presented as a model. PMID:23124498

  12. Radiological survey and evaluation of the fallout area from the Trinity test: Chupadera Mesa and White Sands Missile Range, New Mexico

    International Nuclear Information System (INIS)

    Hansen, W.R.; Rodgers, J.C.

    1985-06-01

    Current radiological conditions were evaluated for the site of the first nuclear weapons test, the Trinity test, and the associated fallout zone. The test, located on White Sands Missile Range, was conducted as part of the research with nuclear materials for the World War II Manhattan Engineer District atomic bomb project. Some residual radioactivity attributable to the test was found in the soils of Ground Zero on White Sands Missile Range and the areas that received fallout from the test. The study considered relevant information including historical records, environmental data extending back to the 1940s, and new data acquired by field sampling and measurements. Potential exposures to radiation were evaluated for current land uses. Maximum estimated doses on Chupadera Mesa and other uncontrolled areas are less than 3% of the DOE Radiation Protection Standards (RPSs). Radiation exposures during visits to the US Army-controlled Ground Zero area are less than 1 mrem per annual visit or less than 0.2% of the RPS for a member of the public. Detailed data and interpretations are provided in appendixes. 14 figs., 45 tabs

  13. Radiological survey and evaluation of the fallout area from the Trinity test: Chupadera Mesa and White Sands Missile Range, New Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, W.R.; Rodgers, J.C.

    1985-06-01

    Current radiological conditions were evaluated for the site of the first nuclear weapons test, the Trinity test, and the associated fallout zone. The test, located on White Sands Missile Range, was conducted as part of the research with nuclear materials for the World War II Manhattan Engineer District atomic bomb project. Some residual radioactivity attributable to the test was found in the soils of Ground Zero on White Sands Missile Range and the areas that received fallout from the test. The study considered relevant information including historical records, environmental data extending back to the 1940s, and new data acquired by field sampling and measurements. Potential exposures to radiation were evaluated for current land uses. Maximum estimated doses on Chupadera Mesa and other uncontrolled areas are less than 3% of the DOE Radiation Protection Standards (RPSs). Radiation exposures during visits to the US Army-controlled Ground Zero area are less than 1 mrem per annual visit or less than 0.2% of the RPS for a member of the public. Detailed data and interpretations are provided in appendixes. 14 figs., 45 tabs.

  14. Nanoimprint-defined, large-area meta-surfaces for unidirectional optical transmission with superior extinction in the visible-to-infrared range.

    Science.gov (United States)

    Yao, Yuhan; Liu, He; Wang, Yifei; Li, Yuanrui; Song, Boxiang; Wang, Richard P; Povinelli, Michelle L; Wu, Wei

    2016-07-11

    Optical devices with asymmetric transmission have important applications in optical systems, but optical isolators with the modal asymmetry can only be built using magneto-optical or nonlinear materials, as dictated by the Lorentz reciprocity theorem. However, optical devices with the power asymmetry can be achieved by linear materials such as metals and dielectrics. In this paper, we report a large-area, nanoimprint-defined meta-surface (stacked subwavelength gratings) with high-contrast asymmetric transmittance in the visible-to-infrared wavelength range for TM-polarized light. The physical origin of asymmetric transmission through the meta-surface is studied by analyzing the scattering matrix.

  15. Inclusion of underserved racial and ethnic groups in cancer intervention research using new media: a systematic literature review.

    Science.gov (United States)

    Thompson, Hayley S; Shelton, Rachel C; Mitchell, Jamie; Eaton, Tara; Valera, Pamela; Katz, Anne

    2013-12-01

    An increasing number of behavioral and psychosocial cancer interventions incorporate new media elements that are digital, networked, and interactive. However, it is unclear to what extent new media is being leveraged to benefit underserved racial and ethnic groups who disproportionately bear the burden of cancer. This inquiry is timely in light of growing evidence that these groups are receptive to new media. A systematic literature review was conducted to assess the inclusion of these groups in research on cancer-related new media interventions and use of new media to reduce racial and ethnic cancer disparities. A systematic search of three databases was conducted for articles published between January 2000 and March 2012 that presented studies of user experience with a behavioral or psychosocial cancer-related intervention with at least one new media component. Thirty-six articles were included in the final review. In about one-quarter of the studies, less than 20% of participants were African American, Latino, Asian American, or American Indian. In less than 10% of the studies, 80% or more of the samples were members of the aforementioned groups. Almost one-third of the studies reviewed were categorized as disparity focused but limited data were available on racial and ethnic differences in responses to new media interventions. Findings suggest that the promise and potential of new media cancer interventions are largely unrealized among the underserved. Additional research is needed to investigate a wide range of issues related to the development and delivery of such interventions in diverse racial and ethnic groups.

  16. Factors associated with differential uptake of seasonal influenza immunizations among underserved communities during the 2009-2010 influenza season.

    Science.gov (United States)

    Vlahov, David; Bond, Keosha T; Jones, Kandice C; Ompad, Danielle C

    2012-04-01

    Influenza vaccination coverage remains low and disparities persist. In New York City, a community-based participatory research project (Project VIVA) worked to address this issue in Harlem and the South Bronx by supplementing existing vaccination programs with non-traditional venues (i.e., community-based organizations). We conducted a 10 min survey to assess access to influenza vaccine as well as attitudes and beliefs towards influenza vaccination that could inform intervention development for subsequent seasons. Among 991 participants recruited using street intercept techniques, 63% received seasonal vaccine only, 11% seasonal and H1N1, and 26% neither; 89% reported seeing a health care provider (HCP) during the influenza season. Correlates of immunization among those with provider visits during the influenza season included being US-born, interest in getting the vaccine, concern about self or family getting influenza, an HCP's recommendation and comfort with government. Among those without an HCP visit, factors associated with immunization included being US born, married, interest in getting the vaccine, understanding influenza information, and concern about getting influenza. Factors associated with lack of interest in influenza vaccine included being born outside the US, Black and uncomfortable with government. In medically underserved areas, having access to routine medical care and understanding the medical implications of influenza play an important role in enhancing uptake of seasonal influenza vaccination. Strategies to improve vaccination rates among Blacks and foreign-born residents need to be addressed. The use of non-traditional venues to provide influenza vaccinations in underserved communities has the potential to reduce health disparities.

  17. Geologic Map of the Cascade Head Area, Northwestern Oregon Coast Range (Neskiwin, Nestucca Bay, Hebo, and Dolph 7.5 minute Quadrangles)

    Science.gov (United States)

    Snavely, Parke D.; Niem, Alan; Wong, Florence L.; MacLeod, Norman S.; Calhoun, Tracy K.; Minasian, Diane L.; Niem, Wendy

    1996-01-01

    The geology of the Cascade Head area bridges the geology in the Tillamook Highlands to the north (Wells and others, 1994; 1995) with that of the Newport Embayment on the south (Snavely and others, 1976 a,b,c). The four 7.5-minute quadrangles (Neskowin, Nestucca Bay, Hebo, and Dolph) which comprise the Cascade Head area include significant stratigraphic, structural, and igneous data that are essential in unraveling the geology of the northern and central part of the Oregon Coast Range and of the adjacent continental shelfEarlier studies (Snavely and Vokes, 1949) were of a broad reconnaissance nature because of limited access in this rugged, densely forested part of the Siuslaw National Forest. Also, numerous thick sills of late middle Eocene diabase and middle Miocene basalt mask the Eocene stratigraphic relationships. Previous mapping was hampered by a lack of precise biostratigraphic data. However, recent advances in biostratigraphy and radiometric age dating and geochemistry have provided the necessary tools to decipher stratigraphic and structural relationships in the Eocene sedimentary and volcanic rock sequences (W.W. Rau, personal communication, 1978 to 1988; Bukry and Snavely, 1988). Many important stratigraphic and igneous relationships are displayed within the Casacde Head area: (1) turbidite sandstone of the middle Eocene Tyee Formation, which is widespread in the central and southern part of the Oregon Coast Range (Snavely and others, 1964), was not deposited in the western part of the Cascade Head, and is of limited extent north of the map area (Wells and others, 1994); (2) the late middle Eocene Yamhill Formation, which crops out along the west and east flank of the Oregon Coast Range, overlaps older strata and overlies an erosional unconformity on the lower Eocene Siletz River Volcanics (Snavely and others, 1990; 1991); (3) thick sills of late middle Eocene diabase (43 Ma) are widespread in the Cascade Head area and also form much of the eastern

  18. Corrective Action Investigation Plan for Corrective Action Unit 490: Station 44 Burn Area, Tonopah Test Range, Nevada (with Record of Technical Change No.1)

    International Nuclear Information System (INIS)

    2000-01-01

    This Corrective Action Investigation Plan (CAIP) contains the U.S. Department of Energy, Nevada Operations Office's approach to collect the data necessary to evaluate corrective action alternatives appropriate for the closure of Corrective Action Unit (CAU) 490 under the Federal Facility Agreement and Consent Order. Corrective Active Unit 490 consists of four Corrective Action Sites (CASs): 03-56-001-03BA, Fire Training Area (FTA); RG-56-001-RGBA, Station 44 Burn Area; 03-58-001-03FN, Sandia Service Yard; and 09-54-001-09L2, Gun Propellant Burn Area. These CASs are located at the Tonopah Test Range near Areas 3 and 9. Historically, the FTA was used for training exercises where tires and wood were ignited with diesel fuel. Records indicate that water and carbon dioxide were the only extinguishing agents used during these training exercises. The Station 44 Burn Area was used for fire training exercises and consisted of two wooden structures. The two burn areas (ignition of tires, wood, and wooden structures with diesel fuel and water) were limited to the building footprints (10 ft by 10 ft each). The Sandia Service Yard was used for storage (i.e., wood, tires, metal, electronic and office equipment, construction debris, and drums of oil/grease) from approximately 1979 to 1993. The Gun Propellant Burn Area was used from the 1960s to 1980s to burn excess artillery gun propellant, solid-fuel rocket motors, black powder, and deteriorated explosives; additionally, the area was used for the disposal of experimental explosive items. Based on site history, the focus of the field investigation activities will be to: (1) determine the presence of contaminants of potential concern (COPCs) at each CAS, (2) determine if any COPCs exceed field-screening levels and/or preliminary action levels, and (3) determine the nature and extent of contamination with enough certainty to support selection of corrective action alternatives for each CAS. The scope of this CAIP is to resolve the

  19. Corrective Action Investigation Plan for Corrective Action Unit 490: Station 44 Burn Area, Tonopah Test Range, Nevada (with Record of Technical Change No.1)

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Nevada Operations Office

    2000-06-09

    This Corrective Action Investigation Plan (CAIP) contains the U.S. Department of Energy, Nevada Operations Office's approach to collect the data necessary to evaluate corrective action alternatives appropriate for the closure of Corrective Action Unit (CAU) 490 under the Federal Facility Agreement and Consent Order. Corrective Active Unit 490 consists of four Corrective Action Sites (CASs): 03-56-001-03BA, Fire Training Area (FTA); RG-56-001-RGBA, Station 44 Burn Area; 03-58-001-03FN, Sandia Service Yard; and 09-54-001-09L2, Gun Propellant Burn Area. These CASs are located at the Tonopah Test Range near Areas 3 and 9. Historically, the FTA was used for training exercises where tires and wood were ignited with diesel fuel. Records indicate that water and carbon dioxide were the only extinguishing agents used during these training exercises. The Station 44 Burn Area was used for fire training exercises and consisted of two wooden structures. The two burn areas (ignition of tires, wood, and wooden structures with diesel fuel and water) were limited to the building footprints (10 ft by 10 ft each). The Sandia Service Yard was used for storage (i.e., wood, tires, metal, electronic and office equipment, construction debris, and drums of oil/grease) from approximately 1979 to 1993. The Gun Propellant Burn Area was used from the 1960s to 1980s to burn excess artillery gun propellant, solid-fuel rocket motors, black powder, and deteriorated explosives; additionally, the area was used for the disposal of experimental explosive items. Based on site history, the focus of the field investigation activities will be to: (1) determine the presence of contaminants of potential concern (COPCs) at each CAS, (2) determine if any COPCs exceed field-screening levels and/or preliminary action levels, and (3) determine the nature and extent of contamination with enough certainty to support selection of corrective action alternatives for each CAS. The scope of this CAIP is to resolve

  20. Morphostructural characterization of the Charco basin and its surrounding areas in the Chihuahua segment of north Mexican Basin and Range Province

    Science.gov (United States)

    Troiani, Francesco; Menichetti, Marco

    2014-05-01

    The Chihuahua Basin and Range (CBR) is the eastern branch of the northern Mexican Basin and Range Province that, from a morphostructural point of view, presently is one amongst the lesser-known zones of the southern portion of the North America Basin and Range Province. The study area covers an approximately 800 km2-wide portion of the CBR and encompasses the fault-bounded Charco basin and its surrounding areas. The bedrock of the area pertains to the large siliceous-igneous province of the Sierra Madre Occidental and consists of volcanoclastic rocks including Oligocene dacite, rhyolite, rhyolitic tuffs, and polimitic conglomerates. The region is characterized by a series of NW-SE oriented valleys delimited by tilted monoclinal blocks bounded by high angle, SW-dipping, normal faults. Abrupt changes in elevation, alternating between narrow faulted mountain chains and flat arid valleys or basins are the main morphological elements of the area. The valleys correspond to structural grabens filled with Plio-Pleistocene continental sediments. These grabens are about 10 km wide, while the extensional fault system extend over a distance of more than 15 km. The mountain ranges are in most cases continuous over distances that range from 10 to 70 km including different branches of the extensional and transfer faults. The morphogenesis is mainly erosive in character: erosional landforms (such as rocky scarps, ridges, strath-terraces, erosional pediment, reverse slopes, landslide scar zones, litho-structural flat surfaces) dominate the landscape. In contrast, Quaternary depositional landforms are mainly concentrated within the flat valleys or basins. The Quaternary deposits consist of wide alluvial fans extending to the foot of the main ridges, fluvial and debris-slope deposits. The morphostructural characterization of the area integrated different methodologies, including: i) geomorphological and structural field analyses; ii) remote sensing and geo-morphometric investigations

  1. American Dental Association White Paper Targets Dental Care for the Underserved

    Science.gov (United States)

    Berthold, Mark

    2005-01-01

    Reaffirming its leadership role toward better oral health for all Americans, the ADA has produced a white paper that also challenges policy-makers and the US to improve access to dental services. The white paper, "State and Community Models for Improving Access to Dental Care for the Underserved," was presented October 1 to the House of…

  2. The Quick Peek Program: A Model for Developmental Screening within Underserved Communities

    Science.gov (United States)

    Harris, Jill; Norton, Amy

    2016-01-01

    Developmental screening of young children is important in all populations, especially underserved communities with known health care disparities. The American Academy of Pediatrics created guidelines and a toolkit for pediatricians to conduct developmental surveillance and screening, yet these guidelines are not uniformly implemented within…

  3. How to Guide: Aggregate under-served markets into buying pools

    Energy Technology Data Exchange (ETDEWEB)

    None

    2000-12-26

    This activity promotes new opportunities to increase energy security and lower energy costs for under-served markets. It involves market analysis and collaboration with community partners, as well as outreach activities to inform target markets and technical assistance for participants.

  4. Investigating the Factors of Resiliency among Exceptional Youth Living in Rural Underserved Communities

    Science.gov (United States)

    Curtin, Kevin A.; Schweitzer, Ashley; Tuxbury, Kristen; D'Aoust, Janelle A.

    2016-01-01

    Resilience is an important social justice concept that has important implications for educators working with exceptional youth in rural underserved communities who may suffer from the consequences associated with economic hardships. This multi-school qualitative study examined resilience among exceptional youth living in rural poverty through the…

  5. Promising Practices: A Literature Review of Technology Use by Underserved Students

    Science.gov (United States)

    Zielezinski, Molly B.; Darling-Hammond, Linda

    2016-01-01

    How can technologies and digital learning experiences be used to support underserved, under-resourced, and underprepared students? For many years, educators, researchers, and policy makers looking for strategies to close the achievement gap and improve student learning have sought solutions involving new uses of technology, especially for students…

  6. A Smart Partnership: Integrating Educational Technology for Underserved Children in India

    Science.gov (United States)

    Charania, Amina; Davis, Niki

    2016-01-01

    This paper explores the evolution of a large multi-stakeholder partnership that has grown since 2011 to scale deep engagement with learning through technology and decrease the digital divide for thousands of underserved school children in India. Using as its basis a case study of an initiative called integrated approach to technology in education…

  7. Breaking Barriers to Bike Share: Insights from Residents of Traditionally Underserved Neighborhoods

    Science.gov (United States)

    2017-06-01

    Evidence has shown that higher income and white populations are overrepresented in both access to and use of bike share. Efforts to overcome underserved communities barriers to access and use of bike share have been initiated in a number of cities...

  8. Using Social Cognitive Theory to Predict Physical Activity and Fitness in Underserved Middle School Children

    Science.gov (United States)

    Martin, Jeffrey J.; McCaughtry, Nate; Flory, Sara; Murphy, Anne; Wisdom, Kimberlydawn

    2011-01-01

    Few researchers have used social cognitive theory and environment-based constructs to predict physical activity (PA) and fitness in underserved middle-school children. Hence, we evaluated social cognitive variables and perceptions of the school environment to predict PA and fitness in middle school children (N = 506, ages 10-14 years). Using…

  9. Corrective Action Investigation Plan for Corrective Action Unit 428: Area 3 Septic Waste Systems 1 and 5, Tonopah Test Range, Nevada

    International Nuclear Information System (INIS)

    ITLV

    1999-01-01

    The Corrective Action Investigation Plan for Corrective Action Unit 428, Area 3 Septic Waste Systems 1 and 5, has been developed in accordance with the Federal Facility Agreement and Consent Order that was agreed to by the U. S. Department of Energy, Nevada Operations Office; the State of Nevada Division of Environmental Protection; and the U. S. Department of Defense. Corrective Action Unit 428 consists of Corrective Action Sites 03- 05- 002- SW01 and 03- 05- 002- SW05, respectively known as Area 3 Septic Waste System 1 and Septic Waste System 5. This Corrective Action Investigation Plan is used in combination with the Work Plan for Leachfield Corrective Action Units: Nevada Test Site and Tonopah Test Range, Nevada , Rev. 1 (DOE/ NV, 1998c). The Leachfield Work Plan was developed to streamline investigations at leachfield Corrective Action Units by incorporating management, technical, quality assurance, health and safety, public involvement, field sampling, and waste management information common to a set of Corrective Action Units with similar site histories and characteristics into a single document that can be referenced. This Corrective Action Investigation Plan provides investigative details specific to Corrective Action Unit 428. A system of leachfields and associated collection systems was used for wastewater disposal at Area 3 of the Tonopah Test Range until a consolidated sewer system was installed in 1990 to replace the discrete septic waste systems. Operations within various buildings at Area 3 generated sanitary and industrial wastewaters potentially contaminated with contaminants of potential concern and disposed of in septic tanks and leachfields. Corrective Action Unit 428 is composed of two leachfield systems in the northern portion of Area 3. Based on site history collected to support the Data Quality Objectives process, contaminants of potential concern for the site include oil/ diesel range total petroleum hydrocarbons, and Resource Conservation

  10. Influence of vegetation physiognomy, elevation and fire frequency on medium and large mammals in two protected areas of the Espinhaço Range

    Directory of Open Access Journals (Sweden)

    Fernando Ferreira de Pinho

    2017-05-01

    Full Text Available ABSTRACT The objectives of this study were to determine the richness of medium and large mammal species in two protected areas of the Espinhaço Mountain Range, state of Minas Gerais, Brazil; and to investigate the factors affecting the occurrence of those species. To accomplish that we placed 49 camera traps activated by heat and motion at Rio Preto State Park (RPSP and 48 at Sempre Vivas National Park (SVNP. We also collected data on three environmental variables: vegetation physiognomy, elevation and wildfire frequency, to evaluate the influence of these factors on species richness and use intensity (inferred from camera trap detection rate by large mammals. We recorded 23 large mammal species in the two parks combined. The lowest species richness was found at the rupestrian habitat of RPSP, and in the open grasslands of SVNP. The forest and savannah physiognomies were used more intensively by large mammals. Species richness was higher and use was greater at lower elevations of RPSP. In SVNP, fire frequency did not affect species richness or use intensity. The savannah habitat had very similar richness compared to the forests of the two protected areas. The high species richness and use intensity observed in these forest habitats highlights the importance of riparian environments in the Cerrado biome. The highest species richness and use intensity observed at low elevation follows patterns found in the literature, probably due to variation in the vegetation, which results in greater resource availability. Although rupestrian habitats at high elevations of the Espinhaço Range are known to have a high degree of endemism for some taxa, large mammal richness and use were not high in this habitat. These results indicate that the protection of native vegetation at lower elevations is crucial for the long-term conservation of large mammals in the Espinhaço Range.

  11. Summary report of the grazing studies conducted on a plutonium-contaminated range in Area 13 of the Nevada Test Site

    International Nuclear Information System (INIS)

    Smith, D.D.

    1979-05-01

    Actinide concentrations in the tissues of beef animals periodically sacrificed and sampled during a 3-year grazing study on a plutonium-contaminated range of the Nevada Test Site are tabulated and discussed. The primary objective of this study was to determine the uptake and tissue distribution of the plutonium by ruminants. Food habit analyses of ingesta from rumen-fistulated steers and sacrificed cattle revealed that shrub species made up the major portion of their diet during most seasons of the year. Grasses were preferred during the spring months. Using activity levels found in the rumen contents, it was estimated that a study cow ingested 100 microcuries of plutonium-239 prior to sacrifice. Of this, 16.4 microcuries was in rumen fluids from which a combined retention factor of 0.0034% was calculated for the bone, muscle, and liver. Comparisons of plutonium-239/plutonium-238 ratios in ingesta and tissues indicate that the plutonium-238 is more readily absorbed and retained. No radiologically significant lesions were found. The gonadal concentrations of the actinides were significantly higher than those of blood and muscle and approached those of bone. These data indicate that consideration should be given to the plutonium-239 dose to gonads as well as that to bone, liver, and lungs of man. Actinide concentrations of animals born in the study areas showed an increasing trend with time. Concentrations of plutonium-239 in the lung, liver, muscle, and femur tissues of the Area 13 cattle were significantly higher than in tissues collected from grazing cattle from other sites. The plutonium-239 concentrations in bones, lungs, and livers collected from wildlife with free access to and from the contaminated zones reflect the dilution resulting from these animals ranging into the less contaminated areas around the study sites

  12. Corrective Action Plan for Corrective Action Unit 428: Area 3 Septic Waste Systems 1 and 5 Tonopah Test Range, Nevada; TOPICAL

    International Nuclear Information System (INIS)

    D. S. Tobiason

    2000-01-01

    Area 3 Septic Waste Systems 1 and 5 are located in Area 3 of the Tonopah Test Range (TTR) (Figure 1). The site is listed in the Federal Facility Agreement and Consent Order (FFACO, 1996) as Corrective Action Unit (CAU) 428 and includes Corrective Action Sites 03-05-002-SW01 (Septic Waste System 1[SWS 1]), and 03-05-002-SW05 (Septic Waste System 5[SWS 5]). The site history for the CAU is provided in the Corrective Action Investigation Plan (U.S. Department of Energy, Nevada Operations Office[DOE/NV], 1999). SWS 1 consists of two leachfields and associated septic tanks. SWS 1 received effluent from both sanitary and industrial sources from various buildings in Area 3 of the TTR (Figure 2). SWS 5 is comprised of one leachfield and outfall with an associated septic tank. SWS 5 received effluent from sources in Building 03-50 in Area 3 of the TTR (Figure 2). Both systems were active until 1990 when a consolidated sewer system was installed. The purpose of this Corrective Action Plan (CAP) is to provide the strategy and methodology to close the Area 3 SWS 1 and 5. The CAU will be closed following state and federal regulations and the FFACO (1996). Site characterization was done during May and June 1999. Samples of the tank contents, leachfield soil, and soil under the tanks and pipes were collected. The results of the characterization were reported in the Corrective Action Decision Document (CADD) (DOE/NV, 2000). Additional sampling was done in May 2000, the results of which are presented in this plan. Soil sample results indicated that two constituents of concern were detected above Preliminary Action Levels (PALs). Total arsenic was detected at a concentration of 68.7 milligrams per kilogram (mg/kg). The arsenic was found under the center distribution line at the proximal end of the SWS 5 Leachfield (Figure 3). Total benzo(a)pyrene was detected at a concentration of 480 micrograms per kilogram ((micro)g/kg). The benzo(a)pyrene was found in the soil under the discharge

  13. Rural Health, Center of Excellence for Remote and Medically Under-Served Areas (CERMUSA). Addendum

    Science.gov (United States)

    2010-07-01

    Plaque *c. Pulpitis or an abscess d. Gingivitis 4. Pulp necrosis can be defined as: a. A viral infection in the gums *b. Death of the pulp...families. Available data indicate higher incidences of breast and prostate cancer affecting U.S. military versus the general population (Zhu et al...Meyerowitz, B. E., et al. (2006). Fatigue in long-term breast carcinoma survivors: A longitudinal investigation. Cancer, 106(4), 751-758. Courneya, K

  14. Mobile colposcopy in urban and underserved suburban areas in Baja California

    Science.gov (United States)

    Madiedo, Marta; Contreras, Sonia; Villalobos, Octavio; Kahn, Bruce S.; Safir, Amit; Levitz, David

    2016-03-01

    Cervical cancer is the leading cause of cancer death for women in low resource settings, often affecting the most economically disenfranchised segment of the population. The key challenge with cervical cancer is the lack of an effective screening program for many of the at-risk, difficult-to-reach women. Outreach programs that utilize mobile clinics to increase access to screening and care in Baja California have been developed. However, many barriers such as quality assurance, efficient referral remained a challenge in this region. Visualization-based co-tests together with cytology (Pap smears) as a primary screen have been proposed. Here, the mobile colposcope of the enhanced visual assessment (EVA) is used to capture an image immediately following a Pap smear. EVA images were reviewed by expert colposcopists. Initial or preliminary data from pilot services showed that Pap false positives and Pap false negatives maybe reduced by expert review of EVA images. This suggests that reviewing of EVA images may be instrumental in catching inaccurate Pap results, thereby improving care. Thus, there is a need to further explore the benefits of using EVA as additional information when conducting Pap smear screenings.

  15. Rural Health, Center of Excellence for Remote and Medically Under-served Area (CERMUSA)

    Science.gov (United States)

    2007-05-01

    Curriculum: Foundations, principles, and issues. Needham Heights, MA: Allyn and Bacon. Taylor, R. (2002). Pros and cons of online learning: A...Online 11/9 • 7. Preparation For Final Assignment • 7.1. Conducting a SWOT Analysis - Online 11/16 8. Ne class -Thanksgiving 11/23 9. O~en

  16. Nurse Education, Center of Excellence for Remote and Medically Under-Served Areas (CERMUSA)

    Science.gov (United States)

    2013-10-01

    for the clinical managemen t of all ages and populations affected by disasters and public health emergencies , in accordance with...Essential VII, Objective 9 8.0 Demonstrate knowledge of public health principles and practices for the managemen t of all ages and...Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204

  17. Center of Excellence for Remote and Medically Under-Served Areas

    Science.gov (United States)

    2008-04-11

    healthcare projects. Telemedicine is not the sole cure for the rural health dilemma; it can be a major ingredient if aggressively deployed. Providers can...effects of this course curriculum on student health will be evidenced in BMI changes, absentee rates, and number of visits to the school nurse...ninth grade students will result in improved health as evidenced by prevention of weight gain, decreased absenteeism , and decreased number of

  18. Remote Patient Management in a Mammographic Screening Environment in Underserved Areas

    Science.gov (United States)

    2005-09-01

    of 4,945 paired examinations. Radiology 2001; 218:873-880. 10. Malich A, Marx C, Facius M, Boehm T, Fleck M, Kaiser WA. Tumour 24. Venta LA, Hendrick...218:873-880. KF, Sickles EA. Mammographic character- factor determining the quality of com- 15. Venta LA, Hendrick RE, Adler YT, et al. iSicks of 115

  19. Multidisciplinary approach for the characterization of landslides in volcanic areas - a case study from the Palma Sola-Chiconquiaco Mountain Range, Mexico

    Science.gov (United States)

    Wilde, Martina; Rodríguez Elizarrarás, Sergio R.; Morales Barrera, Wendy V.; Schwindt, Daniel; Bücker, Matthias; Flores Orozco, Adrián; García García, Emilio; Pita de la Paz, Carlos; Terhorst, Birgit

    2017-04-01

    The Palma Sola-Chiconquiaco mountain range, situated in the State of Veracruz, Mexico, is highly susceptible to landslides, which is evidenced by the high frequency of landslide events of different sizes. The study area is located near the Gulf of Mexico coastline in the eastern sector of the Trans Mexican Volcanic Belt. There, landslide triggers are intense rainfalls related to tropical storms and hurricanes. Steeper slopes are commonly affected by rockfalls, whereas moderate slopes, covered by massive slope deposits, are affected by shallow as well as deep seated landslides. Some of the landslides in the slope deposits reach dimensions of more than 1000 m in length and depths of over 30 m. The heterogeneous parent material as well as older slide masses hamper the detailed characterization of the involved materials. Therefore, in this study, a multidisciplinary approach is applied that integrates geomorphological, geological, and geophysical data. The aim is the reconstruction of process dynamics by analyzing the geomorphological situation and subsurface conditions before and after the event. The focus lies on the identification of past landslide areas, which represent areas with high susceptibility for the reactivation of old slide masses. Furthermore, the analysis of digital terrain models, generated before the landslide event, indicate initial movements like extension cracks, which are located close to the current scarp area. In order to characterize the subsurface of slide masses geophysical investigations are applied. The geophysical survey consists of a total of nine profiles covering relevant key features of the large affected area. Along these profiles, electrical resistivity tomography (ERT) and seismic refraction tomography (SRT) data were collected. Both, electrical and seismic images reveal a sharp contrast between relatively loose and dry material of the slide mass (high resistivities and low seismic velocities) and the former land surface that is

  20. Internal variability of fine-scale components of meteorological fields in extended-range limited-area model simulations with atmospheric and surface nudging

    Science.gov (United States)

    Separovic, Leo; Husain, Syed Zahid; Yu, Wei

    2015-09-01

    Internal variability (IV) in dynamical downscaling with limited-area models (LAMs) represents a source of error inherent to the downscaled fields, which originates from the sensitive dependence of the models to arbitrarily small modifications. If IV is large it may impose the need for probabilistic verification of the downscaled information. Atmospheric spectral nudging (ASN) can reduce IV in LAMs as it constrains the large-scale components of LAM fields in the interior of the computational domain and thus prevents any considerable penetration of sensitively dependent deviations into the range of large scales. Using initial condition ensembles, the present study quantifies the impact of ASN on IV in LAM simulations in the range of fine scales that are not controlled by spectral nudging. Four simulation configurations that all include strong ASN but differ in the nudging settings are considered. In the fifth configuration, grid nudging of land surface variables toward high-resolution surface analyses is applied. The results show that the IV at scales larger than 300 km can be suppressed by selecting an appropriate ASN setup. At scales between 300 and 30 km, however, in all configurations, the hourly near-surface temperature, humidity, and winds are only partly reproducible. Nudging the land surface variables is found to have the potential to significantly reduce IV, particularly for fine-scale temperature and humidity. On the other hand, hourly precipitation accumulations at these scales are generally irreproducible in all configurations, and probabilistic approach to downscaling is therefore recommended.

  1. Post-Closure Inspection Report for Corrective Action Unit 453: Area 9 UXO Landfill Tonopah Test Range, Nevada, Calendar Year 2000; TOPICAL

    International Nuclear Information System (INIS)

    K. B. Campbell

    2001-01-01

    Post-closure monitoring requirements for the Area 9 Unexploded Ordnance Landfill (Corrective Action Unit[CAU] 453) (Figure 1) are described in Closure Report for Corrective Action Unit 453: Area 9 UXO Landfill, Tonopah Test Range, Nevada, report number DOE/NV-284. The Closure Report (CR) was submitted to the Nevada Division of Environmental Protection (NDEP) on August 5,1999. The CR (containing the Post-Closure Monitoring Plan) was approved by the NDEP on September 10,1999. Post-closure monitoring at CAU 453 consists of the following: (1) Site inspections done twice a year to evaluate the condition of the unit; (2) Verification that the site is secure; (3) Notice of any subsidence or deficiencies that may compromise the integrity of the unit; (4) Remedy of any deficiencies within 90 days of discovery; and (5) Preparation and submittal of an annual report. Site inspections were conducted on June 20, 2000 and November 21, 2000. Both site inspections were conducted after NDEP approval of the CR, and in accordance with the Post-Closure Monitoring Plan in the NDEP-approved CR. This report includes copies of the inspection checklists, photographs, recommendations, and conclusions. The Post-Closure Inspection Checklists are found in Attachment A, a copy of the field notes is found in Attachment B, and inspection photographs are found in Attachment C

  2. Corrective Action Decision Document for Corrective Action Unit 428: Area 3 Septic Waste Systems 1 and 5, Tonopah Test Range, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Nevada Operations Office

    2000-02-08

    This Corrective Action Decision Document identifies and rationalizes the US Department of Energy, Nevada Operations Office's selection of a recommended corrective action alternative (CAA) appropriate to facilitate the closure of Corrective Action Unit (CAU) 428, Septic Waste Systems 1 and 5, under the Federal Facility Agreement and Consent Order. Located in Area 3 at the Tonopah Test Range (TTR) in Nevada, CAU 428 is comprised of two Corrective Action Sites (CASs): (1) CAS 03-05-002-SW01, Septic Waste System 1 and (2) CAS 03-05-002- SW05, Septic Waste System 5. A corrective action investigation performed in 1999 detected analyte concentrations that exceeded preliminary action levels; specifically, contaminants of concern (COCs) included benzo(a) pyrene in a septic tank integrity sample associated with Septic Tank 33-1A of Septic Waste System 1, and arsenic in a soil sample associated with Septic Waste System 5. During this investigation, three Corrective Action Objectives (CAOs) were identified to prevent or mitigate exposure to contents of the septic tanks and distribution box, to subsurface soil containing COCs, and the spread of COCs beyond the CAU. Based on these CAOs, a review of existing data, future use, and current operations in Area 3 of the TTR, three CAAs were developed for consideration: Alternative 1 - No Further Action; Alternative 2 - Closure in Place with Administrative Controls; and Alternative 3 - Clean Closure by Excavation and Disposal. These alternatives were evaluated based on four general corrective action standards and five remedy selection decision factors. Based on the results of the evaluation, the preferred CAA was Alternative 3. This alternative meets all applicable state and federal regulations for closure of the site and will eliminate potential future exposure pathways to the contaminated soils at the Area 3 Septic Waste Systems 1 and 5.

  3. Self-collected cervicovaginal sampling for site-of-care primary HPV-based cervical cancer screening: a pilot study in a rural underserved Greek population.

    Science.gov (United States)

    Chatzistamatiou, Kimon; Chatzaki, Εkaterini; Constantinidis, Τheocharis; Nena, Evangelia; Tsertanidou, Athena; Agorastos, Theodoros

    2017-11-01

    In the present pilot study, the feasibility of a site-of-care cervicovaginal self-sampling methodology for HPV-based screening was tested in 346 women residing in underserved rural areas of Northern Greece. These women provided self-collected cervicovaginal sample along with a study questionnaire. Following molecular testing, using the cobas ® HPV Test, Roche ® , HPV positive women, were referred to colposcopy and upon abnormal findings, to biopsy and treatment. Participation rate was 100%. Regular pap-test examination was reported for 17.1%. Among hrHPV testing, 11.9% were positive and colposcopy/biopsy revealed 2 CIN3 cases. Non-compliance was the most prevalent reason for no previous attendance. Most women reported non-difficulty and non-discomfort in self-sampling (77.6% and 82.4%, respectively). They would choose self-sampling over clinician-sampling (86.2%), and should self-sampling being available, they would test themselves more regularly (92.3%). In conclusion, self-sampling is feasible and well-accepted for HPV-based screening, and could increase population coverage in underserved areas, helping towards successful prevention.

  4. Permian charnockites in the Pobeda area: Implications for Tarim mantle plume activity and HT metamorphism in the South Tien Shan range

    Science.gov (United States)

    Loury, Chloé; Rolland, Yann; Lanari, Pierre; Guillot, Stéphane; Bosch, Delphine; Ganino, Clément; Jourdon, Anthony; Petit, Carole; Gallet, Sylvain; Monié, Patrick; Riel, Nicolas

    2018-04-01

    adjacent transpressive shear-zone indicates continuation of the strike-slip tectonics at shallow crustal levels, after the exhumation of the Charnockite unit, at 248-257 Ma. These results demonstrate that Tien Shan Permian magmatism is linked to the Tarim mantle plume activity. Lithosphere-scale shear zones in the Tien Shan range, could have been responsible for lateral flow focusing of the Tarim mantle plume up to the boundary with the Tien Shan range and subsequent decompression melting resulting in the Permian magmatism observed in the Pobeda area.

  5. Post-Closure Inspection Report for Corrective Action Unit 424: Area 3 Landfill Complexes Tonopah Test Range, Nevada Calendar Year 2001; TOPICAL

    International Nuclear Information System (INIS)

    K. B. Campbell

    2002-01-01

    Corrective Action Unit (CAU) 424, the Area 3 Landfill Complexes at Tonopah Test Range, consists of eight Corrective Action Sites (CASs), seven of which are landfill cells that were closed previously by capping. (The eighth CAS, A3-7, was not used as a landfill site and was closed without taking any corrective action.) Figure 1 shows the general location of the landfill cells. Figure 2 shows in more detail the location of the eight landfill cells. CAU 424 closure activities included removing small volumes of soil containing petroleum hydrocarbons, repairing cell covers that were cracked or had subsided, and installing above-grade and at-grade monuments marking the comers of the landfill cells. Post-closure monitoring requirements for CAU 424 are detailed in Section 5.0, Post-Closure Inspection Plan, contained in the Closure Report for Corrective Action Unit 424: Area 3 Landfill Complexes, Tonopah Test Range, Nevada, report number DOE/NV-283, July 1999. The Closure Report (CR) was approved by the Nevada Division of Environmental Protection (NDEP) in July 1999. The CR includes compaction and permeability results of soils that cap the seven landfill cells. As stated in Section 5.0 of the NDEP-approved CR, post-closure monitoring at CAU 424 consists of the following: (1) Site inspections conducted twice a year to evaluate the condition of the unit. (2) Verification that landfill markers and warning signs are in-place, intact, and readable. (3) Notice of any subsidence, erosion, unauthorized use, or deficiencies that may compromise the integrity of the landfill covers. (4) Remedy of any deficiencies within 90 days of discovery. (5) Preparation and submittal of an annual report. Site inspections were conducted on May 16, 2001, and November 6, 2001. The inspections were preformed after the NDEP approval of the CR. This report includes copies of the inspection checklist, photographs, recommendations, and conclusions. The Post-Closure Inspection Checklists are found in

  6. Disseminating relevant health information to underserved audiences: implications of the Digital Divide Pilot Projects*

    Science.gov (United States)

    Kreps, Gary L.

    2005-01-01

    Objective: This paper examines the influence of the digital divide on disparities in health outcomes for vulnerable populations, identifying implications for medical and public libraries. Method: The paper describes the results of the Digital Divide Pilot Projects demonstration research programs funded by the National Cancer Institute to test new strategies for disseminating relevant health information to underserved and at-risk audiences. Results: The Digital Divide Pilot Projects field-tested innovative systemic strategies for helping underserved populations access and utilize relevant health information to make informed health-related decisions about seeking appropriate health care and support, resisting avoidable and significant health risks, and promoting their own health. Implications: The paper builds on the Digital Divide Pilot Projects by identifying implications for developing health communication strategies that libraries can adopt to provide digital health information to vulnerable populations. PMID:16239960

  7. Disseminating relevant health information to underserved audiences: implications of the Digital Divide Pilot Projects.

    Science.gov (United States)

    Kreps, Gary L

    2005-10-01

    This paper examines the influence of the digital divide on disparities in health outcomes for vulnerable populations, identifying implications for medical and public libraries. The paper describes the results of the Digital Divide Pilot Projects demonstration research programs funded by the National Cancer Institute to test new strategies for disseminating relevant health information to underserved and at-risk audiences. The Digital Divide Pilot Projects field-tested innovative systemic strategies for helping underserved populations access and utilize relevant health information to make informed health-related decisions about seeking appropriate health care and support, resisting avoidable and significant health risks, and promoting their own health. The paper builds on the Digital Divide Pilot Projects by identifying implications for developing health communication strategies that libraries can adopt to provide digital health information to vulnerable populations.

  8. Effects of dance on depression, physical function, and disability in underserved adults.

    Science.gov (United States)

    Murrock, Carolyn J; Graor, Christine Heifner

    2014-07-01

    This study documented the feasibility and immediate effects of a dance intervention two times per week for 12 weeks on depression, physical function, and disability in older, underserved adults. The one-group, pretest-posttest study had a convenience sample of 40 participants recruited from a federally subsidized apartment complex located in an economically depressed, inner-city neighborhood. Depression, physical function, and disability were measured at baseline and 12 weeks. Average age was 63 years (SD = 7.9), 92% were female, and 75% were African American. At baseline, participants reported increased depression (M = 20.0, SD = 12.4), decreased physical function (M = 56.6, SD = 10.9), and increased disability limitations (M = 65.7, SD = 14.9). At posttest, paired t tests showed that the dance intervention significantly decreased depression, t = 6.11, p dance intervention may be an effective adjunct therapy to improve depression, disability, and physical function in underserved adults.

  9. Knowledgeable Neighbors: a mobile clinic model for disease prevention and screening in underserved communities.

    Science.gov (United States)

    Hill, Caterina; Zurakowski, David; Bennet, Jennifer; Walker-White, Rainelle; Osman, Jamie L; Quarles, Aaron; Oriol, Nancy

    2012-03-01

    The Family Van mobile health clinic uses a "Knowledgeable Neighbor" model to deliver cost-effective screening and prevention activities in underserved neighborhoods in Boston, MA. We have described the Knowledgeable Neighbor model and used operational data collected from 2006 to 2009 to evaluate the service. The Family Van successfully reached mainly minority low-income men and women. Of the clients screened, 60% had previously undetected elevated blood pressure, 14% had previously undetected elevated blood glucose, and 38% had previously undetected elevated total cholesterol. This represents an important model for reaching underserved communities to deliver proven cost-effective prevention activities, both to help control health care costs and to reduce health disparities.

  10. Identification and conservation of important plant areas (IPAS) for the distribution of medicinal, aromatic and economic plants in the Hindukush-Himalaya mountain range

    International Nuclear Information System (INIS)

    Sher, H.; Ali, H.; Rehman, S.

