WorldWideScience

Sample records for underserved areas microform

  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. 24 CFR 81.13 - Central Cities, Rural Areas, and Other Underserved Areas Housing Goal.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Central Cities, Rural Areas, and...) Housing Goals § 81.13 Central Cities, Rural Areas, and Other Underserved Areas Housing Goal. (a) Purpose... cities, rural areas, and other underserved areas is intended to achieve increased purchases by the GSEs...

  3. The prevalence of uncorrected refractive errors in underserved rural areas

    Directory of Open Access Journals (Sweden)

    Hassan Hashemi

    2017-12-01

    Full Text Available Purpose: To determine the prevalence of uncorrected refractive errors, need for spectacles, and the determinants of unmet need in underserved rural areas of Iran. Methods: In a cross-sectional study, multistage cluster sampling was done in 2 underserved rural areas of Iran. Then, all subjects underwent vision testing and ophthalmic examinations including the measurement of uncorrected visual acuity (UCVA, best corrected visual acuity, visual acuity with current spectacles, auto-refraction, retinoscopy, and subjective refraction. Need for spectacles was defined as UCVA worse than 20/40 in the better eye that could be corrected to better than 20/40 with suitable spectacles. Results: Of the 3851 selected individuals, 3314 participated in the study. Among participants, 18.94% [95% confidence intervals (CI: 13.48–24.39] needed spectacles and 11.23% (95% CI: 7.57–14.89 had an unmet need. The prevalence of need for spectacles was 46.8% and 23.8% in myopic and hyperopic participants, respectively. The prevalence of unmet need was 27% in myopic, 15.8% in hyperopic, and 25.46% in astigmatic participants. Multiple logistic regression showed that education and type of refractive errors were associated with uncorrected refractive errors; the odds of uncorrected refractive errors were highest in illiterate participants, and the odds of unmet need were 12.13, 5.1, and 4.92 times higher in myopic, hyperopic and astigmatic participants as compared with emmetropic individuals. Conclusion: The prevalence of uncorrected refractive errors was rather high in our study. Since rural areas have less access to health care facilities, special attention to the correction of refractive errors in these areas, especially with inexpensive methods like spectacles, can prevent a major proportion of visual impairment. Keywords: Uncorrected refractive errors, Population-based study, Unmet need

  4. 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%)

  5. 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

  6. 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

  7. 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

  8. Teleophthalmology: A Model for Eye Care Delivery in Rural and Underserved Areas of India

    Directory of Open Access Journals (Sweden)

    Vijayaraghavan Prathiba

    2011-01-01

    Full Text Available Objectives. To describe the application of teleophthalmology in rural and underserved areas of India. Study Design. This paper describes the major teleophthalmology projects in India and its benefits. Results. Teleophthalmology is the use of telecommunication for electronic transfer of health-related data from rural and underserved areas of India to specialities in urban cities. The MDRF/WDF Rural Diabetes Project has proved to be very beneficial for improvement of quality health care in Tamilnadu and can be replicated at the national level. This community outreach programme using telemedicine facilities has increased awareness of eye diseases, improved access to specialized health care, helped in local community empowerment, and provided employment opportunities. Early detection of sight threatening disorders by teleophthalmology and prompt treatment can help decrease visual impairment. Conclusion. Teleophthalmology can be a very effective model for improving eye care delivery system in rural and underserved areas of India.

  9. 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.

  10. 76 FR 31998 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2012

    Science.gov (United States)

    2011-06-02

    ... necessary to comply with a provision of the FEHB law that mandates special consideration for enrollees of...: FEHB law (5 U.S.C. 8902(m)(2)) requires special consideration for enrollees of certain FEHB plans who... of the law requires that a State be designated as a Medically Underserved Area if 25 percent or more...

  11. 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.

  12. 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

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

    Directory of Open Access Journals (Sweden)

    Bärnighausen Till

    2009-05-01

    Full Text Available Abstract Background In many geographic regions, both in developing and in developed countries, the number of health workers is insufficient to achieve population health goals. Financial incentives for return of service are intended to alleviate health worker shortages: A (future health worker enters into a contract to work for a number of years in an underserved area in exchange for a financial pay-off. Methods We carried out systematic literature searches of PubMed, the Excerpta Medica database, the Cumulative Index to Nursing and Allied Health Literature, and the National Health Services Economic Evaluation Database for studies evaluating outcomes of financial-incentive programs published up to February 2009. To identify articles for review, we combined three search themes (health workers or students, underserved areas, and financial incentives. In the initial search, we identified 10,495 unique articles, 10,302 of which were excluded based on their titles or abstracts. We conducted full-text reviews of the remaining 193 articles and of 26 additional articles identified in reference lists or by colleagues. Forty-three articles were included in the final review. We extracted from these articles information on the financial-incentive programs (name, location, period of operation, objectives, target groups, definition of underserved area, financial incentives and obligation and information on the individual studies (authors, publication dates, types of study outcomes, study design, sample criteria and sample size, data sources, outcome measures and study findings, conclusions, and methodological limitations. We reviewed program results (descriptions of recruitment, retention, and participant satisfaction, program effects (effectiveness in influencing health workers to provide care, to remain, and to be satisfied with work and personal life in underserved areas, and program impacts (effectiveness in influencing health systems and health outcomes

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

    Science.gov (United States)

    Bärnighausen, Till; Bloom, David E

    2009-05-29

    In many geographic regions, both in developing and in developed countries, the number of health workers is insufficient to achieve population health goals. Financial incentives for return of service are intended to alleviate health worker shortages: A (future) health worker enters into a contract to work for a number of years in an underserved area in exchange for a financial pay-off. We carried out systematic literature searches of PubMed, the Excerpta Medica database, the Cumulative Index to Nursing and Allied Health Literature, and the National Health Services Economic Evaluation Database for studies evaluating outcomes of financial-incentive programs published up to February 2009. To identify articles for review, we combined three search themes (health workers or students, underserved areas, and financial incentives). In the initial search, we identified 10,495 unique articles, 10,302 of which were excluded based on their titles or abstracts. We conducted full-text reviews of the remaining 193 articles and of 26 additional articles identified in reference lists or by colleagues. Forty-three articles were included in the final review. We extracted from these articles information on the financial-incentive programs (name, location, period of operation, objectives, target groups, definition of underserved area, financial incentives and obligation) and information on the individual studies (authors, publication dates, types of study outcomes, study design, sample criteria and sample size, data sources, outcome measures and study findings, conclusions, and methodological limitations). We reviewed program results (descriptions of recruitment, retention, and participant satisfaction), program effects (effectiveness in influencing health workers to provide care, to remain, and to be satisfied with work and personal life in underserved areas), and program impacts (effectiveness in influencing health systems and health outcomes). Of the 43 reviewed studies 34

  15. A systematic literature review of undergraduate clinical placements in underserved areas.

    Science.gov (United States)

    Crampton, Paul E S; McLachlan, John C; Illing, Jan C

    2013-10-01

    The delivery of undergraduate clinical education in underserved areas is increasing in various contexts across the world in response to local workforce needs. A collective understanding of the impact of these placements is lacking. Previous reviews have often taken a positivist approach by only looking at outcome measures. This review addresses the question: What are the strengths and weaknesses for medical students and supervisors of community placements in underserved areas? A systematic literature review was carried out by database searching, citation searching, pearl growing, reference list checking and use of own literature. The databases included MEDLINE, EMBASE, PsycINFO, Web of Science and ERIC. The search terms used were combinations and variations of four key concepts exploring general practitioner (GP) primary care, medical students, placements and location characteristics. The papers were analysed using a textual narrative synthesis. The initial search identified 4923 results. After the removal of duplicates and the screening of titles and abstracts, 185 met the inclusion criteria. These full articles were obtained and assessed for their relevance to the research question; 54 were then included in the final review. Four main categories were identified: student performance, student perceptions, career pathways and supervisor experiences. This review reflects the emergent qualitative data as well as the quantitative data used to assess initiatives. Underserved area placements have produced many beneficial implications for students, supervisors and the community. There is a growing amount of evidence regarding rural, underserved areas, but little in relation to inner city, deprived areas, and none in the UK. © John Wiley & Sons Ltd 2013.

  16. 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.

  17. 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.

  18. Physician recruitment and retention in rural and underserved areas.

    Science.gov (United States)

    Lee, Dane M; Nichols, Tommy

    2014-01-01

    The purpose of this paper is to identify the challenges when recruiting and retaining rural physicians and to ascertain methods that make rural physician recruitment and retention successful. There are studies that suggest rural roots is an important factor in recruiting rural physicians, while others look at rural health exposure in medical school curricula, self-actualization, community sense and spousal perspectives in the decision to practice rural medicine. An extensive literature review was performed using Academic Search Complete, PubMed and The Cochrane Collaboration. Key words were rural, rural health, community hospital(s), healthcare, physicians, recruitment, recruiting, retention, retaining, physician(s) and primary care physician(s). Inclusion criteria were peer-reviewed full-text articles written in English, published from 1997 and those limited to USA and Canada. Articles from foreign countries were excluded owing to their unique healthcare systems. While there are numerous articles that call for special measures to recruit and retain physicians in rural areas, there is an overall dearth. This review identifies several articles that suggest recruitment and retention techniques. There is a need for a research agenda that includes valid, reliable and rigorous analysis regarding formulating and implementing these strategies. Rural Americans are under-represented when it comes to healthcare and what research there is to assist recruitment and retention is difficult to find. This paper identify the relevant research and highlights key strategies.

  19. Microforms in Series Union List.

    Science.gov (United States)

    Hartsock, Ralph, Comp.

    This union list contains over 100 microform music collections from eight libraries which are members of the Mountain-Plains Chapter of the Music Library Association. The 22-page list includes major sets, series, and complete works of composers. Excluded are periodicals, single work/dissertation titles, and general collections that are currently…

  20. Are public health physicians still needed in medically underserved rural areas in Korea?

    Science.gov (United States)

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

    2017-05-01

    Public health physicians (PHPs) are certified physicians who are serving in a public health center or subcenter in a rural village, instead of serving in the military. However, the PHP program has recently become the subject of a profound debate, over 30 years after its adoption. In this study, we attempted to ascertain physicians' perspectives on the PHP program, including: whether the PHP policy should continue; if they agree on changing the role of PHPs in healthcare; what would be the desired role of PHPs; and what resources would be required and what possible barriers would be anticipated under the changes. We selected 88 PHPs as our study sample using quota sampling. Over 60% of respondents were in support of continuing the PHP program. They believed some remote islands and mountainous areas are still in need of public healthcare doctors. However, some of them believed that the role of PHPs should be changed to take on community health promotion, because the problem of medically underserved rural areas has almost been resolved. However, people living in rural areas are ageing and suffering from a lack of education and health information. In particular, in order to successfully transition into new roles, PHPs must be provided with continuing education and professional development programs covering their new responsibilities. It is imperative to refurbish the PHP program to meet current needs and continue its central role in public healthcare.

  1. 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%).

  2. 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...

  3. 12 CFR 1282.13 - Central Cities, Rural Areas, and Other Underserved Areas Housing Goal.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Central Cities, Rural Areas, and Other... HOUSING GOALS AND MISSION ENTERPRISE HOUSING GOALS AND MISSION Housing Goals § 1282.13 Central Cities... purchase by each Enterprise of mortgages on housing located in central cities, rural areas, and other...

  4. Placenta previa, anemia, care in antenatal, employment score: Development of a scoring system to predict low birth weight in underserved area in Indonesia

    OpenAIRE

    Lumbanraja, Sarma Nursani

    2016-01-01

    Background: Early intervention of low birth weight (LBW) should reduce maternal and fetal morbidity. In underserved areas, with inadequacy of health technologies, it was very important to develop a simple scoring system based on the LBW risk factors. Aims and Objective: The aim of this study is to develop a scoring system to predict LBW in underserved area. Materials and Methods: This case–control study enrolled total of women with a singleton LBW in Padang Sidempuan General Hospi...

  5. Cooperative Microform Publishing: The Law Library Experience.

    Science.gov (United States)

    Dupont, Jerry

    1983-01-01

    Discussion of the Hawaii-based Law Library Microform Consortium (LLMC), a nonprofit interlibrary cooperative microfiche project involving several hundred American and foreign law libraries, outlines LLMC's history, organizational structure, operations, publishing record, marketing efforts, and prospects for the future. (EJS)

  6. 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.

  7. Development of microforming process combined with thin film transfer printing

    Directory of Open Access Journals (Sweden)

    Koshimizu Kazushi

    2015-01-01

    Full Text Available Microforming receives a lot of attentions in the recent years due to the increased use of microparts in electronics and medical sectors. For the further functionalization of these micro devices, high functional surface with noble metals are strongly required for the devices in bio- and medical fields, such as bio-sensors. To realize the submillimeter structure of metal foils and micro to nanometer structures in one forming process, the present study proposes a combined process of microforming for metal foils and transfer printing of gold (Au thin films. To clarify the availability of the proposed combined process, transferability of Au thin films under micro bulging deformation are investigated. 0.1 mm-thick pure titanium (Ti foils and 100 nm-thick Au films were used as blank and functional materials, respectively. The forming tests of the proposed process were conducted. With increasing strain of Ti foils, Au TP areas increase. By this experiment, it’s confirmed that the hydrogen reduction of oxidation layers and the strain of Ti foil are significant factor for Au TP on Ti foils.

  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. Subject Index to Collections in the Microforms Section.

    Science.gov (United States)

    Pontius, Jack E., Comp.

    This document is a subject index to the microform (microfilm, microfiche, superfiche, COM, micro-opaques) collections of the Pattee Library of Pennsylvania State University. Collections are listed under both general and specific subject headings and are identified by main entry, title, and microform call number. (JD)

  10. Five Decades of Microforms at the Library of Congress.

    Science.gov (United States)

    Sullivan, Robert C.

    1988-01-01

    Discusses the history of the microform collections at the Library of Congress (LC), highlighting the exchange of microfilmed newspapers between LC and the Biblioteca Nacional, Brazil. Recent developments in preservation microfilming, LC's acquisition of microforms, and the activities of the LC Preservation Microfilming Office are described. (3…

  11. Impact of an interprofessional education program on developing skilled graduates well-equipped to practise in rural and underserved areas.

    Science.gov (United States)

    Mpofu, Ratie; Daniels, Priscilla S; Adonis, Tracy-Ann; Karuguti, Wallace M

    2014-01-01

    Poverty, limited access to resources and a lack of infrastructure characterise the division of rural areas from urban South Africa. Low numbers of social welfare professionals compound the problem. With education linked inextricably in social responsibility, higher education institutions (HEIs) are called upon increasingly to create conditions that encourage students and graduates to practise in more socially responsible ways, involving more than mere disciplinary expertise or technical knowledge, and that consider the problems of rural areas. Use of interprofessional education (IPE) programs, based on teamwork, could enable HEIs to train and guide health sciences students in how best to cooperate with each other and combine their skills to mutual benefit. This would enable them to develop professional skills facilitated by interactive engagement within community settings. Referencing experience gained in Australia and elsewhere, the Faculty of Community and Health Sciences (FCHS) at the University of Western Cape (UWC) has developed and applied an IPE program for South Africa. Students were placed in interdisciplinary groups in a rural and underserved municipality of the Western Cape - 17 students participated in a study on the effectiveness of this program. A quantitative self-administered questionnaire, followed by qualitative focus group discussions, established student perceptions of their IPE experience, how the experience influenced their intentions for or against future practice in rural and underserved areas, and their interest in future interprofessional collaboration and practice. More than 75% of the participating students agreed that they had learnt to develop knowledge base, procedural and healthcare practice presentation skills, along with preparing written community health histories. Student willingness to practise in rural areas was evidenced, citing community- and resource-based factors as determinants; however, concerns that some community

  12. Balancing the role of the dental school in teaching, research and patient care; including care for underserved areas.

    Science.gov (United States)

    Holbrook, W P; Brodin, P; Balciuniene, I; Brukiene, V; Bucur, M V; Corbet, E; Dillenberg, J; Djukanovic, D; Ekanayake, K; Eriksen, H; Fisher, J; Goffin, G; Hull, P; Kumchai, T; Lumley, P; Lund, J; Mathur, V; Novaes, A; Puriene, A; Roger-Leroi, V; Saito, I; Turner, S; Mabelya, L

    2008-02-01

    Inequalities within dentistry are common and are reflected in wide differences in the levels of oral health and the standard of care available both within and between countries and communities. Furthermore there are patients, particularly those with special treatment needs, who do not have the same access to dental services as the general public. The dental school should aim to recruit students from varied backgrounds into all areas covered by the oral healthcare team and to train students to treat the full spectrum of patients including those with special needs. It is essential, however, that the dental student achieves a high standard of clinical competence and this cannot be gained by treating only those patients with low expectations for care. Balancing these aspects of clinical education is difficult. Research is an important stimulus to better teaching and better clinical care. It is recognized that dental school staff should be active in research, teaching, clinical work and frequently administration. Maintaining a balance between the commitments to clinical care, teaching and research while also taking account of underserved areas in each of these categories is a difficult challenge but one that has to be met to a high degree in a successful, modern dental school.

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

    Science.gov (United States)

    2013-10-01

    Overpopulation and urbanization – Population migration to coastal regions – Climate change – Terrorism and pandemics • September 11, 2001 • SARS and...years due to a multitude of factors, overpopulation and urbanization, population migration to coastal areas, and climate change to name a few (Scott...of factors, overpopulation and urbanization, population migration to coastal areas, and climate change to name a few (Scott 2011; Study shows

  14. 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…

  15. 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

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

    Science.gov (United States)

    Shah, Tayyab Ikram; Bell, Scott; Wilson, Kathi

    2016-01-01

    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 level. In

  17. Space Consuming U.S. Government Documents Available in Microform.

    Science.gov (United States)

    Johnson, Nancy P.

    1980-01-01

    Contains a listing of federal publications available in microform, supplying price, publisher, format, estimated shelf space, and, where available, review citations to aid documents librarians conscious of the space saving advantages of microformatted documents. (Author)

  18. Microforming process for embossing of LTCC tapes

    Science.gov (United States)

    Bartsch, H.; Albrecht, A.; Hoffmann, M.; Müller, J.

    2012-01-01

    Embossing of low-temperature cofired ceramics (LTCC) enables the fine patterning of these multilayer materials in the green state and thus allows the fabrication of smart ceramic microsystems even for moderate quantities or prototypes. To understand the embossing process, mechanical properties such as the viscoelastic modulus, yield strain and densification are investigated for commercially available LTCC tapes. The forming and shrinkage behaviour are compared for large cavities as well as for fine patterns. The results are discussed and a comprehensive explanation of the forming mechanism is worked out. Relevant material properties are identified and the microforming of different tapes is explained under consideration of their mechanical properties. This paper therefore gives an essential guide to understanding the main forming influences and failures for LTCC tapes.

  19. 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.

  20. Landmarks of Science: Microforms Cataloging Project, September 1981-December 1983.

    Science.gov (United States)

    Van Orden, Richard

    To improve bibliographic access to the individual works contained in "Landmarks of Science" and "Landmarks II," two comprehensive microform collections of materials related to the history of science, the staff of the University of Utah Libraries cataloged the individual titles. Staff members with backgrounds in Renaissance…

  1. Bibliographies of Microforms Relating to African-Americans.

    Science.gov (United States)

    Ransom, Charles G.

    1994-01-01

    Lists approximately 250 microforms from the University of Michigan library that relate to African Americans. Headings are biographies, civil rights, Civil War, colonization, economics, employment, freedmen, history, Michigan, music, news, papers, periodicals, politics, race, Reconstruction, religion, riots, segregation, slavery, social conditions,…

  2. "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.

  3. Provision of medical abortion by midlevel healthcare providers in Kyrgyzstan: testing an intervention to expand safe abortion services to underserved rural and periurban areas.