    2012-01-01

    Study on the identification of Important Plant Areas (IPAs) was conducted in seven valleys of Hindukush-Himalayas mountainous ranges of Pakistan during 2005 and 2006. The principal aim of the study is to search new avenues for the conservation and sustainable utilization of threatened medicinal and economic plants and their habitats in IPAs. IPAs are sites of tremendous ecological and economic values that still exist in the world and are being managed on specific sites to study wild plant diversity. Several of such plants are used in the traditional medicines that are being used since the dawn of history to provide basic healthcare to people the world over. According to WHO, 80% of the human population of Africa still use medicinal plants in their primary healthcare. The popularity of herbal drugs is on the constant rise in many developed countries of the world, while in developing countries like Pakistan; medicinal plants contribute significantly to the income sources of people living in remote areas. Keeping such importance in view, the World Health Organization (WHO) launched a global vision in the form of 'Global Strategy for Plant Conservation' having various targets and mile stones. Target 5 of the strategy required for the global integration of the herbal medicine in health care system with proper identification of medicinal plants and the conservation of sites where such plants are found naturally, as its basic elements. In order to contribute to the specified target, WHO advised the relevant institutions to develop research plans and conservation programmes that are focused on the Global strategy in general and target 5 in specific. While complementing the appeal and contributing to its vision, a study was conducted in various eco-systems of the Pakistan's Hindukush-Himalayas region, identifying Important Plant Areas (IPAs) for their subsequent conservation and uses for scientific purposes. Site selection for the study was based on: 1). Exceptional

  11. Personal values of family physicians, practice satisfaction, and service to the underserved.

    Science.gov (United States)

    Eliason, B C; Guse, C; Gottlieb, M S

    2000-03-01

    Personal values are defined as "desirable goals varying in importance that serve as guiding principles in people's lives," and have been shown to influence specialty choice and relate to practice satisfaction. We wished to examine further the relationship of personal values to practice satisfaction and also to a physician's willingness to care for the underserved. We also wished to study associations that might exist among personal values, practice satisfaction, and a variety of practice characteristics. We randomly surveyed a stratified probability sample of 1224 practicing family physicians about their personal values (using the Schwartz values questionnaire), practice satisfaction, practice location, breadth of practice, demographics, board certification status, teaching involvement, and the payor mix of the practice. Family physicians rated the benevolence (motivation to help those close to you) value type highest, and the ratings of the benevolence value type were positively associated with practice satisfaction (correlation coefficient = 0.14, P = .002). Those involved in teaching medical trainees were more satisfied than those who were not involved (P = .009). Some value-type ratings were found to be positively associated with caring for the underserved. Those whose practices consisted of more than 40% underserved (underserved defined as Medicare, Medicaid, and indigent populations) rated the tradition (motivation to maintain customs of traditional culture and religion) value type significantly higher (P = .02). Those whose practices consisted of more than 30% indigent care rated the universalism (motivation to enhance and protect the well-being of all people) value type significantly higher (P = .03). Family physicians who viewed benevolence as a guiding principle in their lives reported a higher level of professional satisfaction. Likewise, physicians involved in the teaching of medical trainees were more satisfied with their profession. Family physicians

  12. Designing for Underserved Populations: Constraints and Requirements of Personal Health Record Systems

    Centers for Disease Control (CDC) Podcasts

    2009-02-11

    In this podcast, Dr. Thomas Horan discusses how language, literacy, and access barriers can be overcome with electronic Personal Health Record (PHR) systems to improve health among the most vulnerable, isolated, and underserved populations.  Created: 2/11/2009 by Coordinating Center for Health Information Service (CCHIS), Healthy Healthcare Settings Goal Team, Office of Strategy and Innovation.   Date Released: 9/2/2009.

  13. Health effects of training laypeople to deliver emergency care in underserviced populations: a systematic review protocol

    OpenAIRE

    Orkin, Aaron M; Curran, Jeffrey D; Fortune, Melanie K; McArthur, Allison; Mew, Emma J; Ritchie, Stephen D; Van de Velde, Stijn; VanderBurgh, David

    2016-01-01

    Introduction The Disease Control Priorities Project recommends emergency care training for laypersons in low-resource settings, but evidence for these interventions has not yet been systematically reviewed. This review will identify the individual and community health effects of educating laypeople to deliver prehospital emergency care interventions in low-resource settings. Methods and analysis This systematic review addresses the following question: in underserviced populations and low-reso...

  14. A potential recovery of a population of the sand lizard Liolaemus lutzae Mertens, 1938 in an area within its range: a lizard endemic and threatened with extinction

    Directory of Open Access Journals (Sweden)

    CFD. Rocha

    Full Text Available The endemic and threatened lizard Liolaemus lutzae has a relatively small geographic range restricted to only 200 km of along the coast of Rio de Janeiro State, Brazil, which are habitats under intensive anthropic disturbance. At the Barra da Tijuca beach, in Rio de Janeiro city an estimate of the population abundance made in 1991, compared to a previous estimate made in 1984, showed a considerable decrease (about 65%. Most of the decrease was attributed to anthropic disturbances that locally affected the beach vegetation, the species habitat. In this study we present estimates made in 2002 and in 2006 at the same area and compare them with the estimates of 1984 and 1991, using the same methodology in order to make comparable the data from different samplings years and to evaluate the present status of the local population. The estimated indexes of L. lutzae abundance in 2002 and in 2006 were higher than that of 1991. There was a significant increase in the mean number of recorded lizards in 2002 compared to 1991, but the mean number of lizards sighted in 2006 remained stable when compared with that of 2002. Our data based on the index of abundance recorded suggested that the number of L. lutzae at Barra da Tijuca beach recorded increased, which can be indicative of a potential recovery of the local population.

  15. Intrinsic rewards experienced by a group of dentists working with underserved populations.

    Science.gov (United States)

    Gardner, S P; Roberts-Thomson, K F; Winning, T A; Peterson, R

    2014-09-01

    The aim of this study was to explore, using qualitative methods, the intrinsic reasons why dentists work with underserved groups. Minority and marginalized groups of Australians suffer a greater burden of dental disease than the general population due to disparities in accessing care. Recruitment and retention of dentists to care for underserved groups is problematic due to personal, professional and structural reasons. What drives dentists to work with underserved groups is not widely known. Sixteen dentists were recruited using 'snowball' purposeful sampling. Semi-structured in-depth interviews were conducted. Thematic analysis was conducted on the transcriptions to identify themes. Five key themes emerged: (1) 'tapped on the shoulder', being personally approached or invited; (2) 'dental school experience', the challenges faced as a student; (3) 'empathic concern', the non-judgemental expressions of care toward others; (4) 'resilience', the ability to bounce back after setbacks; (5) 'intrinsic reward', the personal gain and satisfaction received. This study focuses on the intrinsic rewards which were found to be simple, unexpected, and associated with relieving pain, community engagement and making a difference. Emphasizing personal fulfilment and intrinsic reward could be useful when promoting dentistry as a career and when encouraging graduates to consider working with disadvantaged groups. © 2014 Australian Dental Association.

  16. Phase 1 Environmental Baseline Survey for the Leasing of Nevada Test and Training Range, EC-South Range, Well Site ER-EC-11, for the Underground Test Area Pahute Mesa Phase 2 Drilling and Testing Program Nye County, Nevada

    Science.gov (United States)

    2009-05-01

    many areas by a variety of late Tertiary and Quaternary surficial deposits, including alluvium, colluvium, and basalt (Slate et al., 1999). Most...buried) ´ Claim Canyon Caldera marginPliocene & Quaternary basaltic rocks (1996) Source: NSTec, 2009 24 features in the PM-OV area are buried by...return it to the Fibers and Organics Branch. • Transformer Registration Form -I structions (E.QE)_ (1 pg, lOK) • Form 7720-12 (PDF) (1 pg, 13K

  17. 40Ar/39Ar thermo-chronology and lithospheric mechanisms. Methodological and applied approach: the Kunlun range (Asia) and the Afar triple junction area (East Africa)

    International Nuclear Information System (INIS)

    Mock, C.

    1998-01-01

    A 40 Ar/ 39 Ar thermo-chronological study has been carried out for two contrasted geodynamic settings: - the Eastern Kunlun range (Northern Tibet), in order to characterize the lithospheric deformation mechanisms related to the India-Asia collision; - the Afar triple junction area (East Africa), in order to constrain the timing of mantle plume-related basement uplift in Ethiopia and Yemen, which will indicate whether rifting was active or passive. In the Kunlun, the cooling event (9-15 deg.C/Ma) outlined at 30 Ma for the granitoids (Bt = 128-138 Ma; Kf = 102-147 Ma) reflects a denudation event (0.2-0.3 km/Ma), related to ramp stacking and normal faulting with associated uplift. This unroofing period is coeval with the great Asian strike-slip faults. This suggests that 30 Ma ago, the India-Asia collision was accommodated by lateral extrusion along great strike-slip faults, which might have led to local crustal thickening because of the formation of anticlines from major thrusts 'branching' from the Kunlun fault. In the Afar area the Panafrican basement (granitoids = 462-678 Ma;metamorphic rocks 505-750 Ma) has undergone a reheating event during the Cenozoic; its temperature is estimated around 138-177 deg.C over the last 50 Ma for a depth of 2 km, implying a thermal gradient of 69-88 deg./km. This reheating event results from both heat conduction, related to the mantle plume. and heat advection. because of magma transfer. However, it was not possible to define the timing of the mantle plume-related basement uplift. This study outlines the important thermal effect of continental flood basalts on the crust and suggests that the 40 Ar/ 39 Ar thermo-chronology does not allow to characterize the denudation of the lithosphere for an extension-type geodynamic setting. Finally, some of the results suggest that diffusion in the laboratory and in nature may be different. 40 Ar/ 39 Ar thermo-chronological analysis thus might be tricky, especially in investigating geologic

  18. A psychosocial approach to dentistry for the underserved: incorporating theory into practice.

    Science.gov (United States)

    Flaer, Paul J; Younis, Mustafa Z; Benjamin, Paul L; Al Hajeri, Maha

    2010-01-01

    Dentistry for the underserved is more than an egalitarian social issue--it is a key factor in the health and social progress of our nation. The first signs or manifestations of several diseases such as varicella (i.e., chicken pox and shingles), STDs, and influenza become apparent in the oral cavity. The value of access to quality dentistry is an immeasurable factor in maintaining general medical health of people and fulfilling their psychosocial needs of pain reduction and enhanced cosmetics. In the United States, for the most part, only the middle and upper classes receive non-extraction, restorative, and prosthetic dentistry that is economically within their ability to pay. In addition, uninsured and poverty-level individuals often must face overwhelming long waiting lists, unnecessary referrals, lack of choice, and bureaucratic hurdles when seeking primary dental care. Therefore, it seems pertinent to put forth the question: What are the critical values and beliefs of psychosocial theory that can underscore the practice of dentistry for underserved populations in the United States? The widely employed public health theory, the health belief model (HBM), is applied to evaluate psychosocial factors in dental care for the underserved. The HBM is used to predict and explain behavioral changes in dental health and associated belief patterns. The HBM as applied to dentistry for the underserved predicts self-perceptions of susceptibility and seriousness of dental disease, health status, cues to action, and self-efficacy. Furthermore, patients can make judgments about benefits, costs, and risks of dental treatment. A theoretical approach to dentistry employing the HBM, mediated by values and culture, can provide significant insights into patient thinking, beliefs, and perceptions. These insights can mediate access to and use of primary care dental services by underserved populations. Evidence-based practice (i.e., based on research using the scientific method) has been

  19. 33 CFR 334.200 - Chesapeake Bay, Point Lookout to Cedar Point; aerial and surface firing range and target area, U...

    Science.gov (United States)

    2010-07-01

    ... degrees 09 minutes 26 seconds identified as Hannibal Target. (3) The regulations. Nonexplosive projectiles and bombs will be dropped at frequent intervals in the target areas. Hooper and Hannibal target areas...

  20. Fault tectonics and earthquake hazards in parts of southern California. [penninsular ranges, Garlock fault, Salton Trough area, and western Mojave Desert

    Science.gov (United States)

    Merifield, P. M. (Principal Investigator); Lamar, D. L.; Gazley, C., Jr.; Lamar, J. V.; Stratton, R. H.

    1976-01-01

    The author has identified the following significant results. Four previously unknown faults were discovered in basement terrane of the Peninsular Ranges. These have been named the San Ysidro Creek fault, Thing Valley fault, Canyon City fault, and Warren Canyon fault. In addition fault gouge and breccia were recognized along the San Diego River fault. Study of features on Skylab imagery and review of geologic and seismic data suggest that the risk of a damaging earthquake is greater along the northwestern portion of the Elsinore fault than along the southeastern portion. Physiographic indicators of active faulting along the Garlock fault identifiable in Skylab imagery include scarps, linear ridges, shutter ridges, faceted ridges, linear valleys, undrained depressions and offset drainage. The following previously unrecognized fault segments are postulated for the Salton Trough Area: (1) An extension of a previously known fault in the San Andreas fault set located southeast of the Salton Sea; (2) An extension of the active San Jacinto fault zone along a tonal change in cultivated fields across Mexicali Valley ( the tonal change may represent different soil conditions along opposite sides of a fault). For the Skylab and LANDSAT images studied, pseudocolor transformations offer no advantages over the original images in the recognition of faults in Skylab and LANDSAT images. Alluvial deposits of different ages, a marble unit and iron oxide gossans of the Mojave Mining District are more readily differentiated on images prepared from ratios of individual bands of the S-192 multispectral scanner data. The San Andreas fault was also made more distinct in the 8/2 and 9/2 band ratios by enhancement of vegetation differences on opposite sides of the fault. Preliminary analysis indicates a significant earth resources potential for the discrimination of soil and rock types, including mineral alteration zones. This application should be actively pursued.

  1. Behavioral economics: "nudging" underserved populations to be screened for cancer.

    Science.gov (United States)

    Purnell, Jason Q; Thompson, Tess; Kreuter, Matthew W; McBride, Timothy D

    2015-01-15

    Persistent disparities in cancer screening by race/ethnicity and socioeconomic status require innovative prevention tools and techniques. Behavioral economics provides tools to potentially reduce disparities by informing strategies and systems to increase prevention of breast, cervical, and colorectal cancers. With an emphasis on the predictable, but sometimes flawed, mental shortcuts (heuristics) people use to make decisions, behavioral economics offers insights that practitioners can use to enhance evidence-based cancer screening interventions that rely on judgments about the probability of developing and detecting cancer, decisions about competing screening options, and the optimal presentation of complex choices (choice architecture). In the area of judgment, we describe ways practitioners can use the availability and representativeness of heuristics and the tendency toward unrealistic optimism to increase perceptions of risk and highlight benefits of screening. We describe how several behavioral economic principles involved in decision-making can influence screening attitudes, including how framing and context effects can be manipulated to highlight personally salient features of cancer screening tests. Finally, we offer suggestions about ways practitioners can apply principles related to choice architecture to health care systems in which cancer screening takes place. These recommendations include the use of incentives to increase screening, introduction of default options, appropriate feedback throughout the decision-making and behavior completion process, and clear presentation of complex choices, particularly in the context of colorectal cancer screening. We conclude by noting gaps in knowledge and propose future research questions to guide this promising area of research and practice.

  2. Meeting the Needs of Underserved Patients in Western Kenya by Creating the Next Generation of Global Health Pharmacists.

    Science.gov (United States)

    Miller, Monica L; Karwa, Rakhi; Schellhase, Ellen M; Pastakia, Sonak D; Crowe, Susie; Manji, Imran; Jakait, Beatrice; Maina, Mercy

    2016-03-25

    Objective. To describe a novel training model used to create a sustainable public health-focused pharmacy residency based in Kenya and to describe the outcomes of this training program on underserved populations. Design. The postgraduate year 2 residency was designed to expose trainees to the unique public health facets of inpatient, outpatient, and community-based care delivery in low and middle-income countries. Public health areas of focus included supply chain management, reproductive health, pediatrics, HIV, chronic disease management, and teaching. Assessment. The outcomes of the residency were assessed based on the number of new clinical programs developed by residents, articles and abstracts written by residents, and resident participation in grant writing. To date, six residents from the United States and eight Kenyan residents have completed the residency. Eleven sustainable patient care services have been implemented as a result of the residency program. Conclusion. This pharmacy residency training model developed accomplished pharmacists in public health pharmacy, with each residency class expanding funding and clinical programming, contributing to curriculum development, and creating jobs.

  3. Effects of long-range transported air pollution from vegetation fires on daily mortality and hospital admissions in the Helsinki metropolitan area, Finland.

    Science.gov (United States)

    Kollanus, Virpi; Tiittanen, Pekka; Niemi, Jarkko V; Lanki, Timo

    2016-11-01

    Fine particulate matter (PM 2.5 ) emissions from vegetation fires can be transported over long distances and may cause significant air pollution episodes far from the fires. However, epidemiological evidence on health effects of vegetation-fire originated air pollution is limited, particularly for mortality and cardiovascular outcomes. We examined association between short-term exposure to long-range transported PM 2.5 from vegetation fires and daily mortality due to non-accidental, cardiovascular, and respiratory causes and daily hospital admissions due to cardiovascular and respiratory causes in the Helsinki metropolitan area, Finland. Days significantly affected by smoke from vegetation fires between 2001 and 2010 were identified using air quality measurements at an urban background and a regional background monitoring station, and modelled data on surface concentrations of vegetation-fire smoke. Associations between daily PM 2.5 concentration and health outcomes on i) smoke-affected days and ii) all other days (i.e. non-smoke days) were analysed using Poisson time series regression. All statistical models were adjusted for daily temperature and relative humidity, influenza, pollen, and public holidays. On smoke-affected days, 10µg/m 3 increase in PM 2.5 was associated with a borderline statistically significant increase in cardiovascular mortality among total population at a lag of three days (12.4%, 95% CI -0.2% to 26.5%), and among the elderly (≥65 years) following same-day exposure (13.8%, 95% CI -0.6% to 30.4%) and at a lag of three days (11.8%, 95% CI -2.2% to 27.7%). Smoke day PM 2.5 was not associated with non-accidental mortality or hospital admissions due to cardiovascular causes. However, there was an indication of a positive association with hospital admissions due to respiratory causes among the elderly, and admissions due to chronic obstructive pulmonary disease or asthma among the total population. In contrast, on non-smoke days PM 2.5 was

  4. Influence of Intense secondary aerosol formation and long range transport on aerosol chemistry and properties in the Seoul Metropolitan Area during spring time: Results from KORUS-AQ

    Science.gov (United States)

    Kim, H.; Zhang, Q.

    2017-12-01

    Non-refractory submicrometer particulate matter (NR-PM1) was measured in the Seoul Metropolitan Area (SMA), Korea, using an HR-ToF-AMS from April 14 to June 15, 2016, as a part of the KORUS-AQ campaign. The average concentration of PM1 was 22.1 µg m-3, which was composed of 44% organics, 20% SO4, 17% NO3, and 12 % NH4. Organics had an average O/C ratio of 0.49 and an average OM/OC ratio of 1.82. Four distinct sources of OA were identified via PMF analysis of the HR-ToF-AMS data: hydrocarbon like OA (HOA), cooking OA (COA),semi-volatile oxygenated OA (SV-OOA) and a low volatility oxygenated OA (LV-OOA). Our results indicate that air quality in SMA during KORUS-AQ was influenced strongly by secondary aerosol formation with SO4, NO3, NH4, SV-OOA, and LV-OOA together accounting for 76% of the PM1 mass. Due to high temperature and elevated ozone concentrations, photochemical reactions during daytime promoted the formation of SV-OOA, LV-OOA and SO4. In addition, aqueous-phase or heterogeneous reactions likely promoted efficient formation of NO3 whereas gas-to-particle partitioning processes appeared to have enhanced nighttime SV-OOA and NO3 formation. From May 20 to May 23, LV-OOA was significantly enhanced and accounted for up to 41% of the PM1 mass. Since this intense LV-OOA formation event was associated with large enhancement of VOCs, high concentration of Ox , strong solar radiation, and stagnant conditions, it appeared to be related to local photochemical formation. We also have investigated the formation and evolution mechanisms of severe haze episodes. Unlike the cases observed in winter when haze episodes were mainly caused by intense local emissions coupled with stagnant meteorological conditions, the spring haze events observed in this study appeared to be attributed by both regional and local factors. For example, episodes of long range transport of plumes were followed by calm meteorology conditions, which promoted the formation and accumulation of local

  5. Alzheimer's-type neuropathology in the precuneus is not increased relative to other areas of neocortex across a range of cognitive impairment.

    Science.gov (United States)

    Nelson, Peter T; Abner, Erin L; Scheff, Stephen W; Schmitt, Frederick A; Kryscio, Richard J; Jicha, Gregory A; Smith, Charles D; Patel, Ela; Markesbery, William R

    2009-02-06

    We studied Alzheimer's disease (AD) pathology in the precuneus and surrounding brain areas. Anatomically, the precuneus corresponds to the medial portion of human cerebral cortical Brodmann Area 7. This study utilized patients from the University of Kentucky Alzheimer's Disease Center autopsy cohort. Data from 47 brains were used comprising patients of differing antemortem cognitive impairment severities, each with longitudinal clinical data and extensive neuropathological data. We assessed whether the precuneus and surrounding areas are differentially vulnerable to AD-type pathological lesions (diffuse amyloid plaques, neuritic amyloid plaques, and neurofibrillary tangles). Eleven areas of brain were evaluated for each case: amygdala, hippocampal CA1, subiculum, entorhinal cortex, frontal cortex, superior and middle temporal gyri, inferior parietal lobule, occipital cortex, posterior cingulate gyrus, Brodmann Area 31, and the precuneus proper. Like other areas of neocortex, the precuneus demonstrated increased diffuse and neuritic amyloid plaques early in the evolution in AD, and increased neurofibrillary tangles late in AD. Correcting for the antemortem cognitive status of the patients, there was no evidence of an increase in the density of AD-type pathology in the precuneus or neighboring areas relative to other areas of cerebral neocortex. Our results are not consistent with the idea that the precuneus is involved in a special way with plaques or tangles relative to other areas of neocortex.

  6. Liability concerns and shared use of school recreational facilities in underserved communities.

    Science.gov (United States)

    Spengler, John O; Connaughton, Daniel P; Maddock, Jason E

    2011-10-01

    In underserved communities, schools can provide the physical structure and facilities for informal and formal recreation as well as after-school, weekend, and summer programming. The importance of community access to schools is acknowledged by authoritative groups; however, fear of liability is believed to be a key barrier to community access. The purpose of this study was to investigate perceptions of liability risk and associated issues among school administrators in underserved communities. A national survey of school administrators in underserved communities (n=360, response rate of 21%) was conducted in 2009 and analyzed in 2010. Liability perceptions in the context of community access were assessed through descriptive statistics. The majority of respondents (82.2%) indicated concern for liability should someone be injured on school property after hours while participating in a recreational activity. Among those that did not allow community access, 91% were somewhat to very concerned about liability and 86% believed that stronger legislation was needed to better protect schools from liability for after-hours recreational use. Among those who claimed familiarity with a state law that offered them limited liability protection, nearly three fourths were nevertheless concerned about liability. Liability concerns are prevalent among this group of school administrators, particularly if they had been involved in prior litigation, and even if they indicated they were aware of laws that provide liability protection where use occurs after hours. Reducing these concerns will be important if schools are to become locations for recreational programs that promote physical activity outside of regular school hours. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Factors influencing participation in worksite wellness programs among minority and underserved populations.

    Science.gov (United States)

    Thompson, Sharon E; Smith, Brenda A; Bybee, Ronald F

    2005-01-01

    In the United States, employers and employees are increasingly paying a larger portion of the nation's healthcare bill. Preventive measures are being employed by businesses in an effort to contain the escalating costs of employee healthcare. The work site is an ideal setting for health promotion because 130 million Americans are employed and spend one third of their time at work. However, unhealthy workers tend to be the least likely to participate in health promotion activities. Worksite Wellness Programs must be designed to engage segments of the work force with the greatest health needs. Culturally sensitive and appropriate programs must be developed to engage economically challenged minority and other underserved populations.

  8. Neighborhood Social Predictors of Weight-related Measures in Underserved African Americans in the PATH Trial.

    Science.gov (United States)

    McDaniel, Tyler C; Wilson, Dawn K; Coulon, Sandra M; Hand, Gregory A; Siceloff, E Rebekah

    2015-11-05

    African Americans have the highest rate of obesity in the United States relative to other ethnic minority groups. Bioecological factors including neighborhood social and physical environmental variables may be important predictors of weight-related measures specifically body mass index (BMI) in African American adults. Baseline data from the Positive Action for Today's Health (PATH) trial were collected from 417 African American adults. Overall a multiple regression model for BMI was significant, showing positive associations with average daily moderate-to-vigorous physical activity (MVPA) (B =-.21, Psocial interaction (B =-.13, Psocial interaction was associated with healthier BMI, highlighting it as a potential critical factor for future interventions in underserved, African American communities.

  9. Weight status as a moderator of the relationship between motivation, emotional social support, and physical activity in underserved adolescents.

    Science.gov (United States)

    St George, Sara M; Wilson, Dawn K; Lawman, Hannah G; Van Horn, M Lee

    2013-05-01

    This study examined weight status as a moderator of the relationship between motivation (controlled, autonomous, regulatory), emotional social support (parents, peers) and moderate-to-vigorous physical activity (MVPA) in underserved adolescents (ethnic minority, low-income). Participants from the Active by Choice Today Trial (n = 1,416; 54% girls, 73% African American, 52% overweight/obese) completed baseline measures, including height and weight, psychosocial surveys, and 7-day accelerometry estimates. Weight status was defined by body mass index z-score (zBMI). Weight status moderated the effects of controlled, autonomous, and regulatory motivation on MVPA, such that these variables were more strongly associated with MVPA in adolescents with lower versus higher zBMI scores. A better understanding of why motivation is not related to MVPA in underserved youth with a higher weight status is needed. Future pediatric obesity treatment in underserved youth may need to move beyond motivation into environmental factors associated with long-term behavior change.

  10. Metal exposure and accumulation patterns in free-range cows (Bos taurus) in a contaminated natural area: Influence of spatial and social behavior

    NARCIS (Netherlands)

    Roggeman, S.; Brink, van den N.W.; Praet, van N.; Blust, R.; Bervoets, L.

    2013-01-01

    Possible effects of spatial metal distribution, seasonal-, ecological- and ethological parameters, on the metal exposure of cows were investigated. Therefore the habitat use, vegetation selection and foraging behavior of two free ranging Galloway herds in a metal polluted nature reserve were

  11. Molecular comparison of cattle fever ticks from native and introduced ranges with insights into optimal search areas for classical biological control agents

    Science.gov (United States)

    Classical biological control using specialist parasitoids, predators and/or nematodes from the native ranges of cattle fever ticks could complement existing control strategies for this livestock pest in the transboundary region between Mexico and Texas. DNA fingerprinting tools were used to compare ...

  12. Randomized Trial of a Family-based, Automated, Conversational Obesity Treatment Program for Underserved Populations

    Science.gov (United States)

    Wright, J. A.; Phillips, B.D.; Watson, B.L.; Newby, P.K.; Norman, G. J.; Adams, W.G.

    2013-01-01

    Objective To evaluate the acceptability and feasibility of a scalable obesity treatment program integrated with pediatric primary care and delivered using interactive voice technology (IVR) to families from underserved populations. Design and Methods Fifty parent-child dyads (child 9–12 yrs, BMI >95th percentile) were recruited from a pediatric primary care clinic and randomized to either an IVR or a wait-list control (WLC) group. The majority were lower-income, African-American (72%) families. Dyads received IVR calls for 12 weeks. Call content was informed by two evidenced-based interventions. Anthropometric and behavioral variables were assessed at baseline and 3 mo follow-up. Results Forty-three dyads completed the study. IVR parents ate 1 cup more fruit than WLC (p 75% agreed that the calls were useful, made for people like them, credible, and helped them eat healthy foods. Conclusion An obesity treatment program delivered via IVR may be an acceptable and feasible resource for families from underserved populations. PMID:23512915

  13. Effect of Health Literacy on Decision-Making Preferences among Medically Underserved Patients.

    Science.gov (United States)

    Seo, Joann; Goodman, Melody S; Politi, Mary; Blanchard, Melvin; Kaphingst, Kimberly A

    2016-05-01

    Participation in the decision-making process and health literacy may both affect health outcomes; data on how these factors are related among diverse groups are limited. This study examined the relationship between health literacy and decision-making preferences in a medically underserved population. We analyzed a sample of 576 primary care patients. Multivariable logistic regression was used to examine the independent association of health literacy (measured by the Rapid Estimate of Adult Literacy in Medicine-Revised) and patients' decision-making preferences (physician directed or patient involved), controlling for age, race/ethnicity, and gender. We tested whether having a regular doctor modified this association. Adequate health literacy (odds ratio [OR] = 1.7;P= 0.009) was significantly associated with preferring patient-involved decision making, controlling for age, race/ethnicity, and gender. Having a regular doctor did not modify this relationship. Males were significantly less likely to prefer patient-involved decision making (OR = 0.65;P= 0.024). Findings suggest health literacy affects decision-making preferences in medically underserved patients. More research is needed on how factors, such as patient knowledge or confidence, may influence decision-making preferences, particularly for those with limited health literacy. © The Author(s) 2016.

  14. Employing Young Talent from Underserved Populations: Designing a Flexible Organizational Process for Assimilation and Productivity

    Directory of Open Access Journals (Sweden)

    Arthur Mark Langer

    2013-04-01

    Full Text Available This article describes an ongoing 13-year-old program designed to improve the ability of organizations to assimilate young talent from underserved populations, mostly students who have recently graduated from high school. Although many firms have internship and orientation programs, few have well-tested organizational approaches for assimilating 17-20 year-olds into their organizations in an efficient and productive manner. The objective of this study is to describe and evaluate the solution introduced by Workforce Opportunity Services (WOS, a non-profit agency that provides organizations with well-trained talent from underserved local communities. The WOS model is a systemic design involving a lead agency (WOS, corporate clients, training partnerships with local colleges and universities, and underutilized human capital. Over 290 students have completed the WOS program and obtained long-term employment, mostly in IT jobs that normally are outsourced. The results of the study show that companies have success employing young talent when they follow the WOS organizational process. Companies need to have patience with WOS student employees, but within six months most members of the WOS program make positive contributions to their sponsoring firm and have a strong likelihood of becoming permanently employed. Implications of the WOS model for organization design are discussed.

  15. Improving cardiovascular health of underserved populations in the community with Life's Simple 7.

    Science.gov (United States)

    Murphy, Marcia Pencak; Coke, Lola; Staffileno, Beth A; Robinson, Janis D; Tillotson, Robin

    2015-11-01

    The purpose of this nurse practitioner (NP) led initiative was to improve the cardiovascular health of two underserved populations in the community using the American Heart Association (AHA) Life's Simple 7 and My Life Check (MLC) tools. Two inner city community sites were targeted: (a) a senior center servicing African American (AA) older adults, and (b) a residential facility servicing homeless women. Preprogram health data (blood pressure, cholesterol, blood glucose levels, body mass index, and health behaviors) were collected to calculate MLC scores. Postprogram health data were obtained on participants with the lowest MLC scores who completed the program. Eight older adults completed the program with a 37.1% increase in average MLC score (6.2 vs. 8.5). Ten women completed the program with a 9.3% decrease in average MLC score (4.3 vs. 3.9). Favorable benefits were observed in the AA older adults. In contrast, similar benefits were not observed in the women, which may be because of a constellation of social, environmental, biological, and mental health factors. NPs are prepared to target community-based settings to address the health of underserved populations. Engaging key stakeholders in the planning and implementation is essential for success. ©2015 American Association of Nurse Practitioners.

  16. Impact of Patient Empathy Modeling on Pharmacy Students Caring for the Underserved

    Science.gov (United States)

    Chen, Judy T.; LaLopa, Joseph

    2008-01-01

    Objective To determine the impact of the Patient Empathy Modeling pedagogy on students' empathy towards caring for the underserved during an advanced pharmacy practice experience (APPE). Design Pharmacy students completing an APPE at 2 primary care clinics participated in a Patient Empathy Modeling assignment for 10 days. Each student “became the patient,” simulating the life of an actual patient with multiple chronic diseases who was coping with an economic, cultural, or communication barrier to optimal healthcare. Students completed the Jefferson Scale of Physician Empathy (JSPE) before and after completing the assignment, and wrote daily journal entries and a reflection paper. Assessment Twenty-six students completed the PEM exercises from 2005-2006. Scores on the JSPE improved. Students' comments in journals and reflection papers revealed 3 major themes: greater appreciation of the difficulty patients have with adherence to medication and treatment regimens, increased empathy for patients from different backgrounds and patients with medical and psychosocial challenges, and improved ability to apply the lessons learned in the course to their patient care roles. Conclusion A Patient Empathy Modeling assignment improved pharmacy students' empathy toward underserved populations. Integrating the assignment within an APPE allowed students to immediately begin applying the knowledge and insight gained from the exercise. PMID:18483606

  17. Multicultural Milky Way: Ethnoastronomy and Planetarium Shows for Under-served Arizonans

    Science.gov (United States)

    Knierman, Karen

    2018-01-01

    The astronomy outreach initiative, Multicultural Milky Way, partners the School of Earth and Space Exploration (SESE) at Arizona State University (ASU) with under-served populations in Arizona in learning about our Milky Way and other galaxies. Arizona is home to many diverse populations with rich cultural histories such as Mayan, Navajo, and Apache. Linking astronomy practiced by one’s indigenous culture to that of Western astronomy may increase the interest in science. Through multicultural planetarium shows and associated hands-on activities, under-served students and families will learn how the Milky Way is represented in different cultures and about the science of galaxies. New planetarium shows using the Mesa Community College (MCC) Digital Planetarium and STARLAB portable planetarium explore how the Milky Way is interpreted in different cultures. STARLAB shows and associated new hands-on activities have been featured during school visits, teacher trainings, and Community Astronomy Nights around Arizona. For authentic assessment, evaluation techniques and procedures were developed.

  18. Practices Caring For The Underserved Are Less Likely To Adopt Medicare's Annual Wellness Visit.

    Science.gov (United States)

    Ganguli, Ishani; Souza, Jeffrey; McWilliams, J Michael; Mehrotra, Ateev

    2018-02-01

    In 2011 Medicare introduced the annual wellness visit to help address the health risks of aging adults. The visit also offers primary care practices an opportunity to generate revenue, and may allow practices in accountable care organizations to attract healthier patients while stabilizing patient-practitioner assignments. However, uptake of the visit has been uneven. Using national Medicare data for the period 2008-15, we assessed practices' ability and motivation to adopt the visit. In 2015, 51.2 percent of practices provided no annual wellness visits (nonadopters), while 23.1 percent provided visits to at least a quarter of their eligible beneficiaries (adopters). Adopters replaced problem-based visits with annual wellness visits and saw increases in primary care revenue. Compared to nonadopters, adopters had more stable patient assignment and a slightly healthier patient mix. At the same time, visit rates were lower among practices caring for underserved populations (for example, racial minorities and those dually enrolled in Medicaid), potentially worsening disparities. Policy makers should consider ways to encourage uptake of the visit or other mechanisms to promote preventive care in underserved populations and the practices that serve them.

  19. Development and pilot evaluation of novel genetic educational materials designed for an underserved patient population.

    Science.gov (United States)

    Lubitz, Rebecca Jean; Komaromy, Miriam; Crawford, Beth; Beattie, Mary; Lee, Robin; Luce, Judith; Ziegler, John

    2007-01-01

    Genetic counseling for BRCA1 and BRCA2 mutations involves teaching about hereditary cancer, genetics and risk, subjects that are difficult to grasp and are routinely misunderstood. Supported by a grant from the Avon Foundation, the UCSF Cancer Risk Program started the first genetic testing and counseling service for a population of traditionally underserved women of varied ethnic and social backgrounds at the San Francisco General Hospital (SFGH). Informed by educational theory and clinical experience, we devised and piloted two simplified explanations of heredity and genetic risk, with the aim of uncovering how to best communicate genetics and risk to this underserved population. A "conventional" version comprised pictures of genes, pedigrees, and quantitative representations of risk. A "colloquial" pictorial version used an analogy of the "information book" of genes, family stories and vignettes, and visual representations of risk, without using scientific words such as genes or chromosomes. A verbal narrative accompanied each picture. We presented these modules to four focus groups of five to eight women recruited from the SFGH Family Practice Clinic. Overall, women preferred a picture-based approach and commented that additional text would have been distracting. The majority of women preferred the colloquial version because it was easier to understand and better conveyed a sense of comfort and hope. We conclude that simplicity, analogies, and familiarity support comprehension while vignettes, family stories, and photos of real people provide comfort and hope. These elements may promote understanding of complex scientific topics in healthcare, particularly when communicating with patients who come from disadvantaged backgrounds.

  20. Sharing Gravity's Microscope: Star Formation and Galaxy Evolution for Underserved Arizonans

    Science.gov (United States)

    Knierman, Karen A.; Monkiewicz, Jacqueline A.; Bowman, Catherine DD; Taylor, Wendy

    2016-01-01

    Learning science in a community is important for children of all levels and especially for many underserved populations. This project combines HST research of galaxy evolution using gravitationally lensed galaxies with hands-on activities and the Starlab portable planetarium to link astronomy with families, teachers, and students. To explore galaxy evolution, new activities were developed and evaluated using novel evaluation techniques. A new set of galaxy classification cards enable inquiry-based learning about galaxy ages, evolution, and gravitational lensing. Activities using new cylinder overlays for the Starlab transparent cylinder will enable the detailed examination of star formation and galaxy evolution as seen from the viewpoint inside of different types of galaxies. These activities were presented in several Arizona venues that enable family and student participation including ASU Earth and Space Open House, Arizona Museum of Natural History Homeschooling Events, on the Salt River Pima-Maricopa Indian Community, and inner city Phoenix schools serving mainly Hispanic populations. Additional events targeted underserved families at the Phoenix Zoo, in Navajo County, and for the Pascua Yaqui Tribe. After evaluation, the activities and materials will also be shared with local teachers and nationally.

  1. Cancer screening promotion among medically underserved Asian American women: integration of research and practice.

    Science.gov (United States)

    Yu, Mei-yu; Seetoo, Amy D; Hong, Oi Saeng; Song, Lixin; Raizade, Rekha; Weller, Adelwisa L Agas

    2002-01-01

    Mammography and Pap smear tests are known to be effective early detection measures for breast and cervical cancers, respectively, but Asian Americans are reluctant to make visits for routine preventive care. Quantitative and qualitative research conducted by the Healthy Asian Americans Project (HAAP) between 1996 and 1999 indicated that Asian residents in southeastern Michigan, like the general Asian population in the US, underutilized early cancer screening programs due to cultural, psychosocial, linguistic, and economic barriers. This article reports how the HAAP's research findings guided the Michigan Breast and Cervical Cancer Control Program (BCCCP) promotion (conducted from 2000 to 2001 among medically underserved Asian women residing in southeastern Michigan), and how evaluation of the HAAP's BCCCP promotion will direct future research and health promotion programs. The article presents strategies used to improve access to cancer screening programs for diverse Asian sub-groups as well as outcomes of the 2-year HAAP's BCCCP promotion among the target population. Discussion regarding lessons and experiences gained from integration of research and practice has implications on design and implementation of the cancer screening promotion for the rapidly increasing Asian American population as well as other medically underserved minority populations in the US.

  2. Rehearsal for Assessment of atmospheric optical Properties during biomass burning Events and Long-range transportation episodes at Metropolitan Area of São Paulo-Brazil (RAPEL)

    Science.gov (United States)

    Lopes, Fábio J. S.; Luis Guerrero-Rascado, Juan; Benavent-Oltra, Jose A.; Román, Roberto; Moreira, Gregori A.; Marques, Marcia T. A.; da Silva, Jonatan J.; Alados-Arboledas, Lucas; Artaxo, Paulo; Landulfo, Eduardo

    2018-04-01

    During the period of August-September 2016 an intensive campaign was carried out to assess aerosol properties in São Paulo-Brazil aiming to detect long-range aerosol transport events and to characterize the instrument regarding data quality. Aerosol optical properties retrieved by the GALION - LALINET SPU lidar station and collocated AERONET sunphotometer system are presented as extinction/ backscatter vertical profiles with microphysical products retrieved with GRASP inversion algorithm.

  3. Infection by Leishmania spp. in Free-Ranging Opossums (Didelphis albiventris) in an Environmentally Protected Area Inhabited by Humans in Southeastern Brazil.

    Science.gov (United States)

    Paiz, Laís Moraes; Donalisio, Maria Rita; Richini-Pereira, Virgínia Bodelão; Motoie, Gabriela; Castagna, Claudio Luiz; Tolezano, José Eduardo

    2016-11-01

    There is a growing concern about the participation of wild hosts and reservoirs in the epidemiology of leishmaniasis, particularly within the context of increasingly frequent environmental changes and the expansion of the One Health concept. This work is a molecular research of infection by Leishmania spp. among the wildlife of an environmentally protected area located in the municipality of Campinas, São Paulo, Brazil. The studied area has a history of intense environmental changes, with notifications of human cases of cutaneous leishmaniasis in the 1990s, and a focus of canine visceral leishmaniasis since 2009. Eighty-two wild mammals were sampled by monthly captures in this region over a 1-year period. Blood samples were collected from each animal and subjected to DNA extraction and PCR using primers for the region of the internal transcribed spacer-1. The results of gene sequencing for the first time revealed the infection of opossums (Didelphis albiventris) by Leishmania spp., subgenera Leishmania and Viannia, in Campinas. These findings, in addition to environmental and historical characteristics of the studied area, indicate a possible role of wildlife in the introduction and/or maintenance of natural foci of leishmaniasis transmission.

  4. Experiences, opportunities and challenges of implementing task shifting in underserved remote settings: the case of Kongwa district, central Tanzania

    Directory of Open Access Journals (Sweden)

    Munga Michael A

    2012-11-01

    infrastructures are not in place before formalising tasks shifting. There was also a perception that implementation of task shifting has ensured access to services especially in underserved remote areas. Professional discontent and challenges related to the management of health personnel policies were also perceived as important issues to consider when implementing task shifting practices. Additional resources for additional training and supervisory tasks were also considered important in the implementation of task shifting in order to make it deliver much the same way as it is for conventional modalities of delivering care. Conclusions Task shifting implementation occurs as an ad hoc coping mechanism to the existing shortages of health workers in many undeserved areas of the country, not just in the study site whose findings are reported in this paper. It is recommended that the most important thing to do now is not to determine whether task shifting is possible or effective but to define the limits of task shifting so as to reach a consensus on where it can have the strongest and most sustainable impact in the delivery of quality health services. Any action towards this end needs to be evidence-based.

  5. Interactive web-based portals to improve patient navigation and connect patients with primary care and specialty services in underserved communities.

    Science.gov (United States)

    Highfield, Linda; Ottenweller, Cecelia; Pfanz, Andre; Hanks, Jeanne

    2014-01-01

    This article presents a case study in the redesign, development, and implementation of a web-based healthcare clinic search tool for virtual patient navigation in underserved populations in Texas. It describes the workflow, assessment of system requirements, and design and implementation of two online portals: Project Safety Net and the Breast Health Portal. The primary focus of the study was to demonstrate the use of health information technology for the purpose of bridging the gap between underserved populations and access to healthcare. A combination of interviews and focus groups was used to guide the development process. Interviewees were asked a series of questions about usage, usability, and desired features of the new system. The redeveloped system offers a multitier architecture consisting of data, business, and presentation layers. The technology used in the new portals include Microsoft .NET Framework 3.5, Microsoft SQL Server 2008, Google Maps JavaScript API v3, jQuery, Telerik RadControls (ASP.NET AJAX), and HTML. The redesigned portals have 548 registered clinics, and they have averaged 355 visits per month since their launch in late 2011, with the average user visiting five pages per visit. Usage has remained relatively constant over time, with an average of 142 new users (40 percent) each month. This study demonstrates the successful application of health information technology to improve access to healthcare and the successful adoption of the technology by targeted end users. The portals described in this study could be replicated by health information specialists in other areas of the United States to address disparities in healthcare access.