    Science.gov (United States)

    Johnson, Brooke Ronald; Maksutova, Elmira; Boobekova, Aigul; Davletova, Ainura; Kazakbaeva, Chinara; Kondrateva, Yelena; Landoulsi, Sihem; Lazdane, Gunta; Monolbaev, Kubanychbek; Seuc Jo, Armando H

    2018-02-01

    To demonstrate the feasibility and safety of training midlevel healthcare providers (midwives and family nurses) to provide medical abortion and postabortion contraception in underserved areas in Kyrgyzstan. This was an implementation study at four referral facilities and 28 Felsher Obstetric Points in two districts to train their midwives and family nurses to deliver safe and effective abortion care with co-packaged mifepristone-misoprostol and provide contraceptives postabortion. The outcome of abortion - complete abortion, incomplete abortion or o-going pregnancy - was the primary end point measured. An international consultant trained 18 midwives and 14 family nurses (with midwifery diplomas) to provide medical abortion care. Supervising gynecologists based in the referral centers and study investigators based in Bishkek provided monthly monitoring of services and collection of patient management forms. A voluntary self-administered questionnaire at the follow-up visit documented women's acceptability of medical abortion services. All study data were cross-checked and entered into an online data management system for descriptive analysis. Between August 2014 and September 2015, midwives provided medical abortion to 554 women with a complete abortion rate of 97.8%, of whom 62% chose to use misoprostol at home. No women were lost to follow-up. Nearly all women (99.5%) chose a contraceptive method postabortion; 61% of women receiving services completed the acceptability form, of whom more than 99% indicated a high level of satisfaction with the service and would recommend it to a friend. This study demonstrates that trained Kyrgyz midwives and nurses can provide medical abortion safely and effectively. This locally generated evidence can be used by the Kyrgyz Ministry of Health to reduce unintended pregnancy and expand safe abortion care to women in underserved periurban and rural settings. Success in scaling up midwife/nurse provision of medical abortion in

  4. Micro-scaled products development via microforming deformation behaviours, processes, tooling and its realization

    CERN Document Server

    Fu, Ming Wang

    2014-01-01

    ‘Micro-scaled Products Development via Microforming’ presents state-of-the-art research on microforming processes, and focuses on the development of micro-scaled metallic parts via microforming processes. Microforming refers to the fabrication of microparts via micro-scaled plastic deformation and  presents a promising micromanufacturing process. When compared to other  micromanufacturing processes, microforming offers advantages such as high productivity and good mechanical properties of the deformed microparts. This book provides extensive and informative illustrations, tables and photos in order to convey this information clearly and directly to readers. Although the knowledge of macroforming processes is abundant and widely used in industry, microparts cannot be developed by leveraging existing knowledge of macroforming because the size effect presents a barrier to this knowledge transfer. Therefore systematic knowledge of microforming needs to be developed. In tandem with product miniaturization, t...

  5. Tele-Nephrology: A Feasible Way to Improve Access to Care for Patients with Kidney Disease Who Reside in Underserved Areas.

    Science.gov (United States)

    Ladino, Marco A; Wiley, Joslyn; Schulman, Ivonne Hernandez; Sabucedo, Alberto J; Garcia, Desiree; Cardona, Jose M; Valdes, Alejandro; Pedraza, Fernando; Echeverri, Roberto J

    2016-08-01

    The Miami VA Healthcare System serves veterans in three South Florida counties: Miami-Dade, Broward, and Monroe, with an estimated veteran population of 175,000. To overcome geographical barriers and facilitate the access to nephrology clinics, we implemented provider-patient tele-nephrology using secured videoconferencing. A retrospective and descriptive study design was used to evaluate the effect of the tele-nephrology clinic intervention. Multiple clinical indicators were included in the analysis: blood pressure (BP) control, stabilization of the renal function, and electrolyte/metabolic control. One hundred one patients who were evaluated in the clinic between 2013 and 2015 were included in the analysis, and the indicators were collected retrospectively. One hundred one patients were included in the analysis, with 95% of patients being male (n = 96) and 5% female (n = 5). The mean age was 65.5 years. Fifty patients had chronic kidney disease (CKD) stage III (49.5%), 14 patients had CKD stage IV (13%), and 8 patients had CKD stage II (7.9%). A one-way analysis of variance between subjects was conducted and showed that the effect of the tele-nephrology clinic intervention on reducing BP was statistically significant (systolic BP less than 140 p value nephrology clinic intervention, we were able to effectively improve BP and stabilize renal function in patients with kidney disease who reside in underserved areas.

  6. 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

  7. 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.

  8. Development of microforming process combined with selective chemical vapor deposition

    Directory of Open Access Journals (Sweden)

    Koshimizu Kazushi

    2015-01-01

    Full Text Available Microforming has been received much attention in the recent decades due to the wide use of microparts in electronics and medical purpose. For the further functionalization of these micro devices, high functional surface with noble metals and nanomaterials are strongly required in bio- and medical fields, such as bio-sensors. To realize the efficient manufacturing process, which can deform the submillimeter scale bulk structure and can construct the micro to nanometer scale structures in one process, the present study proposes a combined process of microforming for metal foils with a selective chemical vapor deposition (SCVD on the active surface of work materials. To clarify the availability of this proposed process, the feasibility of SCVD of functional materials to active surface of titanium (Ti was investigated. CVD of iron (Fe and carbon nanotubes (CNTs which construct CNTs on the patterned surface of active Ti and non-active oxidation layer were conducted. Ti thin films on silicon substrate and Fe were used as work materials and functional materials, respectively. CNTs were grown on only Ti surface. Consequently, the selectivity of the active surface of Ti to the synthesis of Fe particles in CVD process was confirmed.

  9. 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

  10. Friction related size-effect in microforming – a review

    Directory of Open Access Journals (Sweden)

    Wang Chunju

    2014-01-01

    Full Text Available This paper presents a thorough literature review of the size effects of friction in microforming. During miniaturization, the size effects of friction occur clearly. The paper first introduces experimental research progress on size effects of friction in both micro bulk and sheet forming. The effects of several parameters are discussed. Based on the experimental results, several approaches have been performed to develop a model or functions to analyse the mechanism of size effects of friction, and simulate the micro deep drawing process by integrating them into an FE program. Following this, surface modification, e.g. a DLC film and a micro structure/textured surface, as a method to reduce friction are presented. Finally, the outlook for the size effect of friction in the future is assessed, based on the understanding of the current research progress.

  11. Review on progressive microforming of bulk metal parts directly using sheet metals (Keynote Paper

    Directory of Open Access Journals (Sweden)

    Fu M.W.

    2015-01-01

    Full Text Available Due to the ubiquitous trend of product miniaturization, energy saving and weight reduction, micro/meso-scale parts have been widely used in many industrial clusters. Micromanufacturing processes for production of such micro/meso-scale parts are thus critically needed. Microforming, as one of these micro manufacturing processes, is a promising process and thus got many explorations and researches. Compared with the research on size effect affected deformation behaviours, less attention has been paid to the process development for mass production of micro-parts. The product quality and fabrication productivity of micro-parts depend on the involved process chain. To address the difficulty in handling and transporting of the micro-sized workpiece, development of a progressive microforming process for directly fabricating bulk micro-parts using sheet metals seems quite promising as it avoids or facilitates billet handling, transportation, positioning, and ejection in the process chain. In this paper, an intensive review on the latest development of progressive microforming technologies is presented. First of all, the paper summarizes the characteristic of progressive microforming directly using sheet metal. The size effect-affected deformation behaviour and the dimensional accuracy, deformation load, ductile fracture, and the surface finish of the microformed parts by progressive microforming using sheet metals are then presented. Finally, some research issues from the implementation of mass production perspective are also discussed.

  12. Microform-related community patterns of methane-cycling microbes in boreal Sphagnum bogs are site specific.

    Science.gov (United States)

    Juottonen, Heli; Kotiaho, Mirkka; Robinson, Devin; Merilä, Päivi; Fritze, Hannu; Tuittila, Eeva-Stiina

    2015-09-01

    Vegetation and water table are important regulators of methane emission in peatlands. Microform variation encompasses these factors in small-scale topographic gradients of dry hummocks, intermediate lawns and wet hollows. We examined methane production and oxidization among microforms in four boreal bogs that showed more variation of vegetation within a bog with microform than between the bogs. Potential methane production was low and differed among bogs but not consistently with microform. Methane oxidation followed water table position with microform, showing higher rates closer to surface in lawns and hollows than in hummocks. Methanogen community, analysed by mcrA terminal restriction fragment length polymorphism and dominated by Methanoregulaceae or 'Methanoflorentaceae', varied strongly with bog. The extent of microform-related variation of methanogens depended on the bog. Methanotrophs identified as Methylocystis spp. in pmoA denaturing gradient gel electrophoresis similarly showed effect of bog, and microform patterns were stronger within individual bogs. Our results suggest that methane-cycling microbes in boreal Sphagnum bogs with seemingly uniform environmental conditions may show strong site-dependent variation. The bog-intrinsic factor may be related to carbon availability but contrary to expectations appears to be unrelated to current surface vegetation, calling attention to the origin of carbon substrates for microbes in bogs. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Preparing a Union List of Microforms on the Classical, Medieval, and Renaissance Periods.

    Science.gov (United States)

    Henneman, John B., Jr.

    1988-01-01

    Describes a project of the Association of College and Research Libraries to compile a union list of microforms dealing with the classical, medieval, and Renaissance periods. Goals of the project, questionnaire development, survey response, and questions raised by the project are discussed. The union list, including 101 titles and 45 libraries, is…

  14. University of New Mexico General Libraries Guide to the Microform Collections.

    Science.gov (United States)

    Lewis, Linda K.

    The contents--sets of archives, books, documents, manuscripts, music, periodicals, plays and scores--and indexing of the university collection of microforms are described in this guide. When available, the following information has been included: call number, card catalog entry, description, format, indexes, publisher, and review. Arranged…

  15. Tool Wear and Life Span Variations in Cold Forming Operations and Their Implications in Microforming

    Directory of Open Access Journals (Sweden)

    Anders E. W. Jarfors

    2016-12-01

    Full Text Available The current paper aims to review tooling life span, failure modes and models in cold microforming processes. As there is nearly no information available on tool-life for microforming the starting point was conventional cold forming. In cold forming common failures are (1 over stressing of the tool; (2 abrasive wear; (3 galling or adhesive wear, and (4 fatigue failure. The large variation in tool life observed in production and how to predict this was reviewed as this is important to the viability of microforming based on that the tooling cost takes a higher portion of the part cost. Anisotropic properties of the tool materials affect tool life span and depend on both the as-received and in-service conditions. It was concluded that preconditioning of the tool surface, and coating are important to control wear and fatigue. Properly managed, the detrimental effects from surface particles can be reduced. Under high stress low-cycle fatigue conditions, fatigue failure form internal microstructures and inclusions are common. To improve abrasive wear resistance larger carbides are commonly the solution which will have a negative impact on tooling life as these tend to be the root cause of fatigue failures. This has significant impact on cold microforming.

  16. Nevada Underserved Science Education Program

    Energy Technology Data Exchange (ETDEWEB)

    Nicole Rourke; Jason Marcks

    2004-07-06

    Nevada Underserved Science Education Program (NUSEP) is a project to examine the effect of implementing new and innovative Earth and space science education curriculum in Nevada schools. The project provided professional development opportunities and educational materials for teachers participating in the program.

  17. Immunization coverage levels among 19- to 35-month-old children in 4 diverse, medically underserved areas of the United States

    NARCIS (Netherlands)

    Rosenthal, J; Rodewald, L; McCauley, M; Berman, S; Irigoyen, M; Sawyer, M; Yusuf, H; Davis, R; Kalton, G

    2004-01-01

    Background. The National Immunization Survey demonstrates that national immunization coverage in 2002 remained near the all-time highs achieved in 2000. However, that survey cannot detect whether coverage is uniformly high within relatively small areas or populations. The measles resurgence in the

  18. Development of in-situ observation system of dynamic contact interface between dies and materials during microforming operation

    Directory of Open Access Journals (Sweden)

    Shimizu Tetsuhide

    2015-01-01

    Full Text Available Application of diamond like carbon (DLC films are reported in several microforming processes, in view of its great tribological performance owe to the low friction and the high chemical stability. However, due to its high internal residual stress, the film properties with the low adhesion strength and the high wear rate under severe tribological conditions are still remain as technical issues. However, since the dynamic variation of the contact state cannot be observed during the forming operation, it is difficult to recognize the origin and the influential tribological factors of tool life for DLC coated microforming die. Therefore, the appropriate DLC film properties for the contact state in microforming operation have not been clarified. To observe the dynamic variation of the contact state during the microforming operation, present study developed a novel microforming die assembly installed the in-situ observation system with silica glass die and high speed recording camera. By using this system, the dynamic delamination behaviour of DLC films during the progressive micro-bending process was successfully demonstrated. The influential factors for the durability of DLC coated microdies were discussed.

  19. 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.

  20. Fabrication of Times and Micro-Formation of Discourse at a Secondary School

    Directory of Open Access Journals (Sweden)

    Michalis Kontopodis

    2007-01-01

    Full Text Available The paper presented here starts with a reference to modernist time theories, followed by a presentation of alternative views in the works of FOUCAULT, DELEUZE, LATOUR and others. The study concentrates on the concrete context of an experimental school aiming at incorporation of excluded students into society. Based on the synthesis of discourse analysis and Actor-Network-Theory, the study puts forward a twofold question: a whether and how the "fabrication of times" is interrelated to micro-formations of discourses and b how micro-formations of discourses emerge as processes in the concrete setting of a school in regard to their temporal and other aspects. To answer this query, I combine some critical ethnographic work with an Actor-Network-Theory methodology—an approach which could be regarded as "rhizomatic analysis" (DELEUZE & GUATTARI, 1980. Examining discursive and non-discursive action with a particular focus on materialities (sites, students' documents, educational reports, CVs, and files, I introduce the notion of "temporal devices of control" and map two of them: that of synchronicity and that of convergence. In this way, I propose a new understanding of time and relate it to discourse formation. This, in turn, reveals a new potential for critical reflection on theories of time as well as on all action taking place in the school. URN: urn:nbn:de:0114-fqs0701119

  1. Feasibility study of the microforming combined with selective chemical vapor deposition

    Directory of Open Access Journals (Sweden)

    Koshimizu Kazushi

    2015-01-01

    Full Text Available Microforming has been received much attention in the recent decades due to the wide use of microparts in electronics and medical applications. For the further functionalization of these micro devices, high functional surfaces with noble metals and nanomaterials are strongly required in bio- and medical fields, such as bio-sensors. To realize an efficient manufacturing process, which can deform the submillimeter scale bulk structure and can construct the micro to nanometer scale structures in one process, the present study proposes a combined process of microforming for metal foils with a selective chemical vapor deposition (SCVD on the active surfaces of the working material. To demonstrate feasibility of this proposed process, feasibility of SCVD of functional materials onto active surfaces of titanium (Ti was investigated. CVD of iron (Fe and carbon nanotubes (CNTs which construct CNTs on the patterned surfaces of the active Ti and non-active Ti oxidation layers were conducted. Ti thin films on silicon substrate and Fe were used as working materials and functional materials respectively. CNTs were grown only on the Ti surface. Consequently, selectivity of the active surface of Ti to the synthesis of Fe particles in CVD was confirmed.

  2. Organización de las microformas en la biblioteca Organization of microforms in libraries

    Directory of Open Access Journals (Sweden)

    Maite Legaz

    2004-06-01

    Full Text Available Se relevan, a partir de la consulta de la literatura especializada, las características particulares de las microformas y la problemática inherente a su gestión en las bibliotecas. En primer lugar, se realiza una breve reseña histórica sobre el origen y evolución de estos recursos para, luego, presentar una tipología y algunas aproximaciones terminológicas. Se considera especialmente la descripción bibliográfica y se proporcionan lineamientos generales sobre la determinación de los puntos de acceso. Se contemplan otras cuestiones relativas a su gestión, como ser su selección, almacenamiento y preservación. Además, se destacan las ventajas y desventajas de las microformas como soporte en las unidades de información.The particular characteristics of the microforms and the problems arised in their management are reviewed from the special literature. Firstly, a brief history about the origin and evolution of these resources is presented, followed by a typology and the terminology concerned. Bibliographic description is specially emphasized and guidelines for determination of access points are proposed. Criteria about its selection, storage and preservation are also provided. Besides, the advantages and disadvantages of microforms as library material are remarked.

  3. The geographic accessibility of retail clinics for underserved populations.

    Science.gov (United States)

    Pollack, Craig Evan; Armstrong, Katrina

    2009-05-25

    The extent to which retail clinics provide access to care for underserved populations remains largely unknown. The purpose of this study was to determine whether retail clinics tend to be located in census tracts with higher medical need. The locations of retail clinics as of July 1, 2008, were mapped and linked to the 2000 US Census and 2008 Health Resources and Services Administration data. Bivariate analyses and logistic regression models with random effects were used to compare the characteristics of census tracts with and without retail clinics. To determine whether retail clinics followed the underlying distribution of chain stores, the location of clinics conditional on there being a chain store was analyzed in 6 counties. Of the 932 retail clinics, 930 were successfully mapped. Eighteen states had no retail clinics, and 17 states had 25 or more clinics. Within counties with at least 1 retail clinic, census tracts with retail clinics had a lower black population percentage, lower poverty rates, and higher median incomes and were less likely to be medically underserved areas/populations compared with census tracts without retail clinics. Similarly, stores with retail clinics were less likely to be located in medically underserved areas compared with stores without retail clinics. Retail clinics are currently located in more advantaged neighborhoods, which may make them less accessible for those most in need.

  4. 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

  5. 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.

  6. Microforms in gravel bed rivers: Formation, disintegration, and effects on bedload transport

    Science.gov (United States)

    Strom, K.; Papanicolaou, A.N.; Evangelopoulos, N.; Odeh, M.

    2004-01-01

    This research aims to advance current knowledge on cluster formation and evolution by tackling some of the aspects associated with cluster microtopography and the effects of clusters on bedload transport. The specific objectives of the study are (1) to identify the bed shear stress range in which clusters form and disintegrate, (2) to quantitatively describe the spacing characteristics and orientation of clusters with respect to flow characteristics, (3) to quantify the effects clusters have on the mean bedload rate, and (4) to assess the effects of clusters on the pulsating nature of bedload. In order to meet the objectives of this study, two main experimental scenarios, namely, Test Series A and B (20 experiments overall) are considered in a laboratory flume under well-controlled conditions. Series A tests are performed to address objectives (1) and (2) while Series B is designed to meet objectives (3) and (4). Results show that cluster microforms develop in uniform sediment at 1.25 to 2 times the Shields parameter of an individual particle and start disintegrating at about 2.25 times the Shields parameter. It is found that during an unsteady flow event, effects of clusters on bedload transport rate can be classified in three different phases: a sink phase where clusters absorb incoming sediment, a neutral phase where clusters do not affect bedload, and a source phase where clusters release particles. Clusters also increase the magnitude of the fluctuations in bedload transport rate, showing that clusters amplify the unsteady nature of bedload transport. A fourth-order autoregressive, autoregressive integrated moving average model is employed to describe the time series of bedload and provide a predictive formula for predicting bedload at different periods. Finally, a change-point analysis enhanced with a binary segmentation procedure is performed to identify the abrupt changes in the bedload statistic characteristics due to the effects of clusters and detect the

  7. Reaching high-risk underserved individuals for cancer genetic counseling by video-teleconferencing.

    Science.gov (United States)

    Mette, Lindsey A; Saldívar, Anna Maria Pulido; Poullard, Natalie E; Torres, Ivette C; Seth, Sarah G; Pollock, Brad H; Tomlinson, Gail E

    2016-04-01

    Breast and colorectal cancers are common cancers for which genetic risk assessment and counseling are available. However, these services are often limited to metropolitan areas and are not readily accessible to underserved populations. Moreover, ethnic and racial disparities present additional obstacles to identifying and screening high-risk individuals and have a bearing on treatment outcomes. To provide cancer genetic risk assessment and counseling through telemedicine to the remote, underserved primarily Hispanic population of the Texas-Mexico border region. Program participants were mailed a questionnaire to assess their satisfaction with the program so that we could determine the acceptability of video-teleconferencing for cancer risk assessment. The overall level of satisfaction with the program was very high, demonstrating the acceptability of a cancer genetic risk assessment program that relied on telemedicine to reach and underserved minority community. Delivery model requires the availability of and access to communication technologies; trained staff are needed at remote sites for sample collection and patient handling. Video-teleconferencing is an acceptable method of providing cancer risk assessment in a remote, underserved population. ©2016 Frontline Medical Communications.

  8. 75 FR 32099 - Enterprise Duty To Serve Underserved Markets

    Science.gov (United States)

    2010-06-07

    ... 2590-AA27 Enterprise Duty To Serve Underserved Markets AGENCY: Federal Housing Finance Agency. ACTION... Recovery Act of 2008 (HERA) amended section 1335 of the Federal Housing Enterprises Financial Safety and... Enterprises) to serve three specified underserved markets--manufactured housing, affordable housing...

  9. 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…

  10. Factors that impact Patient Web Portal Readiness (PWPR) among the underserved.

    Science.gov (United States)

    Nambisan, Priya

    2017-06-01

    Healthcare organizations in the US are increasingly using Patient Portals as a means to provide patients with partial access to their health records and thereby comply with the 'meaningful use' of Health Information Technology policy issued by the US federal government. Patient portals are used to not only provide access to parts of the health records such as lab results but also offer services such as customized educational materials and appointment scheduling. While prior studies examining the adoption rates of these patient portals have not offered consistent findings, many of the studies have reported limited adoption and use [1] of patient portals, especially among the underserved population. This study explores the factors behind the reduced adoption rate of patient portals among the underserved by focusing on their Patient Web Portal Readiness (PWPR). The study empirically evaluates the impact of three important variables on PWPR among the underserved: (a) Personal Health Information Management (PHIM) activities, (b) patient attitude toward personal health record keeping; and (c) use of Internet for health information seeking. The study also incorporates three other factors: (d) access to Internet; (e) demographics; and (f) presence of chronic illness. Data were collected through a survey from 132 patients from the underserved population who visited 5 free clinics in the Northern Virginia area in the US. The paper-based survey was administered to the patients who visited these free clinics for care. The study findings show support for the hypotheses related to the impact of the two key factors - Personal Health Information Management (PHIM) activities and attitude toward personal health record keeping - on PWPR. The findings also indicate that the use of Internet for health information seeking has relatively more impact than patient's Internet access on PWPR. Overall, the findings imply the critical importance of complementary activities - e.g., PHIM

  11. Show me the money! An analysis of underserved stakeholders' funding priorities in Patient Centered Outcomes Research domains.

    Science.gov (United States)

    Cargill, Stephanie Solomon; Baker, Lauren Lyn; Goold, Susan Dorr

    2017-07-01

    Develop an accessible exercise to engage underserved populations about research funding priorities; analyze the criteria they use to prioritize research; contrast these criteria to those currently used by Patient Centered Outcomes Research Institute (PCORI). Academic and community partners collaborated to develop an Ipad exercise to facilitate group deliberation about PCOR funding priorities. 16 groups (n = 183) of underserved individuals in both urban and rural areas participated. Recordings were qualitatively analyzed for prioritization criteria. Analysis yielded ten codes, many of which were similar to PCORI criteria, but all of which challenged or illuminated these criteria. Directly involving underserved populations in determining funding criteria is both feasible and important, and can better fulfill PCORI's goal of incorporating patient priorities.

  12. Dental therapists: improving access to oral health care for underserved children.

    Science.gov (United States)

    Friedman, Jay W; Mathu-Muju, Kavita R

    2014-06-01

    Disparities in dental health care that characterize poor populations are well known. Children suffer disproportionately and most severely from dental diseases. Many countries have school-based dental therapist programs to meet children's primary oral health care needs. Although dental therapists in the United States face opposition from national and state dental associations, many state governments are considering funding the training and deployment of dental therapists to care for underserved populations. Dental therapists care for American Indians/Alaska Natives in Alaska, and Minnesota became the first state to legislate dental therapist training. Children should receive priority preference; therefore, the most effective and economical utilization of dental therapists will be as salaried employees in school-based programs, beginning in underserved rural areas and inner cities.

  13. Experiences promoting healthcare career interest among high-school students from underserved communities.

    Science.gov (United States)

    Zayas, Luis E; McGuigan, Denise

    2006-09-01

    Promoting early interest in healthcare careers among youth from underserved areas is one promising strategy for addressing the health professional shortage in such communities, Most career choice studies try to predict outcomes using such traditional measures as grades and test scores, This study examines experiences influencing healthcare career interest among high-school students participating in health professions introductory programs in underserved communities. The opinions of parents and teachers regarding students' motivations are also considered. Seven focus groups (N=51) were conducted in one rural and two largely minority urban communities in New York State designated as health professional shortage areas. Qualitative data analysis involved a theory-driven, immersion and crystallization approach following the experiential learning model. Constructive experiences with the healthcare system, family role-modelpan>ing and support, interactive health-related school activities, the media, inspirational and accessible school staff, and strategic community partnerships, among other factors, facilitated student interest in health professions. Findings suggest that underserved and disenfranchised community environments still pose challenges for furthering healthcare career interest among youth.

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

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

    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 communities. Maternal and child health concerns According to the World Health Organization, Nigeria's maternal mortality ratio in 2013 was 560, down from 610 in ...

  15. 77 FR 35245 - Substantially Underserved Trust Areas (SUTA)

    Science.gov (United States)

    2012-06-13

    ... conflict with this rule will be preempted. No retroactive effect will be given to the rule and, in..., Alaska Natives, Native Hawaiians, and Pacific Islanders have a deep spiritual, cultural, and historical... can be at odds with spiritual, cultural, historical, and environmental values. Additionally, there are...

  16. 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 ...

  17. 76 FR 63846 - Substantially Underserved Trust Areas (SUTA)

    Science.gov (United States)

    2011-10-14

    ..., and telecommunications and broadband programs. The data covered by this collection of information are... application materials are covered by the information collection package for the specific RUS program being..., water and waste, and telecom and broadband infrastructure, RUS also plays a big role in improving other...

  18. Improving Immunization Rates of Underserved Children: A Historical Study of 10 Health Departments

    Directory of Open Access Journals (Sweden)

    Donald Robert Haley

    2014-05-01

    Full Text Available Background Despite high immunization rates, hundreds of thousands of poor and underserved children continue to lack their necessary immunizations and are at risk of acquiring a vaccine-preventable disease. Local Health Departments (LHDs and public health clinicians figure prominently in efforts to address this problem. Methods This exploratory research compared ten (10 North Carolina LHDs with respect to immunization delivery factors. The study sample was identified based on urban designation as well as county demographic and socio-economic indicators that identified predicted “pockets” of underimmunization. Survey instruments were used to identify specific LHD immunization delivery factors. Results It was found that hours of operation, appointment policies, use and type of tracking systems, and wait times influence a health department’s ability to immunize underserved children. This exploratory research is of particular importance, because it suggests that the implementation of specific policy interventions may reduce the morbidity and mortality related to vaccine-preventable diseases in poor and underserved children. This research also highlights the significance of the nurses’ role in the policy making process in this important area of community health assurance. Conclusion To improve childhood immunization rates, policy-makers should encourage adequate and appropriate funding for LHDs to adopt service delivery factors that are associated with higher-performing local health departments. LHDs should study the population they serve to further refine service delivery factors to meet the population’s needs.

  19. 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......) facilitation of opportunities for training graduate students in a variety of health-related fields. World Spine Care has (a) recognized the enormous need to establish clinical programs aimed at easing the suffering and disability associated with spinal disorders in resource-poor communities, (b) shown...

  20. 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.

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

    African Journals Online (AJOL)

    Effects of a psychological skills training programme for underserved rugby union players. ... The programme's effectiveness was further validated by the experimental group's feedback. Recommendations are made for future research, as well as practical application within existing rugby development programmes in South ...

  3. 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.

  4. 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.

  5. Perceptions of cardiovascular health in an underserved community of deaf adults using American Sign Language.

    Science.gov (United States)

    McKee, Michael; Schlehofer, Deirdre; Cuculick, Jessica; Starr, Matthew; Smith, Scott; Chin, Nancy P

    2011-07-01

    Cardiovascular disease leads in overall mortality and morbidity in the United States. Cardiovascular disparities remain high among minority and underserved groups. Deaf American Sign Language (ASL) users are an underserved and understudied group that receives little attention from researchers due to language and communication barriers. A recent ASL survey in Rochester, NY, indicated greater cardiovascular risk among Deaf participants. The study objective was to investigate risk perceptions of cardiovascular disease among Deaf ASL users, linking perceptions to features of Deaf culture and communication. This information will be used to inform future strategies to promote cardiovascular health among Deaf adults. Four focus groups were conducted in Rochester, New York, with 22 Deaf participants in ASL. Videotaped sessions were translated and transcribed by a bilingual researcher. A team of investigators coded, analyzed, and identified key themes from the data. Themes centered on five major domains: knowledge, barriers, facilitators, practices, and dissemination. The majority of themes focused on barriers and knowledge. Barriers included lack of health care information access due to language and communication challenges, financial constraints, and stress. Inconsistent knowledge emerged from many key areas of cardiovascular health. The study outlines key themes for improving cardiovascular health knowledge and perceptions among Deaf ASL users. Findings suggest the importance of providing health educational programs and information in ASL to maximize understanding and minimize misconceptions. When caring for Deaf ASL users, providers should take extra effort to ask about cardiovascular risk factors and confirm patients' understanding of these factors. Copyright © 2011 Elsevier Inc. All rights reserved.

  6. 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...

  7. 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.

  8. Novel findings of left ventricular non-compaction cardiomyopathy, microform cleft lip and poor vision in patient with SMC1A-associated Cornelia de Lange syndrome.

    Science.gov (United States)

    Wenger, Tara L; Chow, Penny; Randle, Stephanie C; Rosen, Anna; Birgfeld, Craig; Wrede, Joanna; Javid, Patrick; King, Darcy; Manh, Vivian; Hing, Anne V; Albers, Erin

    2017-02-01

    Relatively few patients with Cornelia de Lange syndrome (CdLS) due to SMC1A mutation have been reported, limiting understanding of the full extent of the phenotype. Compared to children with classic NIPBL-associated CdLS, patients with SMC1A-associated CdLS have a milder physical phenotype with prominent intellectual disability, high rate of cleft palate and absence of limb reductions. We present a patient with SMC1A-associated CdLS who had typical features including developmental delay, seizure disorder, feeding difficulties, hirsutism, and cleft palate. She also was found to have three novel features: (i) left ventricular non-compaction (LVNC) cardiomyopathy; (ii) microform cleft lip; and (iii) severe hyperopia and astigmatism. These features have implications regarding potential insight into the pathogenesis of the disorder, screening, and medical management. Hypertrophic cardiomyopathy has previously been reported in SMC1A-associated CdLS, but to our knowledge this is the first reported child with LVNC. Previous reports have included children with isolated clefts of the palate without involvement of the lip. When cleft palate alone is associated with a disorder, the underlying pathophysiology for clefting is sometimes secondary due to mechanical blocking of the fusion of the palatal shelves with the developing tongue. The presence of microform cleft lip in this patient suggests that the pathophysiology of clefting in SMC1A is primary rather than secondary. Few studies report ophthalmologic findings specific to SMC1A. Based on these findings, LVNC cardiomyopathy and cleft lip should be considered features of SMC1A-associated CdLS. All patients should receive echocardiogram and undergo thorough ophthalmologic evaluation as part of routine CdLS care. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  9. Diabetes Self-management Quality Improvement Initiative for Medically Underserved Patients.

    Science.gov (United States)

    Seol, Haesun; Thompson, Mark; Kreider, Kathryn Evans; Vorderstrasse, Allison

    The burden of diabetes is greater for minorities and medically underserved populations in the United States. An evidence-based provider-delivered diabetes self-management education intervention was implemented in a federally qualified health center for medically underserved adult patients with type 2 diabetes. The findings provide support for the efficacy of the intervention on improvement in self-management behaviors and glycemic control among underserved patients with diabetes, while not substantially changing provider visit time or workload.

  10. Facsimile Transmission of Microforms.

    Science.gov (United States)

    1983-12-30

    describes a system, likewise designed and installed by TERA Corporation, at the Federal Energy Regulatory Commission. It combines 16mm microfilm...documents in closed communications networks. Based on the BSG -1 Videophone which can reproduce images in accordance with either broadcast television...Technology at the Federal Energy Regulatory Commission. Journal of Micrographics 16/3s 48-56. Plessey Company, Ltd. (1970). Information Retrieval System

  11. 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

  12. Obesity and secondary conditions in adolescents with disabilities: addressing the needs of an underserved population.

    Science.gov (United States)

    Rimmer, James H; Rowland, Jennifer L; Yamaki, Kiyoshi

    2007-09-01

    Children and adolescents with physical and cognitive disabilities have a higher prevalence of overweight compared to their non-disabled peers. This health risk can lead to a greater number of obesity-related secondary conditions (e.g., fatigue, pain, deconditioning, social isolation, difficulty performing activities of daily living) and can impose significant personal and economic hardship on the child and family. Effective strategies for reducing the risk of overweight/obesity in adolescents with disabilities must begin with greater awareness of the behavioral and environmental antecedents that lead to higher rates of obesity in this underserved segment of the youth population. Research on interventions to reduce obesity among adolescents with disabilities is an important area of future research for public health scientists. A range of interventions will be necessary to overcome the many barriers that youth with disabilities experience in achieving and maintaining a healthy weight.

  13. 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.

  14. 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.

  15. Where Do We Start? Using Family Navigation to Help Underserved Families

    Science.gov (United States)

    Blenner, Stephanie; Fernández, Ivys; Giron, Adriana; Grossman, Xena; Augustyn, Marilyn

    2014-01-01

    The period of time after a child is identified with a developmental or mental health condition can be highly challenging. This is particularly true for diverse, underserved families who may face competing concerns related to poverty, culture, language, immigration, and family issues. Likewise, clinicians working with underserved families may…

  16. 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...

  17. Victim-blaming and the "looping" effect of social policy: the cause of physician maldistribution and underserved rural communities.

    Science.gov (United States)

    Bergstrand, C R

    1979-10-01

    Ryan's (1971) description of the ideology of "victim-blaming" is briefly reviewed. It is then shown how this strategy for obscuring the causes of a social problem is used against rural, medically underserved communities by health care provider and planning interest groups to "explain" critical shortages of physicians in their areas. In addition to lending further support for the existence of this ideology, a "looping" effect of social policy designed to deal with physician maldistribution is identified. It is argued that this can be viewed as analytically distinct from the ideology itself and that it serves the purpose of further obscuring the larger structural sources of the social problem.

  18. 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.

  19. 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

  20. Treating diabetes in underserved populations using an interprofessional care team.

    Science.gov (United States)

    W Hutchison, Robert

    2014-11-01

    Community Health Centers that provide diabetic care for underserved patients have unique challenges. This study describes how interprofessional care improves outcomes and results in cost savings. Interprofessional diabetes education and structured team building are discussed. The team consisted of a physician, nurse practitioner, clinical pharmacist, and a number of pre-medicinal, nursing, and pharmacy students. The outcomes were measured at one year intervals for a total of three years. During the two year period with the interprofessional care team, the diabetic patients in this study achieved a 10% improvement in HgA1c, and 9% improvement in systolic blood pressure, a 5% improvement in diastolic blood pressure, and a 62.6% reduction in triglycerides. These findings suggest that this interprofessional care model in a free clinic significantly improved the HgA1c, triglycerides, and blood pressure.

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. 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)

  6. 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.

  7. Accelerometry cut points for physical activity in underserved African Americans

    Directory of Open Access Journals (Sweden)

    Trumpeter Nevelyn N

    2012-06-01

    Full Text Available Abstract Background Despite their increased use, no studies have examined the validity of Actical accelerometry cut points for moderate physical activity (PA in underserved (low-income, high-crime, minority populations. The high rates of chronic disease and physical inactivity in these populations likely impact the measurement of PA. There is growing concern that traditionally defined cut points may be too high for older or inactive adults. The present study aimed to determine the self-selected pace associated with instructions to “walk for exercise” and the corresponding accelerometry estimates (e.g., Actical counts/minute for underserved, African American adults. Method Fifty one participants (61% women had a mean age of 60.1 (SD = 9.9 and a mean body mass index of 30.5 kg/m2 (SD = 6.0. They performed one seated task, one standing task, and three walking tasks: “strolling”; “walking for exercise”; and “walking in an emergency.” Results The average pace for strolling, walking for exercise, and walking in an emergency were 1.62 miles per hour (mph; SD = .51, 2.51 mph (SD = .53, and 2.86 mph (SD = .58, respectively. The average Actical counts/minute for the five activities were: 4 (SD = 15, 16 (SD = 29, 751 (SD = 591, 2006 (SD = 1095, and 2617 (SD = 1169, respectively. Regression analyses showed that the predicted counts/minute for a pace of 2.0 mph (which is used as the criterion for moderate exercise in this study was 1075 counts/minute (SEM = 73. Conclusions The cut point associated with subjectively determined moderate PA is similar to those previously published for older adults and extends the use of adjusted cut points to African American populations. These results indicate that accurate cut points can be obtained using this innovative methodology.

  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. Community-based colorectal cancer intervention in underserved Korean Americans.

    Science.gov (United States)

    Ma, Grace X; Shive, Steve; Tan, Yin; Gao, Wanzhen; Rhee, Joanne; Park, Micah; Kim, Jaesool; Toubbeh, Jamil I

    2009-11-01

    Despite evidence of a decline in both incidence and prevalence of colorectal cancer nationwide, it remains the second most commonly diagnosed cancer and the third highest cause of mortality among Asian Americans, including Korean Americans. This community-based and theoretically guided study evaluated a culturally appropriate intervention program that included a bilingual cancer educational program among Korean Americans including information on CRC risks, counseling to address psychosocial and access barriers, and patient navigation assistance. A two-group quasi-experimental design with baseline and post-intervention assessment and a 12-month follow-up on screening was used in the study. Korean Americans (N=167) were enrolled from six Korean churches. The intervention group received culturally appropriate intervention program addressing accessibility and psychosocial barriers, and navigation assistance for screening. The control group received general health education that included cancer-related health issues and screening. There was a significant difference (pbenefits and barriers to screening (p<0.001). At baseline, 13% of participants in the intervention group and 10% in control group reported having had a CRC cancer screening test in the previous year. At the 12-month post-intervention follow-up, 77.4% of participants in the intervention group had obtained screening compared to 10.8% in the control group. While health disparities result from numerous factors, a culturally appropriate and church-based intervention can be highly effective in increasing knowledge of and access to, and in reducing barriers to CRC screening among underserved Koreans.

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. Acceptability of self-sample human papillomavirus testing among medically underserved women visiting the emergency department.

    Science.gov (United States)

    Montealegre, Jane R; Landgren, Rachel M; Anderson, Matthew L; Hoxhaj, Shkelzen; Williams, Sandra; Robinson, David J; Scheurer, Michael E; Ramondetta, Lois M

    2015-08-01

    Self-sample human papillomavirus (HPV) testing in public emergency departments (EDs) may be a viable strategy to opportunistically screen women who otherwise do not attend for regular Papanicolaou test-based cervical cancer screening. We describe the acceptability of self-sample HPV testing among women presenting to two high-volume, urban EDs that primarily care for the medically underserved. In 2014, a total of 210 women 21 years of age and older were recruited from two public ED waiting areas following a two-stage cluster sampling design. Questionnaire items inquired about demographics, healthcare access and utilization, history of cervical cancer screening, and acceptability of self-sample HPV testing. Descriptive analyses were performed. Overall, 34.8% of participants were considered screening non-attendees based on their adherence to the current guidelines for Pap testing every three years. Acceptability of self-sample HPV testing was high, with over 85% of participants reporting that they would be willing to use the test if available. A smaller proportion (58%) was deemed likely to accept self-sample HPV testing in a public ED restroom setting. Primary concerns expressed by women were that the sampling may not be done correctly (64%) and that they may not know how to perform the sampling (39%). Opportunistic self-sample HPV testing is acceptable to women seeking care at a high-volume, urban emergency care center. The use of this intervention potentially offers a unique strategy to improve cervical cancer screening among high-risk women who otherwise do not attend for regular screening. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Defining Traditionally Underserved Persons Who Are Deaf. NIU-RTC Research Brief.

    Science.gov (United States)

    Long, Greg; Clark, David Anthony

    This paper addresses issues in the definition of traditionally underserved persons who are deaf. It notes that these people have traditionally been labeled as low functioning, low achieving, multiply handicapped, minimal language skilled, and disadvantaged. A new definition, developed by the Northern Illinois University Research and Training…

  16. Theoretical Considerations for Art Education Research with and about "Underserved Populations"

    Science.gov (United States)

    Kraehe, Amelia M.; Acuff, Joni B.