  6. Care Provided by Students in Community-Based Dental Education: Helping Meet Oral Health Needs in Underserved Communities.

    Science.gov (United States)

    Mays, Keith A; Maguire, Meghan

    2018-01-01

    Since 2000, reports have documented the challenges faced by many Americans in receiving oral health care and the consequences of inadequate care such as high levels of dental caries among many U.S. children. To help address this problem, many dental schools now include community-based dental education (CBDE) in their curricula, placing students in extramural clinics where they provide care in underserved communities. CBDE is intended to both broaden the education of future oral health professionals and expand care for patients in community clinics. The aim of this study was to develop a three-year profile of the patients seen and the care provided by students at extramural clinics associated with one U.S. dental school. Three student cohorts participated in the rotations: final-year students in the Doctor of Dental Surgery, Bachelor of Science in Dental Hygiene, and Master of Dental Therapy programs. The study was a retrospective analysis of data retrieved from the school's database for three consecutive academic years. The data included patients' demographics and special health care needs status (based on information collected by students from their patients) and procedures students performed while on rotations. For the three-year period, the results showed a total of 43,128 patients were treated by 418 student providers. Approximately 25% of all encounters were with pediatric patients. Students completed 5,908 child prophylaxis, 5,386 topical fluoride varnish, and 7,678 sealant procedures on pediatric patients. Annually, 7% of the total patients treated had special health care needs. The results show that these students in CBDE rotations provided a substantial amount of oral health care at extramural sites and gained additional experience in caring for a diverse population of patients and performing a wide range of procedures.

  7. Geochemistry of altered and mineralized rocks from the Morey and Fandango Wilderness Study Areas, northern Hot Creek Range, Nye County, Nevada

    Science.gov (United States)

    Nash, J.T.; John, D.A.; Malcolm, M.J.; Briggs, P.H.; Crock, J.G.

    1986-01-01

    The U.S. Geological Survey and the St. Johns River Water Management District are investigating the hydrogeology of the Floridan aquifer system. An essential element of this investigation is the design and construction of a monitor well network in the lower saline water-bearing zone which occurs at about 2,000 ft below land surface. During 1985, a well near Ponte Vedra in northeast St. Johns County was completed into the lower saline water-bearing zone at a depth of 1,980 to 2,035 ft below land surface. This well and other wells drilled under this or other programs will be used to monitor water levels and water chemistry of the lower saline zone. Chloride concentrations in water above the lower saline zone ranged from 14 to 270 mg/L and specific conductance ranged from 450 to 1,440 micromhos/cm c. In the lower zone, chloride concentrations were as much as 16,210 mg/L and specific conductance as much as 46,000 micromhos per centimeter. Aquifer head and artesian flow from the well generally increased with depth. Water temperatures also increased from 23 C in the upper part of the aquifer to more than 28 C in the lower saline zone. (USGS)

  8. Effect of Active Videogames on Underserved Children's Classroom Behaviors, Effort, and Fitness.

    Science.gov (United States)

    Gao, Zan; Lee, Jung Eun; Pope, Zachary; Zhang, Dachao

    2016-09-30

    The purpose of this study was to examine the effect of active videogames (AVGs) on underserved minority children's on-task classroom behavior, academic effort, and fitness. A one group pre- and posttest repeated measures design was used. In Fall 2013, 95 fourth grade children (57 boys, 38 girls; 96% of minority) from three classes at an underserved urban elementary school participated in teacher-supervised AVG activities (e.g., Wii Sports, Xbox Just Dance). Specifically, students participated in a 50-minute weekly AVG program at school for 6 weeks. Children's academic effort was evaluated by classroom teachers using a validated scale that assessed activity, attention, conduct, and social/emotional behavior. Moreover, children's classroom behavior was observed immediately before and after each AVG session by trained researchers. Finally, cardiovascular fitness was also measured. A paired t-test was used to assess teacher-rated student effort, while one-way (gender) analysis of variance (ANOVA) with repeated measures was performed to analyze children's on-task classroom behavior. There was a significant effect on children's effort between the first (mean = 3.24, SD = 0.75) and last week (mean = 3.41, SD = 0.73) assessments, t = 2.42, P = 0.02. In addition, there was a significant effect on classroom behavior, F = 33.103, P < 0.01. In detail, children scored significantly higher on on-task behavior during the post-AVG observation (mean = 81.4, SD = 12.3) than seen during the pre-AVG observation (mean = 69.8, SD = 14.9). However, no main effect was indicated for gender, F = 0.39, P = 0.54. No significant improvement in cardiovascular fitness was observed, although slight improvements were seen. Offering an AVG program at school could improve underserved minority children's classroom on-task behavior and academic effort. Future studies may include a control group to further confirm the effectiveness of AVG

  9. Predominance of Trypanosoma rangeli infection in children from a Chagas disease endemic area in the west-shore of the Panama canal

    Directory of Open Access Journals (Sweden)

    Azael Saldaña

    2005-11-01

    Full Text Available A total of 206 serum samples from children (3-14 years old living in the Amador County (La Chorrera District, Province of Panama were screened by indirect immunofluorescence antibody test (IFAT for the presence of antibodies against Trypanosoma cruzi. Positive sera were confirmed by recombinant enzyme-linked immunosorbent assay (ELISA and Western blot analysis. The presence of blood trypanosomes was investigated by hemoculture and subsequently identify by a duplex polymerase chain reaction (PCR followed by dot blot hybridization. The results indicated a prevalence of 9.7% for trypanosome infections, a seroprevalence of 2.9% against T. cruzi and a predominance of T. rangeli infection (6.8%. The immunological and clinical implications of these findings are discussed.

  10. Diet and Exercise Adherence and Practices among Medically Underserved Patients with Chronic Disease: Variation across Four Ethnic Groups

    Science.gov (United States)

    Orzech, Kathryn M.; Vivian, James; Huebner Torres, Cristina; Armin, Julie; Shaw, Susan J.

    2013-01-01

    Many factors interact to create barriers to dietary and exercise plan adherence among medically underserved patients with chronic disease, but aspects related to culture and ethnicity are underexamined in the literature. Using both qualitative ("n" = 71) and quantitative ("n" = 297) data collected in a 4-year, multimethod study…

  11. 75 FR 29447 - Public Health Service Act, Rural Physician Training Grant Program, Definition of “Underserved...

    Science.gov (United States)

    2010-05-26

    ..., identified by the Regulatory Information Number (RIN), by any of the following methods: Federal eRulemaking... assisting eligible entities in recruiting students most likely to practice medicine in underserved rural... determined that good cause exists which makes the usual notice and comment procedure impractical, unnecessary...

  12. Navigating the digital divide: A systematic review of eHealth literacy in underserved populations in the United States.

    Science.gov (United States)

    Chesser, Amy; Burke, Anne; Reyes, Jared; Rohrberg, Tessa

    2016-01-01

    eHealth provides an important mechanism to connect medically underserved populations with health information, but little is known about gaps in eHealth literacy research in underserved adult populations within the U.S. Between June and July 2013, three systematic literature reviews of five databases were conducted and a subsequent hand search was completed. Identified literature was screened and studies meeting exclusion and inclusion criteria were synthesized and analyzed for common themes. Of the 221 articles critically appraised, 15 met these criteria. Thirty-five of these studies were excluded due to international origin. Of the articles meeting the inclusion criteria, underserved populations assessed included immigrant women, the elderly, low-income, the un- and underemployed, and African-American and Hispanic populations. eHealth literacy assessments utilized included one or two item screeners, the eHEALS scale, health information competence and cognitive task analysis. Factors examined in relation to eHealth literacy included age, experience, overall health literacy, education, income and culture. The majority did not assess the impact of locality and those that did were predominately urban. These data suggest that there is a gap in the literature regarding eHealth literacy knowledge for underserved populations, and specifically those in rural locations, within the U.S.

  13. Underwater Ranging

    OpenAIRE

    S. P. Gaba

    1984-01-01

    The paper deals with underwater laser ranging system, its principle of operation and maximum depth capability. The sources of external noise and methods to improve signal-to-noise ratio are also discussed.

  14. Reduction of the unnecessary dose from the over-range area with a spiral dynamic z-collimator: comparison of beam pitch and detector coverage with 128-detector row CT.

    Science.gov (United States)

    Shirasaka, Takashi; Funama, Yoshinori; Hayashi, Mutsukazu; Awamoto, Shinichi; Kondo, Masatoshi; Nakamura, Yasuhiko; Hatakenaka, Masamitsu; Honda, Hiroshi

    2012-01-01

    Our purpose in this study was to assess the radiation dose reduction and the actual exposed scan length of over-range areas using a spiral dynamic z-collimator at different beam pitches and detector coverage. Using glass rod dosimeters, we measured the unilateral over-range scan dose between the beginning of the planned scan range and the beginning of the actual exposed scan range. Scanning was performed at detector coverage of 80.0 and 40.0 mm, with and without the spiral dynamic z-collimator. The dose-saving ratio was calculated as the ratio of the unnecessary over-range dose, with and without the spiral dynamic z-collimator. In 80.0 mm detector coverage without the spiral dynamic z-collimator, the actual exposed scan length for the over-range area was 108, 120, and 126 mm, corresponding to a beam pitch of 0.60, 0.80, and 0.99, respectively. With the spiral dynamic z-collimator, the actual exposed scan length for the over-range area was 48, 66, and 84 mm with a beam pitch of 0.60, 0.80, and 0.99, respectively. The dose-saving ratios with and without the spiral dynamic z-collimator for a beam pitch of 0.60, 0.80, and 0.99 were 35.07, 24.76, and 13.51%, respectively. With 40.0 mm detector coverage, the dose-saving ratios with and without the spiral dynamic z-collimator had the highest value of 27.23% with a low beam pitch of 0.60. The spiral dynamic z-collimator is important for a reduction in the unnecessary over-range dose and makes it possible to reduce the unnecessary dose by means of a lower beam pitch.

  15. Congruence between distribution modelling and phylogeographical analyses reveals Quaternary survival of a toadflax species (Linaria elegans) in oceanic climate areas of a mountain ring range.

    Science.gov (United States)

    Fernández-Mazuecos, Mario; Vargas, Pablo

    2013-06-01

    · The role of Quaternary climatic shifts in shaping the distribution of Linaria elegans, an Iberian annual plant, was investigated using species distribution modelling and molecular phylogeographical analyses. Three hypotheses are proposed to explain the Quaternary history of its mountain ring range. · The distribution of L. elegans was modelled using the maximum entropy method and projected to the last interglacial and to the last glacial maximum (LGM) using two different paleoclimatic models: the Community Climate System Model (CCSM) and the Model for Interdisciplinary Research on Climate (MIROC). Two nuclear and three plastid DNA regions were sequenced for 24 populations (119 individuals sampled). Bayesian phylogenetic, phylogeographical, dating and coalescent-based population genetic analyses were conducted. · Molecular analyses indicated the existence of northern and southern glacial refugia and supported two routes of post-glacial recolonization. These results were consistent with the LGM distribution as inferred under the CCSM paleoclimatic model (but not under the MIROC model). Isolation between two major refugia was dated back to the Riss or Mindel glaciations, > 100 kyr before present (bp). · The Atlantic distribution of inferred refugia suggests that the oceanic (buffered)-continental (harsh) gradient may have played a key and previously unrecognized role in determining Quaternary distribution shifts of Mediterranean plants. © 2013 The Authors. New Phytologist © 2013 New Phytologist Trust.

  16. Metal exposure and accumulation patterns in free-range cows (Bos taurus) in a contaminated natural area: Influence of spatial and social behavior

    International Nuclear Information System (INIS)

    Roggeman, Saskia; Brink, Nico van den; Van Praet, Nander; Blust, Ronny; Bervoets, Lieven

    2013-01-01

    Possible effects of spatial metal distribution, seasonal-, ecological- and ethological parameters, on the metal exposure of cows were investigated. Therefore the habitat use, vegetation selection and foraging behavior of two free ranging Galloway herds in a metal polluted nature reserve were observed. Metal concentrations in soil, vegetation, hair, blood and feces were measured. Although both herds lived in the same reserve, their metal exposure differed significantly. A high consumption of soft rush by herd 1 during winter for instance was responsible for a large increase in daily Cd intake. The results of this study suggest that the exposure and health risks of large grazers can probably not only be predicted by a general monitoring of soil and vegetation pollution. Also detailed information about the occurring vegetation types, spatial habitat use together with the social- and foraging behavior and diet selection of the species need to be studied. - Highlights: ► Vegetation selection, social behavior, and seasonal variation determine exposure. ► Soft rush consumption highly increased daily Cd intake during winter. ► Most Cd and Pb levels in vegetation exceeded the maximum tolerable feed levels. - This study reveals that spatial heterogeneity and foraging behavior play a more important role in the metal exposure pattern of large grazers than generally is presumed.

  17. Associations between positive parenting practices and child externalizing behavior in underserved Latino immigrant families.

    Science.gov (United States)

    Holtrop, Kendal; McNeil Smith, Sharde'; Scott, Jenna C

    2015-06-01

    This study examined whether five specific parenting practices (i.e., monitoring, discipline, skill encouragement, problem solving, and positive involvement) were associated with reduced child externalizing behaviors among a sample of Latino immigrant families. It utilized baseline data from 83 Latino couples with children participating in a larger randomized controlled trial of a culturally adapted parenting intervention. Results reveal that monitoring, discipline, skill encouragement, and problem solving each made independent contributions to the prediction of child externalizing behavior, although not all in the expected direction. Further analyses examining mothers and fathers separately suggest that mother-reported monitoring and father-reported discipline practices uniquely contributed to these findings. These results may have important implications for prevention and clinical intervention efforts with Latino immigrant families, including the cultural adaptation and implementation of parenting interventions with this underserved population. © 2014 Family Process Institute.

  18. Against Cursory Treatments in Ethics of Medical Migration from Underserved Countries.

    Science.gov (United States)

    Yuksekdag, Yusuf

    2017-06-01

    In a recent paper, Mpofu, Sen Gupta, and Hays (2016) attempt to outline the obligations of recruiting high-income countries (HICs) and would-be emigrant health workers (HWs) to tackle the effects of mass exodus of health workers from underserved regions. They reconstruct (i) Rawlsian and Kantian global justice approaches to argue for moral obligations of HICs and (ii) an individual justice approach to point to non-enforceable social responsibilities of HWs to assist their compatriots. This critical commentary demonstrates that the argumentation within their individual justice approach is problematic on the basis of three reasons: (1) their discussion under-theorizes and undervalues individual rights and more specifically the right to exit, (2) their argumentation in the latter part, even if problematically, does rather point to moral obligations in lieu of social responsibilities of HWs, and (3) they overlook many other important freedoms, interests, and values pertinent to the issue of retention.

  19. Evaluation of a student-run smoking cessation clinic for a medically underserved population

    Directory of Open Access Journals (Sweden)

    Ebbert Jon O

    2011-03-01

    Full Text Available Abstract Background Smoking is common among medically underserved populations. Accessible resources to encourage and support smoking cessation among these patients are limited. Volunteer medical student-run free smoking cessation clinics may provide an effective option to help these individuals achieve smoking abstinence. In order to demonstrate the feasibility and cost-effectiveness of a student-run clinic, we analyzed a case series of patients receiving care in a medical student-run Smoking Cessation Clinic (SCC at the Rochester, Minnesota Salvation Army Good Samaritan Health Clinic (GSHC. Findings Between January 2005 and March 2009, 282 cigarette smokers seeking care at the SCC were analyzed. Student providers at the SCC conducted 1652 weekly individual counseling sessions averaging 18 minutes per encounter. Patients were offered a choice of pharmacotherapies including nicotine replacement therapy (NRT, bupropion, and varenicline for up to 12 weeks. Smoking abstinence was confirmed with exhaled carbon monoxide (CO. Thirty-two patients completed the entire 12-week program (11.3%. At last contact, 94 patients (33.3% abstained from smoking for ≥ 7 days and 39 patients (13.8% were continuously abstinent for ≥ 4 weeks. The 7-day point prevalence abstinence rates at last contact were 58.6% for varenicline, 41.2% for bupropion, 33.9% for NRT, and 23.5% for bupropion and NRT. Analyzing missing patients as smoking, the 7-day point prevalence abstinence rates were 7.1%, 8.9%, and 8.2%, at 1 month, 2 months, and 3 months after program enrollment, respectively. No serious adverse drug reactions were recorded. Conclusions Our medical student-run smoking cessation clinic provided an effective and safe experience for medically underserved patients who might not otherwise have access to conventional smoking cessation programs because of high cost, lack of insurance, or other disparities. Similar medical student initiatives focusing on healthy lifestyles

  20. Collaboration with pharmacy services in a family practice for the medically underserved

    Directory of Open Access Journals (Sweden)

    Campbell K

    2009-12-01

    Full Text Available Objectives: Pharmacist-managed collaborative services in a family practice setting are described, and diabetes and hypertension outcomes are assessed.Methods: Pharmacist-managed clinics, pharmacotherapy consultations, and drug information services are provided for a medically underserved, predominantly African American population. A pharmacy residency director, an ambulatory care pharmacy resident and three PharmD candidate student pharmacists work directly with physicians, nurse practitioners, nurses, and social workers to form an interdisciplinary health care team. Providers utilize pharmacy services through consultations and referrals. Collaboration outcomes were evaluated in twenty-two patients with diabetes and thirty hypertensive patients. Patients were retrospectively followed throughout their history with pharmacy service. Hemoglobin A1c (A1C was tracked before referral to pharmacy services, 3 to 6 months after, and as the most current measure after at least 6 months. Blood pressure (BP was observed before pharmacy involvement, 2 to 4 months later, and then currently for at least 4 months with the service. The mean of the most current markers was calculated, and the percent of patients at their goal marker was compared to national averages.Results: Fifty percent of pharmacy service patients met the American Diabetes Association hemoglobin A1c goal of less than 7% in our evaluation compared to the national mean of 49.8% overall and 44% in African Americans. Thirty percent of patients were at their BP goal while 33.1% of patients without diabetes and 33.2% of patients with diabetes nationally are at goal. Conclusion: The medically underserved patients under the care of pharmacy services achieved a higher percentage at their A1C goal than the national mean. The percentage of patients who achieved their BP goals was comparable to the national average. Increasing utilization of pharmacy services in the family practice setting allows for

  1. Atmospheric organochlorine pesticides and polychlorinated biphenyls in urban areas of Nepal: spatial variation, sources, temporal trends, and long-range transport potential

    Science.gov (United States)

    Pokhrel, Balram; Gong, Ping; Wang, Xiaoping; Nath Khanal, Sanjay; Ren, Jiao; Wang, Chuanfei; Gao, Shaopeng; Yao, Tandong

    2018-02-01

    The study of persistent organic pollutants (POPs) in low-latitude tropical and subtropical urban cities is necessary to assess their local and global impacts on ecosystems and human health. Despite studies on levels of POPs in water, soils, and sediments, analysis of the distribution patterns, seasonality, and sources of POPs in urban regions of Nepal remain limited. Polyurethane foam (PUF)-based passive air samplers were deployed in three major cities in Nepal: Kathmandu (the capital city), Pokhara, and Hetauda (agricultural cities). Dichlorodiphenyltrichloroethane (DDT) and hexachlorocyclohexane (HCH) were the dominant organochlorine pesticides in the atmosphere at all sites. The average concentrations of POPs were ∑ DDTs, 8.7-1.0 × 103 pg m-3; ∑ HCHs, 5.3-3.3 × 103 pg m-3; HCB, 5.8-3.4 × 102 pg m-3; ∑ endosulfan, BDL-51 pg m-3; and ∑ 6PCBs, 1.4-47 pg m-3. Isomer and metabolite ratio analyses suggested that the concentrations present were from both new and historical applications of the POPs. Vegetable production sites and their market places appeared to be the major DDT and HCH source areas. Higher atmospheric concentrations of DDT and HCH occurred during the pre-monsoon and monsoon seasons, and winter, respectively, closely associated with their local application for soil preparation and vegetable spraying. The estimated travel distances of the POPs (HCB, α-HCH, γ-HCH, and p, p'-DDT) under the Nepalese tropical climate were all above 1000 km, suggesting that high precipitation levels in the tropical climate were not enough to scavenge the POPs and that Nepal could be an important source region for POPs. Due to their close proximity and cold trapping (driven by low temperatures), the high Himalayas and the Tibetan Plateau are likely the key receptors of POPs emitted in Nepal. These results add to the information available on POPs from tropical developing countries.

  2. Atmospheric organochlorine pesticides and polychlorinated biphenyls in urban areas of Nepal: spatial variation, sources, temporal trends, and long-range transport potential

    Directory of Open Access Journals (Sweden)

    B. Pokhrel

    2018-02-01

    Full Text Available The study of persistent organic pollutants (POPs in low-latitude tropical and subtropical urban cities is necessary to assess their local and global impacts on ecosystems and human health. Despite studies on levels of POPs in water, soils, and sediments, analysis of the distribution patterns, seasonality, and sources of POPs in urban regions of Nepal remain limited. Polyurethane foam (PUF-based passive air samplers were deployed in three major cities in Nepal: Kathmandu (the capital city, Pokhara, and Hetauda (agricultural cities. Dichlorodiphenyltrichloroethane (DDT and hexachlorocyclohexane (HCH were the dominant organochlorine pesticides in the atmosphere at all sites. The average concentrations of POPs were  ∑ DDTs, 8.7–1.0  ×  103 pg m−3;  ∑ HCHs, 5.3–3.3  ×  103 pg m−3; HCB, 5.8–3.4  ×  102 pg m−3;  ∑ endosulfan, BDL–51 pg m−3; and  ∑ 6PCBs, 1.4–47 pg m−3. Isomer and metabolite ratio analyses suggested that the concentrations present were from both new and historical applications of the POPs. Vegetable production sites and their market places appeared to be the major DDT and HCH source areas. Higher atmospheric concentrations of DDT and HCH occurred during the pre-monsoon and monsoon seasons, and winter, respectively, closely associated with their local application for soil preparation and vegetable spraying. The estimated travel distances of the POPs (HCB, α-HCH, γ-HCH, and p, p′-DDT under the Nepalese tropical climate were all above 1000 km, suggesting that high precipitation levels in the tropical climate were not enough to scavenge the POPs and that Nepal could be an important source region for POPs. Due to their close proximity and cold trapping (driven by low temperatures, the high Himalayas and the Tibetan Plateau are likely the key receptors of POPs emitted in Nepal. These results add to the information available on POPs from

  3. Seasonality in cholera dynamics : a rainfall-driven model explains the wide range of patterns of an infectious disease in endemic areas

    Science.gov (United States)

    Baracchini, Theo; Pascual, Mercedes; King, Aaron A.; Bouma, Menno J.; Bertuzzo, Enrico; Rinaldo, Andrea

    2015-04-01

    An explanation for the spatial variability of seasonal cholera patterns has remained an unresolved problem in tropical medicine te{pascual_2002}. Previous studies addressing the role of climate drivers in disease dynamics have focused on interannual variability and modelled seasonality as given te{king_nature}. Explanations for seasonality have relied on complex environmental interactions that vary with spatial location (involving regional hydrological models te{bertuzzo_2012}, river discharge, sea surface temperature, and plankton blooms). Thus, no simple and unified theory based on local climate variables has been formulated te{emch_2008}, leaving our understanding of seasonal variations of cholera outbreaks in different regions of the world incomplete. Through the analysis of a unique historical dataset containing 50 years of monthly meteorological, demographic and epidemiological records, we propose a mechanistic, SIR-based stochastic model for the population dynamics of cholera driven by local rainfall and temperature that is able to capture the full range of seasonal patterns in this large estuarine region, which encompasses the variety of patterns worldwide. Parameter inference was implemented via new statistical methods that allow the computation of maximum-likelihood estimates for partially observed Markov processes through sequential Monte-Carlo te{ionides_2011}. Such a model may provide a unprecedented opportunity to gain insights on the conditions and factors responsible for endemicity around the globe, and therefore, to also revise our understanding of the ecology of Vibrio cholerae. Results indicate that the hydrological regime is a decisive driver determining the seasonal dynamics of cholera. It was found that rainfall and longer water residence times tend to buffer the propagation of the disease in wet regions due to a dilution effect, while also enhancing cholera incidence in dry regions. This indicates that overall water levels matter and appear

  4. Atlantic Test Range (ATR)

    Data.gov (United States)

    Federal Laboratory Consortium — ATR controls fully-instrumented and integrated test ranges that provide full-service support for cradle-to-grave testing. Airspace and surface target areas are used...

  5. Corrective Action Investigation Plan for Corrective Action Unit 406: Area 3 Building 03-74 and Building 03-58 Under ground Discharge Points and Corrective Action Unit 429: Area 3 Building 03-55 and Area 9 Building 09-52 Underground Discharge Points, Tonopah Test Range, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    DOE/NV

    1999-05-20

    This Corrective Action Investigation Plan (CAIP) has been developed in accordance with the Federal Facility Agreement and Consent Order (FFACO) that was agreed to by the US Department of Energy, Nevada Operations Office (DOE/NV); the State of Nevada Division of Environmental Protection (NDEP); and the US Department of Defense (FFACO, 1996). The CAIP is a document that provides or references all of the specific information for investigation activities associated with Corrective Action Units (CAUs) or Corrective Action Sites (CASs). According to the FFACO (1996), CASs are sites potentially requiring corrective action(s) and may include solid waste management units or individual disposal or release sites. Corrective Action Units consist of one or more CASs grouped together based on geography, technical similarity, or agency responsibility for the purpose of determining corrective actions. This CAIP contains the environmental sample collection objectives and the criteria for conducting site investigation activities at the Underground Discharge Points (UDPs) included in both CAU 406 and CAU 429. The CAUs are located in Area 3 and Area 9 of the Tonopah Test Range (TTR). The TTR, included in the Nellis Air Force Range, is approximately 255 kilometers (km) (140 miles [mi]) northwest of Las Vegas, Nevada.

  6. Range Scheduling Aid (RSA)

    Science.gov (United States)

    Logan, J. R.; Pulvermacher, M. K.

    1991-01-01

    Range Scheduling Aid (RSA) is presented in the form of the viewgraphs. The following subject areas are covered: satellite control network; current and new approaches to range scheduling; MITRE tasking; RSA features; RSA display; constraint based analytic capability; RSA architecture; and RSA benefits.

  7. Compilation of hydrologic data for White Sands pupfish habitat and nonhabitat areas, northern Tularosa Basin, White Sands Missile Range and Holloman Air Force Base, New Mexico, 1911-2008

    Science.gov (United States)

    Naus, C.A.; Myers, R.G.; Saleh, D.K.; Myers, N.C.

    2014-01-01

    The White Sands pupfish (Cyprinodon tularosa), listed as threatened by the State of New Mexico and as a Federal species of concern, is endemic to the Tularosa Basin, New Mexico. Because water quality can affect pupfish and the environmental conditions of their habitat, a comprehensive compilation of hydrologic data for pupfish habitat and nonhabitat areas in the northern Tularosa Basin was undertaken by the U.S. Geological Survey in cooperation with White Sands Missile Range. The four locations within the Tularosa Basin that are known pupfish habitat areas are the Salt Creek, Malpais Spring and Malpais Salt Marsh, Main Mound Spring, and Lost River habitat areas. Streamflow data from the Salt Creek near Tularosa streamflow-gaging station indicated that the average annual mean streamflow and average annual total streamflow for water years 1995–2008 were 1.35 cubic feet per second (ft3/s) and 983 acre-feet, respectively. Periods of no flow were observed in water years 2002 through 2006. Dissolved-solids concentrations in Salt Creek samples collected from 1911 through 2007 ranged from 2,290 to 66,700 milligrams per liter (mg/L). The average annual mean streamflow and average annual total streamflow at the Malpais Spring near Oscura streamflow-gaging station for water years 2003–8 were 6.81 ft3/s and 584 acre-feet, respectively. Dissolved-solids concentrations for 16 Malpais Spring samples ranged from 3,882 to 5,500 mg/L. Isotopic data for a Malpais Spring near Oscura water sample collected in 1982 indicated that the water was more than 27,900 years old. Streamflow from Main Mound Spring was estimated at 0.007 ft3/s in 1955 and 1957 and ranged from 0.02 to 0.07 ft3/s from 1996 to 2001. Dissolved-solids concentrations in samples collected between 1955 and 2007 ranged from an estimated 3,760 to 4,240 mg/L in the upper pond and 4,840 to 5,120 mg/L in the lower pond. Isotopic data for a Main Mound Spring water sample collected in 1982 indicated that the water was about

  8. A 5A's communication intervention to promote physical activity in underserved populations

    Directory of Open Access Journals (Sweden)

    Carroll Jennifer K

    2012-10-01

    Full Text Available Abstract Background The present study protocol describes the trial design of a clinician training intervention to improve physical activity counseling in underserved primary care settings using the 5As. The 5As (Ask, Advise, Agree, Assist, Arrange are a clinical tool recommended for health behavior counseling in primary care. Methods/Design The study is a two-arm randomized pilot pragmatic trial to examine a primary care clinician communication intervention on use of the 5As in discussion of physical activity in audio-recorded office visits in an ethnically diverse, low-income patient population. The study setting consists of two federally qualified community health centers in Rochester, NY. Eligible clinicians (n=15 are recruited and randomized into two groups. Group 1 clinicians participate in the training intervention first; Group 2 clinicians receive the intervention six months later. The intervention and its outcomes are informed by self-determination theory and principles of patient-centered communication. Assessment of outcomes is blinded. The primary outcome will be the frequency and quality of 5As discussions as judged by evaluating 375 audio-recorded patient visits distributed over baseline and in the post-intervention period (immediately post and at six months. Secondary outcomes will be changes in patients’ perceived competence to increase physical activity (Aim 2 and patients and clinicians beliefs regarding whether pertinent barriers to promoting exercise have been reduced. (Aim 3. Exploratory outcomes (Aim 4 are potential mediators of the intervention’s effect and whether the intervention affects actual enrollment in the community program recommended for exercise. The analysis will use repeated measures (in the form of recorded office visits from each clinician at each time point and aggregate measures of Groups 1 and 2 over time. Discussion Results will help elucidate the role of 5As communication training for clinicians on

  9. Pop Up/Drill Down: A Traveling Exhibit Designed to Reach Underserved Communities through Art and Geosciences

    Science.gov (United States)

    Kurtz, N.

    2017-12-01

    Scientists observe the world around them in an attempt to understand it. Artists observe the world around them in an attempt to create a reflection or response to the environment. It is critical for the two fields to work together in order to engage and inform the general population. The Consortium for Ocean Leadership, the International Ocean Discovery Program and a series of collaborators are designing a traveling exhibit that will inspire underserved communities in the excitement of exploration, the process of science, and the people and tools required to get there. The project aims to learn more about how to increase access to and awareness of ocean/earth science by bringing a pop-up style museum exhibit to local libraries and public events. As an artist with a science and education background and the graphic designer for this exhibit, this author will highlight the ways this project utilizes art and design to educate underserved populations in ocean and geosciences.

  10. Bolivia programme evaluation of a package to reach an underserved population: Community-based maternal and newborn care economic analysis.

    Science.gov (United States)

    Barger, Diana; Pooley, Bertha; Dupuy, Julien Roger; Cardenas, Norma Amparo; Wall, Steve; Owen, Helen; Daviaud, Emmanuelle

    2017-10-01

    To address inequitable access to health services of indigenous communities in the Bolivian highlands, the Bolivian Ministry of Health, with the support of Save the Children-Saving Newborn Lives, conducted operational research to identify, implement and test a package of maternal and newborn interventions using locally recruited, volunteer Community Health Workers (vCHW) between 2008 and 2010. The additional annual economic and financial costs of the intervention were estimated from the perspective of the Bolivian Ministry of Health in two municipalities. The cost of intervention-stimulated increases in facility attendance was estimated with national surveillance data using a pre-post comparison, adjusted for secular trends in facility attendance. Three scale-up scenarios were modelled by varying the levels of coverage and the number (per mother and child pair) and frequency of home visits. Average cost per mother and average cost per home visit are presented in constant 2015 US$. Eighteen per cent of expectant mothers in the catchment area were visited at least once. The annualized additional financial cost of the community-based intervention across both municipalities was $43 449 of which 3% ($1324) was intervention design, 20% ($8474) set-up and 77% ($33 651) implementation. Drivers of additional costs were additional paid staff (68%), 81% of which was for management and support by local implementing partner and 19% of which was for vCHW supervision. The annual financial cost per vCHW was $595. Modelled scale-up scenarios highlight potential efficiency gains. Recognizing local imperatives to reduce inequalities by targeting underserved populations, the observed low coverage by vCHWs resulted in a high cost per mother and child pair ($296). This evaluation raises important questions about this model's ability to achieve its ultimate goals of reducing neonatal mortality and inequalities through behaviour change and increased care seeking and has served to

  11. Relationship of body mass index and psychosocial factors on physical activity in underserved adolescent boys and girls.

    Science.gov (United States)

    Kitzman-Ulrich, Heather; Wilson, Dawn K; Van Horn, M Lee; Lawman, Hannah G

    2010-09-01

    Previous research indicates that body mass index (BMI) and sex are important factors in understanding physical activity (PA) levels. The present study examined the influence of BMI on psychosocial variables (self-efficacy, social support) and PA in underserved (ethnic minority, low income) boys in comparison with girls. Participants (N = 669; 56% girls; 74% African American) were recruited from the "Active by Choice Today" trial. BMI ʐ score was calculated from objectively collected height and weight data, and PA was assessed with 7-day accelerometry estimates. Self-report questionnaires were used to measure self-efficacy and social support (family, peers) for PA. A 3-way interaction between BMI z score, sex, and family support on PA was shown such that family support was positively associated with PA in normal-weight but not overweight or obese boys, and was not associated with PA in girls. Self-efficacy had the largest effect size related to PA in comparison with the other psychosocial variables studied. Self-efficacy was found to be an important variable related to PA in underserved youth. Future studies should evaluate possible barriers to PA in girls, and overweight youth, to provide more effective family support strategies for underserved adolescents' PA. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  12. Home range and travels

    Science.gov (United States)

    Stickel, L.F.; King, John A.

    1968-01-01

    The concept of home range was expressed by Seton (1909) in the term 'home region,' which Burr (1940, 1943) clarified with a definition of home range and exemplified in a definitive study of Peromyscus in the field. Burt pointed out the ever-changing characteristics of home-range area and the consequent absence of boundaries in the usual sense--a finding verified by investigators thereafter. In the studies summarized in this paper, sizes of home ranges of Peromyscus varied within two magnitudes, approximately from 0.1 acre to ten acres, in 34 studies conducted in a variety of habitats from the seaside dunes of Florida to the Alaskan forests. Variation in sizes of home ranges was correlated with both environmental and physiological factors; with habitat it was conspicuous, both in the same and different regions. Food supply also was related to size of home range, both seasonally and in relation to habitat. Home ranges generally were smallest in winter and largest in spring, at the onset of the breeding season. Activity and size also were affected by changes in weather. Activity was least when temperatures were low and nights were bright. Effects of rainfall were variable. Sizes varied according to sex and age; young mice remained in the parents' range until they approached maturity, when they began to travel more widely. Adult males commonly had larger home ranges than females, although there were a number of exceptions. An inverse relationship between population density and size of home range was shown in several studies and probably is the usual relationship. A basic need for activity and exploration also appeared to influence size of home range. Behavior within the home range was discussed in terms of travel patterns, travels in relation to home sites and refuges, territory, and stability of size of home range. Travels within the home range consisted of repeated use of well-worn trails to sites of food, shelter, and refuge, plus more random exploratory travels

  13. Dental Therapists as New Oral Health Practitioners: Increasing Access for Underserved Populations.

    Science.gov (United States)

    Brickle, Colleen M; Self, Karl D

    2017-09-01

    The development of dental therapy in the U.S. grew from a desire to find a workforce solution for increasing access to oral health care. Worldwide, the research that supports the value of dental therapy is considerable. Introduction of educational programs in the U.S. drew on the experiences of programs in New Zealand, Australia, Canada, and the United Kingdom, with Alaska tribal communities introducing dental health aide therapists in 2003 and Minnesota authorizing dental therapy in 2009. Currently, two additional states have authorized dental therapy, and two additional tribal communities are pursuing the use of dental therapists. In all cases, the care provided by dental therapists is focused on communities and populations who experience oral health care disparities and have historically had difficulties in accessing care. This article examines the development and implementation of the dental therapy profession in the U.S. An in-depth look at dental therapy programs in Minnesota and the practice of dental therapy in Minnesota provides insight into the early implementation of this emerging profession. Initial results indicate that the addition of dental therapists to the oral health care team is increasing access to quality oral health care for underserved populations. As evidence of dental therapy's success continues to grow, mid-level dental workforce legislation is likely to be introduced by oral health advocates in other states. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  14. ITEAMS: Increasing the Self-Identification for Girls and Underserved Youth in Pursuing STEM Careers

    Directory of Open Access Journals (Sweden)

    R. Bruce Ward

    2012-02-01

    Full Text Available We report early findings on the efficacy of a technology-based project in increasing self-identification for girls and underserved youth to self-select STEM (science, technology, engineering, and mathematics careers. ITEAMS (Innovative Technology- Enabled Astronomy for Middle Schools – an out-of-schooltime program with online, robotic telescopes as its central focus – targets girls and minority students underrepresented in STEMrelated vocations. The participating students attend urban schools in Eastern Massachusetts. ITEAMS’ twofold goal is to: a provide inspiration for the participants to pursue STEM careers, and b increase the students’ mastery of foundational subject matter so they are prepared for the rigor of further STEM study. We use an online system for surveys and assessments, the former to capture attitudinal changes about career choices, and the latter to assess the students’ subject matter knowledge. Participating students take pre-, intermediate, and post subject-matter tests and career-interest surveys. While we find statistically significant gains in subject matter knowledge free of gender, race, or school bias, we also find girls profess less interest than boys in STEM careers as early as grades five and six, although other attitudinal indicators suggest ways to reverse that trend.

  15. Cardiovascular risk in minority and underserved women in Appalachian Tennessee: a descriptive study.

    Science.gov (United States)

    Pearson, Tamera Lea

    2010-04-01

    The purposes of this study were to translate current knowledge regarding cardiovascular risk factors, screening, and prevention to a disparate population of women and to ascertain the cardiovascular health status and risk factors in a sample of minority and underserved Appalachian women. Demographic data were collected from a voluntary sample of women from a disparate population living in Appalachian Tennessee. A coronary risk profile recorded family health history, personal health history, and lifestyle habits affecting risk for cardiovascular disease. Physiologic measurements included body mass index, blood pressure, fasting glucose, cholesterol levels, ankle brachial index, and carotid artery stenosis. Women in Appalachia Tennessee from a disparate population have high risks for heart disease and stroke. This is a critical time to address any modifiable risk factors and aggressively treat underlying cardiovascular diseases such as hypertension and hypercholesterolemia. Nurse practitioners (NPs) often provide primary care to women who may not be aware of their cardiovascular risks or actual disease. NPs can ensure that their practice incorporates primary and secondary cardiovascular prevention through screening, individual health education, and aggressive evidence-based treatment plans for women.

  16. Underserved Pregnant and Postpartum Women's Access and Use of Their Health Records.

    Science.gov (United States)

    Guo, Yuqing; Hildebrand, Janet; Rousseau, Julie; Brown, Brandon; Pimentel, Pamela; Olshansky, Ellen

    The purpose of this study was to examine knowledge of and experiences with use of their electronic health record (EHR) among mostly Hispanic women during pregnancy and postpartum. Women who were in the MOMS Orange County prenatal or postpartum home visitation program completed surveys and participated in focus groups. Descriptive and content analyses were used. Twenty-six women participated. Nearly all women (24, 92.3%) knew what health records were and most (80.8%) felt that keeping their records would increase or greatly increase their confidence in caring for themselves and their families. Approximately one third reported already keeping a copy of their health records. Common barriers to accessing and understanding health records included healthcare providers' noncompliance with the Health Information Technology for Economic and Clinical Health Act, limited EHR adoption, unfriendly patient portals, complicated medical terminology, rushed appointments with healthcare providers, lack of Spanish interpreters, and lack of Spanish-speaking healthcare providers. Programs are needed to educate and support women and providers in using health records to promote health literacy, pregnancy management, and patient-provider relationships in underserved populations.

  17. Identifying elements of patient-centered care in underserved populations: a qualitative study of patient perspectives.

    Directory of Open Access Journals (Sweden)

    Sheela Raja

    Full Text Available Patient-centered care is an important goal in the delivery of healthcare. However, many patients do not engage in preventive medical care. In this pilot study, we conducted twenty in depth, semi-structured qualitative interviews at the University of Illinois at Chicago Health Sciences campus in a four month time frame. Many patients were underserved and underinsured, and we wanted to understand their experiences in the healthcare system. Using content analysis, several themes emerged from the interview data. Participants discussed the need for empathy and rapport with their providers. They identified provider behaviors that fostered a positive clinical relationship, including step-by step explanations of procedures, attention to body language and clinic atmosphere, and appropriate time management. Participants identified cost as the most common barrier to engaging in preventive care and discussed children and social support as motivating factors. A long-term relationship with a provider was an important motivator for preventive care, suggesting that the therapeutic alliance was essential to many patients. Conversely, many participants discussed a sense of dehumanization in the healthcare system, reporting that their life circumstances were overlooked, or that they were judged based on insurance status or ethnicity. We discuss implications for provider training and healthcare delivery, including the importance of patient-centered medical homes.

  18. Dermatologic care in the homeless and underserved populations: observations from the Venice Family Clinic.

    Science.gov (United States)

    Grossberg, Anna L; Carranza, Dafnis; Lamp, Karen; Chiu, Melvin W; Lee, Catherine; Craft, Noah

    2012-01-01

    Dermatologic care in the homeless and impoverished urban underserved populations is rarely described despite the wide prevalence of skin concerns in this population. Because the homeless population may be subject to increased sun exposure compared to the nonhomeless population, they also may be at increased risk for skin cancer. We sought to describe the spectrum of dermatologic diseases seen in a free clinic in Venice, California--the Venice Family Clinic (VFC)--as well as the differences in diagnoses between the homeless and nonhomeless patients seen at this clinic. A retrospective chart review was performed of dermatology patients (N = 82) seen at VFC throughout the 2006 calendar year. The homeless population (n = 22) was found to have more diagnoses of malignant/premalignant growths (25% [16/64] of all homeless diagnoses) compared to their nonhomeless (n = 60) counterparts (6.1% [8/132] of all nonhomeless diagnoses; P < .0001). This difference was sustained when ethnicity was controlled, with 29.6% [16/54] of diagnoses in the homeless white group consisting of malignant/ premalignant growths compared to 8.9% [4/45] of diagnoses in the nonhomeless white cohort (P < .005). Homeless patients may have a higher incidence of skin cancers and precancerous skin lesions due to increased sun exposure and/or limited access to dermatologic care.

  19. Critical human-factors issues in nuclear-power regulation and a recommended comprehensive human-factors long-range plan. Critical discussion of human factors areas of concern

    International Nuclear Information System (INIS)

    Hopkins, C.O.; Snyder, H.L.; Price, H.E.; Hornick, R.J.; Mackie, R.R.; Smillie, R.J.; Sugarman, R.C.

    1982-08-01

    This comprehensive long-range human factors plan for nuclear reactor regulation was developed by a Study Group of the Human Factors Society, Inc. This Study Group was selected by the Executive Council of the Society to provide a balanced, experienced human factors perspective to the applications of human factors scientific and engineering knowledge to nuclear power generation. The report is presented in three volumes. Volume 1 contains an Executive Summary of the 18-month effort and its conclusions. Volume 2 summarizes all known nuclear-related human factors activities, evaluates these activities wherever adequate information is available, and describes the recommended long-range (10-year) plan for human factors in regulation. Volume 3 elaborates upon each of the human factors issues and areas of recommended human factors involvement contained in the plan, and discusses the logic that led to the recommendations

  20. A study protocol: using demand-side financing to meet the birth spacing needs of the underserved in Punjab Province in Pakistan.

    Science.gov (United States)

    Azmat, Syed Khurram; Ali, Moazzam; Hameed, Waqas; Mustafa, Ghulam; Abbas, Ghazanfer; Ishaque, Muhammad; Bilgrami, Mohsina; Temmerman, Marleen

    2014-05-30

    High fertility rates, unwanted pregnancies, low modern contraceptive prevalence and a huge unmet need for contraception adversely affect women's health in Pakistan and this problem is compounded by limited access to reliable information and quality services regarding birth spacing especially in rural and underserved areas. This paper presents a study protocol that describes an evaluation of a demand-side financing (DSF) voucher approach which aims to increase the uptake of modern contraception among women of the lowest two wealth quintiles in Punjab Province, Pakistan. This study will use quasi-experimental design with control arm and be implemented in: six government clinics from the Population Welfare Department; 24 social franchise facilities branded as 'Suraj' (Sun), led by Marie Stopes Society (a local non-governmental organization); and 12 private sector clinics in Chakwal, Mianwali and Bhakkar districts. The study respondents will be interviewed at baseline and endline subject to voluntary acceptance and medical eligibility. In addition, health service data will record each client visit during the study period. The study will examine the impact of vouchers in terms of increasing the uptake of modern contraception by engaging private and public sector service providers (mid-level and medical doctors). If found effective, this approach can be a viable solution to satisfying the current demand and meeting the unmet need for contraception, particularly among the poorest socio-economic group.

  1. A study protocol: using demand-side financing to meet the birth spacing needs of the underserved in Punjab Province in Pakistan

    Science.gov (United States)

    2014-01-01

    Background High fertility rates, unwanted pregnancies, low modern contraceptive prevalence and a huge unmet need for contraception adversely affect women’s health in Pakistan and this problem is compounded by limited access to reliable information and quality services regarding birth spacing especially in rural and underserved areas. This paper presents a study protocol that describes an evaluation of a demand-side financing (DSF) voucher approach which aims to increase the uptake of modern contraception among women of the lowest two wealth quintiles in Punjab Province, Pakistan. Methods/Design This study will use quasi-experimental design with control arm and be implemented in: six government clinics from the Population Welfare Department; 24 social franchise facilities branded as ‘Suraj’ (Sun), led by Marie Stopes Society (a local non-governmental organization); and 12 private sector clinics in Chakwal, Mianwali and Bhakkar districts. The study respondents will be interviewed at baseline and endline subject to voluntary acceptance and medical eligibility. In addition, health service data will record each client visit during the study period. Discussion The study will examine the impact of vouchers in terms of increasing the uptake of modern contraception by engaging private and public sector service providers (mid-level and medical doctors). If found effective, this approach can be a viable solution to satisfying the current demand and meeting the unmet need for contraception, particularly among the poorest socio-economic group. PMID:24885657

  2. Using information technology to reduce asthma disparities in underserved populations: a pilot study.

    Science.gov (United States)

    Vargas, Perla A; Robles, Elias; Harris, Judith; Radford, Peggy

    2010-10-01

    Low health literacy has been identified as an independent predictor of poor asthma control. The Institute of Medicine considers the role of information technology (IT) as critical in providing "safe, effective, patient centered, timely, efficient, and equitable" care with the potential to reduce health disparities in underserved populations. The aim of this study was to design and evaluate an interactive computer-based questionnaire to assess asthma symptoms in children of parents with limited health literacy and/or limited English proficiency. Volunteer caregivers attending a mobile asthma clinic were randomly assigned to complete the electronic or the paper-and-pencil version of an asthma screening questionnaire (ASQ) in their language of choice (English or Spanish). In the electronic version, a tablet computer was used to present the ASQ questions as video clips and to collect information through the touchscreen. Participants also completed a demographic questionnaire, a brief health literacy questionnaire, and a system usability and satisfaction questionnaire. Reliability of the paper and electronic self-assessments was evaluated by comparing each participant's answers to information they provided during a nurse-guided structured interview (gold standard). A total of 48 parents participated in the study, 26 completed the electronic ASQ and 21 the paper-and-pencil form. Thirty-five percent of the children had well-controlled asthma (n = 17). Most participants were Spanish speaking (67%) Hispanic (n = 44) mothers (n = 43) with a median age of 32 years. More than half had ≤8 years of education (n = 25) and earned education was significant (ρ = .47, p higher than concordance between the paper ASQ and the nurse interview (68% versus 54%; p technology tools may help reduce barriers to access due to inadequate levels of English proficiency and health literacy.

  3. Text4baby program: an opportunity to reach underserved pregnant and postpartum women?

    Science.gov (United States)

    Gazmararian, Julie A; Elon, Lisa; Yang, Baiyu; Graham, Megan; Parker, Ruth

    2014-01-01

    Text4baby was launched in 2010 to promote healthy pregnancies and babies by the use of text messaging. The primary objective of this study was to assess factors related to the enrollment process and reception of text4baby. A prospective cohort study was conducted in two Women, Infant and Children clinics in Atlanta (April 2010-July 2011). Randomly selected pregnant and postpartum women (n = 468) were queried on cell phone use and instructed on text4baby enrollment. Self-enrollment issues were assessed at one-week follow-up (n = 351, 75.0 %), and message reception and reading patterns at two-month follow-up (n = 209, 44.7 %). Forty-two percent of the women had some college education and 82 % had household income education (80 % with some college vs. 62 % with less education), with household income above $10,000 (61 %  $20,000), and among women living in smaller households (77 % 1-3 members vs. 58 % > 3 members) (all p 90 % reported uninterrupted reception and regular reading of messages, and 88 % planned to continue using text4baby. Results also suggested that respondents who were younger (educated and had lower health literacy skills were more likely to have interrupted messages. Despite substantial interest in the text4baby program in an underserved population, innovative ways to help women with significant disadvantages enroll and receive uninterrupted messages are needed.

  4. Health effects of training laypeople to deliver emergency care in underserviced populations: a systematic review protocol.

    Science.gov (United States)

    Orkin, Aaron M; Curran, Jeffrey D; Fortune, Melanie K; McArthur, Allison; Mew, Emma J; Ritchie, Stephen D; Van de Velde, Stijn; VanderBurgh, David

    2016-05-18

    The Disease Control Priorities Project recommends emergency care training for laypersons in low-resource settings, but evidence for these interventions has not yet been systematically reviewed. This review will identify the individual and community health effects of educating laypeople to deliver prehospital emergency care interventions in low-resource settings. This systematic review addresses the following question: in underserviced populations and low-resource settings (P), does first aid or emergency care training or education for laypeople (I) confer any individual or community health benefit for emergency health conditions (O), in comparison with no training or other forms of education (C)? We restrict this review to studies reporting quantitatively measurable outcomes, and search 12 electronic bibliographic databases and grey literature sources. A team of expert content and methodology reviewers will conduct title and abstract screening and full-text review, using a custom-built online platform. Two investigators will independently extract methodological variables and outcomes related to patient-level morbidity and mortality and community-level effects on resilience or emergency care capacity. Two investigators will independently assess external validity, selection bias, performance bias, measurement bias, attrition bias and confounding. We will summarise the findings using a narrative approach to highlight similarities and differences between the gathered studies. Formal ethical approval is not required. The results will be disseminated through a peer-reviewed publication and knowledge translation strategy. CRD42014009685. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. The Role of Parenting Practices in the Home Environment among Underserved Youth.

    Science.gov (United States)

    Conlon, Beth A; McGinn, Aileen P; Lounsbury, David W; Diamantis, Pamela M; Groisman-Perelstein, Adriana E; Wylie-Rosett, Judith; Isasi, Carmen R

    2015-08-01

    The home environment, which includes parenting practices, is an important setting in which children develop their health behaviors. We examined the role of parenting practices in the home environment among underserved youth. We examined baseline data of a family-focused pediatric obesity intervention. Parenting practices (monitoring, discipline, limit setting of soda/snacks [SS] and screen media [SM], pressure to eat, and reinforcement) and availability of fruits/vegetables (FV) and sugar-sweetened beverages (SSBs), family meals, television (TV) watching during meals, TVs in the home, owning active video games/sports equipment, and household food security were assessed in 301 parent/caregivers of overweight/obese children (ages 7-12 years; BMI≥85th percentile). Associations were evaluated using Spearman's rank correlation coefficients and logistic regression models adjusted for potential confounders. Parents/caregivers (ages 22-67 years) were largely Hispanic/Latino (74.1%), female (92.4%), and reported high levels of limit setting SS and low levels of pressure to eat. Parent age, gender, country of birth, and years living in the United States accounted for differences among several parenting practices. Adjusted logistic regression models identified several statistically significant associations, including: Monitoring was positively associated with availability FV (odds ratio [OR]=2.19; 95% confidence interval [CI], 1.25, 3.82); limit setting SS was inversely associated with availability of SSBs (OR=0.40; 95% CI, 0.21, 0.75); and limit setting SM was inversely associated with TV viewing during family meals (OR=0.51; 95% CI, 0.31, 0.85). Nearly 40% of our population was food insecure, and food insecurity was positively associated with pressure to eat (OR=1.77; 95% CI, 1.01, 3.15). Parenting practices play an important role in the home environment, and longitudinal studies are needed to examine these associations in the context of family-focused pediatric obesity

  6. Palliative Oncologic Care Curricula for Providers in Resource-Limited and Underserved Communities: a Systematic Review.

    Science.gov (United States)

    Xu, Melody J; Su, David; Deboer, Rebecca; Garcia, Michael; Tahir, Peggy; Anderson, Wendy; Kinderman, Anne; Braunstein, Steve; Sherertz, Tracy

    2017-12-20

    Familiarity with principles of palliative care, supportive care, and palliative oncological treatment is essential for providers caring for cancer patients, though this may be challenging in global communities where resources are limited. Herein, we describe the scope of literature on palliative oncological care curricula for providers in resource-limited settings. A systematic literature review was conducted using PubMed, Embase, Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Med Ed Portal databases, and gray literature. All available prospective cohort studies, case reports, and narratives published up to July 2017 were eligible for review. Fourteen articles were identified and referenced palliative care education programs in Argentina, Uganda, Kenya, Australia, Germany, the USA, or multiple countries. The most common teaching strategy was lecture-based, followed by mentorship and experiential learning involving role play and simulation. Education topics included core principles of palliative care, pain and symptom management, and communication skills. Two programs included additional topics specific to the underserved or American Indian/Alaskan Native community. Only one program discussed supportive cancer care, and no program reported educational content on resource-stratified decision-making for palliative oncological treatment. Five programs reported positive participant satisfaction, and three programs described objective metrics of increased educational or research activity. There is scant literature on effective curricula for providers treating cancer patients in resource-limited settings. Emphasizing supportive cancer care and palliative oncologic treatments may help address gaps in education; increased outcome reporting may help define the impact of palliative care curriculum within resource-limited communities.

  7. Registered Nurses' personal rights vs. professional responsibility in caring for members of underserved and disenfranchised populations.

    Science.gov (United States)

    Maze, Claire D Martino

    2005-05-01

    Health disparities exist and refer to the chasms in health status between the advantaged and disadvantaged. Intense multiculturalism will require different approaches and moral obligations to work with these groups and urgency exists to develop nursing caring strategies when dealing with these populations. Development of nursing curricula which identify prejudicial thinking and intolerance for marginalized groups will help to decrease fears and increase nurses' willingness to provide culturally competent health care for underserved and disenfranchised populations. Caring for members of disenfranchised groups instills fear at some level in nurses who are working with these individuals. This fear may be due, in part, to the potential harm nurses perceive the patient may cause them, or perhaps it is because they feel they could possibly be in the individual's situation at some point in their lives. Prejudice and discrimination continue to exist in society and have adversely affected the health care system and the nursing profession. Discrimination may be based on differences due to age, ability, gender, race, ethnicity, religion, sexual orientation, or any characteristics by which people differ. Registered Nurses are accountable for nursing decisions and actions regardless of personal preferences. Due to the rapidly changing healthcare system the nurse faces increasing ethical dilemmas and human rights issues. Nurses are individually accountable for caring for each patient and the right to refuse an assignment should be carefully interpreted to avoid patient abandonment. Nurses' objections can be based on moral, ethical, or religious beliefs not on personal preferences and in an emergency the nurse must provide treatment regardless of any personal objections.

  8. Predictors of Willingness to Use a Smartphone for Research in Underserved Persons Living with HIV

    Science.gov (United States)

    Schnall, Rebecca; Cho, Hwayoung; Webel, Allison

    2017-01-01

    Objectives The burden of HIV/AIDS is borne disproportionally by a growing number of racial and ethnic minorities and socioeconomically disadvantaged individuals. Developing mHealth interventions for the everyday self-management needs of persons living with HIV (PLWH) can be challenging given the current constraints of the U.S. healthcare system, especially for those from underserved communities. In order to develop effective, evidence-based mHealth self-management interventions, we need a better understanding of the factors associated with mHealth research. The purpose of this study was to assess factors associated with PLWH's participation in research using smartphones. Methods We conducted a prospective cohort study (parent study) to examine the relationships among HIV self-management, age, gender and mental wellness. Relevant to this study, we analyzed the relationship between self-reported use of smartphones, willingness to use a smartphone for research, and other predictor variables including: HIV stigma, social isolation, social integration functions, and depression. We selected these variables because previous work indicated they may influence smartphone or mHealth use and because they also tend to be elevated in PLWH. Results We found increased age, HIV stigma and social isolation were negatively associated with smartphone use, which supports the use of smartphones for conducting research with PLWH but also suggest that age, stigma, social integration functions and social isolation need to be considered in research involving PLWH. Conclusions Findings here support smartphone use in research involving PLWH. However, future mHealth interventions targeting PLWH should take into account the inverse relationship between smart phone use and age, HIV stigma, and social isolation, and other predictor variables PMID:28118922

  9. Soliton microcomb range measurement

    Science.gov (United States)

    Suh, Myoung-Gyun; Vahala, Kerry J.

    2018-02-01

    Laser-based range measurement systems are important in many application areas, including autonomous vehicles, robotics, manufacturing, formation flying of satellites, and basic science. Coherent laser ranging systems using dual-frequency combs provide an unprecedented combination of long range, high precision, and fast update rate. We report dual-comb distance measurement using chip-based soliton microcombs. A single pump laser was used to generate dual-frequency combs within a single microresonator as counterpropagating solitons. We demonstrated time-of-flight measurement with 200-nanometer precision at an averaging time of 500 milliseconds within a range ambiguity of 16 millimeters. Measurements at distances up to 25 meters with much lower precision were also performed. Our chip-based source is an important step toward miniature dual-comb laser ranging systems that are suitable for photonic integration.

  10. Heavy metals and Pb isotopic composition of aerosols in urban and suburban areas of Hong Kong and Guangzhou, South China—Evidence of the long-range transport of air contaminants

    Science.gov (United States)

    Lee, Celine S. L.; Li, Xiang-Dong; Zhang, Gan; Li, Jun; Ding, Ai-Jun; Wang, Tao

    Rapid urbanization and industrialization in South China has placed great strain on the environment and on human health. In the present study, the total suspended particulate matter (TSP) in the urban and suburban areas of Hong Kong and Guangzhou, the two largest urban centres in South China, was sampled from December 2003 to January 2005. The samples were analysed for the concentrations of major elements (Al, Fe, Mg and Mn) and trace metals (Cd, Cr, Cu, Pb, V and Zn), and for Pb isotopic composition. Elevated concentrations of metals, especially Cd, Pb, V and Zn, were observed in the urban and suburban areas of Guangzhou, showing significant atmospheric trace element pollution. Distinct seasonal patterns were observed in the heavy metal concentrations of aerosols in Hong Kong, with higher metal concentrations during the winter monsoon period, and lower concentrations during summertime. The seasonal variations in the metal concentrations of the aerosols in Guangzhou were less distinct, suggesting the dominance of local sources of pollution around the city. The Pb isotopic composition in the aerosols of Hong Kong had higher 206Pb/ 207Pb and 208Pb/ 207Pb ratios in winter, showing the influence of Pb from the northern inland areas of China and the Pearl River Delta (PRD) region, and lower 206Pb/ 207Pb and 208Pb/ 207Pb ratios in summer, indicating the influence of Pb from the South Asian region and from marine sources. The back trajectory analysis showed that the enrichment of heavy metals in Hong Kong and Guangzhou was closely associated with the air mass from the north and northeast that originated from northern China, reflecting the long-range transport of heavy metal contaminants from the northern inland areas of China to the South China coast.

  11. Application of handheld devices to field research among underserved construction worker populations: a workplace health assessment pilot study

    Directory of Open Access Journals (Sweden)

    Fleming Lora E

    2011-04-01

    Full Text Available Abstract Background Novel low-cost approaches for conducting rapid health assessments and health promotion interventions among underserved worker groups are needed. Recruitment and participation of construction workers is particularly challenging due to their often transient periods of work at any one construction site, and their limited time during work to participate in such studies. In the present methodology report, we discuss the experience, advantages and disadvantages of using touch screen handheld devices for the collection of field data from a largely underserved worker population. Methods In March 2010, a workplace-centered pilot study to examine the feasibility of using a handheld personal device for the rapid health assessment of construction workers in two South Florida Construction sites was undertaken. A 45-item survey instrument, including health-related questions on tobacco exposure, workplace safety practices, musculoskeletal disorders and health symptoms, was programmed onto Apple iPod Touch® devices. Language sensitive (English and Spanish recruitment scripts, verbal consent forms, and survey questions were all preloaded onto the handheld devices. The experience (time to survey administration and capital cost of the handheld administration method was recorded and compared to approaches available in the extant literature. Results Construction workers were very receptive to the recruitment, interview and assessment processes conducted through the handheld devices. Some workers even welcomed the opportunity to complete the questionnaire themselves using the touch screen handheld device. A list of advantages and disadvantages emerged from this experience that may be useful in the rapid health assessment of underserved populations working in a variety of environmental and occupational health settings. Conclusions Handheld devices, which are relatively inexpensive, minimize survey response error, and allow for easy storage of data

  12. Application of handheld devices to field research among underserved construction worker populations: a workplace health assessment pilot study.

    Science.gov (United States)

    Caban-Martinez, Alberto J; Clarke, Tainya C; Davila, Evelyn P; Fleming, Lora E; Lee, David J

    2011-04-01

    Novel low-cost approaches for conducting rapid health assessments and health promotion interventions among underserved worker groups are needed. Recruitment and participation of construction workers is particularly challenging due to their often transient periods of work at any one construction site, and their limited time during work to participate in such studies. In the present methodology report, we discuss the experience, advantages and disadvantages of using touch screen handheld devices for the collection of field data from a largely underserved worker population. In March 2010, a workplace-centered pilot study to examine the feasibility of using a handheld personal device for the rapid health assessment of construction workers in two South Florida Construction sites was undertaken. A 45-item survey instrument, including health-related questions on tobacco exposure, workplace safety practices, musculoskeletal disorders and health symptoms, was programmed onto Apple iPod Touch® devices. Language sensitive (English and Spanish) recruitment scripts, verbal consent forms, and survey questions were all preloaded onto the handheld devices. The experience (time to survey administration and capital cost) of the handheld administration method was recorded and compared to approaches available in the extant literature. Construction workers were very receptive to the recruitment, interview and assessment processes conducted through the handheld devices. Some workers even welcomed the opportunity to complete the questionnaire themselves using the touch screen handheld device. A list of advantages and disadvantages emerged from this experience that may be useful in the rapid health assessment of underserved populations working in a variety of environmental and occupational health settings. Handheld devices, which are relatively inexpensive, minimize survey response error, and allow for easy storage of data. These technological research modalities are useful in the

  13. Teaching the content in context: Preparing "highly qualified" and "high quality" teachers for instruction in underserved secondary science classrooms

    Science.gov (United States)

    Tolbert, Sara E.

    2011-12-01

    This dissertation research project presents the results of a longitudinal study that investigates the knowledge, beliefs, and practices of 13 preservice secondary science teachers participating in a science teacher credentialing/Masters program designed to integrate issues of equity and diversity throughout coursework and seminars. Results are presented in the form of three papers: The first paper describes changes in preservice teacher knowledge about contextualization in science instruction, where contextualization is defined as facilitating authentic connections between science learning and relevant personal, social, cultural, ecological, and political contexts of students in diverse secondary classrooms; the second paper relates changes in the self-efficacy and content-specific beliefs about science, science teaching, diversity, and diversity in science instruction; and the final paper communicates the experiences and abilities of four "social justice advocates" learning to contextualize science instruction in underserved secondary placement classrooms. Results indicate that secondary student teachers developed more sophisticated understandings of how to contextualize science instruction with a focus on promoting community engagement and social/environmental activism in underserved classrooms and how to integrate science content and diversity instruction through student-centered inquiry activities. Although most of the science teacher candidates developed more positive beliefs about teaching science in underrepresented classrooms, many teacher candidates still attributed their minority students' underperformance and a (perceived) lack of interest in school to family and cultural values. The "social justice advocates" in this study were able to successfully contextualize science instruction to varying degrees in underserved placement classrooms, though the most significant limitations on their practice were the contextual factors of their student teaching

  14. Hearing the Silenced Voices of Underserved Women -The Role of Qualitative Research in Gynecologic and Reproductive Care

    Science.gov (United States)

    Lawson, Angela K.; Marsh, Erica E.

    2017-01-01

    Summary for Indexing In order to provide effective evidence-based health care to women, rigorous research that examines women’s lived experiences in their own voices in needed. However, clinical health research has often excluded the experiences of women and minority patient populations. Further, clinical research has often relied on quantitative research strategies; this provides an interesting but limited understanding of women’s health experiences and hinders the provision of effective patient-centered care. In this review, we define qualitative research and its unique contributions to research, and provide examples of how qualitative research has given insights into the reproductive health perspectives and behaviors of underserved women. PMID:28160888

  15. XVIII-XIX. Y��zyılın İlk Yarısında Gebze Menzilhanesi Gebze Range Area (Menzilhane During First Half Of The 18th-19th Centuries

    Directory of Open Access Journals (Sweden)

    Yaşar BAŞ

    2013-07-01

    Full Text Available To meet communication and accommodation needs, variousfacilities and organizations were created in the past times. One of themis range organizations and range areas. This organization played animportant role in such matters as communication, transportation,lodging, recreation and pet supplies. During the Ottoman Period,especially the vizier of Sultan Süleyman the Magnificent, Lutfi Pasha,developed the organization and ascribed it to certain principles.Towards the end of 17th century, the structure of the sameorganization, administration and operation were harmonized withconditions of the day. Accordingly, besides the existing range areas ofAnatolia and Rumelia side, new range areas were periodically opened.Among the centers concerned, those united the intersection of the mainroads and centrally located at the intersections and close to the bigcities gained importance. In this regard, Gebze Range Area had been themost important institution of its kind in Anatolia. Due to its centrallocation, it served as a messenger, pilgrimage and excursion range. Butits feature of being a range area of messenger came to the fore. It is alsofeatured to be a place used by civilians. In this capacity, besides servingas a range service, its foundation is supposedly estimated to be at theend of the 17th century. Taking into consideration the need of the newsystem and period of Tanzimat Reforms of Administration, it began tobe administered in the form of post office given in trust or lease fromthis period of time. However, it partly maintained its old system and thegovernment shape. From its establishment till its closure, it welcomed alarge group of charge and visitors. Plenty of registration documents andfiles about it were reached so far. Because of the importance ofmessenger, pilgrimage and excursion, they were worth being checkedout. It was abolished on 27 October 1862 and was transferred to thetreasury income by inventory stock sale. Haberleşme ve konaklama

  16. Engaging the underserved: a process model to mobilize rural community health coalitions as partners in translational research.

    Science.gov (United States)

    Davis, Melinda M; Aromaa, Susan; McGinnis, Paul B; Ramsey, Katrina; Rollins, Nancy; Smith, Jamie; Beamer, Beth Ann; Buckley, David I; Stange, Kurt C; Fagnan, Lyle J

    2014-08-01

    Community engagement (CE) and community-engaged research (CEnR) are increasingly recognized as critical elements in research translation. Process models to develop CEnR partnerships in rural and underserved communities are needed. Academic partners transformed four established Community Health Improvement Partnerships (CHIPs) into Community Health Improvement and Research Partnerships (CHIRPs). The intervention consisted of three elements: an academic-community kickoff/orientation meeting, delivery of eight research training modules to CHIRP members, and local community-based participatory research (CBPR) pilot studies addressing childhood obesity. We conducted a mixed methods analysis of pre-/postsurveys, interviews, session evaluations, observational field notes, and attendance logs to evaluate intervention effectiveness and acceptability. Forty-nine community members participated; most (78.7%) attended five or more research training sessions. Session quality and usefulness was high. Community members reported significant increases in their confidence for participating in all phases of research (e.g., formulating research questions, selecting research methods, writing manuscripts). All CHIRP groups successfully conducted CBPR pilot studies. The CHIRP process builds on existing infrastructure in academic and community settings to foster CEnR. Brief research training and pilot studies around community-identified health needs can enhance individual and organizational capacity to address health disparities in rural and underserved communities. © 2014 Wiley Periodicals, Inc.

  17. Sustainable Supply of Safe Drinking Water for Underserved Households in Kenya: Investigating the Viability of Decentralized Solutions

    Directory of Open Access Journals (Sweden)

    Pauline Chepchirchir Cherunya

    2015-10-01

    Full Text Available Water quality and safe water sources are pivotal aspects of consideration for domestic water. Focusing on underserved households in Kenya, this study compared user perceptions and preferences on water-service provision options, particularly investigating the viability of decentralized models, such as the Safe Water Enterprise (SWE, as sustainable safe drinking water sources. Results showed that among a number of water-service provision options available, the majority of households regularly sourced their domestic water from more than one source (86% Ngoliba/Maguguni, 98% Kangemi Gichagi. A majority of households perceived their water sources to be unsafe to drink (84% Ngoliba/Maguguni, 73% Kangemi Gichagi. For this reason, drinking water was mainly chlorinated (48% Ngoliba/Maguguni, 33% Kangemi Gichagi or boiled (42% Ngoliba/Maguguni, 67% Kangemi Gichagi. However, this study also found that households in Kenya did not apply these household water treatment methods consistently, thus indicating inconsistency in safe water consumption. The SWE concept, a community-scale decentralized safe drinking water source, was a preferred option among households who perceived it to save time and to be less cumbersome as compared to boiling and chlorination. Willingness to pay for SWE water was also a positive indicator for its preference by the underserved households. However, the long-term applicability of such decentralized water provision models needs to be further investigated within the larger water-service provision context.

  18. An Innovative Multiphased Strategy to Recruit Underserved Adults into a Randomized Trial of a Community-Based Diabetes Risk Reduction Program

    Science.gov (United States)

    Santoyo-Olsson, Jasmine; Cabrera, Julissa; Freyre, Rachel; Grossman, Melanie; Alvarez, Natalie; Mathur, Deepika; Guerrero, Maria; Delgadillo, Adriana T.; Kanaya, Alka M.; Stewart, Anita L.

    2011-01-01

    Purpose: To conduct and evaluate a two-phased community-based approach to recruit lower socioeconomic status, minority, or Spanish-speaking adults at risk of developing diabetes to a randomized trial of a lifestyle intervention program delivered by a public health department. Design: Within geographic areas comprising our target population, 4 community organizations provided local space for conducting the study and program. Phase I—outreach in venues surrounding these organizations—included diabetes education, a short diabetes risk appraisal (DRA), and diabetes risk screening based on a fasting fingerstick glucose test. Phase II—trial recruitment—began concurrently for those found to be at risk of developing diabetes in Phase I by explaining the study, lifestyle program, and research process. Those interested and eligible enrolled in the 1-year study. Results: Over 2 years, approximately 5,110 individuals received diabetes education, 1,917 completed a DRA, and 1,164 were screened of which 641 (55%) had an elevated fingerstick result of ≥106 mg/dl. Of the study sampling frame—persons over age 25 at risk of developing diabetes (N = 544)—238 (43%) enrolled in the trial; of those who were study eligible (n = 427), 56% enrolled. In the final sample, mean age was 56 years (SD = 17), 78% were ethnic minorities, 32% were Spanish-speaking, and 15% had a high school education or less. Implications: Providing diabetes health education and screening prior to study recruitment may help overcome barriers to research participation in underserved communities, thus helping address difficulties recruiting minority and older populations into research, particularly research pertaining to chronic disease risk factors. PMID:21565823

  19. Processes Governing Alkaline Groundwater Chemistry within a Fractured Rock (Ophiolitic Mélange Aquifer Underlying a Seasonally Inhabited Headwater Area in the Aladağlar Range (Adana, Turkey

    Directory of Open Access Journals (Sweden)

    Cüneyt Güler

    2017-01-01

    Full Text Available The aim of this study was to investigate natural and anthropogenic processes governing the chemical composition of alkaline groundwater within a fractured rock (ophiolitic mélange aquifer underlying a seasonally inhabited headwater area in the Aladağlar Range (Adana, Turkey. In this aquifer, spatiotemporal patterns of groundwater flow and chemistry were investigated during dry (October 2011 and wet (May 2012 seasons utilizing 25 shallow hand-dug wells. In addition, representative samples of snow, rock, and soil were collected and analyzed to constrain the PHREEQC inverse geochemical models used for simulating water-rock interaction (WRI processes. Hydrochemistry of the aquifer shows a strong interseasonal variability where Mg–HCO3 and Mg–Ca–HCO3 water types are prevalent, reflecting the influence of ophiolitic and carbonate rocks on local groundwater chemistry. R-mode factor analysis of hydrochemical data hints at geochemical processes taking place in the groundwater system, that is, WRI involving Ca- and Si-bearing phases; WRI involving amorphous oxyhydroxides and clay minerals; WRI involving Mg-bearing phases; and atmospheric/anthropogenic inputs. Results from the PHREEQC modeling suggested that hydrogeochemical evolution is governed by weathering of primary minerals (calcite, chrysotile, forsterite, and chromite, precipitation of secondary minerals (dolomite, quartz, clinochlore, and Fe/Cr oxides, atmospheric/anthropogenic inputs (halite, and seasonal dilution from recharge.

  20. The Reality of Sustaining Community-Based Sport and Physical Activity Programs to Enhance the Development of Underserved Youth: Challenges and Potential Strategies

    Science.gov (United States)

    Whitley, Meredith A.; Forneris, Tanya; Barker, Bryce

    2015-01-01

    Many community-based sport and physical activity programs take a positive youth development approach when operating in underserved communities around the world (Forneris, Whitley, & Barker, 2013). However, one of the biggest challenges for these programs is sustainability (Lindsey, 2008). The purpose of this article is to present the 3…

  1. Prevalence and determinants of caesarean section in private and public health facilities in underserved South Asian communities: Cross-sectional analysis of data from Bangladesh, India and Nepal

    NARCIS (Netherlands)

    M. Neuman (Melissa); G. Alcock (Glyn); K. Azad (Kishwar); A. Kuddus (Abdul); D. Osrin (David); N. Shah More (Neena); N. Nair (Nirmala); P. Tripathy (Prasanta); C. Sikorski (Catherine); N. Saville (Naomi); A. Sen (Aman); T. Colbourn (Tim); A.J. Houweling (Tanja); N. Seward (Nadine); A. Manandhar; B. Shrestha (Bhim); A. Costello (Anthony); A. Prost (Audrey)

    2014-01-01

    textabstractObjectives: To describe the prevalence and determinants of births by caesarean section in private and public health facilities in underserved communities in South Asia. Design: Cross-sectional study. Setting: 81 community-based geographical clusters in four locations in Bangladesh, India

  2. Preparing Historically Underserved Students for STEM Careers: The Role of an Inquiry-based High School Science Sequence Beginning with Physics

    Science.gov (United States)

    Bridges, Jon P.

    Improving the STEM readiness of students from historically underserved groups is a moral and economic imperative requiring greater attention and effort than has been shown to date. The current literature suggests a high school science sequence beginning with physics and centered on developing conceptual understanding, using inquiry labs and modeling to allow students to explore new ideas, and addressing and correcting student misconceptions can increase student interest in and preparation for STEM careers. The purpose of this study was to determine if the science college readiness of historically underserved students can be improved by implementing an inquiry-based high school science sequence comprised of coursework in physics, chemistry, and biology for every student. The study used a retrospective cohort observational design to address the primary research question: are there differences between historically underserved students completing a Physics First science sequence and their peers completing a traditional science sequence in 1) science college-readiness test scores, 2) rates of science college-and career-readiness, and 3) interest in STEM? Small positive effects were found for all three outcomes for historically underserved students in the Physics First sequence.

  3. Evaluation of the Program in Medical Education for the Urban Underserved (PRIME-US) at the UC Berkeley-UCSF Joint Medical Program (JMP): The First 4 Years.

    Science.gov (United States)

    Sokal-Gutierrez, Karen; Ivey, Susan L; Garcia, Roxanna M; Azzam, Amin

    2015-01-01

    Medical educators, clinicians, and health policy experts widely acknowledge the need to increase the diversity of our healthcare workforce and build our capacity to care for medically underserved populations and reduce health disparities. The Program in Medical Education for the Urban Underserved (PRIME-US) is part of a family of programs across the University of California (UC) medical schools aiming to recruit and train physicians to care for underserved populations, expand the healthcare workforce to serve diverse populations, and promote health equity. PRIME-US selects medical students from diverse backgrounds who are committed to caring for underserved populations and provides a 5-year curriculum including a summer orientation, a longitudinal seminar series with community engagement and leadership-development activities, preclerkship clinical immersion in an underserved setting, a master's degree, and a capstone rotation in the final year of medical school. This is a mixed-methods evaluation of the first 4 years of the PRIME-US at the UC Berkeley-UC San Francisco Joint Medical Program (JMP). From 2006 to 2010, focus groups were conducted each year with classes of JMP PRIME-US students, for a total of 11 focus groups; major themes were identified using content analysis. In addition, 4 yearly anonymous, online surveys of all JMP students, faculty and staff were conducted and analyzed. Most PRIME-US students came from socioeconomically disadvantaged backgrounds and ethnic backgrounds underrepresented in medicine, and all were committed to caring for underserved populations. The PRIME-US students experienced many program benefits including peer support, professional role models and mentorship, and curricular enrichment activities that developed their knowledge, skills, and sustained commitment to care for underserved populations. Non-PRIME students, faculty, and staff also benefited from participating in PRIME-sponsored seminars and community-based activities

  4. A Practical Risk Stratification Approach for Implementing a Primary Care Chronic Disease Management Program in an Underserved Community.

    Science.gov (United States)

    Xu, Junjun; Williams-Livingston, Arletha; Gaglioti, Anne; McAllister, Calvin; Rust, George

    2018-01-01

    The use of value metrics is often dependent on payer-initiated health care management incentives. There is a need for practices to define and manage their own patient panels regardless of payer to participate effectively in population health management. A key step is to define a panel of primary care patients with high comorbidity profiles. Our sample included all patients seen in an urban academic family medicine clinic over a two-year period. The simplified risk stratification was built using internal electronic health record and billing system data based on ICD-9 codes. There were 347 patients classified as high-risk out of the 5,364 patient panel. Average age was 59 years (SD 15). Hypertension (90%), hyperlipidemia (62%), and depression (55%) were the most common conditions among high-risk patients. Simplified risk stratification provides a feasible option for our team to understand and respond to the nuances of population health in our underserved community.

  5. The ASSURE Summer REU Program: Introducing research to first-generation and underserved undergraduates through space sciences and engineering projects

    Science.gov (United States)

    Barron, Darcy; Peticolas, Laura; Multiverse Team at UC Berkeley's Space Sciences Lab

    2018-01-01

    The Advancing Space Science through Undergraduate Research Experience (ASSURE) summer REU program is an NSF-funded REU site at the Space Sciences Lab at UC Berkeley that first started in summer 2014. The program recruits students from all STEM majors, targeting underserved students including community college students and first-generation college students. The students have little or no research experience and a wide variety of academic backgrounds, but have a shared passion for space sciences and astronomy. We will describe our program's structure and the components we have found successful in preparing and supporting both the students and their research advisors for their summer research projects. This includes an intensive first week of introductory lectures and tutorials at the start of the program, preparing students for working in an academic research environment. The program also employs a multi-tiered mentoring system, with layers of support for the undergraduate student cohort, as well as graduate student and postdoctoral research advisors.

  6. Do spiritual patients want spiritual interventions?: A qualitative exploration of underserved cancer patients' perspectives on religion and spirituality.

    Science.gov (United States)

    Stein, Emma M; Kolidas, Evelyn; Moadel, Alyson

    2015-02-01

    This study examines religion and spirituality among advanced cancer patients from an underserved, ethnically-diverse population by exploring patient conceptualizations of religion and spirituality, the role of religion and spirituality in coping with cancer, and patient interest in spiritual support. Qualitative semi-structured interviews were conducted with patients who had participated in a study of a "mind-body" support group for patients with all cancer types. Analysis based on grounded theory was utilized to identify themes and theoretical constructs. With regard to patient conceptualizations of religion and spirituality, three categories emerged: (1) Spirituality is intertwined with organized religion; (2) Religion is one manifestation of the broader construct of spirituality; (3) Religion and spirituality are completely independent, with spirituality being desirable and religion not. Religion and spirituality played a central role in patients' coping with cancer, providing comfort, hope, and meaning. Patients diverged when it came to spiritual support, with some enthusiastic about interventions incorporating their spiritual values and others stating that they already get this support through religious communities. Spirituality plays a central role in the cancer experience of this underserved ethnically-diverse population. While spirituality seems to be a universal concern in advanced cancer patients, the meaning of spirituality differs across individuals, with some equating it with organized religion and others taking a more individualized approach. It is important that psychosocial interventions are developed to address this concern. Future research is needed to further explore the different ways that patients conceptualize spirituality and to develop spiritually-based treatments that are not "one size fits all."

  7. Bringing cutting-edge Earth and ocean sciences to under-served and rural audiences through informal science education

    Science.gov (United States)

    Cooper, S. K.; Petronotis, K. E.; Ferraro, C.; Johnson, K. T. M.; Yarincik, K.

    2017-12-01

    The International Ocean Discovery Program (IODP) is an international marine research collaboration that explores Earth's history and dynamics using ocean-going research platforms to recover data recorded in seafloor sediments and rocks and to monitor subseafloor environments. The JOIDES Resolution is the flagship vessel of IODP and is operated by the National Science Foundation. It is an inspirational hook for STEM Earth and ocean topics for children and the general public of all ages, but is not easily accessible due to its international travels and infrequent U.S. port calls. In response, a consortium of partners has created the Pop-Up/Drill Down Science project. The multi-year project, funded by NSF's Advancing Informal Science Learning program, aims to bring the JR and its science to under-served and rural populations throughout the country. Consisting of an inflatable walk-through ship, a multi-media experience, a giant interactive seafloor map and a series of interactive exhibit kiosks, the exhibit, entitled, In Search of Earth's Secrets: A Pop-Up Science Encounter, will travel to 12 communities throughout the next four years. In each community, the project will partner with local institutions like public libraries and small museums as hosts and to train local Girl Scouts to serve as exhibit facilitators. By working with local communities to select events and venues for pop-up events, the project hopes to bring cutting edge Earth and ocean science in creative new ways to underserved populations and inspire diverse audiences to explore further. This presentation will provide details of the project's goals, objectives and development and provide avenues to become involved.