    2013-01-01

    Though it is widely used, the concept of "underserved" is sorely undertheorized in art education. Before the field of art education can effectively address the persistent educational disparities across different sociocultural and economic groups, we need deeper understandings of entangled sociocultural and political processes that create…

  17. Assessing Workplace Communication Skills with Traditionally Underserved Persons Who Are Deaf

    Science.gov (United States)

    Long, Greg

    1996-01-01

    Within the congenitally deaf population there exists a sizeable number of individuals who are considered to be traditionally underserved. These individuals are characterized by severe communication deficits irrespective of modality (e.g., speech, sign language, reading, writing). Unfortunately, until now there has not been a comprehensive…

  18. 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.

  19. A Qualitative Study of Parental Modeling and Social Support for Physical Activity in Underserved Adolescents

    Science.gov (United States)

    Wright, Marcie S.; Wilson, Dawn K.; Griffin, Sarah; Evans, Alexandra

    2010-01-01

    This study obtained qualitative data to assess how parental role modeling and parental social support influence physical activity in underserved (minority, low-income) adolescents. Fifty-two adolescents (22 males, 30 females; ages 10-14 years, 85% African-American) participated in a focus group (6-10 per group, same gender). Focus groups were…

  20. 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…

  1. 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…

  2. 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…

  3. Engaging Youth in Underserved Communities through Digital-Mediated Arts Learning Experiences for Community Inquiry

    Science.gov (United States)

    Lin, Ching-Chiu; Bruce, Bertram C.

    2013-01-01

    Learning for underserved youth is integral to social progress. Yet, too often, young people experience disconnects between their educational experiences and both individual and community needs. Arts can help these youth recover a unity through collective action in the community. Drawing from the experiences of a 4-year interdisciplinary research…

  4. Arts Infusion and Literacy Achievement within Underserved Communities: A Matter of Equity

    Science.gov (United States)

    Carney, Charles L.; Weltsek, Gustave J.; Hall, M. Lynne; Brinn, Ginger

    2016-01-01

    There is ample evidence that arts added to the K-12 curriculum can have many positive learning impacts. Nevertheless, many states do not promote such instruction as an integral part of classroom plans. For particular schools with underserved populations, arts-enhanced curricula can be a powerful learning tool. Beyond arts integration, arts…

  5. 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…

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

    OpenAIRE

    Shah, Tayyab Ikram; Bell, Scott; Wilson, Kathi

    2016-01-01

    Background 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. Methods This study examines spatial accessibility to family physicians using the Thre...

  7. 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.

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

    Science.gov (United States)

    2008-04-11

    continued to maintain their weight. The participants were actively interested in maintaining their weight, and as a result of which self esteem was also...It is apparent that self motivation is important for success. Self -directed education requires certain support to facilitate learning which should...spent in school physical education classes. Make sure you include all sport teams that you participated in during the last year. 1. Aerobics 11

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

    Science.gov (United States)

    2010-07-01

    Develop and expand retention, coordination, self - esteem , and physical and cognitive functioning CERMUSA is collaborating with the Quittie Glen... aerobic exercise and relaxation training on fatigue and physical performance of cancer patients after surgery. A randomised controlled trial. Support Care...of Family Practice. Windsor, P. M., Nicol, K. F., & Potter, J. (2004). A randomized, controlled trial of aerobic exercise for treatment-related

  10. 78 FR 50119 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2014

    Science.gov (United States)

    2013-08-16

    ... law that mandates special consideration for enrollees of certain FEHB plans who receive covered health...-0004. SUPPLEMENTARY INFORMATION: FEHB law (5 U.S.C. 8902(m)(2)) requires special consideration for... primary care physicians. This section of the law requires that a state be designated as a Medically...

  11. 75 FR 32972 - Federal Employees Health Benefits Program; Medically Underserved Areas for 2011

    Science.gov (United States)

    2010-06-10

    ... necessary to comply with a provision of the FEHB law that mandates special consideration for enrollees of... INFORMATION CONTACT: Lynelle T. Frye, 202-606-0004. SUPPLEMENTARY INFORMATION: FEHB law (5 U.S.C. 8902(m)(2)) requires special consideration for enrollees of certain FEHB plans who receive covered health services in...

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

    Science.gov (United States)

    2007-05-01

    interpretation, physician mentoring and the transmission of a video clip to a pediatric specialist are few interactions that have been accomplished...population and rates are even higher for veterans with PTSD. The National Vietnam Veterans Readjustment Study (NVVRS) found that divorce rates for veterans...8217 Readjustment Survey. Abstract retrieved January 3, 2007 from 6 http://www .ncptsd. va.gov /facts/veterans/fs_NVVRS .html The Journal. Hospital Gains

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

    National Research Council Canada - National Science Library

    Gur, David

    2002-01-01

    .... The purpose of this project is to evaluate in a multi-phase project the possible impact of a unique telemammography system that utilizes common carriers with wavelet-based data compression for image...

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

    National Research Council Canada - National Science Library

    Gur, David

    2004-01-01

    .... The purpose of this project is to evaluate in a multi-phase project the possible impact of a unique tele-mammography system that utilizes common carriers with wavelet-based data compression for image...

  15. 77 FR 43127 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2013

    Science.gov (United States)

    2012-07-23

    ... law that mandates special consideration for enrollees of certain FEHB plans who receive covered health... law requires non-HMO FEHB plans to reimburse beneficiaries, subject to their contract terms, for...: Lynelle T. Frye, 202-606-0004. SUPPLEMENTARY INFORMATION: FEHB law (5 U.S.C. 8902(m)(2)) requires special...

  16. Using spatial accessibility to identify polyclinic service gaps and volume of under-served population in Singapore using Geographic Information System.

    Science.gov (United States)

    Wong, Lai Yin; Heng, Bee Hoon; Cheah, Jason Tiang Seng; Tan, Chee Beng

    2012-01-01

    Primary care services in Singapore are provided by 18 Government-funded polyclinics and about 1200 private General Practitioners (GPs). This study aims to examine the spatial accessibility to polyclinics and identify service gaps, and suggest optimal sites using Geographic Information System (GIS) to aid in future planning. A national database containing 3.6 million polyclinic visits in 2006 were geo-analysed using ArcView GIS. Patients' travel impedance to the nearest polyclinic was computed using DriveTime to identify areas with the lowest spatial accessibility and highest volume of under-served population. Jurong West and Sembawang were ranked as top areas with poor spatial accessibility to polyclinic services. ArcGIS was used to identify optimal sites with the minimum accumulated distance impedance to this under-served population. If new facilities were set up at these identified sites, volume of visits by Jurong West and Sembawang patients who could access the nearest polyclinics within 4 km Euclidean distance from their residence would total at 123 000 and 93 000, respectively. Future efforts in polyclinic planning should take this into consideration to maximize patients' benefits and minimize patients' travelling costs in order to achieve social equity on healthcare access. Copyright © 2010 John Wiley & Sons, Ltd.

  17. 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.

  18. Primary Care for Underserved Populations: Navigating Policy to Incorporate Occupational Therapy Into Federally Qualified Health Centers.

    Science.gov (United States)

    Murphy, Aileen D; Griffith, Vanessa M; Mroz, Tracy M; Jirikowic, Tracy L

    Federally qualified health centers (FQHCs) provide low- or no-cost primary care to medically underserved populations such as homeless or low-income people, migrant workers, and members of marginalized cultural groups. Occupational therapy services have the potential to help improve the health and functioning of FQHC patients. Using a FQHC serving American Indian/Alaska Native populations as a case example, we describe how occupational therapy is well suited to help meet the needs of medically underserved populations. We then examine options for integrating occupational therapy into this unique primary care setting, discuss related administrative and policy considerations, and propose possible solutions to identified barriers. Copyright © 2017 by the American Occupational Therapy Association, Inc.

  19. 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

  20. 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.

  1. Increasing participation in cancer research: insights from Native Hawaiian women in medically underserved communities.

    Science.gov (United States)

    Ka'opua, Lana Sue; Mitschke, Diane; Lono, Joelene

    2004-09-01

    The cancer burden falls heavily on Native Hawaiian women, and of particular concern are those living in medically underserved communities where participation in potentially helpful clinical studies may be limited. Difficulty in accrual of Native Hawaiian women to a culturally-grounded intervention led researchers to conduct focus groups aimed at exploring attitudes towards research, use of a traditional Hawaiian practice for family discussion, and study promotion. Social marketing theory guided the development of discussion questions and a survey. Through purposive sampling, 30 women from medically underserved communities were recruited. Content analysis was used to identify major discussion themes. Findings indicate that lack of informational access may be a major barrier to participation. Study information disseminated through community channels with targeted outreach to social and religious organizations, promotion through face-to-face contact with researchers, and culturally tailored messages directed to families were preferred. Community oriented strategies based on linkages with organizational networks may increase participation.

  2. 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

  3. 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.

  4. Bridging Scientific Expertise to Underserved Communities: Initiating and Sustaining Local STEM Outreach

    Science.gov (United States)

    Anderson, Tania; Kenney, Jessica; Maple, John

    2017-06-01

    This presentation will feature effective outreach strategies used to recruit, engage, and sustain student involvement from underserved communities in out-of-school science outreach programs. For example, one strategy is to partner with subject matter experts to provide your audience with a deeper understanding of and a unique perspective on current science. Join us to learn more about how you can initiate and sustain a STEM based program in your local community.

  5. Priorities for Patient-Centered Outcomes Research: The Views of Minority and Underserved Communities.

    Science.gov (United States)

    Goold, Susan Dorr; Myers, C Daniel; Szymecko, Lisa; Cunningham Collins, Carla; Martinez, Sal; Ledón, Charo; Campbell, Terrance R; Danis, Marion; Cargill, Stephanie Solomon; Kim, Hyungjin Myra; Rowe, Zachary

    2017-04-01

    To learn how minority and underserved communities would set priorities for patient-centered outcomes research (PCOR). Sixteen groups (n = 183) from minority and underserved communities in two states deliberated about PCOR priorities using the simulation exercise CHoosing All Together (CHAT). Most participants were minority, one-third reported income research agendas and interviews with community leaders, clinicians, and key informants. Tablet-based CHAT collected demographic information, individual priorities before and after group deliberation, and groups' priorities. Individuals and groups prioritized research on Quality of Life, Patient-Doctor, Access, Special Needs, and (by total resources spent) Compare Approaches. Those with less than a high school education were less likely to prioritize New Approaches, Patient-Doctor, Quality of Life, and Families/Caregivers. Blacks were less likely to prioritize research on Causes of Disease, New Approaches, and Compare Approaches than whites. Compare Approaches, Special Needs, Access, and Families/Caregivers were significantly more likely to be selected by individuals after compared to before deliberation. Members of underserved communities, in informed deliberations, prioritized research on Quality of Life, Patient-Doctor, Special Needs, Access, and Compare Approaches. © Health Research and Educational Trust.

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. Impact of desire to work in underserved communities on selection of specialty among fourth-year medical students.

    Science.gov (United States)

    Bazargan, Mohsen; Lindstrom, Richard W; Dakak, Alan; Ani, Chizobam; Wolf, Kenneth E; Edelstein, Ronald A

    2006-09-01

    The objective of this study was to explore the specific factors that influence medical student's choice of primary care as a specialty. Special attention is given to the influence of desire to work in underserved communities on selection of a specialty. A web-based survey of factors affecting choice of specialty was completed by 668 fourth-year students from 32 medical schools. Students interested in primary care reported an increased likelihood of working with underserved populations when compared with other specialties. The independent impact of both student's social compassion attitudes and values, and subjective and reinforcing influences on the selection of primary care, when compared with all other specialties, was strong. Personal practice-oriented considerations showed an independent negative impact on the selection of primary care when compared with surgery and support specialties. Financial considerations strongly influence the selection of support specialties. Medical training experiences showed an independent influence on the selection of surgery over primary care. The need for primary care physicians and specialists in underserved communities is considerable. Addressing health disparities in underserved communities requires a concerted effort to increase the availability of primary care providers in these communities. This study observed that primary care practice or specialty selection by medical students is influenced by individual values and subjective external influences other than predicted by medical training alone. This observation necessitates a closer determination of strategies required to ensure an increase in the number of primary care physicians serving underserved communities.

  11. Atraumatic restorative treatment for prevention and treatment of caries in an underserved community.

    Science.gov (United States)

    Lopez, Naty; Simpser-Rafalin, Sara; Berthold, Peter

    2005-08-01

    We evaluated the acceptability and effectiveness of atraumatic restorative treatment to prevent and treat caries in an underserved community in Mexico. We placed 370 restorations and 193 sealants in 118 children aged 5 to 18; 85% reported no pain, and 93% were comfortable with their restorations. We then evaluated the children 1 and 2 years later. At 2-year evaluation, 66% of restorations and 35% of sealants were retained. Atraumatic restorative treatment is acceptable and effective to control and prevent decay in a socioeconomically deprived community.

  12. Leadership Opportunities with Communities, the Medically Underserved, and Special Populations (LOCUS).

    Science.gov (United States)

    Haq, Cynthia; Grosch, Michelle; Carufel-Wert, Donald

    2002-07-01

    The Leadership Opportunities with Communities, the Underserved, and Special Populations (LOCUS) Program aims to improve medical students' leadership knowledge and skills, to improve self-awareness and motivation for community service, and to provide models for students to integrate community service into their medical careers. The LOCUS program was established as a longitudinal, extracurricular student opportunity at the University of Wisconsin Medical School in the fall of 1998. Up to 15 new students each year are selected for the program through an application and interview process during their first or second year of medical school. Students remain in the program from acceptance until graduation from medical school. Nearly 50 students have enrolled in the program to date. LOCUS fellows are matched with a physician mentor, participate in core curriculum activities, and complete a longitudinal community service project. Mentors are community generalist physicians who have integrated community service into their own careers. Students participate in their mentors' clinical practices one afternoon a month during the first two years, and mentors serve as role models and provide guidance for students' projects and career development. The program administration and staff are supported through federal predoctoral training and Area Health Education Centers (AHEC) grants. The LOCUS core curriculum is delivered through a series of retreats, workshops, and seminars that emphasize active learning methods and include approximately 20 hours of scheduled activities per academic year. The curriculum addresses concepts of leadership in relation to one's self and in relation to others. Students are introduced to methods of self-reflection and develop their own vision and mission statements. Students also discuss the importance of compassion, self-care, striving for balance, avoiding burnout, and being realistic about what they can accomplish. Students practice strategies for

  13. Sources of health information in a multiethnic, underserved, urban community: does ethnicity matter?

    Science.gov (United States)

    Geana, Mugur V; Kimminau, Kim S; Greiner, K Allen

    2011-07-01

    The Latino population is the fastest growing minority in the country, and is expected to reach about 30% of the total U.S. population by 2050. Historically, primary care practitioners are not the preferred source of health information for Latinos living in the United States. Latinos are known to rely more on media, family, and friends to get answers to health-related questions. Choosing the appropriate information source is an important component of health information-seeking behavior; it also represents a major challenge for health communicators trying to deliver information to their target audience. This study explores how ethnicity influences health information source selection among Latinos and White non-Latinos living together in an underserved, multiethnic urban community with poor health status and underlying socioeconomic characteristics. The results suggest that this community manifests a high degree of homogeneity in their usage of health information sources. Nevertheless, there are significant differences between ethnic groups and age groups on perceived usefulness of the health information retrieved from common sources. Our results suggest that health information sources that are interactive, native to the community (e.g., the local pharmacist), and promote active engagement are the most useful in delivering health messages that will be listened to by those living in this underserved, multiethnic urban community.

  14. 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

  15. 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.

  16. Dental students' attitudes toward underserved populations across four years of dental school.

    Science.gov (United States)

    Habibian, Mina; Seirawan, Hazem; Mulligan, Roseann

    2011-08-01

    The objective of this study was to assess dental students' attitudes toward underserved populations across their four years of dental school. Students at the Herman Ostrow School of Dentistry of the University of Southern California were invited to take part in the study. Participating students completed a questionnaire on their attitudes toward the underserved at three time points: 1) during orientation week; 2) at the end of their second year after taking part in some community dental programs; and 3) at the end of their fourth year after they had completed all their mandatory and volunteer rotations in community dental programs. Students' attitudes were measured in four categories: societal expectations, dentist/student responsibility, personal efficacy, and access to care. First-year students scored 85 out of a maximum of 115 on the questionnaire. Female students scored higher than male students (P=0.006). Age, debt, and past history of volunteer work were not related to first-year students' total attitude scores; however, students with a history of volunteer experience scored higher on the dentist/student responsibility category (P=0.04). Students' attitude scores declined across the four years of dental school (P=0.001). The same patterns were evident for all categories except societal expectations. The decline was not related to age, gender, debt, or volunteer work experience. Follow-up studies are needed to help explain the factors that may be related to this decline.

  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. Asthma prevalence and risk factor assessment of an underserved and primarily Latino child population in Colorado.

    Science.gov (United States)

    Clark, Maggie L; Reynolds, Stephen J; Hendrikson, Edward; Peel, Jennifer L

    2014-01-01

    Asthma is a substantialpublic health burden among children. Disease and risk-factor discrepancies have been identified among racial, ethnic, and socioeconomic groups. At a rural health clinic (Salud Family Health Center) with primarily underserved and Latino patients in Colorado, the authors evaluated 250 medical records and administered 57 parental surveys to describe this population with respect to asthma diagnosis, asthma-like symptoms, and environmental/occupational risk factors among children. Wheeze and asthma were indicated in 9.7% and 8.9% of medical records, respectively. Twenty parents (35.7%) reported in a questionnaire that their child had experienced wheezing or whistling in the chest. Parents reported that children play in farming fields (21.8%) and feed livestock/animals (10.9%). Additionally, 13.2% and 9.4% of children have a household member who works around livestock or around grain, feed, or dust, respectively. Information from the Salud population can be used to develop larger-scale research and public health initiatives to eliminate health and risk factor disparities among underserved children.

  19. 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

  20. Delivering health care in a large urban hotel: cost effective, quality care for an underserved and uninsured population.

    Science.gov (United States)

    Intili, Henry; Laws, Catherine

    2003-07-01

    Expansion of an occupational health clinic from registered nurse base to nurse practitioner base where employees can be treated for basic emergent conditions can result in health benefits to underserved and underinsured employees and financial benefits to management. It is essential that the financial benefits of the plan to expand clinical services outweigh the costs, and the savings projections be plausible. Emotional appeals to improve the health and well being of employees are not sufficient or credible in the management arena without financial payback. Expanded clinic services increase employee perception that the company cares for their welfare. This benefit is especially important to underserved and underinsured employees.

  1. An Analysis of Oppression and Health Education for Underserved Populations in the United States: The Issues of Acculturation, Patient-Provider Communication, and Health Education

    Science.gov (United States)

    Weaver, Shannon; Gull, Bethany; Ashby, Jeanie; Kamimura, Akiko

    2017-01-01

    The oppression of underserved populations is pervasive throughout the history of the United States (U.S.), especially in health care. Brazilian educator Paulo Freire's controversial ideas about systems of power can be aptly applied to health care. This paper focuses specifically on arguably the most medically underserved group in the U.S.…

  2. 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.

  3. 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.