  8. Gender-specific differences of interaction between obesity and air pollution on stroke and cardiovascular diseases in Chinese adults from a high pollution range area: A large population based cross sectional study

    Energy Technology Data Exchange (ETDEWEB)

    Qin, Xiao-Di [Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Environmental and Occupational Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080 (China); Qian, Zhengmin [Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104 (United States); Vaughn, Michael G. [School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104 (United States); Trevathan, Edwin [Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104 (United States); Emo, Brett [Department of Environmental and Occupational Health, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104 (United States); Paul, Gunther [Facuty of Health, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059 (Australia); Ren, Wan-Hui [Department of Ambient Air Pollution Monitor, Shenyang Environmental Monitoring Center, Shenyang 110004 (China); Hao, Yuan-Tao [Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080 (China); Dong, Guang-Hui, E-mail: donggh5@mail.sysu.edu.cn [Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Environmental and Occupational Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080 (China)

    2015-10-01

    Background: Little information exists regarding the interaction effects of obesity with long-term air pollution exposure on cardiovascular diseases (CVDs) and stroke in areas of high pollution. The aim of the present study is to examine whether obesity modifies CVD-related associations among people living in an industrial province of northeast China. Methods: We studied 24,845 Chinese adults, aged 18 to 74 years old, from three Northeastern Chinese cities in 2009 utilizing a cross-sectional study design. Body weight and height were measured by trained observers. Overweight and obesity were defined as a body mass index (BMI) between 25–29.9 and ≥ 30 kg/m{sup 2}, respectively. Prevalence rate and related risk factors of cardiovascular and cerebrovascular diseases were investigated by a questionnaire. Three-year (2006–2008) average concentrations of particulate matter (PM{sub 10}), sulfur dioxide (SO{sub 2}), nitrogen dioxides (NO{sub 2}), and ozone (O{sub 3}) were measured by fixed monitoring stations. All the participants lived within 1 km of air monitoring sites. Two-level logistic regression (personal level and district-specific pollutant level) was used to examine these effects, controlling for covariates. Results: We observed significant interactions between exposure and obesity on CVDs and stroke. The associations between annual pollutant concentrations and CVDs and stroke were strongest in obese subjects (OR 1.15–1.47 for stroke, 1.33–1.59 for CVDs), less strong in overweight subjects (OR 1.22–1.35 for stroke, 1.07–1.13 for CVDs), and weakest in normal weight subjects (OR ranged from 0.98–1.01 for stroke, 0.93–1.15 for CVDs). When stratified by gender, these interactions were significant only in women. Conclusions: Study findings indicate that being overweight and obese may enhance the effects of air pollution on the prevalence of CVDs and stroke in Northeastern metropolitan China. Further studies will be needed to investigate the temporality

  9. Gender-specific differences of interaction between obesity and air pollution on stroke and cardiovascular diseases in Chinese adults from a high pollution range area: A large population based cross sectional study

    International Nuclear Information System (INIS)

    Qin, Xiao-Di; Qian, Zhengmin; Vaughn, Michael G.; Trevathan, Edwin; Emo, Brett; Paul, Gunther; Ren, Wan-Hui; Hao, Yuan-Tao; Dong, Guang-Hui

    2015-01-01

    Background: Little information exists regarding the interaction effects of obesity with long-term air pollution exposure on cardiovascular diseases (CVDs) and stroke in areas of high pollution. The aim of the present study is to examine whether obesity modifies CVD-related associations among people living in an industrial province of northeast China. Methods: We studied 24,845 Chinese adults, aged 18 to 74 years old, from three Northeastern Chinese cities in 2009 utilizing a cross-sectional study design. Body weight and height were measured by trained observers. Overweight and obesity were defined as a body mass index (BMI) between 25–29.9 and ≥ 30 kg/m 2 , respectively. Prevalence rate and related risk factors of cardiovascular and cerebrovascular diseases were investigated by a questionnaire. Three-year (2006–2008) average concentrations of particulate matter (PM 10 ), sulfur dioxide (SO 2 ), nitrogen dioxides (NO 2 ), and ozone (O 3 ) were measured by fixed monitoring stations. All the participants lived within 1 km of air monitoring sites. Two-level logistic regression (personal level and district-specific pollutant level) was used to examine these effects, controlling for covariates. Results: We observed significant interactions between exposure and obesity on CVDs and stroke. The associations between annual pollutant concentrations and CVDs and stroke were strongest in obese subjects (OR 1.15–1.47 for stroke, 1.33–1.59 for CVDs), less strong in overweight subjects (OR 1.22–1.35 for stroke, 1.07–1.13 for CVDs), and weakest in normal weight subjects (OR ranged from 0.98–1.01 for stroke, 0.93–1.15 for CVDs). When stratified by gender, these interactions were significant only in women. Conclusions: Study findings indicate that being overweight and obese may enhance the effects of air pollution on the prevalence of CVDs and stroke in Northeastern metropolitan China. Further studies will be needed to investigate the temporality of BMI relative to

  10. Influence of intense secondary aerosol formation and long-range transport on aerosol chemistry and properties in the Seoul Metropolitan Area during spring time: results from KORUS-AQ

    Science.gov (United States)

    Kim, Hwajin; Zhang, Qi; Heo, Jongbae

    2018-05-01

    Non-refractory submicrometer particulate matter (NR-PM1) was measured in the Seoul Metropolitan Area (SMA), Korea, using an Aerodyne high-resolution time-of-flight aerosol mass spectrometer (HR-ToF-AMS) from 14 April to 15 June 2016, as a part of the Korea-US Air Quality Study (KORUS-AQ) campaign. This was the first highly time-resolved, real-time measurement study of springtime aerosol in SMA and the results reveal valuable insights into the sources and atmospheric processes that contribute to PM pollution in this region. The average concentration of submicrometer aerosol (PM1 = NR-PM1 + black carbon (BC)) was 22.1 µg m-3, which was composed of 44 % organics, 20 % sulfate, 17 % nitrate, 12 % ammonium, and 7 % BC. Organics had an average atomic oxygen-to-carbon (O / C) ratio of 0.49 and an average organic mass-to-carbon (OM/OC) ratio of 1.82. Four distinct sources of OA were identified via positive matrix factorization (PMF) analysis of the HR-ToF-AMS data: vehicle emissions represented by a hydrocarbon-like OA factor (HOA; O / C = 0.15; 17 % of OA mass), food cooking activities represented by a cooking-influenced OA factor (COA; O / C = 0.19; 22 % of OA mass), and secondary organic aerosol (SOA) represented by a semi-volatile oxygenated OA factor (SV-OOA; O / C = 0.44; 27 % of OA mass) and a low-volatility oxygenated OA factor (LV-OOA; O / C = 0.91; 34 % of OA mass). Our results indicate that air quality in SMA during KORUS-AQ was influenced strongly by secondary aerosol formation, with sulfate, nitrate, ammonium, SV-OOA, and LV-OOA together accounting for 76 % of the PM1 mass. In particular, the formation of LV-OOA and sulfate was mainly promoted by elevated ozone concentrations and photochemical reactions during daytime, whereas SV-OOA and nitrate formation was contributed by both nocturnal processing of VOC and nitrogen oxides, respectively, and daytime photochemical reactions. In addition, lower nighttime temperature promoted gas-to-particle partitioning of

  11. Attending to Communication and Patterns of Interaction: Culturally Sensitive Mental Health Care for Groups of Urban, Ethnically Diverse, Impoverished, and Underserved Women.

    Science.gov (United States)

    Molewyk Doornbos, Mary; Zandee, Gail Landheer; DeGroot, Joleen

    2014-07-01

    The United States is ethnically diverse. This diversity presents challenges to nurses, who, without empirical evidence to design culturally congruent interventions, may contribute to mental health care disparities. Using Leininger's theory of culture care diversity and universality, this study documented communication and interaction patterns of ethnically diverse, urban, impoverished, and underserved women. Using a community-based participatory research framework, 61 Black, Hispanic, and White women participated in focus groups around their experiences with anxiety/depression. Researchers recorded verbal communication, nonverbal behavior, and patterns of interaction. The women's communication and interaction patterns gave evidence of three themes that were evident across all focus groups and five subthemes that emerged along ethnic lines. The results suggest cultural universalities and cultural uniquenesses relative to the communication and interaction patterns of urban, ethnically diverse, impoverished, and underserved women that may assist in the design of culturally sensitive mental health care. © The Author(s) 2014.

  12. The role of motivation in understanding social contextual influences on physical activity in underserved adolescents in the ACT Trial: a cross-sectional study.

    Science.gov (United States)

    Lawman, Hannah G; Wilson, Dawn K; Van Horn, M Lee; Zarrett, Nicole

    2012-12-01

    Previous research has shown that social contextual factors are important in understanding physical activity (PA) behavior, although little is known about how these factors may relate to PA, especially in underserved adolescents (low income, minorities). This study examined how motivation may differentially mediate the relationship of two social contextual variables (i.e., peer and parent social support) and moderate-to-vigorous PA (MVPA). Baseline data (n = 1421 sixth graders, 54% female, 72% African American) from the Active by Choice Today (ACT) trial in underserved adolescents were analyzed. Motivation was examined as a mediator of the relationships between peer social support, parent social support, and MVPA (measured by 7-day accelerometer estimates). Motivation and peer but not parent support were significantly related to MVPA overall. Significant mediation effects were found indicating motivation partially mediated the relation between peer social support and MVPA and to a lesser degree parent support and MVPA. These findings provide support for the importance of social contextual influences, especially peer social support, on underserved adolescents' PA and motivation for PA.

  13. Camp NERF: methods of a theory-based nutrition education recreation and fitness program aimed at preventing unhealthy weight gain in underserved elementary children during summer months.

    Science.gov (United States)

    Hopkins, Laura C; Fristad, Mary; Goodway, Jacqueline D; Eneli, Ihuoma; Holloman, Chris; Kennel, Julie A; Melnyk, Bernadette; Gunther, Carolyn

    2016-10-26

    The number of obese children in the US remains high, which is problematic due to the mental, physical, and academic effects of obesity on child health. Data indicate that school-age children, particularly underserved children, experience unhealthy gains in BMI at a rate nearly twice as fast during the summer months. Few efforts have been directed at implementing evidence-based programming to prevent excess weight gain during the summer recess. Camp NERF is an 8-week, multi-component (nutrition, physical activity, and mental health), theory-based program for underserved school-age children in grades Kindergarten - 5th coupled with the USDA Summer Food Service Program. Twelve eligible elementary school sites will be randomized to one of the three programming groups: 1) Active Control (non-nutrition, physical activity, or mental health); 2) Standard Care (nutrition and physical activity); or 3) Enhanced Care (nutrition, physical activity, and mental health) programming. Anthropometric, behavioral, and psychosocial data will be collected from child-caregiver dyads pre- and post-intervention. Site-specific characteristics and process evaluation measures will also be collected. This is the first, evidence-based intervention to address the issue of weight gain during the summer months among underserved, school-aged children. Results from this study will provide researchers, practitioners, and public health professionals with insight on evidence-based programming to aid in childhood obesity prevention during this particular window of risk. NCT02908230/09-19-2016.

  14. A mixed-methods examination of communication between oncologists and primary care providers among primary care physicians in underserved communities.

    Science.gov (United States)

    Shen, Megan Johnson; Binz-Scharf, Maria; D'Agostino, Tom; Blakeney, Natasha; Weiss, Elisa; Michaels, Margo; Patel, Shilpa; McKee, M Diane; Bylund, Carma L

    2015-03-15

    Research has demonstrated that communication and care coordination improve cancer patient outcomes. To improve communication and care coordination, it is important to understand primary care providers' (PCPs') perceptions of communication with oncologists as well as PCPs' communication needs. A mixed-methods approach was used in the present study. In the qualitative phase of the study, 18 PCPs practicing in underserved, minority communities were interviewed about their experiences communicating with oncologists. In the quantitative phase of the study, 128 PCPs completed an online survey about their preferences, experiences, and satisfaction with communication with oncologists. Results indicated a PCP-oncologist gap in communication occurred between diagnosis and treatment. PCPs wanted more communication with oncologists, updates on their patients' prognosis throughout treatment, and to be contacted via telephone or email and saw their role as crucial in providing supportive care for their patients. Although PCPs recognize that they play a critical, proactive role in supporting patients throughout the continuum of their cancer care experience, existing norms regarding postreferral engagement and oncologist-PCP communication often hinder activation of this role among PCPs. Expected standards regarding the method, frequency, and quality of postreferral communication should be jointly articulated and made accountable between PCPs and oncologists to help improve cancer patients' quality of care, particularly in minority communities. © 2014 American Cancer Society.

  15. The association between women's self-rated health and satisfaction with environmental services in an underserved community in Lebanon.

    Science.gov (United States)

    Habib, Rima R; Elzein, Kareem; Hojeij, Safa

    2013-01-01

    This research evaluated the association between women's self-rated health and a number of socioeconomic and environmental health indicators relating to drinking water services in an underserved Lebanese community. A population-based, cross-sectional survey using interviews was adopted to obtain information from female homemakers of 2,223 households in the town of Bebnine, Lebanon. The questionnaire included indicators on self-rated health, satisfaction with water quality, source of drinking water, occurrence of diarrhea, and socioeconomic variables, such as education, occupation, and perceived economic status. Self-rated health was categorized as poor, fair, and good. Odds ratios for poor and fair compared to good self-rated health values were calculated using multinomial logistic regression. A total of 712 women (32%) reported poor self-rated health. Women who perceived their household income to be worse than others in town were four times as likely to report poor health. Compared to women who were satisfied with drinking water quality, dissatisfied women were 42% more likely to report poor health. Women living in households reporting recent episodes of diarrheal illness had poorer health ratings than those without. The findings suggest a positive relationship between individual perceptions of water quality and self-rated health. Community concerns over their surrounding environment serve as a primary guide for infrastructural development and government policy.

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

    Science.gov (United States)

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

    2012-03-01

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

  17. Pediatric Obesity Empowerment Model Group Medical Visits (POEM-GMV) as Treatment for Pediatric Obesity in an Underserved Community.

    Science.gov (United States)

    Geller, Jeffrey S; Dube, Eileen T; Cruz, Glavielinys A; Stevens, Jason; Keating Bench, Kara

    2015-10-01

    This is a retrospective cohort study to evaluate a novel group medical visit (GMV) program using an empowerment curriculum as treatment for pediatric obesity in a federally qualified community health center. Biometric and self-reported data were reviewed from 417 overweight or obese children ages 5-18 attending the pediatric obesity empowerment model GMV program (POEM-GMV) at least twice during a 3-year period. Variables were evaluated using paired means t-test. Pearson's correlation test was used to evaluate variables and the BMI z-score. Subanalysis by gender was performed. The average participant was 10.48 ± 2.53 years old and participated for 301 ± 287 days. BMI z-score reduced from 2.99 ± 0.96 to 2.88 ± 0.88 (p pediatric obesity in an underserved community. There were statistically significantly improved outcomes in obesity, especially for boys. Significant improvement was observed in many lifestyle factors associated with obesity. Weight loss most closely correlated with reduced stress levels and sugary beverage consumption. Additional studies are needed to further evaluate the efficacy of POEM-GMV.

  18. Dental care for the underserved children of Monterey County: meeting the challenge.

    Science.gov (United States)

    Stewart, R E

    1998-05-01

    With its expansive area, and the special needs of agricultural workers, Monterey County held significant challenges for setting up a children's health clinic. Part of the solution to addressing the county's unmet dental needs was the establishment of the Children's Miracle Network dental center in 1995. But working in the fields leaves little time for travel to appointments, so the dental center expanded to a mobile unit that can go where the need is. Understanding the special needs of one's community is crucial to establishing programs that can successfully address the state's needs for children's dental care.

  19. Behavioral Economics: “Nudging” Underserved Populations to Be Screened for Cancer

    Science.gov (United States)

    Thompson, Tess; Kreuter, Matthew W.; McBride, Timothy D.

    2015-01-01

    Persistent disparities in cancer screening by race/ethnicity and socioeconomic status require innovative prevention tools and techniques. Behavioral economics provides tools to potentially reduce disparities by informing strategies and systems to increase prevention of breast, cervical, and colorectal cancers. With an emphasis on the predictable, but sometimes flawed, mental shortcuts (heuristics) people use to make decisions, behavioral economics offers insights that practitioners can use to enhance evidence-based cancer screening interventions that rely on judgments about the probability of developing and detecting cancer, decisions about competing screening options, and the optimal presentation of complex choices (choice architecture). In the area of judgment, we describe ways practitioners can use the availability and representativeness of heuristics and the tendency toward unrealistic optimism to increase perceptions of risk and highlight benefits of screening. We describe how several behavioral economic principles involved in decision-making can influence screening attitudes, including how framing and context effects can be manipulated to highlight personally salient features of cancer screening tests. Finally, we offer suggestions about ways practitioners can apply principles related to choice architecture to health care systems in which cancer screening takes place. These recommendations include the use of incentives to increase screening, introduction of default options, appropriate feedback throughout the decision-making and behavior completion process, and clear presentation of complex choices, particularly in the context of colorectal cancer screening. We conclude by noting gaps in knowledge and propose future research questions to guide this promising area of research and practice. PMID:25590600

  20. Effects of long-range transported pollutants on vegetation in boreal coniferous forests: Results from an five year investigation in the Solholmfjell area, Gjerstad, Aust-Agder; Effekter av langtransporterte luftforurensninger i boreal barskog: resultater av fem aars undersoekelser i Solhomfjell-omraadet, Gjerstad, Aust-Agder

    Energy Technology Data Exchange (ETDEWEB)

    Oekland, R H

    1996-01-01

    The conference paper relates to a project on investigating the effects of long-range transported pollutants in Norway. The paper gives a brief description of the more important results obtained in the project. The aim of the project was to investigate the pollution load in vegetation, soils and trees in Norwegian forest areas of the coniferous type. The project included the collection of samples from 200 test areas in a period of five years. 11 refs.

  1. Tonopah Test Range - Index

    Science.gov (United States)

    Capabilities Test Operations Center Test Director Range Control Track Control Communications Tracking Radars Photos Header Facebook Twitter YouTube Flickr RSS Tonopah Test Range Top TTR_TOC Tonopah is the testing range of choice for all national security missions. Tonopah Test Range (TTR) provides research and

  2. Ranging Behaviour of Commercial Free-Range Laying Hens.

    Science.gov (United States)

    Chielo, Leonard Ikenna; Pike, Tom; Cooper, Jonathan

    2016-04-26

    In this study, the range use and behaviour of laying hens in commercial free-range flocks was explored. Six flocks were each visited on four separate days and data collected from their outdoor area (divided into zones based on distance from shed and available resources). These were: apron (0-10 m from shed normally without cover or other enrichments); enriched belt (10-50 m from shed where resources such as manmade cover, saplings and dust baths were provided); and outer range (beyond 50 m from shed with no cover and mainly grass pasture). Data collection consisted of counting the number of hens in each zone and recording behaviour, feather condition and nearest neighbour distance (NND) of 20 birds per zone on each visit day. In addition, we used techniques derived from ecological surveys to establish four transects perpendicular to the shed, running through the apron, enriched belt and outer range. Number of hens in each 10 m × 10 m quadrat was recorded four times per day as was the temperature and relative humidity of the outer range. On average, 12.5% of hens were found outside. Of these, 5.4% were found in the apron; 4.3% in the enriched zone; and 2.8% were in the outer range. This pattern was supported by data from quadrats, where the density of hens sharply dropped with increasing distance from shed. Consequently, NND was greatest in the outer range, least in the apron and intermediate in the enriched belt. Hens sampled in outer range and enriched belts had better feather condition than those from the apron. Standing, ground pecking, walking and foraging were the most commonly recorded activities with standing and pecking most likely to occur in the apron, and walking and foraging more common in the outer range. Use of the outer range declined with lower temperatures and increasing relative humidity, though use of apron and enriched belt was not affected by variation in these measures. These data support previous findings that outer range areas tend to be

  3. Ranging Behaviour of Commercial Free-Range Laying Hens

    Directory of Open Access Journals (Sweden)

    Leonard Ikenna Chielo

    2016-04-01

    Full Text Available In this study, the range use and behaviour of laying hens in commercial free-range flocks was explored. Six flocks were each visited on four separate days and data collected from their outdoor area (divided into zones based on distance from shed and available resources. These were: apron (0–10 m from shed normally without cover or other enrichments; enriched belt (10–50 m from shed where resources such as manmade cover, saplings and dust baths were provided; and outer range (beyond 50 m from shed with no cover and mainly grass pasture. Data collection consisted of counting the number of hens in each zone and recording behaviour, feather condition and nearest neighbour distance (NND of 20 birds per zone on each visit day. In addition, we used techniques derived from ecological surveys to establish four transects perpendicular to the shed, running through the apron, enriched belt and outer range. Number of hens in each 10 m × 10 m quadrat was recorded four times per day as was the temperature and relative humidity of the outer range. On average, 12.5% of hens were found outside. Of these, 5.4% were found in the apron; 4.3% in the enriched zone; and 2.8% were in the outer range. This pattern was supported by data from quadrats, where the density of hens sharply dropped with increasing distance from shed. Consequently, NND was greatest in the outer range, least in the apron and intermediate in the enriched belt. Hens sampled in outer range and enriched belts had better feather condition than those from the apron. Standing, ground pecking, walking and foraging were the most commonly recorded activities with standing and pecking most likely to occur in the apron, and walking and foraging more common in the outer range. Use of the outer range declined with lower temperatures and increasing relative humidity, though use of apron and enriched belt was not affected by variation in these measures. These data support previous findings that outer range

  4. Foraging optimally for home ranges

    Science.gov (United States)

    Mitchell, Michael S.; Powell, Roger A.

    2012-01-01

    Economic models predict behavior of animals based on the presumption that natural selection has shaped behaviors important to an animal's fitness to maximize benefits over costs. Economic analyses have shown that territories of animals are structured by trade-offs between benefits gained from resources and costs of defending them. Intuitively, home ranges should be similarly structured, but trade-offs are difficult to assess because there are no costs of defense, thus economic models of home-range behavior are rare. We present economic models that predict how home ranges can be efficient with respect to spatially distributed resources, discounted for travel costs, under 2 strategies of optimization, resource maximization and area minimization. We show how constraints such as competitors can influence structure of homes ranges through resource depression, ultimately structuring density of animals within a population and their distribution on a landscape. We present simulations based on these models to show how they can be generally predictive of home-range behavior and the mechanisms that structure the spatial distribution of animals. We also show how contiguous home ranges estimated statistically from location data can be misleading for animals that optimize home ranges on landscapes with patchily distributed resources. We conclude with a summary of how we applied our models to nonterritorial black bears (Ursus americanus) living in the mountains of North Carolina, where we found their home ranges were best predicted by an area-minimization strategy constrained by intraspecific competition within a social hierarchy. Economic models can provide strong inference about home-range behavior and the resources that structure home ranges by offering falsifiable, a priori hypotheses that can be tested with field observations.

  5. Exclusionary policies in urban development: Under-servicing migrant households in Brazilian cities.

    Science.gov (United States)

    Feler, Leo; Henderson, J Vernon

    2011-05-01

    Localities in developed countries often enact regulations to deter low-income households from moving in. In developing countries, such restrictions lead to the emergence of informal housing sectors. To deter low-income migrants, localities in developing countries withhold public services to the informal housing sector. Using a large sample of Brazilian localities, we examine migration and exclusion, focusing on the public provision of water to small houses where low-income migrants are likely to live. Withholding water connections reduces the locality growth rate, particularly of low-education households. In terms of service provision, during dictatorship in Brazil, we find evidence of strategic exclusion, where localities appear to withhold services to deter in-migration. We also find evidence of strategic interactions among localities within metro areas in their setting of service levels: if one locality provides more services to migrant households, other localities respond by withholding service.

  6. Exclusionary policies in urban development: Under-servicing migrant households in Brazilian cities

    Science.gov (United States)

    Feler, Leo; Henderson, J. Vernon

    2012-01-01

    Localities in developed countries often enact regulations to deter low-income households from moving in. In developing countries, such restrictions lead to the emergence of informal housing sectors. To deter low-income migrants, localities in developing countries withhold public services to the informal housing sector. Using a large sample of Brazilian localities, we examine migration and exclusion, focusing on the public provision of water to small houses where low-income migrants are likely to live. Withholding water connections reduces the locality growth rate, particularly of low-education households. In terms of service provision, during dictatorship in Brazil, we find evidence of strategic exclusion, where localities appear to withhold services to deter in-migration. We also find evidence of strategic interactions among localities within metro areas in their setting of service levels: if one locality provides more services to migrant households, other localities respond by withholding service. PMID:22707807

  7. Collaboration Among Institutions to Bring Geospatial Technology to an Underserved Rural Region

    Science.gov (United States)

    Johnson, T.

    2012-12-01

    The University of Maine at Machias and Washington County Community College, the two smallest and most remote public institutions in Maine, provide important education and workforce development services in a rural and economically-challenged region. Through an innovative collaboration supported by the National Science Foundation, the two institutions have developed geospatial technology (GST) programs designed to meet the specific workforce needs of the region, affording students with the opportunity to pursue degrees, certificates and minors. Prior to this effort, neither school had the resources to maintain a GST laboratory or to offer courses consistently. The region had almost no GST capacity with which to manage critical environmental resources and grapple with economic, public safety, and public health challenges. Several statewide studies had shown a growing need for more GST technicians and training for incumbent workers. The new programs are designed to produce a small number of specialist technicians with associate's degrees and a large number of ancillary users with significant GST expertise from courses, certificates or minors. Course content is shaped by workforce research in Maine and elsewhere, and all courses are offered in either blended, online or short-term intensive formats to provide access to incumbent workers and extend the geographic reach of the programs. Through the university's Geographic Information Systems (GIS) Service Center, students from both institutions engage in real-world projects, and are linked with employers via internships. This has the added plus of providing low-cost and no-cost GIS services to area clients, generating demand. Many of these projects and internships lead to work for graduates, even through the economic downturn. By creating courses that serve multiple audiences, each contributing a small number to the total enrollment, the programs constitute a sustainable model that serves the growing needs of the region

  8. The Breast and Cervical Cancer Early Detection Program, Medicaid, and breast cancer outcomes among Ohio's underserved women.

    Science.gov (United States)

    Koroukian, Siran M; Bakaki, Paul M; Htoo, Phyo Than; Han, Xiaozhen; Schluchter, Mark; Owusu, Cynthia; Cooper, Gregory S; Rose, Johnie; Flocke, Susan A

    2017-08-15

    As an organized screening program, the national Breast and Cervical Cancer Early Detection Program (BCCEDP) was launched in the early 1990s to improve breast cancer outcomes among underserved women. To analyze the impact of the BCCEDP on breast cancer outcomes in Ohio, this study compared cancer stages and mortality across BCCEDP participants, Medicaid beneficiaries, and "all others." This study linked data across the Ohio Cancer Incidence Surveillance System, Medicaid, the BCCEDP database, death certificates, and the US Census and identified 26,426 women aged 40 to 64 years who had been diagnosed with incident invasive breast cancer during the years 2002-2008 (deaths through 2010). The study groups were as follows: BCCEDP participants (1-time or repeat users), Medicaid beneficiaries (women enrolled in Medicaid before their cancer diagnosis [Medicaid/prediagnosis] or around the time of their cancer diagnosis [Medicaid/peridiagnosis]), and all others (women identified as neither BCCEDP participants nor Medicaid beneficiaries). The outcomes included advanced-stage cancer at diagnosis and mortality. A multivariable logistic and survival analysis was conducted to examine the independent association between the BCCEDP and Medicaid status and the outcomes. The percentage of women presenting with advanced-stage disease was highest among women in the Medicaid/peridiagnosis group (63.4%) and lowest among BCCEDP repeat users (38.6%). With adjustments for potential confounders and even in comparison with Medicaid/prediagnosis beneficiaries, those in the Medicaid/peridiagnosis group were twice as likely to be diagnosed with advanced-stage disease (adjusted odds ratio, 2.20; 95% confidence interval, 1.83-2.66). Medicaid/peridiagnosis women are at particularly high risk to be diagnosed with advanced-stage disease. Efforts to reduce breast cancer disparities must target this group of women before they present to Medicaid. Cancer 2017;123:3097-106. © 2017 American Cancer Society

  9. Validation of English and Spanish-language versions of a screening questionnaire for rheumatoid arthritis in an underserved community.

    Science.gov (United States)

    Potter, Jeffrey; Odutola, Jennifer; Gonzales, Christian Amurrio; Ward, Michael M

    2008-08-01

    Questionnaires to screen for rheumatoid arthritis (RA) have been tested in groups that were primarily well educated and Caucasian. We sought to validate the RA questions of the Connective Tissue Disease Screening Questionnaire (CSQ) in ethnic minorities in an underserved community, and to test a Spanish-language version. The Spanish-language version was developed by 2 native speakers. Consecutive English-speaking or Spanish-speaking patients in a community-based rheumatology practice completed the questionnaire. Diagnoses were confirmed by medical record review. Sensitivity and specificity of the questionnaire for a diagnosis of RA were computed for each language version, using 2 groups as controls: patients with noninflammatory conditions, and participants recruited from the community. The English-language version was tested in 53 patients with RA (79% ethnic minorities; mean education level 11.3 yrs), 85 rheumatology controls with noninflammatory conditions, and 82 community controls. Using 3 positive responses as indicating a positive screening test, the sensitivity of the questionnaire was 0.77, the specificity based on rheumatology controls was 0.45, and the specificity based on community controls was 0.94. The Spanish-language version was tested in 55 patients with RA (mean education level 7.8 yrs), 149 rheumatology controls, and 88 community controls. The sensitivity of the Spanish-language version was 0.87, with specificities of 0.60 and 0.97 using the rheumatology controls and community controls, respectively. The sensitivity of the English-language version of the RA questions of the CSQ was lower in this study than in other cohorts, reflecting differences in the performance of the questions in different ethnic or socioeconomic groups. The Spanish-language version demonstrated good sensitivity, and both had excellent specificity when tested in community controls.

  10. Integrating community-based participatory research and informatics approaches to improve the engagement and health of underserved populations.

    Science.gov (United States)

    Unertl, Kim M; Schaefbauer, Chris L; Campbell, Terrance R; Senteio, Charles; Siek, Katie A; Bakken, Suzanne; Veinot, Tiffany C

    2016-01-01

    We compare 5 health informatics research projects that applied community-based participatory research (CBPR) approaches with the goal of extending existing CBPR principles to address issues specific to health informatics research. We conducted a cross-case analysis of 5 diverse case studies with 1 common element: integration of CBPR approaches into health informatics research. After reviewing publications and other case-related materials, all coauthors engaged in collaborative discussions focused on CBPR. Researchers mapped each case to an existing CBPR framework, examined each case individually for success factors and barriers, and identified common patterns across cases. Benefits of applying CBPR approaches to health informatics research across the cases included the following: developing more relevant research with wider impact, greater engagement with diverse populations, improved internal validity, more rapid translation of research into action, and the development of people. Challenges of applying CBPR to health informatics research included requirements to develop strong, sustainable academic-community partnerships and mismatches related to cultural and temporal factors. Several technology-related challenges, including needs to define ownership of technology outputs and to build technical capacity with community partners, also emerged from our analysis. Finally, we created several principles that extended an existing CBPR framework to specifically address health informatics research requirements. Our cross-case analysis yielded valuable insights regarding CBPR implementation in health informatics research and identified valuable lessons useful for future CBPR-based research. The benefits of applying CBPR approaches can be significant, particularly in engaging populations that are typically underserved by health care and in designing patient-facing technology. © The Authors 2015. Published by Oxford University Press on behalf of the American Medical

  11. Telehealth for diabetes self-management education and support in an underserved, free clinic population: A pilot study.

    Science.gov (United States)

    Threatt, Tiffaney B; Ward, Eileen D

    Primary study objectives were to (1) describe mean change in A1c from baseline of a free clinic population enrolled in telehealth diabetes self-management education and support (DSME/S) services and (2) to compare change in A1C and other clinical outcomes measures with free clinic patients enrolled in a traditional face-to-face DSME/S program. An exploratory study design and comparative evaluation of telehealth DSME/S services in a free clinic population was used. Baseline clinical measures were collected upon referral. Diabetes educators met with patients individually over 2-3 months. Clinical outcomes measures were collected within 6 months of program completion. Data from the telehealth group was assessed individually and compared to a free clinic traditional DSME/S program population. Twelve patients completed a telehealth free clinic DSME/S pilot program with a mean ± SD change in A1C from baseline of -1.03 ± 1.53% (P = 0.050). Mean ± SD change in A1C from baseline in the free clinic population participating in traditional face-to-face DSME/S services was -1.42 ± 1.80% (P = 0.001). No significant differences in secondary outcomes measures, including body mass index and blood pressure, were revealed among the study populations. Expanding access to care in populations faced with challenges of socioeconomics, limited education, and lower health literacy is a step toward reducing health disparities and positively affecting care. Mean A1C can be improved with telehealth DSME/S services in an underserved, free clinic population. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  12. Effects of racial and ethnic group and health literacy on responses to genomic risk information in a medically underserved population.

    Science.gov (United States)

    Kaphingst, Kimberly A; Stafford, Jewel D; McGowan, Lucy D'Agostino; Seo, Joann; Lachance, Christina R; Goodman, Melody S

    2015-02-01

    Few studies have examined how individuals respond to genomic risk information for common, chronic diseases. This randomized study examined differences in responses by type of genomic information (genetic test/family history) and disease condition (diabetes/heart disease), and by race/ethnicity in a medically underserved population. 1,057 English-speaking adults completed a survey containing 1 of 4 vignettes (2-by-2 randomized design). Differences in dependent variables (i.e., interest in receiving genomic assessment, discussing with doctor or family, changing health habits) by experimental condition and race/ethnicity were examined using chi-squared tests and multivariable regression analysis. No significant differences were found in dependent variables by type of genomic information or disease condition. In multivariable models, Hispanics were more interested in receiving a genomic assessment than Whites (OR = 1.93; p literacy had greater interest than those with adequate health literacy. Blacks (OR = 1.78; p = .001) and Hispanics (OR = 1.85; p = .001) had greater interest in discussing information with family than Whites. Non-Hispanic Blacks (OR = 1.45; p = .04) had greater interest in discussing genomic information with a doctor than Whites. Blacks (β = -0.41; p literacy was negatively associated with number of health habits participants intended to change. Findings suggest that race/ethnicity may affect responses to genomic risk information. Additional research could examine how cognitive representations of this information differ across racial/ethnic groups. Health literacy is also critical to consider in developing approaches to communicating genomic information.

  13. Macular edema in underserved diabetic patients: Improving detection by enhancing the optical signature and data analysis techniques

    Science.gov (United States)

    Alhamami, Mastour Abdullah

    Diabetic retinopathy and diabetic macular edema are chief causes of vision loss in working adults. Thus, retinal screening of patients with diabetes has become standard practice in some countries to prevent visual impairment and blindness from diabetic retinopathy. One goal is to improve techniques currently used to diagnose diabetic retinopathy. Another goal is to probe pathophysiological changes seen with imaging methods. Analysis was performed on a novel dataset from more than 2000 underserved adult diabetic patients, who were recruited for a screening study for diabetic eye disease. Data were collected from four county clinics at Alameda Health, Alameda County, CA. Over 90% of patients self-identified as a racial/ethnic identity other than non-Hispanic white. We investigated the prevalence and optical properties of macular edema. In the first study, a retrospective cohort study was performed to compare macular thickness in diabetic patients with and without macular edema to determine the presence of damage to the external limiting membrane or and the relation of damage to the ELM to damage to photoreceptors. In the second study, we investigated whether the information in red light better visualizes cysts in diabetic macular edema, as compared to green light. In the third study, we investigated whether the demographic and blood glucose information predict diabetic macular edema. Three logistic regression analyses were compared. In the fourth study, we examined how different outcome measures of retinal thickness vary with demographic and blood glucose measures, using a trichotomous variable for retinal thickness. The findings point strongly to large individual differences in the development of macular edema, which is difficult to diagnose with the most common methods in dark eyes. Further, while blood glucose was found to be important, there are additional differences in the potential for macular edema that are associated with ethnic group and gender.

  14. 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.

  15. Sex-specific difference of the association between ambient air pollution and the prevalence of obesity in Chinese adults from a high pollution range area: 33 Communities Chinese Health Study

    Science.gov (United States)

    Li, Meng; Qian, Zhengmin; Vaughn, Michael; Boutwell, Brian; Ward, Patrick; Lu, Tao; Lin, Shao; Zhao, Yang; Zeng, Xiao-Wen; Liu, Ru-Qing; Qin, Xiao-Di; Zhu, Yu; Chen, Wen; Dong, Guang-Hui

    2015-09-01

    Experimental data suggests that exposure to airborne fine particulate matter is associated with obesity. There is little supporting epidemiologic evidence of this, however. To evaluate the effects of ambient air pollution on the prevalence of obesity among adults living in a primarily industrial province of northeast China, 24,845 Chinese adults between the ages of 18 and 74 were randomly recruited from 33 communities in 11 districts of three northeastern Chinese cities during 2009. The participants' weight and height were measured. Three-year (2006-2008) average concentrations of particles with an aerodynamic diameter ≤10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) were calculated from monitoring stations in each of the 11 districts. Two-level logistic regressions models were used to examine the effects of pollutants exposure. Overall, 35.3% (8764) were overweight and 5.8% (1435) were obese. After adjusting for confounding factors, significant associations between concentrations of air pollutants and prevalence of obesity were found. When the analysis was stratified by sex, the associations were significant only in women. Among women, an increased prevalence of obesity was associated with an interquartile range increase in PM10 (19 μg/m3; odds ratio [ORs] = 1.18; 95% confidence interval [CI]:1.06-1.32), NO2 (9 μg/m3; ORs = 1.24; 95% CI: 1.09-1.41), and O3 (22 μg/m3; ORs = 1.14; 95% CI: 1.01-1.30). Associations were stronger among older participants. In conclusion, this study reveals a positive association between the long-term exposure to ambient air pollution and increased prevalence of obesity, and that these associations were more apparent in women than in men.

  16. Self-care self-efficacy, religious participation and depression as predictors of poststroke self-care among underserved ethnic minorities

    Directory of Open Access Journals (Sweden)

    Suzanne M. Robertson

    2013-04-01

    Full Text Available Underserved ethnic minorities have multiple chronic disease risk factors, including tobacco, alcohol and substance use, which contribute to increased incidence of stroke. Self-efficacy (self-care self-efficacy, religious participation and depression may directly and indirectly influence engagement in post stroke self-care behaviors. The primary aim of the present study was to investigate the effects of self-care self-efficacy, religious participation and depression, on tobacco, alcohol and substance use in a sample of largely ethnic minority, underserved stroke survivors (n=52. Participants previously recruited for a culturally tailored secondary stroke prevention self-care intervention were included. The treatment group received three stroke self-care sessions. The usual care group completed assessments only. Both groups were included in these analyses. Main outcome measures included tobacco, alcohol and substance use. Self-care self-efficacy, religious participation and depression were also assessed. Logistic regression analyses, using self-efficacy, religious practice and depression as the referents, were used to predict binary outcomes of tobacco, alcohol and substance use at 4-weeks post-stroke. Higher depression and self-care self-efficacy were associated with reduced odds of smoking and substance use. Greater participation in religious activities was associated with lower odds of alcohol use. We can conclude that incorporating depression treatment and techniques to increase self-care self-efficacy, and encouraging religious participation may help to improve stroke self-care behaviors for underserved and low socioeconomic status individuals. Results are discussed in the context of stroke self-management.

  17. Compressive laser ranging.

    Science.gov (United States)

    Babbitt, Wm Randall; Barber, Zeb W; Renner, Christoffer

    2011-12-15

    Compressive sampling has been previously proposed as a technique for sampling radar returns and determining sparse range profiles with a reduced number of measurements compared to conventional techniques. By employing modulation on both transmission and reception, compressive sensing in ranging is extended to the direct measurement of range profiles without intermediate measurement of the return waveform. This compressive ranging approach enables the use of pseudorandom binary transmit waveforms and return modulation, along with low-bandwidth optical detectors to yield high-resolution ranging information. A proof-of-concept experiment is presented. With currently available compact, off-the-shelf electronics and photonics, such as high data rate binary pattern generators and high-bandwidth digital optical modulators, compressive laser ranging can readily achieve subcentimeter resolution in a compact, lightweight package.

  18. Dryden Aeronautical Test Range

    Data.gov (United States)

    Federal Laboratory Consortium — Recently redesignated to honor Dr. Hugh L. Dryden, NASA's Dryden Aeronautical Test Range (DATR) supports aerospace flight research and technology integration, space...

  19. Compact Antenna Range

    Data.gov (United States)

    Federal Laboratory Consortium — Facility consists of a folded compact antenna range including a computer controlled three axis position table, parabolic reflector and RF sources for the measurement...

  20. A randomized controlled trial to assess the efficacy of an interactive mobile messaging intervention for underserved smokers: Project ACTION.

    Science.gov (United States)

    Vidrine, Damon J; Fletcher, Faith E; Danysh, Heather E; Marani, Salma; Vidrine, Jennifer Irvin; Cantor, Scott B; Prokhorov, Alexander V

    2012-08-25

    Despite a significant decrease in smoking prevalence over the past ten years, cigarette smoking still represents the leading cause of preventable morbidity and mortality in the United States. Moreover, smoking prevalence is significantly higher among those with low levels of education and those living at, or below, the poverty level. These groups tend to be confronted with significant barriers to utilizing more traditional smoking cessation intervention approaches. The purpose of the study, Project ACTION (Adult smoking Cessation Treatment through Innovative Outreach to Neighborhoods), is to utilize a mobile clinic model, a network of community sites (i.e., community centers and churches) and an interactive mobile messaging system to reach and deliver smoking cessation treatment to underserved, low-income communities. We are using a group-randomized design, with the community site as the sampling unit, to compare the efficacy of three smoking cessation interventions: 1) Standard Care--brief advice to quit smoking, nicotine replacement therapy (NRT), and self-help materials; 2) Enhanced Care--standard care components plus a cell phone-delivered text/graphical messaging component; and 3) Intensive Care--enhanced care components plus a series of 11 cell phone-delivered proactive counseling sessions. An economic evaluation will also be performed to evaluate the relative cost effectiveness of the three treatment approaches. We will recruit 756 participants (252 participants in each of the 3 intervention groups). At the time of randomization, participants complete a baseline assessment, consisting of smoking history, socio-demographic, and psychosocial variables. Monthly cell phone assessments are conducted for 6 months-post enrollment, and a final 12-month follow-up is conducted at the original neighborhood site of enrollment. We will perform mixed-model logistic regression to compare the efficacy of the three smoking cessation intervention treatment groups. It is

  1. A randomized controlled trial to assess the efficacy of an interactive mobile messaging intervention for underserved smokers: Project ACTION

    Directory of Open Access Journals (Sweden)

    Vidrine Damon J

    2012-08-01

    Full Text Available Abstract Background Despite a significant decrease in smoking prevalence over the past ten years, cigarette smoking still represents the leading cause of preventable morbidity and mortality in the United States. Moreover, smoking prevalence is significantly higher among those with low levels of education and those living at, or below, the poverty level. These groups tend to be confronted with significant barriers to utilizing more traditional smoking cessation intervention approaches. The purpose of the study, Project ACTION (Adult smoking Cessation Treatment through Innovative Outreach to Neighborhoods, is to utilize a mobile clinic model, a network of community sites (i.e., community centers and churches and an interactive mobile messaging system to reach and deliver smoking cessation treatment to underserved, low-income communities. Methods/Design We are using a group-randomized design, with the community site as the sampling unit, to compare the efficacy of three smoking cessation interventions: 1 Standard Care - brief advice to quit smoking, nicotine replacement therapy (NRT, and self-help materials; 2 Enhanced Care - standard care components plus a cell phone-delivered text/graphical messaging component; and 3 Intensive Care - enhanced care components plus a series of 11 cell phone-delivered proactive counseling sessions. An economic evaluation will also be performed to evaluate the relative cost effectiveness of the three treatment approaches. We will recruit 756 participants (252 participants in each of the 3 intervention groups. At the time of randomization, participants complete a baseline assessment, consisting of smoking history, socio-demographic, and psychosocial variables. Monthly cell phone assessments are conducted for 6 months-post enrollment, and a final 12-month follow-up is conducted at the original neighborhood site of enrollment. We will perform mixed-model logistic regression to compare the efficacy of the three smoking

  2. Extending the Pathway: Building on a National Science Foundation Workforce Development Project for Underserved k-12 Students

    Science.gov (United States)

    Slattery, W.; Smith, T.

    2014-12-01

    own learning and shows promise of raising parents, teachers, administrators and other k-12 students awareness of educational opportunities in the geosciences, confidence in the ability of underserved rural students to reach their educational goals and supporting them through the critical middle and high school years towards a geoscience career.

  3. On Range of Skill

    DEFF Research Database (Denmark)

    Hansen, Thomas Dueholm; Miltersen, Peter Bro; Sørensen, Troels Bjerre

    2008-01-01

    size (and doubly exponential in its depth). We also provide techniques that yield concrete bounds for unbalanced game trees and apply these to estimate the Range of Skill of Tic-Tac-Toe and Heads-Up Limit Texas Hold'em Poker. In particular, we show that the Range of Skill of Tic-Tac-Toe is more than...

  4. Autonomous Vehicles Have a Wide Range of Possible Energy Impacts (Poster)

    Energy Technology Data Exchange (ETDEWEB)

    Brown, A.; Repac, B.; Gonder, J.

    2013-07-01

    This poster presents initial estimates of the net energy impacts of automated vehicles (AVs). Automated vehicle technologies are increasingly recognized as having potential to decrease carbon dioxide emissions and petroleum consumption through mechanisms such as improved efficiency, better routing, lower traffic congestion, and by enabling advanced technologies. However, some effects of AVs could conceivably increase fuel consumption through possible effects such as longer distances traveled, increased use of transportation by underserved groups, and increased travel speeds. The net effect on petroleum use and climate change is still uncertain. To make an aggregate system estimate, we first collect best estimates for the energy impacts of approximately ten effects of AVs. We then use a modified Kaya Identity approach to estimate the range of aggregate effects and avoid double counting. We find that depending on numerous factors, there is a wide range of potential energy impacts. Adoption of automated personal or shared vehicles can lead to significant fuel savings but has potential for backfire.

  5. Autonomous Target Ranging Techniques

    DEFF Research Database (Denmark)

    Jørgensen, Peter Siegbjørn; Jørgensen, John Leif; Denver, Troelz

    2003-01-01

    of this telescope, a fast determination of the range to and the motion of the detected targets are important. This is needed in order to prepare the future observation strategy for each target, i.e. when is the closest approach where imaging will be optimal. In order to quickly obtain such a determination two...... ranging strategies are presented. One is an improved laser ranger with an effective range with non-cooperative targets of at least 10,000 km, demonstrated in ground tests. The accuracy of the laser ranging will be approximately 1 m. The laser ranger may furthermore be used for trajectory determination...... of nano-gravity probes, which will perform direct mass measurements of selected targets. The other is triangulation from two spacecraft. For this method it is important to distinguish between detection and tracking range, which will be different for Bering since different instruments are used...

  6. Examining inequalities in uptake of maternal health care and choice of provider in underserved urban areas of Mumbai, India: a mixed methods study.

    Science.gov (United States)

    Alcock, Glyn; Das, Sushmita; Shah More, Neena; Hate, Ketaki; More, Sharda; Pantvaidya, Shanti; Osrin, David; Houweling, Tanja A J

    2015-09-28

    Discussions of maternity care in developing countries tend to emphasise service uptake and overlook choice of provider. Understanding how families choose among health providers is essential to addressing inequitable access to care. Our objectives were to quantify the determinants and choice of maternity care provider in Mumbai's informal urban settlements, and to explore the reasons underlying their choices. The study was conducted in informal urban communities in eastern Mumbai. We developed regression models using data from a census of married women aged 15-49 to test for associations between maternal characteristics and uptake of care and choice of provider. We then conducted seven focus group discussions and 16 in-depth interviews with purposively selected participants, and used grounded theory methods to examine the reasons for their choices. Three thousand eight hundred forty-eight women who had given birth in the preceding 2 years were interviewed in the census. The odds of institutional prenatal and delivery care increased with education, economic status, and duration of residence in Mumbai, and decreased with parity. Tertiary public hospitals were the commonest site of care, but there was a preference for private hospitals with increasing socio-economic status. Women were more likely to use tertiary public hospitals for delivery if they had fewer children and were Hindu. The odds of delivery in the private sector increased with maternal education, wealth, age, recent arrival in Mumbai, and Muslim faith. Four processes were identified in choosing a health care provider: exploring the options, defining a sphere of access, negotiating autonomy, and protective reasoning. Women seeking a positive health experience and outcome adopted strategies to select the best or most suitable, accessible provider. In Mumbai's informal settlements, institutional maternity care is the norm, except among recent migrants. Poor perceptions of primary public health facilities often cause residents to bypass them in favour of tertiary hospitals or private sector facilities. Families follow a complex selection process, mediated by their ability to mobilise economic and social resources, and a concern for positive experiences of health care and outcomes. Health managers must ensure quality services, a functioning regulatory mechanism, and monitoring of provider behaviour.

  7. Goal setting using telemedicine in rural underserved older adults with diabetes: experiences from the informatics for diabetes education and telemedicine project.

    Science.gov (United States)

    West, Susan P; Lagua, Carina; Trief, Paula M; Izquierdo, Roberto; Weinstock, Ruth S

    2010-05-01

    To describe the use of telemedicine for setting goals for behavior change and examine the success in achieving these goals in rural underserved older adults with diabetes. Medicare beneficiaries with diabetes living in rural upstate New York who were enrolled in the telemedicine intervention of the Informatics for Diabetes Education and Telemedicine (IDEATel) project (n = 610) participated in home televisits with nurse and dietitian educators every 4-6 weeks for 2-6 years. Behavior change goals related to nutrition, physical activity, monitoring, diabetes health maintenance, and/or use of the home telemedicine unit were established at the conclusion of each televisit and assessed at the next visit. Collaborative goal setting was employed during 18,355 televisits (mean of 33 goal-setting televisits/participant). The most common goals were related to monitoring, followed by diabetes health maintenance, nutrition, exercise, and use of the telemedicine equipment. Overall, 68% of behavioral goals were rated as "improved" or "met." The greatest success was achieved for goals related to proper insulin injection technique and daily foot care. These elderly participants had the most difficulty achieving goals related to use of the computer. No gender differences in goal achievement were observed. Televisits can be successfully used to collaboratively establish behavior change goals to help improve diabetes self-management in underserved elderly rural adults.

  8. Differential access to digital communication technology: association with health and health survey recruitment within an African-American underserviced urban population.

    Science.gov (United States)

    Schneider, John; Makelarski, Jennifer A; Van Haitsma, Martha; Lipton, Rebecca B; Abramsohn, Emily; Lauderdale, Diane S; Lindau, Stacy Tessler

    2011-06-01

    Digital communication technologies (DCT), such as cell phones and the internet, have begun to replace more traditional technologies even in technology-poor communities. We characterized access to DCT in an underserved urban population and whether access is associated with health and study participation. A general probability community sample and a purposive high-turnover housing sample were recruited and re-interviewed after 3 months. Selected characteristics were compared by sample type and retention. Associations between DCT access and self-reported health were examined using multivariable logistic regression. Of 363 eligible individuals, 184 (general community = 119; high-turnover housing = 65) completed the baseline survey. Eighty-four percent of respondents had a cell phone and 62% had ever texted. Ever use of the internet was high (69%) overall, but frequency and years of internet use were higher in the general community sample. Self-reported fair or poor health was more common for residents of cell phone-only households and those with less frequent internet use. Technology use was similar for those retained and not retained. Overall, access to DCT was high in this underserved urban population but varied by sample type. Health varied significantly by DCT use, but study retention did not. These data have implications for incorporating DCT into health-related research in urban populations.

  9. Giving Voice to the Medically Under-Served: A Qualitative Co-Production Approach to Explore Patient Medicine Experiences and Improve Services to Marginalized Communities.

    Science.gov (United States)

    Latif, Asam; Tariq, Sana; Abbasi, Nasa; Mandane, Baguiasri

    2018-01-27

    With an aging population, the appropriate, effective and safe use of medicines is a global health priority. However, "'medically under-served" patients continue to experience significant inequalities around access to healthcare services. This study forms part of a wider project to co-develop and evaluate a digital educational intervention for community pharmacy. The aim of this paper is to explore the medicine needs of patients from marginalized communities and suggest practical way on how services could be better tailored to their requirements. Following ethical approval, qualitative data was gathered from: (1) workshops with patients and professionals ( n = 57 attendees); and (2) qualitative semi-structured interviews (10 patients and 10 pharmacists). Our findings revealed that patients from marginalized communities reported poor management of their medical conditions and significant problems with adherence to prescribed medicines. Their experience of pharmacy services was found to be variable with many experiencing discrimination or disadvantage as a result of their status. This study highlights the plight of medically under-served communities and the need for policy makers to tailor services to an individual's needs and circumstances. Furthermore, patients and professionals can work in collaboration using a co-production approach to develop educational interventions for pharmacy service improvements.

  10. Prediction ranges. Annual review

    Energy Technology Data Exchange (ETDEWEB)

    Parker, J.C.; Tharp, W.H.; Spiro, P.S.; Keng, K.; Angastiniotis, M.; Hachey, L.T.

    1988-01-01

    Prediction ranges equip the planner with one more tool for improved assessment of the outcome of a course of action. One of their major uses is in financial evaluations, where corporate policy requires the performance of uncertainty analysis for large projects. This report gives an overview of the uses of prediction ranges, with examples; and risks and uncertainties in growth, inflation, and interest and exchange rates. Prediction ranges and standard deviations of 80% and 50% probability are given for various economic indicators in Ontario, Canada, and the USA, as well as for foreign exchange rates and Ontario Hydro interest rates. An explanatory note on probability is also included. 23 tabs.

  11. Interstitial Area Final Range Environmental Assessment, Revision 1

    Science.gov (United States)

    2009-04-01

    water quality concern. Historically, primer components contained mercury in the form of mercury fulminate , but this compound has not been used in...Mitsch, W. J., and J. G. Gosselink, 2000. Wetlands, 3rd Edition. John Wiley & Sons: New York. Schultz, T. J., 1978. Synthesis of social surveys on noise

  12. Test Area B-70 Final Range Environmental Assessment, Revision 1

    Science.gov (United States)

    2009-06-01

    environmental impacts to Eglin ecosystems. Some of the main invasive non-native species of concern are Chinese tallow, cogon grass , Japanese climbing fern...2003a). Typical plant species include St. John’s Wort (Hypericum brachyphyllum) around the margins with spikerush (Eleocharis spp.), yellow-eyed grass ...Karst Pond Yellow-eyed Grass Xyris longisepala SE -- Pineland Hoary Pea Tephrosia mohrii ST -- Pineland Wild Indigo Baptista calycosa var villosa ST

  13. Antenna Pattern Range (APR)

    Data.gov (United States)

    Federal Laboratory Consortium — TheAntenna Pattern Range (APR)features a non-metallic arch with a trolley to move the transmit antenna from the horizon to zenith. At the center of the ground plane,...

  14. EV range sensitivity analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ostafew, C. [Azure Dynamics Corp., Toronto, ON (Canada)

    2010-07-01

    This presentation included a sensitivity analysis of electric vehicle components on overall efficiency. The presentation provided an overview of drive cycles and discussed the major contributors to range in terms of rolling resistance; aerodynamic drag; motor efficiency; and vehicle mass. Drive cycles that were presented included: New York City Cycle (NYCC); urban dynamometer drive cycle; and US06. A summary of the findings were presented for each of the major contributors. Rolling resistance was found to have a balanced effect on each drive cycle and proportional to range. In terms of aerodynamic drive, there was a large effect on US06 range. A large effect was also found on NYCC range in terms of motor efficiency and vehicle mass. figs.

  15. Eye safe laser range finders

    International Nuclear Information System (INIS)

    Snir, M.; Margaliot, M.; Amitzi, A.

    2004-01-01

    During the 1970's, Ruby (Q switched) laser based range finders with a wavelength of 694nm were first used. These lasers operated in a pulse mode within the visible light range and produced a risk for the eye retina. The laser beam striking the macula could damage the eye and might cause blindness. Over the years, Nd:YAG (Q switched) lasers were developed (operating at 1064nm) for range finding and designation uses. The wavelength of these lasers, operating in the near Infra-Red range (invisible), is also focused tightly on the retina. The human eye does not respond to the invisible light so there is no natural protection (eye blink reflex) as in the visible light. The operation of these lasers worldwide, especially when the laser beam is exposed, causes occasional eye accidents. Another risk is stemming from the use of observation systems with a high optical gain, in the laser operation areas, which enlarge the range of risk quite significantly. Therefore, research and development efforts were invested in order to introduce eye safe lasers. One of the solutions for this problem is presented in following document

  16. Free range hens use the range more when the outdoor environment is enriched.

    Science.gov (United States)

    Nagle, T A D; Glatz, P C

    2012-04-01

    To evaluate the role of using forage, shade and shelterbelts in attracting birds into the range, three trials were undertaken with free range layers both on a research facility and on commercial farms. Each of the trials on the free range research facility in South Australia used a total of 120 laying hens (Hyline Brown). Birds were housed in an eco-shelter which had 6 internal pens of equal size with a free range area adjoining the shelter. The on-farm trials were undertaken on commercial free range layer farms in the Darling Downs in Southeast Queensland with bird numbers on farms ranging from 2,000-6,800 hens. The first research trial examined the role of shaded areas in the range; the second trial examined the role of forage and the third trial examined the influence of shelterbelts in the range. These treatments were compared to a free range area with no enrichment. Aggressive feather pecking was only observed on a few occasions in all of the trials due to the low bird numbers housed. Enriching the free range environment attracted more birds into the range. Shaded areas were used by 18% of the hens with a tendency (p = 0.07) for more hens to be in the paddock. When forage was provided in paddocks more control birds (55%) were observed in the range in morning than in the afternoon (30%) while for the forage treatments 45% of the birds were in the range both during the morning and afternoon. When shelterbelts were provided there was a significantly (prange (43% vs. 24%) and greater numbers of birds were observed in areas further away from the poultry house. The results from the on-farm trials mirrored the research trials. Overall 3 times more hens used the shaded areas than the non shaded areas, with slightly more using the shade in the morning than in the afternoon. As the environmental temperature increased the number of birds using the outdoor shade also increased. Overall 17 times more hens used the shelterbelt areas than the control areas, with slightly

  17. Range Selection and Median

    DEFF Research Database (Denmark)

    Jørgensen, Allan Grønlund; Larsen, Kasper Green

    2011-01-01

    and several natural special cases thereof. The rst special case is known as range median, which arises when k is xed to b(j 􀀀 i + 1)=2c. The second case, denoted prex selection, arises when i is xed to 0. Finally, we also consider the bounded rank prex selection problem and the xed rank range......Range selection is the problem of preprocessing an input array A of n unique integers, such that given a query (i; j; k), one can report the k'th smallest integer in the subarray A[i];A[i+1]; : : : ;A[j]. In this paper we consider static data structures in the word-RAM for range selection...... selection problem. In the former, data structures must support prex selection queries under the assumption that k for some value n given at construction time, while in the latter, data structures must support range selection queries where k is xed beforehand for all queries. We prove cell probe lower bounds...

  18. Control Areas

    Data.gov (United States)

    Department of Homeland Security — This feature class represents electric power Control Areas. Control Areas, also known as Balancing Authority Areas, are controlled by Balancing Authorities, who are...

  19. 128 EVALUATION OF RANGE CONDITION AND TREND OF ...

    African Journals Online (AJOL)

    2010-03-01

    Mar 1, 2010 ... areas with available forage to areas where the forage is overgrazed but there is water. ... Herbaceous layer estimate was made using a .... Biomass. Assessment and Range Condition on. Range Sites in southern Arizona. J.

  20. Online Sorted Range Reporting

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Fagerberg, Rolf; Greve, Mark

    2009-01-01

    is motivated by (and is a generalization of) a problem with applications in search engines: On a tree where leaves have associated rank values, report the highest ranked leaves in a given subtree. Finally, the problem studied generalizes the classic range minimum query (RMQ) problem on arrays....

  1. Substring Range Reporting

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li

    2014-01-01

    We revisit various string indexing problems with range reporting features, namely, position-restricted substring searching, indexing substrings with gaps, and indexing substrings with intervals. We obtain the following main results. We give efficient reductions for each of the above problems...

  2. Substring Range Reporting

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li

    2011-01-01

    We revisit various string indexing problems with range reporting features, namely, position-restricted substring searching, indexing substrings with gaps, and indexing substrings with intervals. We obtain the following main results. – We give efficient reductions for each of the above problems...

  3. Range-clustering queries

    NARCIS (Netherlands)

    Abrahamsen, M.; de Berg, M.T.; Buchin, K.A.; Mehr, M.; Mehrabi, A.D.

    2017-01-01

    In a geometric k -clustering problem the goal is to partition a set of points in R d into k subsets such that a certain cost function of the clustering is minimized. We present data structures for orthogonal range-clustering queries on a point set S : given a query box Q and an integer k>2 , compute

  4. Mobile and portable dental services catering to the basic oral health needs of the underserved population in developing countries: a proposed model.

    Science.gov (United States)

    Ganavadiya, R; Chandrashekar, Br; Goel, P; Hongal, Sg; Jain, M

    2014-05-01

    India is the second most populous country in the world with an extensive rural population (68.8%). Children less than 18 years constitute about 40% of the population. Approximately, 23.5% of the urban population resides in urban slums. The extensive rural population, school children and the urban slum dwellers are denied of even the basic dental services though there is continuous advancement in the field of dentistry. The dentist to population ratio has dramatically improved in the last one to two decades with no significant improvement in the oral health status of the general population. The various studies have revealed an increasing trend in oral diseases in the recent times especially among this underserved population. Alternate strategies have to be thought about rather than the traditional oral health-care delivery through private dentists on fee for service basis. Mobile and portable dental services are a viable option to take the sophisticated oral health services to the doorsteps of the underserved population. The databases were searched for publications from 1900 to the present (2013) using terms such as Mobile dental services, Portable dental services and Mobile and portable dental services with key articles obtained primarily from MEDLINE. This paper reviews the published and unpublished literature from different sources on the various mobile dental service programs successfully implemented in some developed and developing countries. Though the mobile and portable systems have some practical difficulties like financial considerations, they still seem to be the only way to reach every section of the community in the absence of national oral health policy and organized school dental health programs in India. The material for the present review was obtained mainly by searching the biomedical databases for primary research material using the search engine with key words such as mobile and/or portable dental services in developed and developing countries

  5. Mobile and Portable Dental Services Catering to the Basic Oral Health Needs of the Underserved Population in Developing Countries: A Proposed Model

    Science.gov (United States)

    Ganavadiya, R; Chandrashekar, BR; Goel, P; Hongal, SG; Jain, M

    2014-01-01

    India is the second most populous country in the world with an extensive rural population (68.8%). Children less than 18 years constitute about 40% of the population. Approximately, 23.5% of the urban population resides in urban slums. The extensive rural population, school children and the urban slum dwellers are denied of even the basic dental services though there is continuous advancement in the field of dentistry. The dentist to population ratio has dramatically improved in the last one to two decades with no significant improvement in the oral health status of the general population. The various studies have revealed an increasing trend in oral diseases in the recent times especially among this underserved population. Alternate strategies have to be thought about rather than the traditional oral health-care delivery through private dentists on fee for service basis. Mobile and portable dental services are a viable option to take the sophisticated oral health services to the doorsteps of the underserved population. The databases were searched for publications from 1900 to the present (2013) using terms such as Mobile dental services, Portable dental services and Mobile and portable dental services with key articles obtained primarily from MEDLINE. This paper reviews the published and unpublished literature from different sources on the various mobile dental service programs successfully implemented in some developed and developing countries. Though the mobile and portable systems have some practical difficulties like financial considerations, they still seem to be the only way to reach every section of the community in the absence of national oral health policy and organized school dental health programs in India. The material for the present review was obtained mainly by searching the biomedical databases for primary research material using the search engine with key words such as mobile and/or portable dental services in developed and developing countries

  6. Stories From the Field: The Use of Information and Communication Technologies to Address the Health Needs of Underserved Populations in Latin America and the Caribbean.

    Science.gov (United States)

    Farach, Nasim; Faba, Gladys; Julian, Soroya; Mejía, Felipe; Cabieses, Báltica; D'Agostino, Marcelo; Cortinois, Andrea A

    2015-01-01

    As their availability grew exponentially in the last 20 years, the use of information and communication technologies (ICT) in health has been widely espoused, with many emphasizing their potential to decrease health inequities. Nonetheless, there is scarce availability of information regarding ICT as tools to further equity in health, specifically in Latin American and Caribbean settings. Our aim was to identify initiatives that used ICT to address the health needs of underserved populations in Latin America and Caribbean. Among these projects, explore the rationale behind the selection of ICT as a key component, probe perceptions regarding contributions to health equity, and describe the challenges faced during implementation. We conducted an exploratory qualitative study. Interviews were completed via Skype or face-to-face meetings using a semistructured interview guide. Following participant consent, interviews were audio recorded and verbatim transcriptions were developed. All transcriptions were coded using ATLASti7 software. The text was analyzed for patterns, shared themes, and diverging opinions. Emerging findings were reviewed by all interviewers and shared with participants for feedback. We interviewed representatives from eight organizations in six Latin American and Caribbean countries that prominently employed ICT in health communication, advocacy, or surveillance projects. ICT expanded project's geographic coverage, increased their reach into marginalized or hard-to-reach groups, and allowed real-time data collection. Perceptions of contributions to health equity resided mainly in the provision of health information and linkage to health services to members of groups experiencing greater morbidity because of poverty, remote place of residence, lack of relevant public programs, and/or stigma and discrimination, and in more timely responses by authorities to the health needs of these groups as a result of the increased availability of strategic

  7. Do health information technology self-management interventions improve glycemic control in medically underserved adults with diabetes? A systematic review and meta-analysis.

    Science.gov (United States)

    Heitkemper, Elizabeth M; Mamykina, Lena; Travers, Jasmine; Smaldone, Arlene

    2017-09-01

    The purpose of this systematic review and meta-analysis was to examine the effect of health information technology (HIT) diabetes self-management education (DSME) interventions on glycemic control in medically underserved patients. Following an a priori protocol, 5 databases were searched. Studies were appraised for quality using the Cochrane Risk of Bias assessment. Studies reporting either hemoglobin A1c pre- and post-intervention or its change at 6 or 12 months were eligible for inclusion in the meta-analysis using random effects models. Thirteen studies met the criteria for the systematic review and 10 for the meta-analysis and represent data from 3257 adults with diabetes (mean age 55 years; 66% female; 74% racial/ethnic minorities). Most studies ( n  = 10) reflected an unclear risk of bias. Interventions varied by HIT type: computer software without Internet ( n  = 2), cellular/automated telephone ( n  = 4), Internet-based ( n  = 4), and telemedicine/telehealth ( n  = 3). Pooled A1c decreases were found at 6 months (-0.36 (95% CI, -0.53 and -0.19]; I 2  = 35.1%, Q  = 5.0), with diminishing effect at 12 months (-0.27 [95% CI, -0.49 and -0.04]; I 2  = 42.4%, Q  = 10.4). Findings suggest that medically underserved patients with diabetes achieve glycemic benefit following HIT DSME interventions, with dissipating but significant effects at 12 months. Telemedicine/telehealth interventions were the most successful HIT type because they incorporated interaction with educators similar to in-person DSME. These results are similar to in-person DSME in medically underserved patients, showing that well-designed HIT DSME has the potential to increase access and improve outcomes for this vulnerable group. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  8. Extended Range Intercept Technology

    Science.gov (United States)

    1991-09-01

    1988). Desert bighorn ewes with lambs show a stronger response than do groups of only rams, only ewes, or mixed groups of adults (Miller and Smith...1985). While all startle events may affect desert bighorns, those occurring during the lambing period (February-April) would represent the highest...35807 U.S. Army Pueblo Depot Activity SDSTE-PU-EE Pueblo, CO 81001-5000 U.S. Army White Sands Missile Range STEWS -EL-N White Sands, NM 88002-5076

  9. ORANGE: RANGE OF BENEFITS

    OpenAIRE

    Parle Milind; Chaturvedi Dev

    2012-01-01

    No wonder that oranges are one of the most popular fruits in the world. Orange (citrus sinensis) is well known for its nutritional and medicinal properties throughout the world. From times immemorial, whole Orange plant including ripe and unripe fruits, juice, orange peels, leaves and flowers are used as a traditional medicine. Citrus sinensis belongs to the family Rutaceae. The fruit is a fleshy, indehiscent, berry that ranges widely in size from 4 cm to 12 cm. The major medicinal proper...

  10. Range Flight Safety Requirements

    Science.gov (United States)

    Loftin, Charles E.; Hudson, Sandra M.

    2018-01-01

    The purpose of this NASA Technical Standard is to provide the technical requirements for the NPR 8715.5, Range Flight Safety Program, in regards to protection of the public, the NASA workforce, and property as it pertains to risk analysis, Flight Safety Systems (FSS), and range flight operations. This standard is approved for use by NASA Headquarters and NASA Centers, including Component Facilities and Technical and Service Support Centers, and may be cited in contract, program, and other Agency documents as a technical requirement. This standard may also apply to the Jet Propulsion Laboratory or to other contractors, grant recipients, or parties to agreements to the extent specified or referenced in their contracts, grants, or agreements, when these organizations conduct or participate in missions that involve range flight operations as defined by NPR 8715.5.1.2.2 In this standard, all mandatory actions (i.e., requirements) are denoted by statements containing the term “shall.”1.3 TailoringTailoring of this standard for application to a specific program or project shall be formally documented as part of program or project requirements and approved by the responsible Technical Authority in accordance with NPR 8715.3, NASA General Safety Program Requirements.

  11. A novel educational strategy targeting health care workers in underserved communities in Central America to integrate HIV into primary medical care.

    Science.gov (United States)

    Flys, Tamara; González, Rosalba; Sued, Omar; Suarez Conejero, Juana; Kestler, Edgar; Sosa, Nestor; McKenzie-White, Jane; Monzón, Irma Irene; Torres, Carmen-Rosa; Page, Kathleen

    2012-01-01

    Current educational strategies to integrate HIV care into primary medical care in Central America have traditionally targeted managers or higher-level officials, rather than local health care workers (HCWs). We developed a complementary online and on-site interactive training program to reach local HCWs at the primary care level in underserved communities. The training program targeted physicians, nurses, and community HCWs with limited access to traditional onsite training in Panama, Nicaragua, Dominican Republic, and Guatemala. The curriculum focused on principles of HIV care and health systems using a tutor-supported blended educational approach of an 8-week online component, a weeklong on-site problem-solving workshop, and individualized project-based interventions. Of 258 initially active participants, 225 (225/258=87.2%) successfully completed the online component and the top 200 were invited to the on-site workshop. Of those, 170 (170/200=85%) attended the on-site workshop. In total, 142 completed all three components, including the project phase. Quantitative and qualitative evaluation instruments included knowledge assessments, reflexive essays, and acceptability surveys. The mean pre and post-essay scores demonstrating understanding of social determinants, health system organization, and integration of HIV services were 70% and 87.5%, respectively, with an increase in knowledge of 17.2% (pstructure, and effectiveness in improving their HIV-related knowledge and skills. This innovative curriculum utilized technology to target HCWs with limited access to educational resources. Participants benefited from technical skills acquired through the process, and could continue working within their underserved communities while participating in the online component and then implement interventions that successfully converted theoretical knowledge to action to improve integration of HIV care into primary care.

  12. Effects of a culturally tailored physical activity promotion program on selected self-regulation skills and attitudes in adolescents of an underserved, multiethnic milieu.

    Science.gov (United States)

    Laberge, Suzanne; Bush, Paula Louise; Chagnon, Miguel

    2012-01-01

    To implement a culturally tailored physical activity (PA) promotion program (FunAction) and to assess its impact on five self-regulation skills and attitudes in adolescents. Design . The design and implementation of the FunAction program were informed by social marketing principles. The study used a quasi-experimental approach to assess the impact of the program on specific outcome variables. A multiethnic, underserved middle school in Montreal, Quebec, Canada. The intervention group was made up of grade 8 students (n  =  165) and the control group was made up of grade 7 students (n  =  137). During the 16-week intervention, adolescents were able to choose from a variety of 45-minute cardiovascular PAs offered daily during their school lunch period. Adolescents participated in the activities on a voluntary basis. A self-report questionnaire was administered preintervention and postintervention to measure adolescents' scores on the following self-regulation skills and attitudes: self-control, self-esteem, attention/concentration, social competence, and interethnic relationships. Three-way repeated measures analyses of variance and correlational analyses were used. Results . A significant improvement was observed only in attention/concentration. Girls' attention/concentration scores improved significantly in the intervention group compared to the control group (F(1,127)  =  16.26, p marketing principles can help encourage adolescents from underserved, multiethnic milieus to participate in PA during their school lunch hour. Furthermore, voluntary participation in a culturally tailored PA program can improve youths' attention/concentration.

  13. ‘Much clearer with pictures’: using community-based participatory research to design and test a Picture Option Grid for underserved patients with breast cancer

    Science.gov (United States)

    Durand, Marie-Anne; Alam, Shama; Grande, Stuart W; Elwyn, Glyn

    2016-01-01

    Objective Women of low socioeconomic status (SES) diagnosed with early stage breast cancer experience decision-making, treatment and outcome disparities. Evidence suggests that decision aids can benefit underserved patients, when tailored to their needs. Our aim was to develop and test the usability, acceptability and accessibility of a pictorial encounter decision aid targeted at women of low SES diagnosed with early stage breast cancer. Design Community-based participatory research (CBPR) using think-aloud protocols (phases 1 and 2) and semistructured interviews (phase 3). Setting Underserved community settings (eg, knitting groups, bingo halls, senior centres) and breast clinics. Participants In phase 1, we recruited a convenience sample of clinicians and academics. In phase 2, we targeted women over 40 years of age, of low SES, regardless of breast cancer history, and in phase 3, women of low SES, recently diagnosed with breast cancer. Intervention The pictorial encounter decision aid was derived from an evidence-based table comparing treatment options for breast cancer (http://www.optiongrid.org). Outcome measures We assessed the usability, acceptability and accessibility of the pictorial decision aid prototypes using the think-aloud protocol and semistructured interviews. Results After initial testing of the first prototype with 18 academics and health professionals, new versions were developed and tested with 53 lay individuals in community settings. Usability was high. In response to feedback indicating that the use of cartoon characters was considered insensitive, a picture-only version was developed and tested with 23 lay people in phase 2, and 10 target users in phase 3. Conclusions and relevance Using CBPR methods and iterative user testing cycles improved usability and accessibility, and led to the development of the Picture Option Grid, entirely guided by multiple stakeholder feedback. All women of low SES recently diagnosed with early stage breast

  14. Long-range antigravity

    Energy Technology Data Exchange (ETDEWEB)

    Macrae, K.I.; Riegert, R.J. (Maryland Univ., College Park (USA). Center for Theoretical Physics)

    1984-10-01

    We consider a theory in which fermionic matter interacts via long-range scalar, vector and tensor fields. In order not to be in conflict with experiment, the scalar and vector couplings for a given fermion must be equal, as is natural in a dimensionally reduced model. Assuming that the Sun is not approximately neutral with respect to these new scalar-vector charges, and if the couplings saturate the experimental bounds, then their strength can be comparable to that of gravity. Scalar-vector fields of this strength can compensate for a solar quadrupole moment contribution to Mercury's anomalous perihelion precession.

  15. Long-range antigravity

    International Nuclear Information System (INIS)

    Macrae, K.I.; Riegert, R.J.

    1984-01-01

    We consider a theory in which fermionic matter interacts via long-range scalar, vector and tensor fields. In order not to be in conflict with experiment, the scalar and vector couplings for a given fermion must be equal, as is natural in a dimensionally reduced model. Assuming that the Sun is not approximately neutral with respect to these new scalar-vector charges, and if the couplings saturate the experimental bounds, then their strength can be comparable to that of gravity. Scalar-vector fields of this strength can compensate for a solar quadrupole moment contribution to Mercury's anomalous perihelion precession. (orig.)

  16. Range Process Simulation Tool

    Science.gov (United States)

    Phillips, Dave; Haas, William; Barth, Tim; Benjamin, Perakath; Graul, Michael; Bagatourova, Olga

    2005-01-01

    Range Process Simulation Tool (RPST) is a computer program that assists managers in rapidly predicting and quantitatively assessing the operational effects of proposed technological additions to, and/or upgrades of, complex facilities and engineering systems such as the Eastern Test Range. Originally designed for application to space transportation systems, RPST is also suitable for assessing effects of proposed changes in industrial facilities and large organizations. RPST follows a model-based approach that includes finite-capacity schedule analysis and discrete-event process simulation. A component-based, scalable, open architecture makes RPST easily and rapidly tailorable for diverse applications. Specific RPST functions include: (1) definition of analysis objectives and performance metrics; (2) selection of process templates from a processtemplate library; (3) configuration of process models for detailed simulation and schedule analysis; (4) design of operations- analysis experiments; (5) schedule and simulation-based process analysis; and (6) optimization of performance by use of genetic algorithms and simulated annealing. The main benefits afforded by RPST are provision of information that can be used to reduce costs of operation and maintenance, and the capability for affordable, accurate, and reliable prediction and exploration of the consequences of many alternative proposed decisions.

  17. Calculation of projected ranges

    International Nuclear Information System (INIS)

    Biersack, J.P.

    1980-09-01

    The concept of multiple scattering is reconsidered for obtaining the directional spreading of ion motion as a function of energy loss. From this the mean projection of each pathlength element of the ion trajectory is derived which - upon summation or integration - leads to the desired mean projected range. In special cases, the calculation can be carried out analytically, otherwise a simple general algorithm is derived which is suitable even for the smallest programmable calculators. Necessary input for the present treatment consists only of generally accessable stopping power and straggling formulas. The procedure does not rely on scattering cross sections, e.g. power potential or f(t 1 sup(/) 2 ) approximations. The present approach lends itself easily to include electronic straggling or to treat composed target materials, or even to account for the so-called time integral. (orig.)

  18. 50 CFR 30.1 - Surplus range animals.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Surplus range animals. 30.1 Section 30.1... NATIONAL WILDLIFE REFUGE SYSTEM RANGE AND FERAL ANIMAL MANAGEMENT Range Animals § 30.1 Surplus range animals. Range animals on fenced wildlife refuge areas, including buffalo and longhorn cattle, determined...

  19. Long-range alpha detector

    International Nuclear Information System (INIS)

    MacArthur, D.W.; McAtee, J.L.

    1991-01-01

    Historically, alpha-particle and alpha-contamination detectors have been limited by the very short range of alpha particles in air and by relatively poor sensitivity even if the particles are intercepted. Alpha detectors have had to be operated in a vacuum or in close proximity to the source if reasonable efficiency is desired. Alpha particles interact with the ambient air, producing ionization in the air at the rate of ∼30,000 ion pairs per mega-electron-volt of alpha energy. These charges can be transported over significant distances (several meters) in a moving current of air generated by a small fan. An ion chamber located in front of the fan measures the current carried by the moving ions. The long-range alpha detector (LRAD) offers several advantages over more traditional alpha detectors. First and foremost, it can operate efficiently even if the contamination is not easily accessible. Second, ions generated by contamination in crevices and other unmonitorable locations can be detected if the airflow penetrates those areas. Third, all of the contamination on a large surface will generate ions that can be detected in a single detector; hence, the detector's sensitivity to distributed sources is not limited by the size of the probe. Finally, a simple ion chamber can detect very small electric currents, making this technique potentially quite sensitive

  20. Long range trajectories

    Energy Technology Data Exchange (ETDEWEB)

    Allen, P. W.; Jessup, E. A.; White, R. E. [Air Resources Field Research Office, Las Vegas, Nevada (United States)

    1967-07-01

    A single air molecule can have a trajectory that can be described with a line, but most meteorologists use single lines to represent the trajectories of air parcels. A single line trajectory has the disadvantage that it is a categorical description of position. Like categorized forecasts it provides no qualification, and no provision for dispersion in case the parcel contains two or more molecules which may take vastly different paths. Diffusion technology has amply demonstrated that an initial aerosol cloud or volume of gas in the atmosphere not only grows larger, but sometimes divides into puffs, each having a different path or swath. Yet, the average meteorologist, faced with the problem of predicting the future motion of a cloud, usually falls back on the line trajectory approach with the explanation that he had no better tool for long range application. In his more rational moments, he may use some arbitrary device to spread his cloud with distance. One such technique has been to separate the trajectory into two or more trajectories, spaced about the endpoint of the original trajectory after a short period of travel, repeating this every so often like a chain reaction. This has the obvious disadvantage of involving a large amount of labor without much assurance of improved accuracy. Another approach is to draw a circle about the trajectory endpoint, to represent either diffusion or error. The problem then is to know what radius to give the circle and also whether to call it diffusion or error. Meteorologists at the Nevada Test Site (NTS) are asked frequently to provide advice which involves trajectory technology, such as prediction of an aerosol cloud path, reconstruction of the motion of a volume of air, indication of the dilution, and the possible trajectory prediction error over great distances. Therefore, we set out, nearly three years ago, to provide some statistical knowledge about the status of our trajectory technology. This report contains some of the

  1. Free Range Hens Use the Range More When the Outdoor Environment Is Enriched

    Directory of Open Access Journals (Sweden)

    T. A. D. Nagle

    2012-04-01

    Full Text Available To evaluate the role of using forage, shade and shelterbelts in attracting birds into the range, three trials were undertaken with free range layers both on a research facility and on commercial farms. Each of the trials on the free range research facility in South Australia used a total of 120 laying hens (Hyline Brown. Birds were housed in an eco-shelter which had 6 internal pens of equal size with a free range area adjoining the shelter. The on-farm trials were undertaken on commercial free range layer farms in the Darling Downs in Southeast Queensland with bird numbers on farms ranging from 2,000–6,800 hens. The first research trial examined the role of shaded areas in the range; the second trial examined the role of forage and the third trial examined the influence of shelterbelts in the range. These treatments were compared to a free range area with no enrichment. Aggressive feather pecking was only observed on a few occasions in all of the trials due to the low bird numbers housed. Enriching the free range environment attracted more birds into the range. Shaded areas were used by 18% of the hens with a tendency (p = 0.07 for more hens to be in the paddock. When forage was provided in paddocks more control birds (55% were observed in the range in morning than in the afternoon (30% while for the forage treatments 45% of the birds were in the range both during the morning and afternoon. When shelterbelts were provided there was a significantly (p<0.05 higher % of birds in the range (43% vs. 24% and greater numbers of birds were observed in areas further away from the poultry house. The results from the on-farm trials mirrored the research trials. Overall 3 times more hens used the shaded areas than the non shaded areas, with slightly more using the shade in the morning than in the afternoon. As the environmental temperature increased the number of birds using the outdoor shade also increased. Overall 17 times more hens used the shelterbelt

  2. A novel educational strategy targeting health care workers in underserved communities in Central America to integrate HIV into primary medical care.

    Directory of Open Access Journals (Sweden)

    Tamara Flys

    Full Text Available BACKGROUND: Current educational strategies to integrate HIV care into primary medical care in Central America have traditionally targeted managers or higher-level officials, rather than local health care workers (HCWs. We developed a complementary online and on-site interactive training program to reach local HCWs at the primary care level in underserved communities. METHODS: The training program targeted physicians, nurses, and community HCWs with limited access to traditional onsite training in Panama, Nicaragua, Dominican Republic, and Guatemala. The curriculum focused on principles of HIV care and health systems using a tutor-supported blended educational approach of an 8-week online component, a weeklong on-site problem-solving workshop, and individualized project-based interventions. RESULTS: Of 258 initially active participants, 225 (225/258=87.2% successfully completed the online component and the top 200 were invited to the on-site workshop. Of those, 170 (170/200=85% attended the on-site workshop. In total, 142 completed all three components, including the project phase. Quantitative and qualitative evaluation instruments included knowledge assessments, reflexive essays, and acceptability surveys. The mean pre and post-essay scores demonstrating understanding of social determinants, health system organization, and integration of HIV services were 70% and 87.5%, respectively, with an increase in knowledge of 17.2% (p<0.001. The mean pre- and post-test scores evaluating clinical knowledge were 70.9% and 90.3%, respectively, with an increase in knowledge of 19.4% (p<0.001. A survey of Likert scale and open-ended questions demonstrated overwhelming participant satisfaction with course content, structure, and effectiveness in improving their HIV-related knowledge and skills. CONCLUSION: This innovative curriculum utilized technology to target HCWs with limited access to educational resources. Participants benefited from technical skills

  3. The Engineering 4 Health Challenge - an interdisciplinary and intercultural initiative to foster student engagement in B.C. and improve health care for children in under-serviced communities.

    Science.gov (United States)

    Price, Morgan; Weber-Jahnke, Jens H

    2009-01-01

    This paper describes the Engineering 4 Health (E4H) Challenge, an interdisciplinary and intercultural initiative that, on the one hand, seeks to improve health education of children in under-serviced communities and, on the other, seeks to attract students in British Columbia to professions in engineering and health. The E4H Challenge engages high school and university students in BC to cooperatively design and develop health information and communication technology (ICT) to educate children living in under-serviced communities. The E4H Challenge works with the One Laptop Per Child (OLPC) program to integrate applications for health awareness into the school programs of communities in developing countries. Although applications developed by the E4H Challenge use the low-cost, innovative XO laptop (the "$100 laptop" developed by the OLPC foundation) the software can also be used with other inexpensive hardware.

  4. Anchorage Areas

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — An anchorage area is a place where boats and ships can safely drop anchor. These areas are created in navigable waterways when ships and vessels require them for...

  5. The Effect of Volunteering at a Student-Run Free Healthcare Clinic on Medical Students' Self-Efficacy, Comfortableness, Attitude, and Interest in Working with the Underserved Population and Interest in Primary Care.

    Science.gov (United States)

    Tran, Kelvin; Kovalskiy, Aleksandr; Desai, Anand; Imran, Amna; Ismail, Rahim; Hernandez, Caridad

    2017-02-23

    The number of primary care physicians in the United States continues to lag behind the number of uninsured people. There has been a growing demand for medical students to improve their self-efficacy, comfortableness, attitude, and interest in working with the underserved and in primary care. This study aims to discern whether volunteering at a student-run, free healthcare clinic has a positive impact on these five variables of interest or not. A 95-item survey was distributed through Qualtrics Survey Software (Qualtrics, Provo, UT, USA) to medical students from the Class of 2018 and Class of 2019 at the University of Central Florida College of Medicine. They were recruited via emails, Facebook, and in-classroom announcements. Mean responses on a Likert-like scale to different survey items were collected and compared between two study cohorts: Keeping Neighbors In Good Health Through Service (KNIGHTS) Clinic volunteers and non-volunteers. Results from 128 students showed no significant differences in the means between the two cohorts (p-values were not significant). When volunteers were asked the survey item, "KNIGHTS Clinic positively influenced my attitude towards working with underserved patients," 62% strongly agreed, 26% agreed, 10% were neutral, and 2% disagreed. Based on the results, volunteering at KNIGHTS Clinic may not have a positive impact on the five variables of interest. However, the lack of significance may also be due to certain limitations of this study addressed elsewhere in this paper. With the majority of KNIGHTS Clinic volunteers agreeing that "KNIGHTS Clinic positively influenced […their] attitude towards working with underserved patients," there may be a positive impact of volunteering on volunteers' attitude towards working with the underserved.

  6. Makran Mountain Range, Iran and Pakistan

    Science.gov (United States)

    1983-01-01

    The long folded mountain ridges and valleys of the coastal Makran Ranges of Iran and Pakistan (26.0N, 63.0E) illustrate the classical Trellis type of drainage pattern, common in this region. The Dasht River and its tributaries is the principal drainage network for this area. To the left, the continental drift of the northward bound Indian sub-continent has caused the east/west parallel ranges to bend in a great northward arc.

  7. Building an argument for Internet expansion in Dwesa- an under-serviced rural community in South Africa

    CSIR Research Space (South Africa)

    Dlamini, S

    2014-11-01

    Full Text Available The purpose of this paper is to present research findings that investigate the extent of Internet usage as well as options for extending the current reach of the wireless network in Dwesa, a rural area in South Africa’s Eastern Cape Province. A mix...

  8. Relationships Between Health Literacy and Genomics-Related Knowledge, Self-Efficacy, Perceived Importance, and Communication in a Medically Underserved Population.

    Science.gov (United States)

    Kaphingst, Kimberly A; Blanchard, Melvin; Milam, Laurel; Pokharel, Manusheela; Elrick, Ashley; Goodman, Melody S

    2016-01-01

    The increasing importance of genomic information in clinical care heightens the need to examine how individuals understand, value, and communicate about this information. Based on a conceptual framework of genomics-related health literacy, we examined whether health literacy was related to knowledge, self-efficacy, and perceived importance of genetics and family health history (FHH) and communication about FHH in a medically underserved population. The analytic sample was composed of 624 patients at a primary care clinic in a large urban hospital. About half of the participants (47%) had limited health literacy; 55% had no education beyond high school, and 58% were Black. In multivariable models, limited health literacy was associated with lower genetic knowledge (β = -0.55, SE = 0.10, p interval [CI; 0.28, 0.90], p = .020), and greater perceived importance of genetic information (OR = 1.95, 95% CI [1.27, 3.00], p = .0022) but lower perceived importance of FHH information (OR = 0.47, 95% CI [0.26, 0.86], p = .013) and more frequent communication with a doctor about FHH (OR = 2.02, 95% CI [1.27, 3.23], p = .0032). The findings highlight the importance of considering domains of genomics-related health literacy (e.g., knowledge, oral literacy) in developing educational strategies for genomic information. Health literacy research is essential to avoid increasing disparities in information and health outcomes as genomic information reaches more patients.