  4. Medicare payments, healthcare service use, and telemedicine implementation costs in a randomized trial comparing telemedicine case management with usual care in medically underserved participants with diabetes mellitus (IDEATel)

    Science.gov (United States)

    Shea, Steven; Starren, Justin; Teresi, Jeanne A; Ganz, Michael L; Burton, Tanya M; Pashos, Chris L; Blustein, Jan; Field, Lesley; Morin, Philip C; Izquierdo, Roberto E; Silver, Stephanie; Eimicke, Joseph P; Lantigua, Rafael A; Weinstock, Ruth S

    2010-01-01

    Objective To determine whether a diabetes case management telemedicine intervention reduced healthcare expenditures, as measured by Medicare claims, and to assess the costs of developing and implementing the telemedicine intervention. Design We studied 1665 participants in the Informatics for Diabetes Education and Telemedicine (IDEATel), a randomized controlled trial comparing telemedicine case management of diabetes to usual care. Participants were aged 55 years or older, and resided in federally designated medically underserved areas of New York State. Measurements We analyzed Medicare claims payments for each participant for up to 60 study months from date of randomization, until their death, or until December 31, 2006 (whichever happened first). We also analyzed study expenditures for the telemedicine intervention over six budget years (February 28, 2000– February 27, 2006). Results Mean annual Medicare payments (SE) were similar in the usual care and telemedicine groups, $9040 ($386) and $9669 ($443) per participant, respectively (p>0.05). Sensitivity analyses, including stratification by censored status, adjustment by enrollment site, and semi-parametric weighting by probability of dropping-out, rendered similar results. Over six budget years 28 821 participant/months of telemedicine intervention were delivered, at an estimated cost of $622 per participant/month. Conclusion Telemedicine case management was not associated with a reduction in Medicare claims in this medically underserved population. The cost of implementing the telemedicine intervention was high, largely representing special purpose hardware and software costs required at the time. Lower implementation costs will need to be achieved using lower cost technology in order for telemedicine case management to be more widely used. PMID:20190064

  5. 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

  6. 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.

  7. 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…

  8. 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.

  9. 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

    2011-06-01

    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 multiple regression analyses we accounted for 12% of the variance in PA and 13-21% of the variance in fitness. The best predictors of PA were barrier self-efficacy, classmate social support, and gender; whereas, only gender predicted fitness. The results affirmed the importance of barrier self-efficacy and gender differences. Our findings regarding classmate social support are some of the first to illuminate the importance of school-specific peers in promoting PA.

  10. Effectively translating diabetes prevention: a successful model in a historically underserved community.

    Science.gov (United States)

    Horowitz, Carol R; Eckhardt, Sarah; Talavera, Sandra; Goytia, Crispin; Lorig, Kate

    2011-09-01

    Lifestyle interventions can prevent diabetes through weight loss, but they are rarely translated for use in underserved communities. The aim of this study was to describe how a community-academic partnership formed and developed a program to address local health disparities by developing a low-cost, culturally and economically appropriate, peer-led community-based diabetes prevention program. Using a participatory approach, the partnership chose to focus on diabetes prevention, and co-developed all intervention, recruitment, research, and evaluation strategies. The partnership's philosophy to maintain high clinical and scientific standards paired with their ability to represent and engage the community facilitated the development of a randomized controlled trial that achieved statistically significant and sustained weight loss, and the recruitment of a largely Spanish-speaking, low income, uninsured population. The success of this intervention lies in the partnership's commitment to the community, co-ownership of research, and a careful balance between academic rigor and community engagement and relevance.

  11. 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.

  12. 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

  13. Patient navigation improves cancer diagnostic resolution: an individually randomized clinical trial in an underserved population.

    Science.gov (United States)

    Raich, Peter C; Whitley, Elizabeth M; Thorland, William; Valverde, Patricia; Fairclough, Diane

    2012-10-01

    Barriers to timely resolution of abnormal cancer screening tests add to cancer health disparities among low-income, uninsured, and minority populations. We conducted a randomized trial to evaluate the impact of lay patient navigators on time to resolution and completion of follow-up testing among patients with abnormal screening tests in a medically underserved patient population. Denver Health, the safety-net health care system serving Denver, is one of 10 performance sites participating in the Patient Navigation Research Program. Of 993 eligible subjects with abnormal screening tests randomized to navigation and no-navigation (control) arms and analyzed, 628 had abnormal breast screens (66 abnormal clinical breast examinations, 304 BIRADS 0, 200 BIRADS 3, 58 BIRADS 4 or 5) whereas 235 had abnormal colorectal and 130 had abnormal prostate screens. Time to resolution was significantly shorter in the navigated group (stratified log rank test, P BIRADS 3 (P = 0.0003) and BIRADS 0 (P = 0.09), but not BIRADS 4/5 or abnormal breast examinations. Navigation shortened the time for both colorectal (P = 0.0017) and prostate screening resolution (P = 0.06). Participant demographics included 72% minority, 49% with annual household income less than $10,000, and 36% uninsured. Patient navigation positively impacts time to resolution of abnormal screening tests for breast, colorectal, and prostate cancers in a medically underserved population. By shortening the time to and increasing the proportion of patients with diagnostic resolution patient navigation could reduce disparities in stage at diagnosis and improve cancer outcomes. 2012 AACR

  14. Determinants of participation in a cardiometabolic health check among underserved groups

    Directory of Open Access Journals (Sweden)

    I. Groenenberg

    2016-12-01

    Full Text Available Cardiometabolic diseases affect underserved groups disparately. Participation in health checks is also lower, widening health inequalities in society. Two-stage screening (non-invasive health risk assessment (HRA and GP consultations for high-risk individuals seems cost-effective, provided that drop-out rates are low in both steps. We aimed to explore the process of decision-making regarding HRA participation among underserved groups (45–70 y: native Dutch with a lower socioeconomic status (SES, Turkish, Moroccan, and Surinamese participants. We conducted a cross-sectional questionnaire study. The questionnaire comprised the following determinants: a self-formulated first reaction, a structured set of predefined determinants, and the most important barrier(s and facilitator(s for HRA completion. We used univariable and (stepwise multivariate logistic regression analyses to assess which determinants were associated with HRA completion. Of the 892 participants in the questionnaire, 78% (n = 696 also completed the HRA. Moroccans and patients from GP practices with a predominantly non-Western population less often completed the HRA. A lower SES score, wanting to know one's risk, not remembering receiving the invitation (thus requiring a phone call, fear of the test result and/or adjusting lifestyle, perceived control of staying healthy, wanting to participate, and perceiving no barriers were associated with completing the HRA. We conclude that our ‘hard-to-reach’ population may not be unwilling to participate in the HRA. A more comprehensive approach, involving key figures within a community informing people about and providing help completing the HRA, would possibly be more suitable. Efforts should be particularly targeted at the less acculturated immigrants with an external locus of control.

  15. Calmer Life: A Culturally Tailored Intervention for Anxiety in Underserved Older Adults.

    Science.gov (United States)

    Stanley, Melinda A; Wilson, Nancy; Shrestha, Srijana; Amspoker, Amber B; Armento, Maria; Cummings, Jeremy P; Evans-Hudnall, Gina; Wagener, Paula; Kunik, Mark E

    2016-08-01

    To evaluate the feasibility of the Calmer Life and Enhanced Community Care interventions delivered by community and expert providers and test their preliminary effectiveness on worry, generalized anxiety disorder (GAD) severity, anxiety, depression, sleep, health-related quality of life, and satisfaction. Small randomized trial, with measurements at baseline and 3 months. Underserved, low-income, mostly minority communities in Houston, TX. Forty underserved adults 50 years and older, with significant worry and principal or coprincipal GAD or anxiety disorder not otherwise specified. Combination of person-centered, flexible skills training to reduce worry; resource counseling to target unmet basic needs; and facilitation of communication with primary care providers developed through a community-academic partnership with social service and faith-based organizations. Religion/spirituality may be incorporated. worry (Penn State Worry Questionnaire-Abbreviated), GAD severity (GAD-7), anxiety (Geriatric Anxiety Inventory-Short Form). depression (Patient Health Questionnaire-8 and Geriatric Depression Scale-Short Form), sleep (Insomnia Severity Index), health-related quality of life (12-item Medical Outcomes Study Short Form), satisfaction (Client Satisfaction Questionnaire and exit interviews). Provider training was valid; mean ratings for community providers were well above average, with none less than adequate. Reach was excellent. Participants receiving the Calmer Life intervention had greater improvement in GAD severity and depression than those receiving Enhanced Community Care. Satisfaction with both treatments was equivalent. A larger comparative-effectiveness trial needs to examine outcomes following the Calmer Life intervention relative to standard community-based care and to evaluate more fully issues of implementation potential. Published by Elsevier Inc.

  16. Pharmacy students teaching prescribers strategies to lower prescription drug costs for underserved patients.

    Science.gov (United States)

    Stebbins, Marilyn R; Frear, Meghan E; Cutler, Timothy W; Lightwood, James M; Fingado, Amanda R; Lai, Cindy J; Lipton, Helene Levens

    2013-09-01

    The rising costs of health care and, in particular, prescription drugs remains a challenge. Health professionals' ability to promote cost-effective prescription drug use is critical, yet this subject is not included consistently in the curriculum of most health professional schools. As experts in prescription drug selection, use, and cost, pharmacists are in a unique position to help manage prescription drug regimens for the best therapeutic outcome, while also helping to keep patients' out-of-pocket (OOP) prescription drug costs low. In addition to promoting interprofessional collaboration, pharmacy student-led lectures may provide an effective means to teach prescription drug cost-savings strategies to other health professional students and current prescribers. To describe and evaluate the impact of a 60- to 90-minute standardized, case-based lecture on prescribers' attitudes and knowledge about drug cost-containment strategies. Four trained pharmacy students delivered a lecture that focused on strategies to help underserved patients with their OOP prescription drug costs. This lecture was given to health professional students and prescribers across disciplines. For purposes of this study, underserved patients included those with no drug insurance, those with limited financial resources who were unable to pay for their prescription drugs, and those whose drug insurance had significant gaps in coverage (e.g., Medicare Part D patients). Lectures targeted future and current prescribers and were delivered in multiple settings (e.g., residents' seminars, medical grand rounds, required health policy courses for medical and nursing students). Pretest/posttest surveys were administered to assess the impact of the lecture on learners' (a) knowledge of strategies to improve underserved patients' access to needed prescription drugs; (b) willingness to address and discuss cost issues with patients; (c) likelihood of collaborating with other health care professionals; and (d

  17. 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

  18. 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.

  19. Investigating Social Ecological Contributors to Diabetes within Hispanics in an Underserved U.S.-Mexico Border Community

    OpenAIRE

    Chang, Jean; Guy, Mignonne C.; Rosales, Cecilia; de Zapien, Jill G.; Staten, Lisa K.; Fernandez, Maria L.; Carvajal, Scott C.

    2013-01-01

    Hispanics bear a disproportionate burden of diabetes in the United States, yet relations of structural, socio-cultural and behavioral factors linked to diabetes are not fully understood across all of their communities. The current study examines disparities and factors associated with diabetes in adult Hispanics of Mexican-descent (N = 648) participating in a population survey of an underserved rural U.S.-Mexico border community. The overall rate of diabetes prevalence rate in the sample, bas...

  20. Assessment of data quality and reporting systems for underserved populations: the case of integrated community case management programs in Nigeria.

    Science.gov (United States)

    Nyangara, Florence M; Hai, Tajrina; Zalisk, Kirsten; Ozor, Lynda; Ufere, Joy; Isiguzo, Chinwoke; Abubakar, Ibrahim Ndaliman

    2018-02-13

    Decision makers are searching for reliable data and best practices to support the implementation and scale-up of the integrated community case management (iCCM) programs in underserved areas to reduce under-five mortality in low-income countries. This study assesses data quality and reporting systems of the World Health Organization supported Rapid Access Expansion program implementing iCCM in Abia and Niger States, Nigeria. This cross-sectional study used data from 16 primary health facilities in both states. Data were collected through review of registers and monthly summary reports of 140 community-oriented resource persons (CORPs), assessments of the five dimensions of the data reporting systems and 46 key informant interviews with stakeholders. Data quality was assessed by availability, completeness and consistency. Each component of the reporting system was assessed on a 3-point scale (weak, satisfactory and strong). Results show that both the structure, functions and capabilities, as well as data collection and reporting tools dimensions of the reporting system were strong, scoring (2.80, 2.73) for Abia and (2.88, 2.75) for Niger, respectively. Data management processes and links with national reporting system components scored low 2 s, indicating fair strength. Data availability, completeness and consistency were found to be good, an indication of adequate training and supervision of CORPs and community health extension workers. Indicator definitions and reporting guidelines were the weakest dimension of the system due to lack of data reporting guidelines in both states. In conclusion, the results indicate satisfactory data reporting systems and good quality data during early implementation of iCCM programs in the two states. Hence, countries planning to adopt and implement iCCM programs should first develop structures, establish national standardized tools for collecting and reporting data, provide for adequate training and supervision of community

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. Identifying Elements of Patient-Centered Care in Underserved Populations: A Qualitative Study of Patient Perspectives

    Science.gov (United States)

    Raja, Sheela; Hasnain, Memoona; Vadakumchery, Tracy; Hamad, Judy; Shah, Raveena; Hoersch, Michelle

    2015-01-01

    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. PMID:25993110

  6. 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."

  7. 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.

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

    Science.gov (United States)

    Skizim, Meg; Sothern, Melinda; Blaha, Ondrej; Tseng, Tung Sung; Griffiths, Lauren; Joseph, Jonathan; Nuss, Henry

    2017-12-13

    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.

  9. 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.

  10. Retaining new dentists in Iowa: a role for dental schools in facilitating graduates' connections to practice opportunities in underserved areas.

    Science.gov (United States)

    Hoyle, Debra A; Ryan, Penni M; Hand, Jed S; Damiano, Peter; Schneider, Galen B

    2014-04-01

    Like many other states, Iowa has an aging dental workforce. As this aging population of dentists retires and communities are unable to find new dentists to take over their practices, more small and rural communities lack easy access to oral health care. The University of Iowa College of Dentistry and Dental Clinics established the Office of Iowa Practice Opportunities in 2006 to promote dental practice opportunities in Iowa for its graduates. With this office, an infrastructure connecting the college with practices and communities across the state has been developed. The Office of Iowa Practice Opportunities is the first place many students go to decide what they will do after graduation and to identify practice opportunities in Iowa. The office has exceeded the college's initial expectations and has provided significant assistance in retaining recently graduated dentists in the state of Iowa and ensuring access to oral health care in the state. This article will show that facilitating connections to practice opportunities has a place in a college of dentistry.

  11. 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

  12. 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/

  13. 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.

  14. 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.

  15. Drug-induced torsades de pointes in an underserved urban population. Methadone: is there therapeutic equipoise?

    Science.gov (United States)

    Romero, Jorge; Baldinger, Samuel H; Goodman-Meza, David; Engstrom, Krysthel; Valencia, Carolina R; Golive, Anjani; Medrano, Francisco; Rangasamy, Sabarivinoth; Makkiya, Mohammed; Fisher, John D; Gross, Jay; Krumerman, Andrew; Kim, Soo; Garcia, Mario J; Di Biase, Luigi; Ferrick, Kevin J

    2016-01-01

    Although it has been well established that methadone use can result in prolonged QTc/torsades de pointes (TdP) and has been labeled as one of the main drugs that cause TdP, it is still prescribed indiscriminately, and several cases of methadone-associated TdP have been seen in our community. Our objective was to determine the associated factors for prolonged QTc and the development of torsades de pointes (TdP) in our underserved patient population. We found 12,550 ECGs with prolonged QTc between 2002 and 2013. Medical records were reviewed in order to identify precipitating factors for prolonged QTc and to detect incidence of TdP. We identified 2735 patients with prolonged QTc who met the inclusion criteria. Of these, 89 (3%) experienced TdP. There was a greater prevalence of HIV infection in the TdP group (11.2 vs. 3.7%, p methadone, haloperidol, and azithromycin were the drugs most often associated with prolonged QTc (31, 8.2, 7.6, 7.1, 3.9, 3.4 and 3.3%, respectively). However, the agents most commonly associated with TdP were furosemide (39.3%), methadone (27%), SSRIs (19.1%), amiodarone (18%), and dofetilide (9%). The medications with statistical significance in the multivariate analysis for TdP development in descending order were as follows: ranolazine (odds ratios [OR] = 53.61, 95% confidence interval [CI] 5.4-524, p methadone (OR = 9.89, CI 4.05-24.15, p Methadone was by far the leading medication implicated in the development of TdP and an independent predictor in both univariate and multivariate analyses despite the fact that it was not the most common QT-prolonging medication in our population.

  16. Effectiveness of a promotora home visitation program for underserved Hispanic children with asthma.

    Science.gov (United States)

    Rashid, Shumyla; Carcel, Consuelo; Morphew, Tricia; Amaro, Silvia; Galant, Stanley

    2015-06-01

    Retention in a mobile asthma clinic, the Breathmobile™, of ≥3 visits has previously been shown to be essential for attaining asthma control in underserved children. The objective of this study in primarily Hispanic-American children was to determine the difference in retention between those seen in the Breathmobile™ compared to those receiving an additional promotora-based home visit (HV). Children with asthma in the Breathmobile™ program were evaluated for asthma status and aeroallergen sensitivity. Indication for HV included poor asthma control, educational and environmental control needs. An initial visit consisted of environmental assessment as well as a 3-h interactive educational session covering asthma basics. A follow-up visit 1 month later assessed implementation. The primary outcome measure of retention was ≥6 months in the Breathmobile™ program. Of the 1007 asthmatic children seen between April 2002 and June of 2005, 136 received HV. These children showed significantly greater retention compared to those without HV with a median number of visits (5 visits versus 2 visits), ≥3 Breathmobile™ visits (86.0% versus 38.8%), median number of days in the program (299 versus 63 days) and percentage of patients in the program ≥6 months (67.8% versus 31.3%) p < 0.001. HV and asthma severity were each independent predictors of retention. The addition of a promotora HV program proved effective in providing greater retention in the Breathmobile™ program essential for asthma control. Randomized clinical trials will be needed to show the impact on health care utilization and asthma control.

  17. 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.

  18. Type-specific HPV and Pap test results among low-income, underserved women: providing insights into management strategies.

    Science.gov (United States)

    Saraiya, Mona; Benard, Vicki B; Greek, April A; Steinau, Martin; Patel, Sonya; Massad, L Stewart; Sawaya, George F; Unger, Elizabeth R

    2014-10-01

    The primary cervical cancer screening strategy for women over age 30 is high-risk human papillomavirus (HPV) testing combined with Papanicolaou (Pap) testing (cotesting) every 5 years. This combination strategy is a preventive service that is required by the Affordable Care Act to be covered with no cost-sharing by most health insurance plans. The cotesting recommendation was made based entirely on prospective data from an insured population that may have a lower proportion of women with HPV positive and Pap negative results (ie, discordant results). The discordant group represents a very difficult group to manage. If the frequency of discordant results among underserved women is higher, health care providers may perceive the cotesting strategy to be a less favorable screening strategy than traditional Pap testing every 3 years. The Centers for Disease Control and Prevention's Cervical Cancer Study was conducted at 15 clinics in 6 federally qualified health centers across Illinois. Providers at these clinics were given the option of cotesting for routine cervical cancer screening. Type-specific HPV detection was performed on residual extracts using linear array. Pap test results were abnormal in 6.0% and HPV was positive in 7.2% of the underserved women screened in this study (mean age, 45.1 years). HPV prevalence decreased with age, from 10.3% among 30- to 39-year-olds to 4.5% among 50- to 60-year-olds. About 5% of the women had a combination of a positive HPV test and normal Pap test results; HPV 16/18 was identified in 14% of discordant women. The rate of discordant results among underserved women was similar to those reported throughout the US in a variety of populations. Typing for HPV 16/18 appears to assist in the management in a small proportion of women with discordant results. Published by Elsevier Inc.

  19. 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

  20. 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

  1. 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

  2. Population Health Outcomes of a Student-Led Free Health Clinic for an Underserved Population: A Naturalistic Study.

    Science.gov (United States)

    Stuhlmiller, Cynthia M; Tolchard, Barry

    2018-02-01

    There are a number of hard to reach and underserved communities who experience inadequate health care. In Australia, the Aboriginal and Torres Strait Islanders peoples experience low life expectancy, higher levels for chronic disease and elevated smoking and drinking. These problems are further exacerbated when living in regional and rural Australia and poverty. There are growing concerns over helping such groups in order to close the health disparity gap. A student-led clinic (SLC) was developed to address clinical placement shortages while providing free health and social services in an underserved community in regional Australia. Health data was collected from 2086 attendees enrolled in the SLC to determine health changes and outcomes of student-delivered services. A series of health data was routinely collected at all contact points. This included physical health care, behavioural health risk, and chronic disease measures. All data was recorded in an electronic monitoring system. Population data identified some significant and positive changes to health patterns-smoking, waist size, and body mass index. Unfortunately, gaps in data entry precluded more robust findings. It was clear that this community suffered from experiences commonly associated with health disparity and poverty. There were higher risks of drinking alcohol and smoking with raised levels of lifestyle disease including diabetes. Some of these issues were mitigated by the community being able to attend a locally situated community driven clinic.