  9. Individual Ranging Behaviour Patterns in Commercial Free-Range Layers as Observed through RFID Tracking.

    Science.gov (United States)

    Larsen, Hannah; Cronin, Greg M; Gebhardt-Henrich, Sabine G; Smith, Carolynn L; Hemsworth, Paul H; Rault, Jean-Loup

    2017-03-09

    In this exploratory study, we tracked free-range laying hens on two commercial flocks with Radio Frequency Identification (RFID) technology with the aim to examine individual hen variation in range use. Three distinct outdoor zones were identified at increasing distances from the shed; the veranda [0-2.4 m], close range [2.4-11.4 m], and far range [>11.4 m]. Hens' movements between these areas were tracked using radio frequency identification technology. Most of the hens in both flocks (68.6% in Flock A, and 82.2% in Flock B) accessed the range every day during the study. Of the hens that accessed the range, most hens accessed all three zones (73.7% in Flock A, and 84.5% in Flock B). Hens spent half of their time outdoors in the veranda area. Within-individual consistency of range use (daily duration and frequency) varied considerably, and hens which were more consistent in their daily range use spent more time on the range overall ( p ranging behaviour may help elucidate the implications of ranging for laying hens.

  10. Sound propagation from a semi-open shooting range

    NARCIS (Netherlands)

    Eerden, F.J.M. van der; Berg, F. van den

    2011-01-01

    Semi-open shooting ranges, in contrast to a fully open shooting range, are often used in the densely populated area of the Netherlands. The Ministry of Defense operates a number of these ranges. In these shooting ranges above the line of fire a number of screens are situated for safety precautions

  11. Super-ranging. A new ranging strategy in European badgers.

    Directory of Open Access Journals (Sweden)

    Aoibheann Gaughran

    Full Text Available We monitored the ranging of a wild European badger (Meles meles population over 7 years using GPS tracking collars. Badger range sizes varied seasonally and reached their maximum in June, July and August. We analysed the summer ranging behaviour, using 83 home range estimates from 48 individuals over 6974 collar-nights. We found that while most adult badgers (males and females remained within their own traditional social group boundaries, several male badgers (on average 22% regularly ranged beyond these traditional boundaries. These adult males frequently ranged throughout two (or more social group's traditional territories and had extremely large home ranges. We therefore refer to them as super-rangers. While ranging across traditional boundaries has been recorded over short periods of time for extraterritorial mating and foraging forays, or for pre-dispersal exploration, the animals in this study maintained their super-ranges from 2 to 36 months. This study represents the first time such long-term extra-territorial ranging has been described for European badgers. Holding a super-range may confer an advantage in access to breeding females, but could also affect local interaction networks. In Ireland & the UK, badgers act as a wildlife reservoir for bovine tuberculosis (TB. Super-ranging may facilitate the spread of disease by increasing both direct interactions between conspecifics, particularly across social groups, and indirect interactions with cattle in their shared environment. Understanding super-ranging behaviour may both improve our understanding of tuberculosis epidemiology and inform future control strategies.

  12. Rock glaciers, Zailiysiky Range, Kungei Ranges, Tienshan, Kazakhstan, Version 1

    Data.gov (United States)

    National Aeronautics and Space Administration — The Zailiyskiy Alatau is the northernmost parallel latitudinal ranges of the Northern Tien Shan. The highest point of this range is the Talgar peak (4973 m a.s.l.)....

  13. The 50/50 cc Total Artificial Heart Trial: Extending the Benefits of the Total Artificial Heart to Underserved Populations.

    Science.gov (United States)

    Wells, Dennis; Villa, Chet R; Simón Morales, David Luís

    2017-01-01

    While use of the total artificial heart (TAH) is growing, the use of the device is not uniform across the gender and age spectrum because the vast majority of implants are in adult males. SynCardia has recently developed a smaller 50 cc TAH that was designed to accommodate patients with a body surface area as low as 1.2 m 2 (potentially even lower using virtual implantation). Herein, we describe the early use of the 50 cc TAH (10 implants in the US and 18 outside the US). Twenty-eight devices have been implanted worldwide. Nineteen (68%) patients were female, 4 (14%) were 21 years of age or younger, and 2 (7%) had a diagnosis of congenital heart disease (1 Fontan). The smallest patient, by body surface area, was 1.35 m 2 . Six patients (21%) have been placed on the Freedom Driver, all of whom have survived. Fourteen patients (50%) have had a positive outcome to date. The development of the 50 cc TAH has expanded the population of patients who may benefit from TAH support and thus may help improve outcomes for patients who have had limited biventricular support options to date. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Increasing Research Capacity in Underserved Communities: Formative and Summative Evaluation of the Mississippi Community Research Fellows Training Program (Cohort 1

    Directory of Open Access Journals (Sweden)

    Danielle Fastring

    2018-02-01

    Full Text Available BackgroundThe Mississippi Community Research Fellows Training Program (MSCRFTP is a 15-week program conducted in Jackson, MS, USA consisting of training in the areas of evidence-based public health, research methods, research ethics, and cultural competency. The purpose of the program was to increase community knowledge and understanding of public health research, develop community-based projects that addressed health disparity in the participants’ community, increase individual and community capacity, and to engage community members as equal partners in the research process.MethodsA comprehensive evaluation of the MSCRFTP was conducted that included both quantitative and qualitative methods. All participants were asked to complete a baseline, midterm, and final assessment as part of their program requirements. Knowledge gained was assessed by comparing baseline assessment responses to final assessment responses related to 27 key content areas addressed in the training sessions. Assessments also collected participants’ attitudes toward participating in research within their communities, their perceived influence over community decisions, and their perceptions of community members’ involvement in research, satisfaction with the program, and the program’s impact on the participants’ daily practice and community work.ResultsTwenty-one participants, the majority of which were female and African-American, completed the MSCRFTP. Knowledge of concepts addressed in 15 weekly training sessions improved significantly on 85.2% of 27 key areas evaluated (p < 0.05. Two mini-grant community based participatory research projects proposed by participants were funded through competitive application. Most participants agreed that by working together, the people in their community could influence decisions that affected the community. All participants rated their satisfaction with the overall program as “very high” (76.2%, n = 16 or

  15. 2011 NASA Range Safety Annual Report

    Science.gov (United States)

    Dumont, Alan G.

    2012-01-01

    Welcome to the 2011 edition of the NASA Range Safety Annual Report. Funded by NASA Headquarters, this report provides a NASA Range Safety overview for current and potential range users. As is typical with odd year editions, this is an abbreviated Range Safety Annual Report providing updates and links to full articles from the previous year's report. It also provides more complete articles covering new subject areas, summaries of various NASA Range Safety Program activities conducted during the past year, and information on several projects that may have a profound impact on the way business will be done in the future. Specific topics discussed and updated in the 2011 NASA Range Safety Annual Report include a program overview and 2011 highlights; Range Safety Training; Range Safety Policy revision; Independent Assessments; Support to Program Operations at all ranges conducting NASA launch/flight operations; a continuing overview of emerging range safety-related technologies; and status reports from all of the NASA Centers that have Range Safety responsibilities. Every effort has been made to include the most current information available. We recommend this report be used only for guidance and that the validity and accuracy of all articles be verified for updates. Once again the web-based format was used to present the annual report. We continually receive positive feedback on the web-based edition and hope you enjoy this year's product as well. As is the case each year, contributors to this report are too numerous to mention, but we thank individuals from the NASA Centers, the Department of Defense, and civilian organizations for their contributions. In conclusion, it has been a busy and productive year. I'd like to extend a personal Thank You to everyone who contributed to make this year a successful one, and I look forward to working with all of you in the upcoming year.

  16. Revitalization Areas

    Data.gov (United States)

    Department of Housing and Urban Development — Revitalization areas are HUD-designated neighborhoods in need of economic and community development and where there is already a strong commitment by the local...

  17. 700 Area

    Data.gov (United States)

    Federal Laboratory Consortium — The 700 Area of the Hanford Site is located in downtown Richland.Called the Federal Office Building, the Richland Operations Site Manager and the Richland Operations...

  18. Are fish outside their usual ranges early indicators of climate-driven range shifts?

    Science.gov (United States)

    Fogarty, Hannah E; Burrows, Michael T; Pecl, Gretta T; Robinson, Lucy M; Poloczanska, Elvira S

    2017-05-01

    Shifts in species ranges are a global phenomenon, well known to occur in response to a changing climate. New species arriving in an area may become pest species, modify ecosystem structure, or represent challenges or opportunities for fisheries and recreation. Early detection of range shifts and prompt implementation of any appropriate management strategies is therefore crucial. This study investigates whether 'first sightings' of marine species outside their normal ranges could provide an early warning of impending climate-driven range shifts. We examine the relationships between first sightings and marine regions defined by patterns of local climate velocities (calculated on a 50-year timescale), while also considering the distribution of observational effort (i.e. number of sampling days recorded with biological observations in global databases). The marine trajectory regions include climate 'source' regions (areas lacking connections to warmer areas), 'corridor' regions (areas where moving isotherms converge), and 'sink' regions (areas where isotherms locally disappear). Additionally, we investigate the latitudinal band in which first sightings were recorded, and species' thermal affiliations. We found that first sightings are more likely to occur in climate sink and 'divergent' regions (areas where many rapid and diverging climate trajectories pass through) indicating a role of temperature in driving changes in marine species distributions. The majority of our fish first sightings appear to be tropical and subtropical species moving towards high latitudes, as would be expected in climate warming. Our results indicate that first sightings are likely related to longer-term climatic processes, and therefore have potential use to indicate likely climate-driven range shifts. The development of an approach to detect impending range shifts at an early stage will allow resource managers and researchers to better manage opportunities resulting from range

  19. Long-Range Neutron Detection

    International Nuclear Information System (INIS)

    Peurrung, A.J.; Stromswold, D.C.; Hansen, R.R.; Reeder, P.L.; Barnett, D.S.

    1999-01-01

    A neutron detector designed for detecting neutron sources at distances of 50 to 100 m has been constructed and tested. This detector has a large surface area (1 m 2 ) to enhance detection efficiency, and it contains a collimator and shielding to achieve direction sensitivity and reduce background. An unusual feature of the detector is that it contains no added moderator, such as polyethylene, to moderate fast neutrons before they reach the 3 He detector. As a result, the detector is sensitive mainly to thermal neutrons. The moderator-free design reduces the weight of the detector, making it more portable, and it also aids in achieving directional sensitivity and background reduction. Test results show that moderated fission-neutron sources of strength about 3 x 10 5 n/s can be detected at a distance out to 70 m in a counting time of 1000 s. The best angular resolution of the detector is obtained at distances of 30 m or less. As the separation .distance between the source and detector increases, the contribution of scattered neutrons to the measured signal increases with a resultant decrease in the ability to detect the direction to a distant source. Applications for which the long-range detector appears to be suitable include detecting remote neutron sources (including sources in moving vehicles) and monitoring neutron storage vaults for the intrusion of humans and the effects they make on the detected neutron signal. Also, the detector can be used to measure waste for the presence of transuranic material in the presence of high gamma-ray background. A test with a neutron source (3 x 10 5 n/s) in a vehicle showed that the detector could readily measure an increase in count rate at a distance of 10 m for vehicle speeds up to 35 mph (the highest speed tested). These results. indicate that the source should be detectable at this distance at speeds up to 55 mph

  20. Budget Impact Analysis of Against Colorectal Cancer In Our Neighborhoods (ACCION): A Successful Community-Based Colorectal Cancer Screening Program for a Medically Underserved Minority Population.

    Science.gov (United States)

    Kim, Bumyang; Lairson, David R; Chung, Tong Han; Kim, Junghyun; Shokar, Navkiran K

    2017-06-01

    Given the uncertain cost of delivering community-based cancer screening programs, we developed a Markov simulation model to project the budget impact of implementing a comprehensive colorectal cancer (CRC) prevention program compared with the status quo. The study modeled the impacts on the costs of clinical services, materials, and staff expenditures for recruitment, education, fecal immunochemical testing (FIT), colonoscopy, follow-up, navigation, and initial treatment. We used data from the Against Colorectal Cancer In Our Neighborhoods comprehensive CRC prevention program implemented in El Paso, Texas, since 2012. We projected the 3-year financial consequences of the presence and absence of the CRC prevention program for a hypothetical population cohort of 10,000 Hispanic medically underserved individuals. The intervention cohort experienced a 23.4% higher test completion rate for CRC prevention, 8 additional CRC diagnoses, and 84 adenomas. The incremental 3-year cost was $1.74 million compared with the status quo. The program cost per person was $261 compared with $86 for the status quo. The costs were sensitive to the proportion of high-risk participants and the frequency of colonoscopy screening and diagnostic procedures. The budget impact mainly derived from colonoscopy-related costs incurred for the high-risk group. The effectiveness of FIT to detect CRC was critically dependent on follow-up after positive FIT. Community cancer prevention programs need reliable estimates of the cost of CRC screening promotion and the added budget impact of screening with colonoscopy. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  1. The Regional Asthma Disease Management Program (RADMP) for low income underserved children in rural western North Carolina: a National Asthma Control Initiative Demonstration Project.

    Science.gov (United States)

    Shuler, Melinda S; Yeatts, Karin B; Russell, Donald W; Trees, Amy S; Sutherland, Susan E

    2015-01-01

    A substantial proportion of low-income children with asthma living in rural western North Carolina have suboptimal asthma management. To address the needs of these underserved children, we developed and implemented the Regional Asthma Disease Management Program (RADMP); RADMP was selected as one of 13 demonstration projects for the National Asthma Control Initiative (NACI). This observational intervention was conducted from 2009 to 2011 in 20 rural counties and the Eastern Band Cherokee Indian Reservation in western North Carolina. Community and individual intervention components included asthma education in-services and environmental assessments/remediation. The individual intervention also included clinical assessment and management. Environmental remediation was conducted in 13 childcare facilities and 50 homes; over 259 administrative staff received asthma education. Fifty children with mild to severe persistent asthma were followed for up to 2 years; 76% were enrolled in Medicaid. From 12-month pre-intervention to 12-month post-intervention, the total number of asthma-related emergency department (ED) visits decreased from 158 to 4 and hospital admissions from 62 to 1 (p < 0.0001). From baseline to intervention completion, lung function FVC, FEV1, FEF 25-75 increased by 7.2%, 13.2% and 21.1%, respectively (all p < 0.001), and average school absences dropped from 17 to 8.8 days. Healthcare cost avoided 12 months post-intervention were approximately $882,021. The RADMP program resulted in decreased ED visits, hospitalizations, school absences and improved lung function and eNO. This was the first NACI demonstration project to show substantial improvements in healthcare utilization and clinical outcomes among rural asthmatic children.

  2. Parent-child reading interactions among English and English as a second language speakers in an underserved pediatric clinic in Hawai'i.

    Science.gov (United States)

    Kitabayashi, Kristyn M; Huang, Gary Y; Linskey, Katy R; Pirga, Jason; Bane-Terakubo, Teresa; Lee, Meta T

    2008-10-01

    The purpose of this study was to compare reading patterns between English-speaking and English as a Second Language (ESL) families in a health care setting in Hawai'i. A cross-sectional study was performed at an underserved pediatric primary care clinic in Hawai'i. Caregivers of patients between the ages of 6 months to 5 years were asked questions regarding demographics and parent-child reading interactions. Respondents were categorized into English-speaking or ESL groups based on primary language spoken at home. Pearson chi2 tests and Fisher exact tests were performed to compare demographic differences, reading frequency, and reading attitudes between groups. One-hundred three respondents completed the survey Fifty percent were ESL. All ESL respondents were of Asian-Pacific Islander (API) or mixed Asian ethnicity. All Caucasians in the study (n = 9) were in the English-speaking group. Between the English-speaking (n = 52) and ESL (n = 51) groups, there were no significant statistical differences in age or gender of the child, reading attitudes, or parent's educational status. Parents in the ESL group read to their children significantly fewer days per week than their English-speaking counterparts, had significantly fewer books in the home, and lived significantly fewer years in the United States. The findings suggest that API immigrant families share similar attitudes about reading as English-speaking families in Hawai'i but have significantly fewer books in their household and read significantly less frequently Physicians working with API populations should be aware that immigrant children may have fewer reading interactions and should counsel parents on the importance of reading daily.

  3. Identifying Telemedicine Services to Improve Access to Specialty Care for the Underserved in the San Francisco Safety Net

    Directory of Open Access Journals (Sweden)

    Ken Russell Coelho

    2011-01-01

    Full Text Available Safety-net settings across the country have grappled with providing adequate access to specialty care services. San Francisco General Hospital and Trauma Center, serving as the city's primary safety-net hospital, has also had to struggle with the same issue. With Healthy San Francisco, the City and County of San Francisco's Universal Healthcare mandate, the increased demand for specialty care services has placed a further strain on the system. With the recent passage of California Proposition 1D, infrastructural funds are now set aside to assist in connecting major hospitals with primary care clinics in remote areas all over the state of California, using telemedicine. Based on a selected sample of key informant interviews with local staff physicians, this study provides further insight into the current process of e-referral which uses electronic communication for making referrals to specialty care. It also identifies key services for telemedicine in primary and specialty care settings within the San Francisco public health system. This study concludes with proposals for a framework that seek to increase collaboration between the referring primary care physician and specialist, to prioritize institution of these key services for telemedicine.

  4. Improved Range Searching Lower Bounds

    DEFF Research Database (Denmark)

    Larsen, Kasper Green; Nguyen, Huy L.

    2012-01-01

    by constructing a hard input set and query set, and then invoking Chazelle and Rosenberg's [CGTA'96] general theorem on the complexity of navigation in the pointer machine. For the group model, we show that input sets and query sets that are hard for range reporting in the pointer machine (i.e. by Chazelle...... and Rosenberg's theorem), are also hard for dynamic range searching in the group model. This theorem allows us to reuse decades of research on range reporting lower bounds to immediately obtain a range of new group model lower bounds. Amongst others, this includes an improved lower bound for the fundamental...

  5. Short-range fundamental forces

    International Nuclear Information System (INIS)

    Antoniadis, I.; Baessler, S.; Buchner, M.; Fedorov, V.V.; Hoedl, S.; Nesvizhevsky, V.V.; Pignol, G.; Protasov, K.V.; Lambrecht, A.; Reynaud, S.; Sobolev, Y.

    2010-01-01

    We consider theoretical motivations to search for extra short-range fundamental forces as well as experiments constraining their parameters. The forces could be of two types: 1) spin-independent forces; 2) spin-dependent axion-like forces. Different experimental techniques are sensitive in respective ranges of characteristic distances. The techniques include measurements of gravity at short distances, searches for extra interactions on top of the Casimir force, precision atomic and neutron experiments. We focus on neutron constraints, thus the range of characteristic distances considered here corresponds to the range accessible for neutron experiments

  6. Report to Congress on Sustainable Ranges, 2013

    Science.gov (United States)

    2013-04-01

    SPECTRUM The growing prevalence of wireless technology and its demand for additional frequency conflicts with the DoD’s requirement to train for...HE R Beaver Training Area US UT ARNG 657 0 0 0 N N Y N N N N N N N N Beckley City Police Range US WV ARNG 2 0 0 0 N N N N Y N N N N N N Beech Fork

  7. Report to Congress on Sustainable Ranges, 2011

    Science.gov (United States)

    2011-07-01

    Tortugas and Fort Jefferson. 3. The ASUW Mission Area for the range complex was deleted for the 2011 assessment; the assessment dropped from 9.09 to...Comments Noise Restrictions Anti-Air Warfare (AAW) Sonic booms generated by VFA aircraft in the vicinity of the Dry Tortugas reportedly startles...Environmental Assessment recommended stipulating the expansion of an existing buffer zone around the Dry Tortugas by 2,000 feet, from 18,000 to 20,000

  8. Dynamic range majority data structures

    DEFF Research Database (Denmark)

    Elmasry, Amr Ahmed Abd Elmoneim; He, Meng; Munro, J. Ian

    2011-01-01

    Given a set P of n coloured points on the real line, we study the problem of answering range α-majority (or "heavy hitter") queries on P. More specifically, for a query range Q, we want to return each colour that is assigned to more than an α-fraction of the points contained in Q. We present a ne...

  9. Range Compressed Holographic Aperture Ladar

    Science.gov (United States)

    2017-06-01

    entropy saturation behavior of the estimator is analytically described. Simultaneous range-compression and aperture synthesis is experimentally...4 2.1 Circular and Inverse -Circular HAL...2.3 Single Aperture, Multi-λ Imaging ...................................................................................... 14 2.4 Simultaneous Range

  10. Precise Range Determination Using Laser Ranging Data of LAGEOS

    Directory of Open Access Journals (Sweden)

    Kwang-Ryul Kim

    1993-12-01

    Full Text Available Satellite laser ranging observation of LAGEOS ¥± has been performed using the SLR System at Sheshan Laser Ranging Station, Shanghai Observatory. And we obtained 1,838 observational points The observed range data is corrected by means of system delay correction using ground target observation, atmospheric refraction delay correction, offset correction, general relativistic correction and tide correction including solid tide, polar tide and ocean tide. As a result, the determined range delay mean value is 19.12m and the mean internal accuracy by means of polynomial fitting and least square method is ¡¾7cm. Corrected observational points are 1,340 and noise ratio to total observational points is 27.1%

  11. Comparison of small-area deprivation measures as predictors of chronic disease burden in a low-income population.

    Science.gov (United States)

    Lòpez-De Fede, Ana; Stewart, John E; Hardin, James W; Mayfield-Smith, Kathy

    2016-06-10

    Measures of small-area deprivation may be valuable in geographically targeting limited resources to prevent, diagnose, and effectively manage chronic conditions in vulnerable populations. We developed a census-based small-area socioeconomic deprivation index specifically to predict chronic disease burden among publically insured Medicaid recipients in South Carolina, a relatively poor state in the southern United States. We compared the predictive ability of the new index with that of four other small-area deprivation indicators. To derive the ZIP Code Tabulation Area-Level Palmetto Small-Area Deprivation Index (Palmetto SADI), we evaluated ten census variables across five socioeconomic deprivation domains, identifying the combination of census indicators most highly correlated with a set of five chronic disease conditions among South Carolina Medicaid enrollees. In separate validation studies, we used both logistic and spatial regression methods to assess the ability of Palmetto SADI to predict chronic disease burden among state Medicaid recipients relative to four alternative small-area socioeconomic deprivation measures: the Townsend index of material deprivation; a single-variable poverty indicator; and two small-area designations of health care resource deprivation, Primary Care Health Professional Shortage Area and Medically Underserved Area/Medically Underserved Population. Palmetto SADI was the best predictor of chronic disease burden (presence of at least one condition and presence of two or more conditions) among state Medicaid recipients compared to all alternative deprivation measures tested. A low-cost, regionally optimized socioeconomic deprivation index, Palmetto SADI can be used to identify areas in South Carolina at high risk for chronic disease burden among Medicaid recipients and other low-income Medicaid-eligible populations for targeted prevention, screening, diagnosis, disease self-management, and care coordination activities.

  12. Quiet areas

    DEFF Research Database (Denmark)

    Petersen, Rikke Munck

    2016-01-01

    This paper argues that drone filming can substantiate our understanding of multisensorial experiences of quiet areas and urban landscapes. Contrary to the distanced gaze often associated with the drone, this paper discusses drone filming as an intimate performativity apparatus that can affect...... perception as a result of its interrelationships between motion, gaze, and sound. This paper uses four films, one of which is a drone flyover, to launch a discussion concerning a smooth and alluring gaze, a sliding gaze that penetrates landscapes, and site appearance. Films hold the capacity to project both...... and transcendence can facilitate a deeper understanding of intimate sensations, substantiating their role in the future design and planning of urban landscapes. Hence, it addresses the ethics of an intimacy perspective (of drone filming) in the qualification of quiet areas....

  13. Children's Healthy Living (CHL) Program for remote underserved minority populations in the Pacific region: rationale and design of a community randomized trial to prevent early childhood obesity.

    Science.gov (United States)

    Wilken, Lynne R; Novotny, Rachel; Fialkowski, Marie K; Boushey, Carol J; Nigg, Claudio; Paulino, Yvette; Leon Guerrero, Rachael; Bersamin, Andrea; Vargo, Don; Kim, Jang; Deenik, Jonathan

    2013-10-09

    's Healthy Living Program environmental trial is designed to focus on capacity building and to maximize the likelihood of sustainable impact on childhood obesity-related behaviors and outcomes. The multiple measures at the individual, community, and environment levels are designed to maximize the likelihood of detecting change. This approach enhances the likelihood for identifying and promoting the best methods to promote health and well-being of the children in the underserved US Affiliated Pacific Region. NIH clinical trial # NCT01881373.

  14. Partnered Evaluation of a Community Engagement Intervention: Use of a “Kickoff” Conference in a Randomized Trial for Depression Care Improvement in Underserved Communities

    Science.gov (United States)

    Mendel, Peter; Ngo, Victoria K.; Dixon, Elizabeth; Stockdale, Susan; Jones, Felica; Chung, Bowen; Jones, Andrea; Masongsong, Zoe; Khodyakov, Dmitry

    2013-01-01

    Community partnered research and engagement strategies are gaining recognition as innovative approaches to improving healthcare systems and reducing health disparities in underserved communities. These strategies may have particular relevance for mental health interventions in low income, minority communities in which there often is great stigma and silence surrounding conditions such as depression and difficulty in implementing improved access and quality of care. At the same time, there is a relative dearth of evidence on the effectiveness of specific community engagement interventions and on the design, process, and context of these interventions necessary for understanding their implementation and generalizability. This paper evaluates one of a number of community engagement strategies employed in the Community Partners in Care (CPIC) study, the first randomized controlled trial of the role of community engagement in adapting and implementing evidence-based depression care. We specifically describe the unique goals and features of a community engagement “kickoff” conference as used in CPIC and provide evidence on the effectiveness of this type of intervention by analyzing its impact on: 1) stimulating a dialogue, sense of collective efficacy, and opportunities for learning and networking to address depression and depression care in the community, 2) activating interest and participation in CPIC’s randomized trial of two different ways to implement evidence-based quality improvement (QI) programs for depression across diverse community agencies, and 3) introducing evidence-based toolkits and collaborative care models to potential participants in both intervention conditions and other community members. We evaluated the effectiveness of the conference through a community-partnered process in which both community and academic project members were involved in study design, data collection and analysis. Data sources include participant conference evaluation

  15. On inertial range scaling laws

    International Nuclear Information System (INIS)

    Bowman, J.C.

    1994-12-01

    Inertial-range scaling laws for two- and three-dimensional turbulence are re-examined within a unified framework. A new correction to Kolmogorov's k -5/3 scaling is derived for the energy inertial range. A related modification is found to Kraichnan's logarithmically corrected two-dimensional enstrophy cascade law that removes its unexpected divergence at the injection wavenumber. The significance of these corrections is illustrated with steady-state energy spectra from recent high-resolution closure computations. The results also underscore the asymptotic nature of inertial-range scaling laws. Implications for conventional numerical simulations are discussed

  16. GPS test range mission planning

    Science.gov (United States)

    Roberts, Iris P.; Hancock, Thomas P.

    The principal features of the Test Range User Mission Planner (TRUMP), a PC-resident tool designed to aid in deploying and utilizing GPS-based test range assets, are reviewed. TRUMP features time history plots of time-space-position information (TSPI); performance based on a dynamic GPS/inertial system simulation; time history plots of TSPI data link connectivity; digital terrain elevation data maps with user-defined cultural features; and two-dimensional coverage plots of ground-based test range assets. Some functions to be added during the next development phase are discussed.

  17. Genus Ranges of Chord Diagrams.

    Science.gov (United States)

    Burns, Jonathan; Jonoska, Nataša; Saito, Masahico

    2015-04-01

    A chord diagram consists of a circle, called the backbone, with line segments, called chords, whose endpoints are attached to distinct points on the circle. The genus of a chord diagram is the genus of the orientable surface obtained by thickening the backbone to an annulus and attaching bands to the inner boundary circle at the ends of each chord. Variations of this construction are considered here, where bands are possibly attached to the outer boundary circle of the annulus. The genus range of a chord diagram is the genus values over all such variations of surfaces thus obtained from a given chord diagram. Genus ranges of chord diagrams for a fixed number of chords are studied. Integer intervals that can be, and those that cannot be, realized as genus ranges are investigated. Computer calculations are presented, and play a key role in discovering and proving the properties of genus ranges.

  18. Intentionally Short Range Communications (ISRC)

    Science.gov (United States)

    1993-05-01

    molecular oxygen in the atmosphere at 60 GHz (figure 9 LIppolito, 1981]). The MMW range is similar to that of the UV links. 3.3.1 Variable Range Similar to...option also requires that the signal be strong enough to overcome the noise from the solar and background sources, although the molecular oxygen and... emisions . Lasing will occur only within the cavity when the alignment is correct and not lasing othem ise. Such a cavity is dcteclable only when an observer

  19. Seismic-Acoustic Active Range Monitoring for Characterizing Low-Order Ordnance Detonation

    National Research Council Canada - National Science Library

    Anderson, Thomas S; Weale, Jason C

    2006-01-01

    .... The Distributed Sources focus area strives to characterize the level of contamination in range environments attributed to ordnance residue for the purpose of range management and environmental remediation...

  20. The eCALM Trial-eTherapy for cancer appLying mindfulness: online mindfulness-based cancer recovery program for underserved individuals living with cancer in Alberta: protocol development for a randomized wait-list controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Zernicke Kristin A

    2013-02-01

    Full Text Available Abstract Background Elevated stress can exacerbate cancer symptom severity, and after completion of primary cancer treatments, many individuals continue to have significant distress. Mindfulness-Based Cancer Recovery (MBCR is an 8-week group psychosocial intervention consisting of training in mindfulness meditation and yoga designed to mitigate stress, pain, and chronic illness. Efficacy research shows face-to-face (F2F MBCR programs have positive benefits for cancer patients; however barriers exist that impede participation in F2F groups. While online MBCR groups are available to the public, none have been evaluated. Primary objective: determine whether underserved patients are willing to participate in and complete an online MBCR program. Secondary objectives: determine whether online MBCR will mirror previous efficacy findings from F2F MBCR groups on patient-reported outcomes. Method/design The study includes cancer patients in Alberta, exhibiting moderate distress, who do not have access to F2F MBCR. Participants will be randomized to either online MBCR, or waiting for the next available group. An anticipated sample size of 64 participants will complete measures online pre and post treatment or waiting period. Feasibility will be tracked through monitoring numbers eligible and participating through each stage of the protocol. Discussion 47 have completed/completing the intervention. Data suggest it is possible to conduct a randomized waitlist controlled trial of online MBCR to reach underserved cancer survivors. Trial registration Clinical Trials.gov Identifier: NCT01476891

  1. Area Health Education Center (AHEC) programs for rural and underrepresented minority students in the Alabama Black Belt.

    Science.gov (United States)

    Patel, Ashruta; Knox, Regina J; Logan, Alicia; Summerville, Katie

    2017-01-01

    This paper evaluated the implementation West Central Alabama Area Health Education Center programs for high school students in grades 9-12 through participant-reported evaluations and feedback during the  September 1st, 2013 to August 31st, 2014 fiscal year. The programs targeted racial/ethnic minorities and/or rural individuals interested in pursuing a career as a healthcare provider in medically underserved counties of Alabama. Students participated in enrichment activities related to prospective health careers that included: successful college preparedness, knowledge about health careers, and the types of primary care health professions that are needed in underserved Alabama communities. The curriculum studied 593 (ACT preparation: n  = 172, AHEC 101: n  = 56, FAFSA: n  = 109, Health Career Exploration: n  = 159, College Career Readiness: n  = 67, Dixie Scholars NERD: n  = 30) baseline measures for the programs to evaluate effectiveness when rated by participants both quantitatively and qualitatively. Interactive activities with video incorporation, hands-on experiences, and group discussions paired with student motivation and interest in specific health career-related activities provided the highest program ratings. It is important to use a variety of successful program strategies when forming healthcare workforce development interventions. Student evaluations can help adapt methods for future program implementation to ultimately achieve strategies for health professional recruitment, training, and retention in areas that lack access to quality healthcare.

  2. Telemedicine in rural areas: general practitioners’ representations and experiences

    Science.gov (United States)

    Durupt, Maxime; Bouchy, Olivier; Christophe, Sonia; Kivits, Joëlle; Boivin, Jean-Marc

    2016-10-19

    Introduction: Telemedicine is a rapidly growing new mode of healthcare practice. It is particularly used and needed in remote areas in Lorraine (North East of France) that currently face a shortage of general practitioners and specialists. The objective of this study was to analyse general practitioner’s representations of telemedicine and teleconsultation. The study also identified the advantages and disadvantages of this new mode of medical practice. Methods: A qualitative research was led: 5 focus groups were conducted with 32 doctors in areas faced with the problems of health professional shortages between June 2014 and July 2015. Results: This study reveals a general ignorance of telemedicine. Doctors want to play a central role in this new form of medical practice which must remain optional. Their reluctance essentially concerns financial and legal aspects that constitute obstacles to the development of telemedicine. Finally, this new mode of medical practice must comply with a legal framework regarding medical responsibility and personal data protection. Discussion.More than 100 medical procedures are delivered by telemedicine in Lorraine each month. This new technology is a solution to provide healthcare services in medically underserved areas. However, general practitioners want to preserve the “doctor-patient” relationship and do not wish to change their practice.

  3. GEA CRDA Range Data Analysis

    Science.gov (United States)

    1999-07-28

    E1, July-August 1998 18 3.3. Example 3: SatMex, Solidaridad 2, May-June 1998 27 3.4. Example 4: PanAmSat, Galaxy IV, May-June 1998 33 3.5...17 Millstone measurements residuals for Telstar 401 on Days 181-263. 26 3-18 Millstone measurement residuals for Solidaridad 1 on Days 141-153...with 29 SatMex range data. 3-19 Hermosillo B-- Solidaridad 1 range residuals through Days 135-144 with bias 30 removed. 3-20 Iztapalapa D

  4. Wide range neutron monitoring device

    International Nuclear Information System (INIS)

    Okido, Fumiyasu; Arita, Setsuo; Ishii, Kazuhiko; Matsumiya, Shoichi; Furusato, Ken-ichiro; Nishida, Akira.

    1994-01-01

    The present invention has a function of reliably switching measuring values between a pulse method and a Cambel method even if noise level and saturated level are fluctuated. That is, a proportional range judging means always monitors neutron flux measuring values in a start-up region and neutron flux measuring values in an intermediate power region, so that the proportional range is detected depending on whether the difference or a variation coefficient of both of the measured values is constant or not. A switching value determining means determines a switching value by the result of judgement of the proportional range judging means. A selection/output means selects and outputs measuring signals at a neutron flux level in the start-up region or the intermediate power region by the output of the switching value determining means. With such procedures, since the measuring value is switched after confirming that arrival at the proportional range where the difference or a variation coefficient of the measured value between the pulse processing method and the measured value by the Cambel method is constant, an accurate neutron flux level containing neither noise level nor saturated level can be outputted. (I.S.)

  5. Truthful approximations to range voting

    DEFF Research Database (Denmark)

    Filos-Ratsika, Aris; Miltersen, Peter Bro

    We consider the fundamental mechanism design problem of approximate social welfare maximization under general cardinal preferences on a finite number of alternatives and without money. The well-known range voting scheme can be thought of as a non-truthful mechanism for exact social welfare...

  6. Heteronuclear Long-Range Correlation

    DEFF Research Database (Denmark)

    Sørensen, Ole W.

    The lecture will cover heteronuclear long-range correlation techniques like HMBC, H2BC, and HAT HMBC with the emphasis on determining the number of covalent bonds between two spins being correlated. H2BC and HMBC spectra are quite complementary as a peak can be strong in one of the two spectra...

  7. The frequency range of TMJ sounds.

    Science.gov (United States)

    Widmalm, S E; Williams, W J; Djurdjanovic, D; McKay, D C

    2003-04-01

    There are conflicting opinions about the frequency range of temporomandibular joint (TMJ) sounds. Some authors claim that the upper limit is about 650 Hz. The aim was to test the hypothesis that TMJ sounds may contain frequencies well above 650 Hz but that significant amounts of their energy are lost if the vibrations are recorded using contact sensors and/or travel far through the head tissues. Time-frequency distributions of 172 TMJ clickings (three subjects) were compared between recordings with one microphone in the ear canal and a skin contact transducer above the clicking joint and between recordings from two microphones, one in each ear canal. The energy peaks of the clickings recorded with a microphone in the ear canal on the clicking side were often well above 650 Hz and always in a significantly higher area (range 117-1922 Hz, P 375 Hz) or in microphone recordings from the opposite ear canal (range 141-703 Hz). Future studies are required to establish normative frequency range values of TMJ sounds but need methods also capable of recording the high frequency vibrations.

  8. Range-Image Acquisition for Discriminated Objects in a Range-gated Robot Vision System

    Energy Technology Data Exchange (ETDEWEB)

    Park, Seung-Kyu; Ahn, Yong-Jin; Park, Nak-Kyu; Baik, Sung-Hoon; Choi, Young-Soo; Jeong, Kyung-Min [KAERI, Daejeon (Korea, Republic of)

    2015-05-15

    The imaging capability of a surveillance vision system from harsh low-visibility environments such as in fire and detonation areas is a key function to monitor the safety of the facilities. 2D and range image data acquired from low-visibility environment are important data to assess the safety and prepare appropriate countermeasures. Passive vision systems, such as conventional camera and binocular stereo vision systems usually cannot acquire image information when the reflected light is highly scattered and absorbed by airborne particles such as fog. In addition, the image resolution captured through low-density airborne particles is decreased because the image is blurred and dimmed by the scattering, emission and absorption. Active vision systems, such as structured light vision and projected stereo vision are usually more robust for harsh environment than passive vision systems. However, the performance is considerably decreased in proportion to the density of the particles. The RGI system provides 2D and range image data from several RGI images and it moreover provides clear images from low-visibility fog and smoke environment by using the sum of time-sliced images. Nowadays, the Range-gated (RG) imaging is an emerging technology in the field of surveillance for security applications, especially in the visualization of invisible night and fog environment. Although RGI viewing was discovered in the 1960's, this technology is, nowadays becoming more applicable by virtue of the rapid development of optical and sensor technologies. Especially, this system can be adopted in robot-vision system by virtue of its compact portable configuration. In contrast to passive vision systems, this technology enables operation even in harsh environments like fog and smoke. During the past decades, several applications of this technology have been applied in target recognition and in harsh environments, such as fog, underwater vision. Also, this technology has been

  9. Range-Image Acquisition for Discriminated Objects in a Range-gated Robot Vision System

    International Nuclear Information System (INIS)

    Park, Seung-Kyu; Ahn, Yong-Jin; Park, Nak-Kyu; Baik, Sung-Hoon; Choi, Young-Soo; Jeong, Kyung-Min

    2015-01-01

    The imaging capability of a surveillance vision system from harsh low-visibility environments such as in fire and detonation areas is a key function to monitor the safety of the facilities. 2D and range image data acquired from low-visibility environment are important data to assess the safety and prepare appropriate countermeasures. Passive vision systems, such as conventional camera and binocular stereo vision systems usually cannot acquire image information when the reflected light is highly scattered and absorbed by airborne particles such as fog. In addition, the image resolution captured through low-density airborne particles is decreased because the image is blurred and dimmed by the scattering, emission and absorption. Active vision systems, such as structured light vision and projected stereo vision are usually more robust for harsh environment than passive vision systems. However, the performance is considerably decreased in proportion to the density of the particles. The RGI system provides 2D and range image data from several RGI images and it moreover provides clear images from low-visibility fog and smoke environment by using the sum of time-sliced images. Nowadays, the Range-gated (RG) imaging is an emerging technology in the field of surveillance for security applications, especially in the visualization of invisible night and fog environment. Although RGI viewing was discovered in the 1960's, this technology is, nowadays becoming more applicable by virtue of the rapid development of optical and sensor technologies. Especially, this system can be adopted in robot-vision system by virtue of its compact portable configuration. In contrast to passive vision systems, this technology enables operation even in harsh environments like fog and smoke. During the past decades, several applications of this technology have been applied in target recognition and in harsh environments, such as fog, underwater vision. Also, this technology has been

  10. Using a Learning Activity Sequence in Large-Enrollment Physical Geology Classes: Supporting the Needs of Underserved Students While Motivating Interest, Learning, and Success

    Science.gov (United States)

    Pun, A.; Smith, G. A.

    2011-12-01

    The learning activity sequence (LAS) strategy is a student-focused pedagogy that emphasizes active classroom learning to promote learning among all students, and in particular, those with diverse backgrounds. Online assessments both set the stage for active learning and help students synthesize material during their learning. UNM is one of only two Carnegie Research University Very High institutions also designated as Hispanic-serving and the only state flagship university that is also a majority-minority undergraduate institution. In 2010 Hispanics comprised 40% of 20,655 undergraduates (and 49% of freshmen), 37% of undergraduates were Pell Grant recipients (the largest proportion of any public flagship research university; J. Blacks Higher Ed., 2009) and 44% of incoming freshmen were first-generation students. To maximize student learning in this environment rich in traditionally underserved students, we designed a LAS for nonmajor physical geology (enrollments 100-160) that integrates in-class instruction with structured out-of-class learning. The LAS has 3 essential parts: Students read before class to acquire knowledge used during in-class collaborative, active-learning activities that build conceptual understanding. Lastly, students review notes and synthesize what they've learned before moving on to the next topic. The model combines online and in-class learning and assessment: Online reading assessments before class; active-learning experiences during class; online learning assessments after class. Class sessions include short lectures, peer instruction "clickers", and small-group problem solving (lecture tutorials). Undergraduate Peer-Learning Facilitators are available during class time to help students with problem solving. Effectiveness of the LAS approach is reflected in three types of measurements. (1) Using the LAS strategy, the overall rate of students earning a grade of C or higher is higher than compared to the average for all large

  11. Internal roosting location is associated with differential use of the outdoor range by free-range laying hens.

    Science.gov (United States)

    Pettersson, I C; Weeks, C A; Norman, K I; Knowles, T G; Nicol, C J

    2018-04-01

    1. In commercial free-range systems for laying hens, popholes to the outdoor range are often installed on one side of the house only. In multi-tier systems, it is possible that some individuals fail to access the range due to internal barriers to movement. 2. Five commercial multi-tier flocks from different units were studied. For each flock, two different colour markers were used to distinguish 200 birds roosting near the popholes (NP-Roost) and 200 birds roosting far from the popholes (FP-Roost) at night. The following day, counts of marked birds on the range and inside the house were performed. 3. Significantly more NP-Roost birds were observed in all areas of the outdoor range than FP-Roost birds the next day. Distance of FP area from the popholes was very strongly positively correlated with effect size in the adjacent range area. 4. Additionally, in the indoor area far from the popholes (FP) more FP-Roost birds were observed the next day than NP-Roost birds. In the indoor area near to the popholes (NP) more NP-Roost birds were observed the next day than FP-Roost birds. 5. These results suggest that roosting location is associated with differential range use when popholes are only available on one side of the shed as birds that roosted far from the popholes used the range less.

  12. Wide range neutron flux monitor

    International Nuclear Information System (INIS)

    Endo, Yorimasa; Fukushima, Toshiki.

    1983-01-01

    Purpose: To provide a wide range neutron-flux monitor adapted such that the flux monitoring function and alarming function can automatically by shifted from pulse counting system to cambel method system. Constitution: A wide range neutron-flux monitor comprises (la) pulse counting system and (lb) cambel-method system for inputting detection signals from neutron detectors and separating them into signals for the pulse measuring system and the cambel measuring system, (2) overlap detection and calculation circuit for detecting the existence of the overlap of two output signals from the (la) and (lb) systems, and (3) trip circuit for judging the abnormal state of neutron detectors upon input of the detection signals. (Seki, T.)

  13. Short-range communication system

    Science.gov (United States)

    Alhorn, Dean C. (Inventor); Howard, David E. (Inventor); Smith, Dennis A. (Inventor)

    2012-01-01

    A short-range communication system includes an antenna, a transmitter, and a receiver. The antenna is an electrical conductor formed as a planar coil with rings thereof being uniformly spaced. The transmitter is spaced apart from the plane of the coil by a gap. An amplitude-modulated and asynchronous signal indicative of a data stream of known peak amplitude is transmitted into the gap. The receiver detects the coil's resonance and decodes same to recover the data stream.

  14. Wide range neutron detection system

    International Nuclear Information System (INIS)

    Todt, W.H. Sr.

    1978-01-01

    A neutron detection system for reactor control is described which is operable over a wide range of neutron flux levels. The system includes a fission type ionization chamber neutron detector, means for gamma and alpha signal compensation, and means for operating the neutron detector in the pulse counting mode for low neutron flux levels, and in the direct current mode for high neutron flux levels

  15. Long Range Aircraft Trajectory Prediction

    OpenAIRE

    Magister, Tone

    2009-01-01

    The subject of the paper is the improvement of the aircraft future trajectory prediction accuracy for long-range airborne separation assurance. The strategic planning of safe aircraft flights and effective conflict avoidance tactics demand timely and accurate conflict detection based upon future four–dimensional airborne traffic situation prediction which is as accurate as each aircraft flight trajectory prediction. The improved kinematics model of aircraft relative flight considering flight ...

  16. Long range supergravity coupling strengths

    International Nuclear Information System (INIS)

    Kenyon, I.R.

    1991-01-01

    A limit of 2x10 -13 has recently been deduced for the fractional difference between the gravitational masses of the K 0 and anti K 0 mesons. This limit is applied here to put stringent limits on the strengths of the long range vector-scalar gravitational couplings envisaged in supergravity theories. A weaker limit is inferred from the general relativistic fit to the precession of the orbit of the pulsar PSR1913+16. (orig.)

  17. Range expansion of heterogeneous populations.

    Science.gov (United States)

    Reiter, Matthias; Rulands, Steffen; Frey, Erwin

    2014-04-11

    Risk spreading in bacterial populations is generally regarded as a strategy to maximize survival. Here, we study its role during range expansion of a genetically diverse population where growth and motility are two alternative traits. We find that during the initial expansion phase fast-growing cells do have a selective advantage. By contrast, asymptotically, generalists balancing motility and reproduction are evolutionarily most successful. These findings are rationalized by a set of coupled Fisher equations complemented by stochastic simulations.

  18. Medium Range Forecasts Representation (and Long Range Forecasts?)

    Science.gov (United States)

    Vincendon, J.-C.

    2009-09-01

    The progress of the numerical forecasts urges us to interest us in more and more distant ranges. We thus supply more and more forecasts with term of some days. Nevertheless, precautions of use are necessary to give the most reliable and the most relevant possible information. Available in a TV bulletin or on quite other support (Internet, mobile phone), the interpretation and the representation of a medium range forecast (5 - 15 days) must be different from those of a short range forecast. Indeed, the "foresee-ability” of a meteorological phenomenon decreases gradually in the course of the ranges, it decreases all the more quickly that the phenomenon is of small scale. So, at the end of some days, the probability character of a forecast becomes very widely dominating. That is why in Meteo-France the forecasts of D+4 to D+7 are accompanied with a confidence index since around ten years. It is a figure between 1 and 5: the more we approach 5, the more the confidence in the supplied forecast is good. In the practice, an indication is supplied for period D+4 / D+5, the other one for period D+6 / D+7, every day being able to benefit from a different forecast, that is be represented in a independent way. We thus supply a global tendency over 24 hours with less and less precise symbols as the range goes away. Concrete examples will be presented. From now on two years, we also publish forecasts to D+8 / J+9, accompanied with a sign of confidence (" good reliability " or " to confirm "). These two days are grouped together on a single map because for us, the described tendency to this term is relevant on a duration about 48 hours with a spatial scale slightly superior to the synoptic scale. So, we avoid producing more than two zones of types of weather over France and we content with giving an evolution for the temperatures (still, in increase or in decline). Newspapers began to publish this information, it should soon be the case of televisions. It is particularly

  19. Metrological large range scanning probe microscope

    International Nuclear Information System (INIS)

    Dai Gaoliang; Pohlenz, Frank; Danzebrink, Hans-Ulrich; Xu Min; Hasche, Klaus; Wilkening, Guenter

    2004-01-01

    We describe a metrological large range scanning probe microscope (LR-SPM) with an Abbe error free design and direct interferometric position measurement capability, aimed at versatile traceable topographic measurements that require nanometer accuracy. A dual-stage positioning system was designed to achieve both a large measurement range and a high measurement speed. This dual-stage system consists of a commercially available stage, referred to as nanomeasuring machine (NMM), with a motion range of 25 mmx25 mmx5 mm along x, y, and z axes, and a compact z-axis piezoelectric positioning stage (compact z stage) with an extension range of 2 μm. The metrological LR-SPM described here senses the surface using a stationary fixed scanning force microscope (SFM) head working in contact mode. During operation, lateral scanning of the sample is performed solely by the NMM. Whereas the z motion, controlled by the SFM signal, is carried out by a combination of the NMM and the compact z stage. In this case the compact z stage, with its high mechanical resonance frequency (greater than 20 kHz), is responsible for the rapid motion while the NMM simultaneously makes slower movements over a larger motion range. To reduce the Abbe offset to a minimum the SFM tip is located at the intersection of three interferometer measurement beams orientated in x, y, and z directions. To improve real time performance two high-end digital signal processing (DSP) systems are used for NMM positioning and SFM servocontrol. Comprehensive DSP firmware and Windows XP-based software are implemented, providing a flexible and user-friendly interface. The instrument is able to perform large area imaging or profile scanning directly without stitching small scanned images. Several measurements on different samples such as flatness standards, nanostep height standards, roughness standards as well as sharp nanoedge samples and 1D gratings demonstrate the outstanding metrological capabilities of the instrument

  20. A Model for Long Range Planning for Seminole Community College.

    Science.gov (United States)

    Miner, Norris

    A model for long-range planning designed to maximize involvement of college personnel, to improve communication among various areas of the college, to provide a process for evaluation of long-range plans and the planning process, to adjust to changing conditions, to utilize data developed at a level useful for actual operations, and to have…

  1. Extending the molecular application range of gas chromatography

    NARCIS (Netherlands)

    Kaal, E.; Janssen, H.-G.

    2008-01-01

    Gas chromatography is an important analytical technique for qualitative and quantitative analysis in a wide range of application areas. It is fast, provides a high peak capacity, is sensitive and allows combination with a wide range of selective detection methods including mass spectrometry.

  2. The Standley allotment: a history of range recovery.

    Science.gov (United States)

    Gerald S. Strickler; Wade B. Hall

    1980-01-01

    One of the first range research programs on National Forest lands was conducted by Dr. Arthur W. Sampson in the Wallowa Mountains, Oregon, between 1907 and 1911. This paper reviews the historical perspective of and the basic range management principles and practices developed from Sampson's studies as well as the land and grazing management of the study area to...

  3. Range prediction for electric vehicles; Reichweitenprognose fuer Elektromobile

    Energy Technology Data Exchange (ETDEWEB)

    Conradi, Peter [All4IP Technologies GmbH and Co.KG, Darmstadt (Germany)

    2012-06-15

    The range of electric vehicles varies strongly in dependency of a number of external factors. To be able to make an exact dynamic prediction of the remaining range during the journey, All4IP Technologies developed a special software that can access the CAN bus. The App, programmed for iOS and Android operating systems considers even the topology of the area. (orig.)

  4. Sampling Number Effects in 2D and Range Imaging of Range-gated Acquisition

    International Nuclear Information System (INIS)

    Kwon, Seong-Ouk; Park, Seung-Kyu; Baik, Sung-Hoon; Cho, Jai-Wan; Jeong, Kyung-Min

    2015-01-01

    In this paper, we analyzed the number effects of sampling images for making a 2D image and a range image from acquired RGI images. We analyzed the number effects of RGI images for making a 2D image and a range image using a RGI vision system. As the results, 2D image quality was not much depended on the number of sampling images but on how much well extract efficient RGI images. But, the number of RGI images was important for making a range image because range image quality was proportional to the number of RGI images. Image acquiring in a monitoring area of nuclear industry is an important function for safety inspection and preparing appropriate control plans. To overcome the non-visualization problem caused by airborne obstacle particles, vision systems should have extra-functions, such as active illumination lightening through disturbance airborne particles. One of these powerful active vision systems is a range-gated imaging system. The vision system based on the range-gated imaging system can acquire image data from raining or smoking environments. Range-gated imaging (RGI) is a direct active visualization technique using a highly sensitive image sensor and a high intensity illuminant. Currently, the range-gated imaging technique providing 2D and 3D images is one of emerging active vision technologies. The range-gated imaging system gets vision information by summing time sliced vision images. In the RGI system, a high intensity illuminant illuminates for ultra-short time and a highly sensitive image sensor is gated by ultra-short exposure time to only get the illumination light. Here, the illuminant illuminates objects by flashing strong light through airborne disturbance particles. Thus, in contrast to passive conventional vision systems, the RGI active vision technology robust for low-visibility environments

  5. Sampling Number Effects in 2D and Range Imaging of Range-gated Acquisition

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Seong-Ouk; Park, Seung-Kyu; Baik, Sung-Hoon; Cho, Jai-Wan; Jeong, Kyung-Min [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    In this paper, we analyzed the number effects of sampling images for making a 2D image and a range image from acquired RGI images. We analyzed the number effects of RGI images for making a 2D image and a range image using a RGI vision system. As the results, 2D image quality was not much depended on the number of sampling images but on how much well extract efficient RGI images. But, the number of RGI images was important for making a range image because range image quality was proportional to the number of RGI images. Image acquiring in a monitoring area of nuclear industry is an important function for safety inspection and preparing appropriate control plans. To overcome the non-visualization problem caused by airborne obstacle particles, vision systems should have extra-functions, such as active illumination lightening through disturbance airborne particles. One of these powerful active vision systems is a range-gated imaging system. The vision system based on the range-gated imaging system can acquire image data from raining or smoking environments. Range-gated imaging (RGI) is a direct active visualization technique using a highly sensitive image sensor and a high intensity illuminant. Currently, the range-gated imaging technique providing 2D and 3D images is one of emerging active vision technologies. The range-gated imaging system gets vision information by summing time sliced vision images. In the RGI system, a high intensity illuminant illuminates for ultra-short time and a highly sensitive image sensor is gated by ultra-short exposure time to only get the illumination light. Here, the illuminant illuminates objects by flashing strong light through airborne disturbance particles. Thus, in contrast to passive conventional vision systems, the RGI active vision technology robust for low-visibility environments.

  6. Fire history and pattern in a Cascade Range landscape.

    Science.gov (United States)

    Peter H. Morrison; Frederick J. Swanson

    1990-01-01

    Fire history from years 1150 to 1985 was reconstructed by analyzing forest stands in two 1940-hectare areas in the central-western Cascade Range of Oregon. Serving as records for major fire episodes, these stands revealed a highly variable fire regime. The steeper, more dissected, lower elevation Cook-Quentin study area experienced more frequent fires (natural fire...

  7. Wide range radiation monitoring apparatus

    International Nuclear Information System (INIS)

    Goldstein, N.P.

    1983-01-01

    There is described a simple and rugged detector capable of measuring radiation fields over the range of 0.02 R/hr up to 10/8 R/hr or higher. The device consists of an emitter element of high atomic number material which is connected to the center conductor of a signal cable. This emitter element is positioned in a spaced-apart relationship between collector element of a low atomic number material with a gap region between the emitter element and the adjacent collector elements

  8. Live Fire Range Environmental Assessment

    Energy Technology Data Exchange (ETDEWEB)

    None

    1993-08-01

    The Central Training Academy (CTA) is a DOE Headquarters Organization located in Albuquerque, New Mexico, with the mission to effectively and efficiently educate and train personnel involved in the protection of vital national security interests of DOE. The CTA Live Fire Range (LFR), where most of the firearms and tactical training occurs, is a complex separate from the main campus. The purpose of the proposed action is to expand the LFR to allow more options of implementing required training. The Department of Energy has prepared this Environmental Assessment (EA) for the proposed construction and operation of an expanded Live Fire Range Facility at the Central Training Academy in Albuquerque, New Mexico. Based on the analysis in the EA, DOE has determined that the proposed action is not a major Federal action significantly affecting the quality of the human environment, within the meaning of the National Environmental Policy Act (NEPA) of 1969. Therefore, the preparation of an environmental impact statement is not required and DOE is issuing this Finding of No Significant Impact (FONSI).

  9. The Ames Vertical Gun Range

    Science.gov (United States)

    Karcz, J. S.; Bowling, D.; Cornelison, C.; Parrish, A.; Perez, A.; Raiche, G.; Wiens, J.-P.

    2016-01-01

    The Ames Vertical Gun Range (AVGR) is a national facility for conducting laboratory- scale investigations of high-speed impact processes. It provides a set of light-gas, powder, and compressed gas guns capable of accelerating projectiles to speeds up to 7 km s(exp -1). The AVGR has a unique capability to vary the angle between the projectile-launch and gravity vectors between 0 and 90 deg. The target resides in a large chamber (diameter approximately 2.5 m) that can be held at vacuum or filled with an experiment-specific atmosphere. The chamber provides a number of viewing ports and feed-throughs for data, power, and fluids. Impacts are observed via high-speed digital cameras along with investigation-specific instrumentation, such as spectrometers. Use of the range is available via grant proposals through any Planetary Science Research Program element of the NASA Research Opportunities in Space and Earth Sciences (ROSES) calls. Exploratory experiments (one to two days) are additionally possible in order to develop a new proposal.

  10. Dynamic Planar Range Maxima Queries

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Tsakalidis, Konstantinos

    2011-01-01

    We consider the dynamic two-dimensional maxima query problem. Let P be a set of n points in the plane. A point is maximal if it is not dominated by any other point in P. We describe two data structures that support the reporting of the t maximal points that dominate a given query point, and allow...... for insertions and deletions of points in P. In the pointer machine model we present a linear space data structure with O(logn + t) worst case query time and O(logn) worst case update time. This is the first dynamic data structure for the planar maxima dominance query problem that achieves these bounds...... are integers in the range U = {0, …,2 w  − 1 }. We present a linear space data structure that supports 3-sided range maxima queries in O(logn/loglogn+t) worst case time and updates in O(logn/loglogn) worst case time. These are the first sublogarithmic worst case bounds for all operations in the RAM model....

  11. Range-Measuring Video Sensors

    Science.gov (United States)

    Howard, Richard T.; Briscoe, Jeri M.; Corder, Eric L.; Broderick, David

    2006-01-01

    Optoelectronic sensors of a proposed type would perform the functions of both electronic cameras and triangulation- type laser range finders. That is to say, these sensors would both (1) generate ordinary video or snapshot digital images and (2) measure the distances to selected spots in the images. These sensors would be well suited to use on robots that are required to measure distances to targets in their work spaces. In addition, these sensors could be used for all the purposes for which electronic cameras have been used heretofore. The simplest sensor of this type, illustrated schematically in the upper part of the figure, would include a laser, an electronic camera (either video or snapshot), a frame-grabber/image-capturing circuit, an image-data-storage memory circuit, and an image-data processor. There would be no moving parts. The laser would be positioned at a lateral distance d to one side of the camera and would be aimed parallel to the optical axis of the camera. When the range of a target in the field of view of the camera was required, the laser would be turned on and an image of the target would be stored and preprocessed to locate the angle (a) between the optical axis and the line of sight to the centroid of the laser spot.

  12. Long-range correlated percolation

    International Nuclear Information System (INIS)

    Weinrib, A.

    1984-01-01

    This paper is a study of the percolation problem with long-range correlations in the site or bond occupations. An extension of the Harris criterion for the relevance of the correlations is derived for the case that the correlations decay as x/sup -a/ for large distances x. For a d the correlations are relevant if dν-2<0. Applying this criterion to the behavior that results when the correlations are relevant, we argue that the new behavior will have ν/sub long/ = 2/a. It is shown that the correlated bond percolation problem is equivalent to a q-state Potts model with quenched disorder in the limit q→1. With the use of this result, a renormalization-group study of the problem is presented, expanding in epsilon = 6-d and in delta = 4-a. In addition to the normal percolation fixed point, we find a new long-range fixed point. The crossover to this new fixed point follows the extended Harris criterion, and the fixed point has exponents ν/sub long/ = 2/a (as predicted) and eta/sub long/ = (1/11)(delta-epsilon). Finally, several results on the percolation properties of the Ising model at its critical point are shown to be in agreement with the predictions of this paper

  13. KERNELHR: A program for estimating animal home ranges

    Science.gov (United States)

    Seaman, D.E.; Griffith, B.; Powell, R.A.

    1998-01-01

    Kernel methods are state of the art for estimating animal home-range area and utilization distribution (UD). The KERNELHR program was developed to provide researchers and managers a tool to implement this extremely flexible set of methods with many variants. KERNELHR runs interactively or from the command line on any personal computer (PC) running DOS. KERNELHR provides output of fixed and adaptive kernel home-range estimates, as well as density values in a format suitable for in-depth statistical and spatial analyses. An additional package of programs creates contour files for plotting in geographic information systems (GIS) and estimates core areas of ranges.

  14. A Behavioral Lifestyle Intervention Enhanced With Multiple-Behavior Self-Monitoring Using Mobile and Connected Tools for Underserved Individuals With Type 2 Diabetes and Comorbid Overweight or Obesity: Pilot Comparative Effectiveness Trial.

    Science.gov (United States)

    Wang, Jing; Cai, Chunyan; Padhye, Nikhil; Orlander, Philip; Zare, Mohammad

    2018-04-10

    Self-monitoring is a cornerstone of behavioral lifestyle interventions for obesity and type 2 diabetes mellitus. Mobile technology has the potential to improve adherence to self-monitoring and patient outcomes. However, no study has tested the use of a smartphone to facilitate self-monitoring in overweight or obese adults with type 2 diabetes mellitus living in the underserved community. The aim of this study was to examine the feasibility of and compare preliminary efficacy of a behavioral lifestyle intervention using smartphone- or paper-based self-monitoring of multiple behaviors on weight loss and glycemic control in a sample of overweight or obese adults with type 2 diabetes mellitus living in underserved communities. We conducted a randomized controlled trial to examine the feasibility and preliminary efficacy of a behavioral lifestyle intervention. Overweight or obese patients with type 2 diabetes mellitus were recruited from an underserved minority community health center in Houston, Texas. They were randomly assigned to one of the three groups: (1) behavior intervention with smartphone-based self-monitoring, (2) behavior intervention with paper diary-based self-monitoring, and (3) usual care group. Both the mobile and paper groups received a total of 11 face-to-face group sessions in a 6-month intervention. The mobile group received an Android-based smartphone with 2 apps loaded to help them record their diet, physical activity, weight, and blood glucose, along with a connected glucometer, whereas the paper group used paper diaries for these recordings. Primary outcomes of the study included percentage weight loss and glycated hemoglobin (HbA 1c ) changes over 6 months. A total of 26 patients were enrolled: 11 in the mobile group, 9 in the paper group, and 6 in the control group. We had 92% (24/26) retention rate at 6 months. The sample is predominantly African Americans with an average age of 56.4 years and body mass index of 38.1. Participants lost an

  15. Flow area optimization in point to area or area to point flows

    International Nuclear Information System (INIS)

    Ghodoossi, Lotfollah; Egrican, Niluefer

    2003-01-01

    results in higher global maximum revenue relative to the other structures. The interesting side of the point to area or area to point flow area structures examined in this paper is that it is easily adaptable to flows in heat transfer problems in electronics, flows in biology, transportation in urban street patterns and a wide range of flow phenomenon in real life

  16. Evaluation of community provision of a preventive cardiovascular programme - the National Health Service Health Check in reaching the under-served groups by primary care in England: cross sectional observational study.

    Science.gov (United States)

    Woringer, Maria; Cecil, Elizabeth; Watt, Hillary; Chang, Kiara; Hamid, Fozia; Khunti, Kamlesh; Dubois, Elizabeth; Evason, Julie; Majeed, Azeem; Soljak, Michael

    2017-06-14

    Cardiovascular disease (CVD) is the leading cause of premature mortality and a major contributor of health inequalities in England. Compared to more affluent and white counterparts, deprived people and ethnic minorities tend to die younger due to preventable CVD associated with lifestyle. In addition, deprived, ethnic minorities and younger people are less likely to be served by CVD prevention services. This study assessed the effectiveness of community-based outreach providers in delivering England's National Health Services (NHS) Health Check programme, a CVD preventive programme to under-served groups. Between January 2008 and October 2013, community outreach providers delivered a preventive CVD programme to 50,573 individuals, in their local communities, in a single consultation without prescheduled appointments. Community outreach providers operated on evenings and weekends as well as during regular business hours in venues accessible to the general public. After exclusion criteria, we analysed and compared socio-demographic data of 43,177 Health Check attendees with the general population across 38 local authorities (LAs). We assessed variation between local authorities in terms of age, sex, deprivation and ethnicity structures using two sample t-tests and within local authority variation in terms of ethnicity and deprivation using Chi squared tests and two sample t-tests respectively. Using Index of Multiple Deprivation, the mean deprivation score of the population reached by community outreach providers was 6.01 higher (p successful in recruiting ethnic minority groups. The mean proportion of men screened was 11.39% lower (p successful in motivating the under-served groups to improve lifestyle, it may reduce health inequalities therein.

  17. 300 Area Disturbance Report

    Energy Technology Data Exchange (ETDEWEB)

    LL Hale; MK Wright; NA Cadoret

    1999-01-07

    The objective of this study was to define areas of previous disturbance in the 300 Area of the U.S. Department of Energy (DOE) Hanford Site to eliminate these areas from the cultural resource review process, reduce cultural resource monitoring costs, and allow cultural resource specialists to focus on areas where subsurface disturbance is minimal or nonexistent. Research into available sources suggests that impacts from excavations have been significant wherever the following construction activities have occurred: building basements and pits, waste ponds, burial grounds, trenches, installation of subsurface pipelines, power poles, water hydrants, and well construction. Beyond the areas just mentioned, substrates in the' 300 Area consist of a complex, multidimen- sional mosaic composed of undisturbed stratigraphy, backfill, and disturbed sediments; Four Geographic Information System (GIS) maps were created to display known areas of disturbance in the 300 Area. These maps contain information gleaned from a variety of sources, but the primary sources include the Hanford GIS database system, engineer drawings, and historic maps. In addition to these maps, several assumptions can be made about areas of disturbance in the 300 Area as a result of this study: o o Buried pipelines are not always located where they are mapped. As a result, cultural resource monitors or specialists should not depend on maps depicting subsurface pipelines for accurate locations of previous disturbance. Temporary roads built in the early 1940s were placed on layers of sand and gravel 8 to 12 in. thick. Given this information, it is likely that substrates beneath these early roads are only minimally disturbed. Building foundations ranged from concrete slabs no more than 6 to 8 in. thick to deeply excavated pits and basements. Buildings constructed with slab foundations are more numerous than may be expected, and minimally disturbed substrates may be expected in these locations. Historic

  18. Understanding synthesis imaging dynamic range

    Science.gov (United States)

    Braun, R.

    2013-03-01

    We develop a general framework for quantifying the many different contributions to the noise budget of an image made with an array of dishes or aperture array stations. Each noise contribution to the visibility data is associated with a relevant correlation timescale and frequency bandwidth so that the net impact on a complete observation can be assessed when a particular effect is not captured in the instrumental calibration. All quantities are parameterised as function of observing frequency and the visibility baseline length. We apply the resulting noise budget analysis to a wide range of existing and planned telescope systems that will operate between about 100 MHz and 5 GHz to ascertain the magnitude of the calibration challenges that they must overcome to achieve thermal noise limited performance. We conclude that calibration challenges are increased in several respects by small dimensions of the dishes or aperture array stations. It will be more challenging to achieve thermal noise limited performance using 15 m class dishes rather than the 25 m dishes of current arrays. Some of the performance risks are mitigated by the deployment of phased array feeds and more with the choice of an (alt,az,pol) mount, although a larger dish diameter offers the best prospects for risk mitigation. Many improvements to imaging performance can be anticipated at the expense of greater complexity in calibration algorithms. However, a fundamental limitation is ultimately imposed by an insufficient number of data constraints relative to calibration variables. The upcoming aperture array systems will be operating in a regime that has never previously been addressed, where a wide range of effects are expected to exceed the thermal noise by two to three orders of magnitude. Achieving routine thermal noise limited imaging performance with these systems presents an extreme challenge. The magnitude of that challenge is inversely related to the aperture array station diameter.

  19. Revised tephra volumes for Cascade Range volcanoes

    Science.gov (United States)

    Nathenson, Manuel

    2017-01-01

    Isopach maps from tephra eruptions from Mount St. Helens were reported in Carey et al. (1995) and for tephra eruptions from Glacier Peak in Gardner et al. (1998). For exponential thinning, the isopach data only define a single slope on a log thickness versus square root of area plot. Carey et al. (1995) proposed a model that was used to estimate a second slope, and volumes were presented in both studies using this model. A study by Sulpizio (2005) for estimating the second slope and square root of area where the lines intersect involves a systematic analysis of many eruptions to provide correlation equations. The purpose of this paper is to recalculate the volumes of Cascades eruptions and compare results from the two methods. In order to gain some perspective on the methods for estimating the second slope, we use data for thickness versus distance beyond the last isopach that are available for some of the larger eruptions in the Cascades. The thickness versus square root of area method is extended to thickness versus distance by developing an approximate relation between the two assuming elliptical isopachs with the source at one of the foci. Based on the comparisons made between the Carey et al. (1995) and Sulpizio (2005) methods, it is felt that the later method provides a better estimate of the second slope. For Mount St. Helens, the estimates of total volume using the Sulpizio (2005) method are generally smaller than those using the Carey et al. (1995) method. For the volume estimates of Carey et al. (1995), the volume of the May 18, 1980, eruption of Mount St. Helens is smaller than six of the eight previous eruptions. With the new volumes using the Sulpizio (2005) method, the 1980 eruption is smaller in volume than the upper end of the range for only three of the layers (Wn, Ye, and Yn) and is the same size as layer We. Thus the 1980 eruption becomes representative of the mid-range of volumes rather than being in the lower range.

  20. Anthropogenic range contractions bias species climate change forecasts

    Science.gov (United States)

    Faurby, Søren; Araújo, Miguel B.

    2018-03-01

    Forecasts of species range shifts under climate change most often rely on ecological niche models, in which characterizations of climate suitability are highly contingent on the species range data used. If ranges are far from equilibrium under current environmental conditions, for instance owing to local extinctions in otherwise suitable areas, modelled environmental suitability can be truncated, leading to biased estimates of the effects of climate change. Here we examine the impact of such biases on estimated risks from climate change by comparing models of the distribution of North American mammals based on current ranges with ranges accounting for historical information on species ranges. We find that estimated future diversity, almost everywhere, except in coastal Alaska, is drastically underestimated unless the full historical distribution of the species is included in the models. Consequently forecasts of climate change impacts on biodiversity for many clades are unlikely to be reliable without acknowledging anthropogenic influences on contemporary ranges.

  1. Wide-range voltage modulation

    International Nuclear Information System (INIS)

    Rust, K.R.; Wilson, J.M.

    1992-06-01

    The Superconducting Super Collider's Medium Energy Booster Abort (MEBA) kicker modulator will supply a current pulse to the abort magnets which deflect the proton beam from the MEB ring into a designated beam stop. The abort kicker will be used extensively during testing of the Low Energy Booster (LEB) and the MEB rings. When the Collider is in full operation, the MEBA kicker modulator will abort the MEB beam in the event of a malfunction during the filling process. The modulator must generate a 14-μs wide pulse with a rise time of less than 1 μs, including the delay and jitter times. It must also be able to deliver a current pulse to the magnet proportional to the beam energy at any time during ramp-up of the accelerator. Tracking the beam energy, which increases from 12 GeV at injection to 200 GeV at extraction, requires the modulator to operate over a wide range of voltages (4 kV to 80 kV). A vacuum spark gap and a thyratron have been chosen for test and evaluation as candidate switches for the abort modulator. Modulator design, switching time delay, jitter and pre-fire data are presented

  2. An introduction to optimal satellite range scheduling

    CERN Document Server

    Vázquez Álvarez, Antonio José

    2015-01-01

    The satellite range scheduling (SRS) problem, an important operations research problem in the aerospace industry consisting of allocating tasks among satellites and Earth-bound objects, is examined in this book. SRS principles and solutions are applicable to many areas, including: Satellite communications, where tasks are communication intervals between sets of satellites and ground stations Earth observation, where tasks are observations of spots on the Earth by satellites Sensor scheduling, where tasks are observations of satellites by sensors on the Earth. This self-contained monograph begins with a structured compendium of the problem and moves on to explain the optimal approach to the solution, which includes aspects from graph theory, set theory, game theory and belief networks. This book is accessible to students, professionals and researchers in a variety of fields, including: operations research, optimization, scheduling theory, dynamic programming and game theory. Taking account of the distributed, ...

  3. Transmission dynamic range in chest radiology

    International Nuclear Information System (INIS)

    Lemmers, H.E.A.S.J.; Schultze Kool, L.J.; van Elburg, H.J.; Boelens, F.

    1989-01-01

    Due to the large difference in transmission between the lung area and the mediastinum, the human chest is a challenging object for radiographic imaging. This study is performed in order to define the dynamic range needed for a chest imaging chain. Eight hundred seventy-five consecutive outpatients were imaged with a prototype AMBER (advanced multiple beam equalization radiography) unit at 141 kVp. The equalization facility was disabled, allowing for the simultaneous capture of a film image and a digital dataset representing the local patient transmission in fields of approximately 2x2 cm. The datasets were analyzed to obtain the relation between the average transmission distribution in a subset of the population and physical parameters characterizing this subset, such as body weight or length

  4. Sapwood area - leaf area relationships for coast redwood

    OpenAIRE

    Stancioiu, P T; O'Hara, K L

    2005-01-01

    Coast redwood (Sequoia sempervirens (D. Don) Endl.) trees in different canopy strata and crown positions were sampled to develop relationships between sapwood cross-sectional area and projected leaf area. Sampling occurred during the summers of 2000 and 2001 and covered tree heights ranging from 7.7 to 45.2 m and diameters at breast height ranging from 9.4 to 92.7 cm. Foliage morphology varied greatly and was stratified into five types based on needle type (sun or shade) and twig color. A str...

  5. Stated preferences of doctors for choosing a job in rural areas of Peru: a discrete choice experiment.

    Directory of Open Access Journals (Sweden)

    J Jaime Miranda

    Full Text Available Doctors' scarcity in rural areas remains a serious problem in Latin America and Peru. Few studies have explored job preferences of doctors working in underserved areas. We aimed to investigate doctors' stated preferences for rural jobs.A labelled discrete choice experiment (DCE was performed in Ayacucho, an underserved department of Peru. Preferences were assessed for three locations: rural community, Ayacucho city (Ayacucho's capital and other provincial capital city. Policy simulations were run to assess the effect of job attributes on uptake of a rural post. Multiple conditional logistic regressions were used to assess the relative importance of job attributes and of individual characteristics. A total of 102 doctors participated. They were five times more likely to choose a job post in Ayacucho city over a rural community (OR 4.97, 95%CI 1.2; 20.54. Salary increases and bonus points for specialization acted as incentives to choose a rural area, while increase in the number of years needed to get a permanent post acted as a disincentive. Being male and working in a hospital reduced considerably chances of choosing a rural job, while not living with a partner increased them. Policy simulations showed that a package of 75% salary increase, getting a permanent contract after two years in rural settings, and getting bonus points for further specialisation increased rural job uptake from 21% to 77%. A package of 50% salary increase plus bonus points for further specialisation would also increase the rural uptake from 21% to 52%.Doctors are five times more likely to favour a job in urban areas over rural settings. This strong preference needs to be overcome by future policies aimed at improving the scarcity of rural doctors. Some incentives, alone or combined, seem feasible and sustainable, whilst others may pose a high fiscal burden.

  6. Final Record of Decision for the South Post Impact Area and Area of Contamination 41 Groundwater and Areas of Contamination 25, 26, and 27

    National Research Council Canada - National Science Library

    1996-01-01

    .... This Record of Decision (ROD) addresses AOCs 25 (the Explosives Ordnance Disposal (EOD) Range), 26 (Zulu Ranges), and 27 (Hotel Range) and a subset of the groundwater within the South Post Impact Area...

  7. Electric refuse collection vehicle with a range extender; Elektrisches Abfallsammelfahrzeug mit Range Extender

    Energy Technology Data Exchange (ETDEWEB)

    Fuchs, Andreas

    2012-10-15

    At the Frankfurt Motor Show IAA 2012, MAN will be presenting the Metropolis, a heavy-duty truck for use in urban areas that produces no emissions and is ultra-quiet. Using mains electricity generated from renewable sources, it can operate without producing any CO{sub 2}. The truck's modular lithium-ion battery is located under the ab. A quiet and efficient diesel engine from the Volkswagen Group generates power as needed and functions as a range extender for the truck. At the end of 2012, the MAN Metropolis will start a two-year field test as a refuse collection vehicle. (orig.)

  8. Ranging behavior relates to welfare indicators pre- and post-range access in commercial free-range broilers.

    Science.gov (United States)

    Taylor, Peta S; Hemsworth, Paul H; Groves, Peter J; Gebhardt-Henrich, Sabine G; Rault, Jean-Loup

    2018-06-01

    Little is known about the effect of accessing an outdoor range on chicken welfare. We tracked individual ranging behavior of 538 mixed-sex Ross 308 chickens on a commercial farm across 4 flocks in winter and summer. Before range access, at 17 to 19 d of age, and post-range access, at 30 to 33 and 42 to 46 d of age in winter and summer flocks respectively, welfare indicators were measured on chickens (pre-range: winter N = 292; summer N = 280; post-range: winter N = 131; summer N = 140), including weight, gait score, dermatitis and plumage condition. Post-ranging autopsies were performed (winter: N = 170; summer: N = 60) to assess breast burn, leg health, and ascites. Fewer chickens accessed the range in winter flocks (32.5%) than summer flocks (82.1%). Few relationships between welfare and ranging were identified in winter, likely due to minimal ranging and the earlier age of post-ranging data collection compared to summer flocks. In summer flocks prior to range access, chickens that accessed the range weighed 4.9% less (P = 0.03) than chickens that did not access the range. Pre-ranging weight, gait score, and overall plumage cover predicted the amount of range use by ranging chickens in summer flocks (P ranging behavior. In summer flocks post-range access, ranging chickens weighed 12.8% less than non-ranging chickens (P range visits were associated with lower weight (P range was associated with lower weight (P range in summer is partly related to changes in broiler chicken welfare. Further investigations are required to determine causation.

  9. Evaluation of Soil Loss and Erosion Control Measures on Ranges and Range Structures at Installations in Temperate Climates

    Science.gov (United States)

    2006-06-01

    Soil Loss Equation ( USLE ) and the Revised Universal Soil Loss Equation (RUSLE) continue to be widely accepted methods for estimating sediment loss...range areas. Therefore, a generalized design methodology using the Universal Soil Loss Equation ( USLE ) is presented to accommodate the variations...constructed use the slope most suitable to the area topography (3:1 or 4:1). Step 4: Using the Universal Soil Loss equation, USLE , find the values of A

  10. Class 1 Areas

    Data.gov (United States)

    U.S. Environmental Protection Agency — A "Class 1" area is a geographic area recognized by the EPA as being of the highest environmental quality and requiring maximum protection. Class I areas are areas...

  11. Ultra-low-power short-range radios

    CERN Document Server

    Chandrakasan, Anantha

    2015-01-01

    This book explores the design of ultra-low-power radio-frequency integrated circuits (RFICs), with communication distances ranging from a few centimeters to a few meters. Such radios have unique challenges compared to longer-range, higher-powered systems. As a result, many different applications are covered, ranging from body-area networks to transcutaneous implant communications and Internet-of-Things devices. A mix of introductory and cutting-edge design techniques and architectures which facilitate each of these applications are discussed in detail. Specifically, this book covers:.

  12. Groundwater quality in the Northern Coast Ranges Basins, California

    Science.gov (United States)

    Mathany, Timothy M.; Belitz, Kenneth

    2015-01-01

    The Northern Coast Ranges (NOCO) study unit is 633 square miles and consists of 35 groundwater basins and subbasins (California Department of Water Resources, 2003; Mathany and Belitz, 2015). These basins and subbasins were grouped into two study areas based primarily on locality. The groundwater basins and subbasins located inland, not adjacent to the Pacific Ocean, were aggregated into the Interior Basins (NOCO-IN) study area. The groundwater basins and subbasins adjacent to the Pacific Ocean were aggregated into the Coastal Basins (NOCO-CO) study area (Mathany and others, 2011).

  13. A mass-wasting dominated Quaternary mountain range, the Coastal Range in eastern Taiwan

    Science.gov (United States)

    Hsieh, Meng-Long; Hogg, Alan; Song, Sheng-Rong; Kang, Su-Chen; Chou, Chun-Yen

    2017-12-01

    Fluvial bedrock incision, which creates topographic relief and controls hillslope development, has been considered the key medium linking denudation and tectonic uplift of unglaciated mountains. This article, however, shows a different scenario from the Coastal Range in eastern Taiwan. This range, with the steepness inherited from pre-orogenic volcanoes, has been subject to mass wasting even before its emergence above sea level no earlier than Middle Pleistocene. Numerous terraced alluvial fans/fan deltas record the ancient mass movements of the range, including rock avalanches. Multiple radiocarbon dates sequences not clearly related to the known climate-change events, and are believed to have been triggered mainly by severe rainfall events, large earthquakes, or their combinations. The resulting fluctuation of sediment yield has episodically changed river behavior, forming river terraces in catchments >1 km2. Alluvial terraces are typically exhibited close to the source ridges of mass movements, and strath terraces along the downstream parts of rivers. Both were created when enormous sediment supply had exceeded or matched the prevailing river transport capacity. This process, along with the protection by giant boulders from mass movement, disturbed the long-term incision trend of rivers in response to tectonic uplift. As a result, the observed Holocene bedrock incision at most sites has not kept pace with the tectonic uplift. The spatial contrast in mass-wasting histories further accounts for the great diversity of the terrace sequences, even in areas with similar tectonic and base-level conditions.

  14. Impact of accessible sexual and reproductive health care on poor and underserved adolescents in Managua, Nicaragua: a quasi-experimental intervention study.

    NARCIS (Netherlands)

    Meuwissen, L.E.; Gorter, A.C.; Knottnerus, A.J.A.

    2006-01-01

    BACKGROUND: The objective of this study was to evaluate a competitive voucher program intended to make sexual and reproductive health care (SRHC) accessible to adolescents from disadvantaged areas of Managua. METHODS: A quasi-experimental intervention study was performed in which 28,711 vouchers

  15. Assessment of a government-subsidized supermarket in a high-need area on household food availability and children's dietary intakes.

    Science.gov (United States)

    Elbel, Brian; Moran, Alyssa; Dixon, L Beth; Kiszko, Kamila; Cantor, Jonathan; Abrams, Courtney; Mijanovich, Tod

    2015-10-01

    To assess the impact of a new government-subsidized supermarket in a high-need area on household food availability and dietary habits in children. A difference-in-difference study design was utilized. Two neighbourhoods in the Bronx, New York City. Outcomes were collected in Morrisania, the target community where the new supermarket was opened, and Highbridge, the comparison community. Parents/caregivers of a child aged 3-10 years residing in Morrisania or Highbridge. Participants were recruited via street intercept at baseline (pre-supermarket opening) and at two follow-up periods (five weeks and one year post-supermarket opening). Analysis is based on 2172 street-intercept surveys and 363 dietary recalls from a sample of predominantly low-income minorities. While there were small, inconsistent changes over the time periods, there were no appreciable differences in availability of healthful or unhealthful foods at home, or in children's dietary intake as a result of the supermarket. The introduction of a government-subsidized supermarket into an underserved neighbourhood in the Bronx did not result in significant changes in household food availability or children's dietary intake. Given the lack of healthful food options in underserved neighbourhoods and need for programmes that promote access, further research is needed to determine whether healthy food retail expansion, alone or with other strategies, can improve food choices of children and their families.

  16. Home range and habitat use of Trumpeter Hornbills Bycanistes ...

    African Journals Online (AJOL)

    46 km2 (95% LoCoH). However, individual home range sizes varied monthly and seasonally. We found that all individuals tagged used mostly the indigenous forest and frequently utilised urban residential areas (gardens) with little or no use of cultivated land. Observed individual variations in monthly and seasonal home ...

  17. Evolution of competitive ability within Lonicera japonica's invaded range

    Science.gov (United States)

    Gregory A. Evans; Francis F. Kilkenny; Laura F. Galloway

    2013-01-01

    Factors influencing invasive taxa may change during the course of an invasion. For example, intraspecific competition is predicted to be more important in areas with older stands of dense monospecific invaders than at the margins of an invaded range. We evaluated evolution in response to predicted changes in competition by comparing the intraspecific competitive...

  18. Colored Range Searching in Linear Space

    DEFF Research Database (Denmark)

    Grossi, Roberto; Vind, Søren Juhl

    2014-01-01

    In colored range searching, we are given a set of n colored points in d ≥ 2 dimensions to store, and want to support orthogonal range queries taking colors into account. In the colored range counting problem, a query must report the number of distinct colors found in the query range, while...... an answer to the colored range reporting problem must report the distinct colors in the query range. We give the first linear space data structure for both problems in two dimensions (d = 2) with o(n) worst case query time. We also give the first data structure obtaining almost-linear space usage and o...

  19. 77 FR 67566 - Regulated Navigation Area; Thames River Degaussing Range Replacement Operations; New London, CT

    Science.gov (United States)

    2012-11-13

    ... rule is necessary to provide for the safety of life on the navigable waters during the replacement of... circumstances change. This rule is necessary to provide for the safety of life on the navigable waters during... contractor has done their due diligence to prevent a need to close the waterway. The Captain of the Port...

  20. Environmental Assessment for Armed Munitions Integration Testing on the Precision Impact Range Area

    Science.gov (United States)

    2005-05-01

    Perognathus 11 longimembris), Merriam’s kangaroo rat (Dipodymus merriami), and desert woodrat (Neotoma lepida). 12 Common bats include the western pipistrelle...or behavioral. Physiological effects can be mild, such as 3 an increase in heart rate, to more severe, such as effects on metabolism and hormone