  3. The institutional development award states pediatric clinical trials network: building research capacity among the rural and medically underserved.

    Science.gov (United States)

    Snowden, Jessica; Darden, Paul; Palumbo, Paul; Saul, Phil; Lee, Jeannette

    2018-04-01

    The institutional development award (IDeA) program was created to increase the competitiveness of investigators in states with historically low success rates for National Institutes of Health (NIH) research funding applications. IDeA states have high numbers of rural and medically underserved residents with disproportionately high rates of infant mortality, obesity, and poverty. This program supports the development and expansion of research infrastructure and research activities in these states. The IDeA States Pediatric Clinical Trials Network (ISPCTN) is part of the environmental influences on child health outcomes program. Its purpose is to build research capacity within IDeA states and provide opportunities for children in IDeA states to participate in clinical trials. This review describes the current and future activities of the network. In its initial year, the ISPCTN created an online series on clinical trials, initiated participation in a study conducted by the pediatric trials network, and proposed two novel clinical trials for obese children. Capacity building and clinical trial implementation will continue in future years. The ISPCTN is uniquely poised to establish and support new pediatric clinical research programs in underserved populations, producing both short and long-term gains in the understanding of child health.

  4. Cancer prevention in underserved African American communities: barriers and effective strategies--a review of the literature.

    Science.gov (United States)

    Wolff, Marie; Bates, Tovah; Beck, Barbra; Young, Staci; Ahmed, Syed M; Maurana, Cheryl

    2003-01-01

    African Americans suffer significantly more cancer morbidity and mortality than the white population. In order to decrease this differential, it is critical to understand the particular barriers to health and health care that underserved African Americans face. It is also important to identify the critical components of effective cancer prevention programs for this population. The barriers that impede care for underserved African Americans have been identified as: 1) inadequate access to and availability of health care services; 2) competing priorities; 3) lack of knowledge of cancer prevention and screening recommendations; 4) culturally inappropriate or insensitive cancer control materials; 5) low literacy; 6) mistrust of the health care system; and 7) fear and fatalism. Effective programs must incorporate community participation, innovative outreach, use of social networks and trusted social institutions, cultural competence, and a sustained approach. Programs that include these strategies are much more likely to be effective in reducing cancer incidence. Cancer ranks second only to cardiovascular disease as the leading cause of death in the United States. For the majority population, cancer incidence and prevalence have declined in recent years and cure rates for certain cancer diagnoses have improved. This can be attributed to progress in the development and implementation of prevention, early detection, and treatment strategies. However, despite these gains, medically underserved African American populations have not fared as well. When African American-white mortality rates are compared, African Americans are 1.3 times more likely to die of cancer than the general population. Data from the Bureau of Health Information, Wisconsin Department of Health and Family Services indicate that from 1996 to 2000, cancer accounted for 33% of deaths in African Americans aged 45-64 and 34% of deaths for those aged 65-74. To decrease the disparities in cancer morbidity and

  5. Using Concept Mapping to Develop a Strategy for Self-Management Support for Underserved Populations Living With Chronic Conditions, British Columbia, August 2013-June 2014.

    Science.gov (United States)

    Mills, Susan L; Bergeron, Kim; Pérez, Guillermina

    2015-10-08

    Self-management support (SMS) is an essential component of public health approaches to chronic conditions. Given increasing concerns about health equity, the needs of diverse populations must be considered. This study examined potential solutions for addressing the gaps in self-management support initiatives for underserved populations. Stakeholders representing government, nongovernment organizations, Aboriginal communities, health authorities, medical practices, and research institutions generated, sorted, and rated ideas on what could be done to improve self-management support for underserved populations. Concept mapping was used to facilitate the collection and organization of the data and to generate conceptual maps. Participants generated 92 ideas that were sorted into 11 clusters (foster partnerships, promote integrated community care, enhance health care provider training, shift government policy, support community development, increase community education, enable client engagement, incorporate client support systems, recognize client capacity, tailor self-management support programs, and develop client skills, training, and tools) and grouped into system, community, and individual levels within a partnership framework. The strategy can stimulate public health dialogue and be a roadmap for developing SMS initiatives. It has the potential to address SMS and chronic condition inequities in underserved populations in several ways: 1) by targeting populations that have greater inequities, 2) by advocating for shifts in government policies that create and perpetuate inequities, 3) by promoting partnerships that may increase the number of SMS initiatives for underserved groups, and 4) by promoting training and engagement that increase the relevance, uptake, and overall effectiveness of SMS.

  6. 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.

  7. The role of spirituality in diabetes self-management in an urban, underserved population: a qualitative exploratory study.

    Science.gov (United States)

    Gupta, Priya S; Anandarajah, Gowri

    2014-03-03

    Although many studies examine motivators for diabetes self-management, few explore the role spirituality plays in this disease, especially in low-income urban populations. This qualitative, focus group study elicits thoughts of diabetic patients regarding spirituality in diabetes self-care, at an urban primary care practice in Rhode Island. Focus group discussions were audiotaped, transcribed verbatim, and analyzed using the immersion/crystallization technique. Themes included: significant impact of diabetes on daily life; fear and family as prominent self-care motivators; relationships with self, others, nature and the divine as major sources of hope and strength. Patients varied considerably regarding the role spirituality played in their illness, ranging from minimal to profound impact. All appeared comfortable discussing spirituality within the context of strength and hope. Patients in this urban, underserved population are willing to discuss spirituality related to their diabetes care. They vary in the role spirituality plays in their illness experience.

  8. 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.

  9. 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.

  10. 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."

  11. The Impact of Primary Care Providers on Patient Screening Mammography and Initial Presentation in an Underserved Clinical Setting.

    Science.gov (United States)

    Keshinro, Ajaratu; Hatzaras, Ioannis; Rifkind, Kenneth; Dhage, Shubhada; Joseph, Kathie-Ann

    2017-03-01

    Cancer screening is a key component of primary care, and access to regular screening mammography (SMG) is highly dependent on recommendation and referral by a primary care provider (PCP). Women with no health insurance or who are underinsured often lack access to a regular PCP and thus access to routine screening. We retrospectively reviewed the charts of 173 surgical patients diagnosed between January 2012 and December 2013. The main outcome variables were PCP status, method of cancer detection, and breast cancer stage at diagnosis. Additional variables included race, age at diagnosis, family history of breast and ovarian cancer, and medical comorbidities. Patients with a PCP received more mammograms (SMG) compared with patients without a PCP (61 vs. 37 %; p = 0.003). The majority (73 %) of patients without a PCP presented symptomatically with a palpable mass versus 42 % of patients with a PCP. A significant difference was noted with regard to final pathologic stage of breast cancer between the two groups (p = 0.019), and Caucasian and African American patients were more likely to have locally advanced breast cancer. Underserved patients with a PCP are more likely to present asymptomatically and at an earlier stage of breast cancer compared with patients without a PCP. Community engagement programs that build relationships with patients may help bring vulnerable patients into the healthcare system for routine screening. Moreover, PCP education regarding the subtleties of breast cancer screening guidelines and referral to a breast specialist is also critical in improving outcomes of underserved patients.

  12. 75 FR 42755 - The Negotiated Rulemaking Committee on the Designation of Medically Underserved Populations and...

    Science.gov (United States)

    2010-07-22

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration The... Professions Shortage Areas AGENCY: Health Resources and Services Administration (HRSA), HHS. ACTION: Notice of... Secretary of Health and Human Services, through the Administrator, Health Resources and Services...

  13. Readiness and capacity of librarians in public libraries to implement a breast cancer outreach and screening campaign in medically underserved communities.

    Science.gov (United States)

    Goytia, Elliott J; Rapkin, Bruce; Weiss, Elisa S; Golub, David; Guzman, Vivian; O'Connor, Maureen

    2005-11-01

    Community-based partnerships are an important means of addressing cancer health disparities in medically underserved communities. Public libraries may be ideal partners in this effort. To assess the readiness and capacity of a public library system to implement cancer recruitment and outreach campaigns, 58 librarians in the Queens Borough Public Library System in New York completed self-administered questionnaires before and after a training on breast health, cancer, and screening. Results indicate that they are interested in participating in a cancer outreach campaign and feel it is a critical need in their community. Many librarians lacked the knowledge about cancer and cancer information resources needed to participate optimally. Nevertheless, librarians provide a cultural bridge to medically underserved communities. Partnering with a public library system to improve access to care has great potential, yet a number of challenges need to be overcome.

  14. 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.

  15. 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.

  16. Investigating social ecological contributors to diabetes within Hispanics in an underserved U.S.-Mexico border community.

    Science.gov (United States)

    Chang, Jean; Guy, Mignonne C; Rosales, Cecilia; de Zapien, Jill G; Staten, Lisa K; Fernandez, Maria L; Carvajal, Scott C

    2013-07-31

    Hispanics bear a disproportionate burden of diabetes in the United States, yet relations of structural, socio-cultural and behavioral factors linked to diabetes are not fully understood across all of their communities. The current study examines disparities and factors associated with diabetes in adult Hispanics of Mexican-descent (N = 648) participating in a population survey of an underserved rural U.S.-Mexico border community. The overall rate of diabetes prevalence rate in the sample, based on self-report and a glucose testing, was 21%; much higher than rates reported for U.S. adults overall, for all Hispanic adults, or for Mexican American adults specifically. Acculturation markers and social determinants of health indicators were only significantly related to diabetes in models not accounting for age. Older age, greater BMI (>30), greater waist-to-hip ratio as well as lower fruit and vegetable consumption were significantly related to increased likelihood of diabetes when all structural, cultural, behavioral, and biological factors were considered. Models with sets of behavioral factors and biological factors each significantly improved explanation of diabetes relative to prior social ecological theory-guided models. The findings show a critical need for diabetes prevention efforts in this community and suggest that health promotion efforts should particularly focus on increasing fruit and vegetable consumption.

  17. Investigating Social Ecological Contributors to Diabetes within Hispanics in an Underserved U.S.-Mexico Border Community

    Directory of Open Access Journals (Sweden)

    Scott C. Carvajal

    2013-07-01

    Full Text Available Hispanics bear a disproportionate burden of diabetes in the United States, yet relations of structural, socio-cultural and behavioral factors linked to diabetes are not fully understood across all of their communities. The current study examines disparities and factors associated with diabetes in adult Hispanics of Mexican-descent (N = 648 participating in a population survey of an underserved rural U.S.-Mexico border community. The overall rate of diabetes prevalence rate in the sample, based on self-report and a glucose testing, was 21%; much higher than rates reported for U.S. adults overall, for all Hispanic adults, or for Mexican American adults specifically. Acculturation markers and social determinants of health indicators were only significantly related to diabetes in models not accounting for age. Older age, greater BMI (>30, greater waist-to-hip ratio as well as lower fruit and vegetable consumption were significantly related to increased likelihood of diabetes when all structural, cultural, behavioral, and biological factors were considered. Models with sets of behavioral factors and biological factors each significantly improved explanation of diabetes relative to prior social ecological theory-guided models. The findings show a critical need for diabetes prevention efforts in this community and suggest that health promotion efforts should particularly focus on increasing fruit and vegetable consumption.

  18. 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.

  19. Language development, delay and intervention-the views of parents from communities that speech and language therapy managers in England consider to be under-served.

    Science.gov (United States)

    Marshall, Julie; Harding, Sam; Roulstone, Sue

    2017-07-01

    Evidence-based practice includes research evidence, clinical expertise and stakeholder perspectives. Stakeholder perspectives are important and include parental ethno-theories, which embrace views about many aspects of speech, language and communication, language development, and interventions. The Developmental Niche Framework provides a useful theory to understand parental beliefs. Ethnotheories, including those about language development, delay and interventions, may vary cross culturally and are less well understood in relation to families who may be considered 'under-served' or 'hard-to-reach' by speech and language therapy services. Who is considered to be under-served and the reasons why some families are under-served are complex. To describe beliefs and reported practices, in relation to speech and language development, delay and intervention, of parents and carers from a small number of groups in England who were perceived to be under-served in relation to SLT services. As part of a wider National Institute for Health Research (NIHR)-funded study (Child Talk), seven focus groups (with a total of 52 participants) were held with parents from three communities in England. Topics addressed included beliefs about language development, language delay and parents' reported responses to language delay. Data were transcribed and analysed using adapted framework analysis, which also drew on directed content analysis. Four themes resulted that broadly matched the topics addressed in the focus groups: language development and the environment; causes and signs of speech and language delay; responses to concerns about speech, language and communication; and improving SLT. These produced some previously unreported ideas, e.g., about how language develops and the causes of delay. The findings are discussed in relation to previous literature and the Developmental Niche Framework. Clinical implications include ideas about issues for SLTs to discuss with families and the

  20. 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.

  1. Stemming the tide of childhood obesity in an underserved urban African American population: a pilot study.

    Science.gov (United States)

    Fletcher, Audwin; Cooper, Janet R; Helms, Pamela; Northington, LaDonna; Winters, Karen

    2009-01-01

    Recent data indicate that Americans are gaining weight at an alarming rate. It is estimated that over 12 million American children ages 2-19 years are overweight, with African American (AA) children comprising 20% of this cohort. The problem of obesity appears to be more prominent in some southern states. According to a new report by the Trust for America's Health, Mississippi has the 1st highest rate of adult obesity and the 8th highest rate of overweight youth ages 10-17 nationwide. The Kids for Healthy Eating and Exercising (KHEE) club was a model developed in the North Midtown area of Jackson, Mississippi. The purpose of this project was to develop the first weight control program and model specifically designed for AA children in the North Midtown area of the city of Jackson. This program devised measures to effectively enhance the lifestyle changes of selected obese children representing the target population. Results of the pilot project revealed the following changes among all participants: a decrease in body mass index (BMI); a decrease in waist girth of greater than 4 inches; and positive behavioral changes as documented in the daily entries of the participants' food journal.

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. Dental students and faculty members' attitudes towards care for underserved patients and community service: do community-based dental education and voluntary service-learning matter?

    Science.gov (United States)

    Volvovsky, Mariya; Vodopyanov, Dmitry; Inglehart, Marita R

    2014-08-01

    The objectives of this study were to explore 1) how students across the four years of a dental curriculum differed in attitudes towards underserved patients and community service at the beginning and end of each school year; 2) how these attitudes changed as a function of participating in required vs. voluntary community-based activities; and 3) what attitudes faculty members held about the effects of community service-learning on students. Surveys were distributed to 440 students at one dental school at the beginning and end of the school year. The overall response rate for those surveys was 75 percent, with variations among classes: first year, 94 percent; second year, 92 percent; third year, 69 percent; and fourth year, 43 percent. Survey data were also collected from twenty-two students (out of a possible forty-seven) who participated in voluntary service-learning and from fifty-four faculty members (out of approximately 150). The results showed that, at the beginning of the year, the first-year students' attitudes were more positive than the responses of students in all other cohorts. However, at the end of the year, their attitudes were less positive. Participating in voluntary service-learning improved students' attitudes towards treating underserved patients only in the short run, and experiencing ten weeks of community-based dental education did not improve their attitudes. The faculty respondents' attitudes, however, were quite positive. The decrease in students' positive attitudes towards treating underserved patients and participating in community service should raise questions about why this loss of idealism occurred.

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. Examining inequalities in uptake of maternal health care and choice of provider in underserved urban areas of Mumbai, India: A mixed methods study

    NARCIS (Netherlands)

    G. Alcock (Glyn); S. Das (Sushmita); N.S. More (Neena Shah); K. Hate (Ketaki); S. More (Sharda); S. Pantvaidya (Shanti); D. Osrin (David); A.J. Houweling (Tanja)

    2015-01-01

    textabstractBackground: 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

  15. 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.

  16. 8 CFR 245.18 - How can physicians (with approved Forms I-140) that are serving in medically underserved areas or...

    Science.gov (United States)

    2010-01-01

    ... when the Service approves a Form I-140 petition with a national interest job offer waiver, the... the Form I-140 and of the national interest waiver. (j) Will a Service officer interview the physician... adjustment interview with a Service officer, unless the Service waives the interview as provided in § 245.6...

  17. 8 CFR 1245.18 - How can physicians (with approved Forms I-140) that are serving in medically underserved areas or...

    Science.gov (United States)

    2010-01-01

    ... with a national interest job offer waiver, the aggregate period during which the medical practice... approval of the Form I-140 and of the national interest waiver. (j) Will a Service officer interview the... adjustment interview with a Service officer, unless the Service waives the interview as provided in § 1245.6...

  18. ENDO ECHO IMPROVES PRIMARY CARE PROVIDER AND COMMUNITY HEALTH WORKER SELF-EFFICACY IN COMPLEX DIABETES MANAGEMENT IN MEDICALLY UNDERSERVED COMMUNITIES.

    Science.gov (United States)

    Bouchonville, Matthew F; Hager, Brant W; Kirk, Jessica B; Qualls, Clifford R; Arora, Sanjeev

    2018-01-01

    To determine whether participation in a multidisciplinary telementorship model of healthcare delivery improves primary care provider (PCP) and community health worker (CHW) confidence in managing patients with complex diabetes in medically underserved regions. We applied a well-established healthcare delivery model, Project ECHO (Extension for Community Healthcare Outcomes), to the management of complex diabetes (Endo ECHO) in medically underserved communities. A multidisciplinary team at Project ECHO connected with PCPs and CHWs at 10 health centers across New Mexico for weekly videoconferencing virtual clinics. Participating PCPs and CHWs presented de-identified patients and received best practice guidance and mentor-ship from Project ECHO specialists and network peers. A robust curriculum was developed around clinical practice guidelines and presented by weekly didactics over the ECHO network. After 2 years of participation in Endo ECHO, PCPs and CHWs completed self-efficacy surveys comparing confidence in complex diabetes management to baseline. PCPs and CHWs in rural New Mexico reported significant improvement in self-efficacy in all measures of complex diabetes management, including PCP ability to serve as a local resource for other healthcare providers seeking assistance in diabetes care. Overall self-efficacy improved by 130% in CHWs ( Pcare may be useful in resource-poor communities with limited access to diabetes specialist services. CHW = community health worker; CME = Continuing Medical Education; ECHO = Extension for Community Healthcare Outcomes; FQHC = federally qualified health center; PCP = primary care provider.

  19. Evaluation of a Community Health Worker Intervention to Reduce HIV/AIDS Stigma and Increase HIV Testing Among Underserved Latinos in the Southwestern U.S.

    Science.gov (United States)

    Rios-Ellis, Britt; Becker, Davida; Espinoza, Lilia; Nguyen-Rodriguez, Selena; Diaz, Gaby; Carricchi, Ana; Galvez, Gino; Garcia, Melawhy

    2015-01-01

    Latinos are at an elevated risk for HIV infection. Continued HIV/AIDS stigma presents barriers to HIV testing and affects the quality of life of HIV-positive individuals, yet few interventions addressing HIV/AIDS stigma have been developed for Latinos. An intervention led by community health workers (promotores de salud, or promotores) targeting underserved Latinos in three southwestern U.S. communities was developed to decrease HIV/AIDS stigma and increase HIV knowledge and perception of risk. The intervention was led by HIV-positive and HIV-affected (i.e., those who have, or have had, a close family member or friend with HIV/AIDS) promotores, who delivered interactive group-based educational sessions to groups of Latinos in Spanish and English. To decrease stigma and motivate behavioral and attitudinal change, the educational sessions emphasized positive Latino cultural values and community assets. The participant pool comprised 579 Latino adults recruited in El Paso, Texas (n=204); San Ysidro, California (n=175); and Los Angeles, California (n=200). From pretest to posttest, HIV/AIDS stigma scores decreased significantly (pstigma scores when compared with their male counterparts, which may have been related to a greater increase in HIV/AIDS knowledge scores (p=0.016 and p=0.007, respectively). Promotores interventions to reduce HIV/AIDS stigma and increase HIV-related knowledge, perception of risk, and willingness to discuss sexual risk with partners show promise in reaching underserved Latino communities.

  20. 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

  1. 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)

    Faba, Gladys; Julian, Soroya; Mejía, Felipe; Cabieses, Báltica; D'Agostino, Marcelo; Cortinois, Andrea A

    2015-01-01

    Background 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. Objective 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. Methods 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. Results 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

  2. National Articulation and Transfer Network (NATN): Building an Alternative Pathway for Underserved Student Populations To Access Historically Black Colleges and Universities (HBCU), Hispanic Serving Institutions (HSI) & Tribal Colleges and Universities (TCU).

    Science.gov (United States)

    City Coll. of San Francisco, CA.

    This is a report on the National Articulation and Transfer Network (NATN) program, which seeks to increase the achievement and aspirations of students from underserved population, namely African Americans, Hispanics, and Native Americans. More than 150 Historically Black Colleges and Universities (HBCU), Hispanic Serving Institutions (HSI), and…

  3. '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

    2016-02-02

    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. Community-based participatory research (CBPR) using think-aloud protocols (phases 1 and 2) and semistructured interviews (phase 3). Underserved community settings (eg, knitting groups, bingo halls, senior centres) and breast clinics. 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. The pictorial encounter decision aid was derived from an evidence-based table comparing treatment options for breast cancer (http://www.optiongrid.org). We assessed the usability, acceptability and accessibility of the pictorial decision aid prototypes using the think-aloud protocol and semistructured interviews. 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. 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 cancer found the Picture Option Grid usable, acceptable and accessible. Published by the BMJ Publishing

  4. Prevalence and associated factors of wheezing illnesses of children aged three to five years living in under-served settlements of the Colombo Municipal Council in Sri Lanka: a cross-sectional study.

    Science.gov (United States)

    Seneviratne, Ruwanika; Gunawardena, Nalika S

    2018-01-11

    A rising trend in Sri Lanka for asthma and wheezing illness is observed with higher morbidity in younger children and a paucity of related research. 'Under-served settlements' (USS) of Colombo Municipal Council (CMC) have poor living environments conducive to childhood wheezing. The objective was to describe the prevalence and associated factors of wheezing illnesses of three to five year old children living in low-income settlements in CMC. A cross-sectional study was conducted on 460 three to five year old children and their caregivers using cluster sampling among residents of two randomly selected USSs of CMC. An interviewer-administered questionnaire, observation checklist and data extraction form were used in data collection. A physician's diagnosis of wheezing/whistling of the chest in their lifetime and a physician's diagnosis of wheezing/whistling within the past twelve months were considered as 'ever-wheezing illness' and 'current-wheezing illness' respectively. Mean age was 3.98 years (SD = ±0.64 years). A majority were males (51.3%) and Tamils (39.8%). Prevalence of 'ever wheezing illness' and 'current wheezing illness' were 38% (95% confidence interval (CI); 33.6%-42.5%) and 21.3% (95%CI; 17.6%-25.0%), respectively. Maternal (p < 0.001) and paternal (p < 0.001) histories of wheezing, playing with soft toys in the sleeping area (p = 0.004), place of cooking combined with the living area (p = 0.03), unsatisfactory ventilation in the sleeping area (p < 0.001) were found to be significantly associated with increased 'current wheezing' through multivariate analysis in this study. Use of formula milk before six months of age (p = 0.014) was found to be protective through multivariate analysis. The magnitude of wheezing illnesses among three to five year old children residing in urban low-income settlements was found to be high. Children with a history of maternal and/or paternal wheezing should be targeted for early interventions to

  5. 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 of methodologies, encompassing ethnographic and quantitative approaches, is used to study the need to expand connectivity in Dwesa and the social impact of providing Internet connection to this rural area. Our findings confirm the need to connect more areas...

  6. Correlation between vegetation pattern and microtopography in periglacial areas of the Central Alps

    Directory of Open Access Journals (Sweden)

    Gerdol, Renato

    1990-06-01

    Full Text Available The distributional patterns of plant species were analyzed within periglacial microforms belonging to the collective groups of patterned grounds and sorted stripes In the Ortles-Cevedale group (Lombardy, Italy. The edges of primitive polygons are practically free of vegetation, whilst the central areas are colonized by pioneer plants of detritic slopes. This is clearly correlated with a low degree of sediment sorting. The morphological evolution of the forms proceeds at a faster rate at the edge of polygons than in the central areas. Vegetation, on the other hand, colonizes the coarse debris at the polygons’ edges slowly but colonizes the fine material in the central areas actively. The centre of the most evolved polygons is covered by a carpet of Salix herbacea. Age determinations of Salix shoots are not useful for dating purposes, but provide Information about the local microclimate.

    [es] Se han analizado los modelos de distribución de especies vegetales en microformas periglaciares pertenecientes al tipo de suelos estructurales en el Ortles-Cevedale (Lombardía, Italia. Los límites de los polígonos de piedras están prácticamente libres de vegetación, mientras las áreas centrales están colonizadas por plantas pioneras de laderas pedregosas. La evolución morfológica actúa a mayor velocidad en el borde de los polígonos que en las áreas centrales. Por otro lado, la vegetación coloniza lentamente los bordes de los polígonos, y más activamente las zonas centrales. El centro de la mayoría de los polígonos está cubierto por un manto de Salix herbacea. La determinación de la edad de los vástagos de Salix no ha sido un método útil a efectos cronológicos, pero proporciona información sobre el microclima local.
    [fr] On étude les modèles de distribution d'espèces végétaux dans microformes périglaciaires appartenants au type de sols structurales dans l'Ortles-Cevedale (Lombardie

  7. Tribological influence of tool surface roughness within microforming

    DEFF Research Database (Denmark)

    Eriksen, Rasmus Solmer; Weidel, S.; Hansen, Hans Nørgaard

    2010-01-01

    A comparative friction study of tooling dies with a simple internal cylindrical geometry has been performed. The purpose of the experiment consist of studying the influence of the surface characteristics of tooling dies on the frictional behaviour in a micro bulk forming operation. This research ...

  8. 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

    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 acquired

  9. 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

  10. Evaluating a complex model designed to increase access to high quality primary mental health care for under-served groups: a multi-method study.

    Science.gov (United States)

    Dowrick, Christopher; Bower, Peter; Chew-Graham, Carolyn; Lovell, Karina; Edwards, Suzanne; Lamb, Jonathan; Bristow, Katie; Gabbay, Mark; Burroughs, Heather; Beatty, Susan; Waheed, Waquas; Hann, Mark; Gask, Linda

    2016-02-17

    Many people with mental distress are disadvantaged because care is not available or does not address their needs. In order to increase access to high quality primary mental health care for under-served groups, we created a model of care with three discrete elements: community engagement, primary care training and tailored wellbeing interventions. We have previously demonstrated the individual impact of each element of the model. Here we assess the effectiveness of the combined model in increasing access to and improving the quality of primary mental health care. We test the assumptions that access to the wellbeing interventions is increased by the presence of community engagement and primary care training; and that quality of primary mental health care is increased by the presence of community engagement and the wellbeing interventions. We implemented the model in four under-served localities in North-West England, focusing on older people and minority ethnic populations. Using a quasi-experimental design with no-intervention comparators, we gathered a combination of quantitative and qualitative information. Quantitative information, including referral and recruitment rates for the wellbeing interventions, and practice referrals to mental health services, was analysed descriptively. Qualitative information derived from interview and focus group responses to topic guides from more than 110 participants. Framework analysis was used to generate findings from the qualitative data. Access to the wellbeing interventions was associated with the presence of the community engagement and the primary care training elements. Referrals to the wellbeing interventions were associated with community engagement, while recruitment was associated with primary care training. Qualitative data suggested that the mechanisms underlying these associations were increased awareness and sense of agency. The quality of primary mental health care was enhanced by information gained from our

  11. 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.

  12. 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...

  13. 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.

  14. 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 project to show substantial improvements in healthcare utilization and clinical outcomes among rural asthmatic children.

  15. 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 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.

  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. 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.

  19. Mortality and readmission rates in patients hospitalized for acute decompensated heart failure: a comparison between cardiology and general-medicine service outcomes in an underserved population.

    Science.gov (United States)

    Selim, Ahmed M; Mazurek, Jeremy A; Iqbal, Muhammad; Wang, Dan; Negassa, Abdissa; Zolty, Ronald

    2015-03-01

    With recent legislation imposing penalties on hospitals for above-average 30-day all-cause readmissions for patients with acute decompensated heart failure (ADHF), there is concern these penalties will more heavily impact hospitals serving socioeconomically vulnerable and underserved populations. Patients with ADHF and low socioeconomic status have better postdischarge mortality and readmission outcomes when cardiologists are involved in their in-hospital care. We retrospectively searched the electronic medical record for patients hospitalized for ADHF from 2001 to 2010 in 3 urban hospitals within a large university-based health system. These patients were divided into 2 groups based on whether a cardiologist was involved in their care or not. Measured outcomes were 30- and 60-day postdischarge mortality and readmission rates. Out of the 7516 ADHF patients, 1434 patients were seen by a cardiologist (19%). These patients had lower 60-day mortality (5.4% vs 7.0%; hazard ratio [HR]: 0.70, 95% confidence interval [CI]: 0.52-0.96, P = 0.034) and lower 30- and 60-day readmission rates (16.7% vs 20.6%; HR: 0.76, 95% CI: 0.66-0.89, P = 0.002, and 26.1% vs 30.2%; HR: 0.81, 95% CI: 0.72-0.92, P = 0.003, respectively). There was no significant difference in the in-hospital mortality between the 2 groups. Compared with other races, whites with systolic HF have marginally lower HF-related readmission rates when treated by cardiologists. In this cohort of ADHF patients from the Bronx, New York, involvement of a cardiologist resulted in improved short-term mortality and readmission outcomes compared with treatment by general internal medicine. © 2015 Wiley Periodicals, Inc.

  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. Examining the Durability of Colorectal Cancer Screening Awareness and Health Beliefs Among Medically Underserved Patients: Baseline to 12 months Post-Intervention.

    Science.gov (United States)

    Christy, Shannon M; Sutton, Steven K; Gwede, Clement K; Chavarria, Enmanuel A; Davis, Stacy N; Abdulla, Rania; Schultz, Ida; Roetzheim, Richard; Shibata, David; Meade, Cathy D

    2017-11-25

    The current study examines changes in awareness and health beliefs from baseline to 12 months post-intervention following receipt of one of two colorectal cancer (CRC) educational interventions that aimed to promote CRC screening among a racially and ethnically diverse and medically underserved population. Participants (N = 270) were enrolled in a randomized controlled trial to increase CRC screening and completed both baseline and 12-month follow-up assessments. Participants were aged 50-75, at average CRC risk, not up-to-date with CRC screening guidelines, and receiving care at one of three community-based clinics. Participants were randomized to receive either a targeted, low-literacy intervention informed by the Preventive Health Model [PHM] (photonovella and DVD plus fecal immunochemical test [FIT]) or a non-targeted intervention (standard educational brochure plus FIT). Changes in CRC awareness and health beliefs from baseline to 12 months were examined both within and between intervention groups using Student's t tests. Participants in both intervention conditions demonstrated an increase in CRC awareness, PHM social influence, and trust in the healthcare system (all p's < .0001), with no significant between-group differences. Among those receiving the targeted intervention, there also was an increase in PHM salience (p < .05). Among individuals receiving the non-targeted intervention, there was an increase in PHM response efficacy (p < .01) and PHM self-efficacy (p < .0001). Both CRC screening interventions promoted positive changes in awareness and several health beliefs from baseline to 12 months, suggesting important benefits of CRC education. Regardless of whether education was targeted or non-targeted, providing CRC screening education successfully promoted durable changes in awareness and health beliefs.

  2. A community engagement process identifies environmental priorities to prevent early childhood obesity: the Children's Healthy Living (CHL) program for remote underserved populations in the US Affiliated Pacific Islands, Hawaii and Alaska.

    Science.gov (United States)

    Fialkowski, Marie Kainoa; DeBaryshe, Barbara; Bersamin, Andrea; Nigg, Claudio; Leon Guerrero, Rachael; Rojas, Gena; Areta, Aufa'i Apulu Ropeti; Vargo, Agnes; Belyeu-Camacho, Tayna; Castro, Rose; Luick, Bret; Novotny, Rachel

    2014-12-01

    Underserved minority populations in the US Affiliated Pacific Islands (USAPI), Hawaii, and Alaska display disproportionate rates of childhood obesity. The region's unique circumstance should be taken into account when designing obesity prevention interventions. The purpose of this paper is to (a), describe the community engagement process (CEP) used by the Children's Healthy Living (CHL) Program for remote underserved minority populations in the USAPI, Hawaii, and Alaska (b) report community-identified priorities for an environmental intervention addressing early childhood (ages 2-8 years) obesity, and (c) share lessons learned in the CEP. Four communities in each of five CHL jurisdictions (Alaska, American Samoa, Commonwealth of the Northern Mariana Islands, Guam, Hawai'i) were selected to participate in the community-randomized matched-pair trial. Over 900 community members including parents, teachers, and community leaders participated in the CEP over a 14 month period. The CEP was used to identify environmental intervention priorities to address six behavioral outcomes: increasing fruit/vegetable consumption, water intake, physical activity and sleep; and decreasing screen time and intake of sugar sweetened beverages. Community members were engaged through Local Advisory Committees, key informant interviews and participatory community meetings. Community-identified priorities centered on policy development; role modeling; enhancing access to healthy food, clean water, and physical activity venues; and healthy living education. Through the CEP, CHL identified culturally appropriate priorities for intervention that were also consistent with the literature on effective obesity prevention practices. Results of the CEP will guide the CHL intervention design and implementation. The CHL CEP may serve as a model for other underserved minority island populations.

  3. 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

  4. 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

  5. Quiet areas

    DEFF Research Database (Denmark)

    Petersen, Rikke Munck

    2016-01-01

    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...... a site and near-sensory experience. In so doing, films can achieve an intimate reflection of both outer experience and affection of inner sensations, and the audio-visual and time-space based presentation of this dualism can mimic human experience. This paper discusses how this embedded transference...... 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....

  6. 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

  7. 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

  8. Stated preferences of doctors for choosing a job in rural areas of Peru: a discrete choice experiment.

    Science.gov (United States)

    Miranda, J Jaime; Diez-Canseco, Francisco; Lema, Claudia; Lescano, Andrés G; Lagarde, Mylene; Blaauw, Duane; Huicho, Luis

    2012-01-01

    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.

  9. 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.

  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. A community-based breast cancer screening program for medically underserved women: its effect on disease stage at diagnosis and on hazard of death Programa basado en la comunidad de tamizaje de cáncer de mama en mujeres médicamente subatendidas: efecto sobre el estadio de la enfermedad en el momento del diagnóstico y el riesgo de muerte

    Directory of Open Access Journals (Sweden)

    Clyde B. McCoy

    2004-03-01

    Full Text Available OBJECTIVE: Earlier studies by this research team found that medically underserved minority women in the Miami-Dade County area of the state of Florida, United States, were in need of breast cancer screening and that there were problems with availability, accessibility, and acceptability of services. In response, a community-based comprehensive breast cancer screening program called the Early Detection Program (EDP was developed. The specific purpose of this study was to assess the effect that EDP participation had on stage at diagnosis and on hazard of death. METHODS: Existing data from the Florida Cancer Data System (FCDS, a statewide cancer registry, were linked with data from the EDP. In December 1998 we assembled a multiethnic (African-American, black Hispanic, white Hispanic, and white non-Hispanic retrospective cohort with the following inclusion criteria: all women aged 40 and older with breast cancer diagnosed and staged at University of Miami/Jackson Memorial Medical Center (which is located in the city of Miami, Florida from January 1987 through December 1997. EDP participants were medically underserved, that is, they resided in lower socioeconomic areas and/or had limited or no health insurance to cover medical costs. Subjects identified as EDP participants were compared to nonparticipants with respect to disease stage at diagnosis and hazard of death. Logistic regression and Cox regression models were used for analysis. RESULTS: EDP participants were 2.4 times as likely (95% confidence interval = 1.71 to 3.43 to present with a diagnosis of localized cancer as were nonparticipants, even after controlling for race and age at diagnosis. EDP participation was independently associated with both earlier diagnosis and reduced hazard of death. CONCLUSIONS: Participation in the EDP increases the likelihood of early detection of breast cancer and reduces the hazard of death for medically underserved women in the Miami-Dade County area of

  12. Determining the efficacy of national strategies aimed at addressing the challenges facing health personnel working in rural areas in KwaZulu-Natal, South Africa

    Directory of Open Access Journals (Sweden)

    Grace Mburu

    2017-01-01

    Full Text Available Background: Shortages of Human Resources for Health (HRH in rural areas are often driven by poor working and living conditions, inadequate salaries and benefits, lack of training and career development opportunities amongst others. The South African government has adopted a human resource strategy for the health sector in 2011 aimed at addressing these challenges.Aim: This study reviews the challenges faced by health personnel against government strategies aimed at attracting and retaining health personnel in these underserved areas.Setting: The study was conducted in six primary health care service sites in the Hlabisa sub-district of Umkhanyakude, located in northern KwaZulu-Natal, South Africa.Methods: The study population comprised 25 health workers including 11 professional nurses, 4 staff nurses and 10 doctors (4 medical doctors, 3 foreign medical doctors and 3 doctors undertaking community service. Qualitative data were collected from semi-structured interviews and analysed using thematic analysis.Results: Government initiatives including the rural allowance, deployment of foreign medical doctors and the presence of health personnel undertaking their community service in rural areas are positively viewed by health personnel working in rural health facilities. However, poor living and working conditions, together with inadequate personal development opportunities, remain unresolved challenges. It is these challenges that will continue to dissuade experienced health personnel from remaining in these underserved areas.Conclusion: South Africa’s HRH strategy for the Health Sector 2012/13–2015/16 had highlighted the key challenges raised by respondents and identified strategies aimed at addressing these challenges. Implementation of these strategies is key to improving both living and working conditions, and providing health personnel with opportunities for further development will require inter-ministerial collaboration if the HRH 2030

  13. Determining the efficacy of national strategies aimed at addressing the challenges facing health personnel working in rural areas in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Mburu, Grace; George, Gavin

    2017-07-31

    Shortages of Human Resources for Health (HRH) in rural areas are often driven by poor working and living conditions, inadequate salaries and benefits, lack of training and career development opportunities amongst others. The South African government has adopted a human resource strategy for the health sector in 2011 aimed at addressing these challenges. This study reviews the challenges faced by health personnel against government strategies aimed at attracting and retaining health personnel in these underserved areas. The study was conducted in six primary health care service sites in the Hlabisa sub-district of Umkhanyakude, located in northern KwaZulu-Natal, South Africa. The study population comprised 25 health workers including 11 professional nurses, 4 staff nurses and 10 doctors (4 medical doctors, 3 foreign medical doctors and 3 doctors undertaking community service). Qualitative data were collected from semi-structured interviews and analysed using thematic analysis. Government initiatives including the rural allowance, deployment of foreign medical doctors and the presence of health personnel undertaking their community service in rural areas are positively viewed by health personnel working in rural health facilities. However, poor living and working conditions, together with inadequate personal development opportunities, remain unresolved challenges. It is these challenges that will continue to dissuade experienced health personnel from remaining in these underserved areas. South Africa's HRH strategy for the Health Sector 2012/13-2015/16 had highlighted the key challenges raised by respondents and identified strategies aimed at addressing these challenges. Implementation of these strategies is key to improving both living and working conditions, and providing health personnel with opportunities for further development will require inter-ministerial collaboration if the HRH 2030 objectives are to be realised.

  14. "I Felt Like It Was God's Hands Putting the Needles In": A Qualitative Analysis of the Experience of Acupuncture for Chronic Pain in a Low-Income, Ethnically Diverse, and Medically Underserved Patient Population.

    Science.gov (United States)

    Kligler, Benjamin; Buonora, Michele; Gabison, Jonathan; Jacobs, Emilie; Karasz, Alison; McKee, M Diane

    2015-11-01

    To examine the experience of patients from a low-income, ethnically diverse medically underserved population receiving acupuncture for chronic pain. Qualitative analysis using inductive thematic analysis of interviews with participants from an acupuncture trial. Four community health centers in the Bronx, New York. Thirty-seven adults with chronic neck or back pain or osteoarthritis who participated in a previous acupuncture trial. Up to 14 weekly acupuncture treatments. Pain and quality of life were examined in the original trial; this study examines qualitative outcomes. The themes grouped naturally into three domains of the acupuncture experience: the decision-making process, the treatment experience, and the effect of acupuncture on health. Regarding decision-making, important factors were a willingness to try something new even if you do not necessarily "believe" in it or have specifically positive expectations; a sense that medications were not working for their pain, that they also caused significant adverse effects, and that natural strategies might be preferable; and a feeling of desperation. Cost and access were significant barriers to acupuncture treatment. Regarding the process of acupuncture, the open and personal communication with the acupuncturist was an important factor, as were the sense that the process of acupuncture related to a natural process of healing or correction within the body and that part of making acupuncture successful required being open to the power of the mind to generate a positive outcome. Regarding the effect of treatment, notable aspects were the deep sense of rest and relaxation participants reported during treatment as well as the benefit they experienced for conditions other than pain. The themes that emerged in this ethnically diverse, low-income population were very similar to those that have emerged over the past decade of qualitative research on the acupuncture experience in other patient populations.

  15. 77 FR 60050 - Special Regulations; Areas of the National Park System, Saguaro National Park, Bicycling

    Science.gov (United States)

    2012-10-02

    ... recently been used to introduce underserved youth to the Park and the NPS via bicycling and educational.... This rule: a. Does not have an annual effect on the economy of $100 million or more. b. Will not cause...

  16. Should Broca's area include Brodmann area 47?

    Science.gov (United States)

    Ardila, Alfredo; Bernal, Byron; Rosselli, Monica

    2017-02-01

    Understanding brain organization of speech production has been a principal goal of neuroscience. Historically, brain speech production has been associated with so-called Broca’s area (Brodmann area –BA- 44 and 45), however, modern neuroimaging developments suggest speech production is associated with networks rather than with areas. The purpose of this paper was to analyze the connectivity of BA47 ( pars orbitalis) in relation to language . A meta-analysis was conducted to assess the language network in which BA47 is involved. The Brainmap database was used. Twenty papers corresponding to 29 experimental conditions with a total of 373 subjects were included. Our results suggest that BA47 participates in a “frontal language production system” (or extended Broca’s system). The BA47  connectivity found is also concordant with a minor role in language semantics. BA47 plays a central role in the language production system.

  17. Vermont Designated Natural Areas

    Data.gov (United States)

    Vermont Center for Geographic Information — Under Natural Areas Law (10 Vermont Statutes Annotated, Chapter 83 � 2607) the FPR commissioner, with the approval of the governor, may designate and set aside areas...

  18. VT ZIP Code Areas

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) A ZIP Code Tabulation Area (ZCTA) is a statistical geographic entity that approximates the delivery area for a U.S. Postal Service five-digit...

  19. Reform in the dental services area in Romania – objective necessity or second option

    Directory of Open Access Journals (Sweden)

    Cristian UŢĂ

    2011-09-01

    Full Text Available The article herein deals with a topic of current interest, not only because the latest economic and social phenomena within the context of globalized crisis in the world, but also from the perspective of the evolution and specific processes in the medical area in Romania. The writer accomplishes a journey into the various medical systems in national economies, by analyzing the features of each type of system and the opportunity for a ‘capitalist’ vision related to the healthcare services in general. The dental medical services share a series of characteristics that help them be better defined from the point of view of provider-customer relation. Thus, it becomes evident that, for Romania, the process initiated in 2006 meaning liberalization of practicing the dental doctor profession represents a natural way of developing the market specific to such services. From this perspective, this issue targets the mentalities level only – to impose quality standards on the market and to witness the offer-demand balance, both deriving from the specific nature itself of the dental services. The involvement of the authorities at Health Department into developing a health insurance policy in the dental field and the support of the private initiative in the underserved areas are the main targets of the ‘reform’.

  20. Ultrasonic-Assisted Incremental Microforming of Thin Shell Pyramids of Metallic Foil

    Directory of Open Access Journals (Sweden)

    Toshiyuki Obikawa

    2017-05-01

    Full Text Available Single point incremental forming is used for rapid prototyping of sheet metal parts. This forming technology was applied to the fabrication of thin shell micropyramids of aluminum, stainless steel, and titanium foils. A single point tool used had a tip radius of 0.1 mm or 0.01 mm. An ultrasonic spindle with axial vibration was implemented for improving the shape accuracy of micropyramids formed on 5–12 micrometers-thick aluminum, stainless steel, and titanium foils. The formability was also investigated by comparing the forming limits of micropyramids of aluminum foil formed with and without ultrasonic vibration. The shapes of pyramids incrementally formed were truncated pyramids, twisted pyramids, stepwise pyramids, and star pyramids about 1 mm in size. A much smaller truncated pyramid was formed only for titanium foil for qualitative investigation of the size reduction on forming accuracy. It was found that the ultrasonic vibration improved the shape accuracy of the formed pyramids. In addition, laser heating increased the forming limit of aluminum foil and it is more effective when both the ultrasonic vibration and laser heating are applied.

  1. [Alveolocapillary microaneurysm in p-ANCA positive microvasculitis (microform of panarteritis nodosa)].

    Science.gov (United States)

    Bubendorf, L; Dalquen, P; Mihatsch, M

    1995-07-01

    In contrast to the panarteriitis nodosa macroform, the lung is frequently involved in p-ANCA-positive microvasculitis. Alveolar capillaritis, which may improve under immunosuppressive therapy, is a characteristic feature of this microvasculitis. We report on an 82-year-old patient who was admitted to the hospital because of severe hemoptysis due to microvasculitis. He died 3 weeks later despite therapy with steroids and cyclophosphamide. At autopsy alveolocapillary microaneurysms were found that may be residues of alveolar capillaritis.

  2. Tribological impact of the finishing technology onto meso- and microforming processes

    Directory of Open Access Journals (Sweden)

    Jahn Stephan F.

    2016-01-01

    Full Text Available Tribological conditions between workpiece and tool have a major impact onto forming processes. Besides lubrication, temperature, and material, they are mainly influenced by the tool surface characteristics, especially by its topography, which is a result of finishing technology. Thereby formed lubricant pockets are of prime importance for the tribosystem due to its ability to separate the tribopartners by storing lubricant. The influence of four different tool finishing processes and their according surface topographies onto frictional behaviour have been investigated and quantified by the barrel compression test, in dry and lubricated tribosystems. The tool steel surfaces were stochastically microstructured by grinding and spark erosion as well as deterministic structured with micro calottes, applied by jet electrochemical machining and compared to a polished reference tool. The allocation of open and closed lubricant pockets over tool surfaces before and after the forming process was analysed by a self-made MATLAB tool.

  3. Aperture area measurement facility

    Data.gov (United States)

    Federal Laboratory Consortium — NIST has established an absolute aperture area measurement facility for circular and near-circular apertures use in radiometric instruments. The facility consists of...

  4. Radon affected areas: Scotland

    International Nuclear Information System (INIS)

    Miles, J.C.H.; Green, B.M.R.; Lomas, P.R.

    1993-01-01

    Board advice on radon in homes issued in 1990 specifies that areas of the UK where 1% or more of homes exceed the Action Level of 200 becquerels per cubic metre of air should be regarded as Affected Areas. Results of radon measurements in homes in the districts of Kincardine and Deeside and Gordon in Grampian Region and Caithness and Sutherland in Highland Region are mapped and used to delineate Affected Areas in these areas where required. The Scottish Office is advised to consider the desirability of developing guidance on precautions against radon in future homes. (author)

  5. CVP Service Area

    Data.gov (United States)

    California Department of Resources — Federal Water Contract Service Area boundaries are incorporated boundaries of districts having contracts with the U.S. Bureau of Reclamation (Reclamation), within...

  6. Fishing Access Areas

    Data.gov (United States)

    Vermont Center for Geographic Information — The Vermont Fish & Wildlife Department maintains developed fishing access areas. These sites provide public access to waters in Vermont for shore fishing...

  7. CVP Service Area

    Data.gov (United States)

    California Natural Resource Agency — Federal Water Contract Service Area boundaries are incorporated boundaries of districts having contracts with the U.S. Bureau of Reclamation (Reclamation), within...

  8. Cervical Cancer Screening in Underserved Populations

    Centers for Disease Control (CDC) Podcasts

    2009-10-15

    Dr. Lisa Flowers, a specialist in human papillovarius (HPV)-related diseases and Director of Colposcopy at Emory University School of Medicine, talks about cervical cancer screening in underinsured or uninsured women.  Created: 10/15/2009 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 6/9/2010.

  9. Increasing Cervical Cancer Screening in Underserved Populations.

    Science.gov (United States)

    Dorsainvil, Merlyn A

    The incidence of cervical cancer has declined dramatically due to Papanicolaou smear testing. However, some minority populations continue to suffer with high incidences and/or death rates of cervical cancer, due to lack of screening. This article updates on cervical cancer screening and prevention and discusses cultural impacts on screening. Knowledge deficits disproportionately affect ethnic minority groups and contribute to cancer incidence, whereas lack of healthcare coverage and low socioeconomic status contribute to screening disparities. Although minority women have cultural beliefs and practices that influence screening, recommendation and/or education from a provider often lead to screening.

  10. Operational Area Environmental Evaluations

    Energy Technology Data Exchange (ETDEWEB)

    Bailey-White, Brenda Eileen [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Nagy, Michael David [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Wagner, Katrina Marie [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Goodman, Thomas Richard [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Herring, Allen [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Catechis, Christopher S. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Kinghorn, Aubrianna Nicole [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Johnson, Ellie [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Barthel, Michael David [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Casaus, Benito [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-08-01

    The Operational Area Environmental Evaluation update provides a description of activities that have the potential to adversely affect natural and cultural resources, including soil, air, water, biological, ecological, and historical resources. The environmental sensitivity of an area is evaluated and summarized, which may facilitate informed management decisions as to where development may be prohibited, restricted, or subject to additional requirements.

  11. Protected areas and poverty.

    Science.gov (United States)

    Brockington, Daniel; Wilkie, David

    2015-11-05

    Protected areas are controversial because they are so important for conservation and because they distribute fortune and misfortune unevenly. The nature of that distribution, as well as the terrain of protected areas themselves, have been vigorously contested. In particular, the relationship between protected areas and poverty is a long-running debate in academic and policy circles. We review the origins of this debate and chart its key moments. We then outline the continuing flashpoints and ways in which further evaluation studies could improve the evidence base for policy-making and conservation practice. © 2015 The Authors.

  12. Do 'poor areas' get the services they deserve? The role of dental services in structural inequalities in oral health.

    Science.gov (United States)

    Harris, R V

    2016-06-01

    All over the world, we see that communities with the greatest dental need receive the poorest care--a truism first summarised by the Inverse Care Law in 1971. Despite efforts to attract dentists to under-served areas with incentives such as 'deprivation payments', the playing field is still uphill because of the fundamental inequalities which exist in society itself Deep-seated cultural values which are accepting of a power difference between the 'haves' and 'have nots', and that emphasise individualism over collectivism, are hard to shift. The marketization of health care contributes, by reinforcing these values through the commodification of care, which stresses efficiency and the transactional aspects of service provision. In response, practitioners working in deprived areas develop 'scripts' of routines that deliver 'satisfactory care', which are in accord with the wishes of patients who place little value on oral health but which also maintain the viability of the practice as a business. A compliance framework contrasting types of organisational (dental practice) power (coercive, utilitarian, normative) with types of patient orientation (alienative, calculative, moral) identifies where certain combinations 'work' (e.g. normative power--moral orientation), but where others struggle. Thus institutional structures combine with patients' and the wider community's demands, to generate a model of dental care which leaves little scope for ongoing, preventive dental treatment. This means that in poor areas, all too often, not only is less care available, it is of lower quality too--just where it is needed most.

  13. The Introduction of a Supermarket via Tax-Credits in a Low-Income Area.

    Science.gov (United States)

    Elbel, Brian; Mijanovich, Tod; Kiszko, Kamila; Abrams, Courtney; Cantor, Jonathan; Dixon, L Beth

    2017-01-01

    Interest and funding continue to grow for bringing supermarkets to underserved areas, yet little is known about their impact. A quasi-experimental study was used to determine the impact of a new supermarket opening as a result of tax and zoning incentives. The study took place in the South Bronx, New York City, New York. Studied were residents of two South Bronx neighborhoods deemed high need. Food purchasing and consumption were examined via surveys and 24-hour dietary recalls before and at two points after the supermarket opened (1-5, 13-17 months). Data were analyzed using difference-in-difference models controlling for gender, race and ethnicity, age, education, marital status, and self-reported income. Ordinary least squares and logistic regression models were estimated for continuous and binary outcomes, respectively. At baseline, 94% to 97% of consumers shopped at a supermarket. There was a 2% increase in this behavior in the intervention community ( p sugary beverages ( p < .05), but no appreciable change in fruit/vegetable consumption or overall dietary quality. The new supermarket did not result in substantial or broad changes in purchasing patterns or nutritional quality of food consumed, though smaller, positive changes were observed over a 1-year period. Future work should examine different contexts and a broader set of outcomes, including economic development.

  14. Carbon Monoxide Nonattainment Areas

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data layer identifies areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for Carbon Monoxide and have...

  15. PM 10 Nonattainment Areas

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data layer identifies areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for PM 10 and have been...

  16. Decontamination & decommissioning focus area

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-08-01

    In January 1994, the US Department of Energy Office of Environmental Management (DOE EM) formally introduced its new approach to managing DOE`s environmental research and technology development activities. The goal of the new approach is to conduct research and development in critical areas of interest to DOE, utilizing the best talent in the Department and in the national science community. To facilitate this solutions-oriented approach, the Office of Science and Technology (EM-50, formerly the Office of Technology Development) formed five Focus AReas to stimulate the required basic research, development, and demonstration efforts to seek new, innovative cleanup methods. In February 1995, EM-50 selected the DOE Morgantown Energy Technology Center (METC) to lead implementation of one of these Focus Areas: the Decontamination and Decommissioning (D & D) Focus Area.

  17. Ice Engineering Research Area

    Data.gov (United States)

    Federal Laboratory Consortium — Refrigerated Physical Modeling of Waterways in a Controlled EnvironmentThe Research Area in the Ice Engineering Facility at the Cold Regions Research and Engineering...

  18. ABACC's nuclear accounting area

    International Nuclear Information System (INIS)

    Nicolas, Ruben O.

    2001-01-01

    The functions and activities of the Brazilian-Argentine Agency for the Accounting and Control of Nuclear Materials (ABACC) accounting area is outlined together with a detailed description of the nuclear accounting system used by the bilateral organization

  19. Pilot Boarding Areas

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Pilot boarding areas are locations at sea where pilots familiar with local waters board incoming vessels to navigate their passage to a destination port. Pilotage is...

  20. SO2 Nonattainment Areas

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data layer identifies areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for Sulfur dioxide and have...

  1. Drainage of radioactive areas

    International Nuclear Information System (INIS)

    1981-04-01

    This Code of Practice covers all the drainage systems which may occur in the radioactive classified area of an establishment, namely surface water, foul, process and radioactive drainage. It also deals with final discharge lines. The Code of Practice concentrates on those aspects of drainage which require particular attention because the systems are in or from radioactive areas and typical illustrations are given in appendices. The Code makes references to sources of information on conventional aspects of drainage design. (author)

  2. 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

  3. Large area LED package

    Science.gov (United States)

    Goullon, L.; Jordan, R.; Braun, T.; Bauer, J.; Becker, F.; Hutter, M.; Schneider-Ramelow, M.; Lang, K.-D.

    2015-03-01

    Solid state lighting using LED-dies is a rapidly growing market. LED-dies with the needed increasing luminous flux per chip area produce a lot of heat. Therefore an appropriate thermal management is required for general lighting with LEDdies. One way to avoid overheating and shorter lifetime is the use of many small LED-dies on a large area heat sink (down to 70 μm edge length), so that heat can spread into a large area while at the same time light also appears on a larger area. The handling with such small LED-dies is very difficult because they are too small to be picked with common equipment. Therefore a new concept called collective transfer bonding using a temporary carrier chip was developed. A further benefit of this new technology is the high precision assembly as well as the plane parallel assembly of the LED-dies which is necessary for wire bonding. It has been shown that hundred functional LED-dies were transferred and soldered at the same time. After the assembly a cost effective established PCB-technology was applied to produce a large-area light source consisting of many small LED-dies and electrically connected on a PCB-substrate. The top contacts of the LED-dies were realized by laminating an adhesive copper sheet followed by LDI structuring as known from PCB-via-technology. This assembly can be completed by adding converting and light forming optical elements. In summary two technologies based on standard SMD and PCB technology have been developed for panel level LED packaging up to 610x 457 mm2 area size.

  4. SELKIRK ROADLESS AREA, IDAHO.

    Science.gov (United States)

    Miller, Fred K.; Benham, John R.

    1984-01-01

    On the basis of mineral-resource surveys the Selkirk Roadless Area, Idaho has little promise for the occurrence of mineral or energy resources. Molybdenum, lead, uranium, thorium, chromium, tungsten, zirconium, and several rare-earth elements have been detected in panned concentrates from samples of stream sediment, but no minerals containing the first five elements were found in place, nor were any conditions conducive to their concentration found. Zirconium, thorium, and the rare earths occur in sparsely disseminated accessory minerals in granitic rocks and no resource potential is identified. There is no history of mining in the roadless area and there are no oil, gas, mineral, or geothermal leases or current claims.

  5. Area Handbook for Syria.

    Science.gov (United States)

    Nyrop, Richard; And Others

    This volume on Syria is one of a series of handbooks prepared by the Foreign Area Studies (FAS) of the American University, designed to be useful to military and other personnel who need a convenient compilation of basic facts about the social, economic, political, and military institutions and practices of various countries. The emphasis is on…

  6. Environmental concern areas

    International Nuclear Information System (INIS)

    Jabben, J.; Potma, C.; Lutter, S.

    2007-01-01

    This report presents an overview of urban problem areas. RIVM made an inventory of environmental problems in urban regions in the Netherlands due to air pollution, noise, potential soil pollution and external safety risks. Environmental problems (exposure or exposure risks) were related to the presence of dwellings in each postal area where critical limit values are exceeded. From the inventory, it appears that the critical exposure values are exceeded at many dwellings. Exceedences are often caused by air pollution (particulate matter and nitrogen oxide) and noise from road- and railway traffic. Many of these dwellings can be found in major cities with ringways (Amsterdam, Rotterdam, Den Haag, Utrecht ) and also in the Province of Noord-Brabant. Inventories are presented in a set of color coded maps, showing the type of environmental damage occurring and indicating the number of dwellings critically exposed in each postal area. The maps give policy makers and urban planners an overall picture of the residential areas demanding attention from an environmental point of view [nl

  7. Subsurface contaminants focus area

    International Nuclear Information System (INIS)

    1996-08-01

    The US Department of Enregy (DOE) Subsurface Contaminants Focus Area is developing technologies to address environmental problems associated with hazardous and radioactive contaminants in soil and groundwater that exist throughout the DOE complex, including radionuclides, heavy metals; and dense non-aqueous phase liquids (DNAPLs). More than 5,700 known DOE groundwater plumes have contaminated over 600 billion gallons of water and 200 million cubic meters of soil. Migration of these plumes threatens local and regional water sources, and in some cases has already adversely impacted off-site rsources. In addition, the Subsurface Contaminants Focus Area is responsible for supplying technologies for the remediation of numerous landfills at DOE facilities. These landfills are estimated to contain over 3 million cubic meters of radioactive and hazardous buried Technology developed within this specialty area will provide efective methods to contain contaminant plumes and new or alternative technologies for development of in situ technologies to minimize waste disposal costs and potential worker exposure by treating plumes in place. While addressing contaminant plumes emanating from DOE landfills, the Subsurface Contaminants Focus Area is also working to develop new or alternative technologies for the in situ stabilization, and nonintrusive characterization of these disposal sites

  8. Protected areas in mountains

    Directory of Open Access Journals (Sweden)

    Hamilton, L. S.

    2006-12-01

    Full Text Available

    The importance of a global Protected Areas Network in sustaining appropriate mountain development is presented in this paper. Present status of the world’s “official” Protected Areas in the UN List, and the proportion that are in mountain areas, and including international designations (World Heritage and Biosphere Reserves. Current and future challenges in the management of these special areas are also commented.



    El autor destaca la importancia de una Red Mundial de Espacios Protegidos para el desarrollo sostenible de las montañas. Comenta luego el estatus actual de las Áreas Protegidas “oficiales” del Mundo en la Lista de las Naciones Unidas y qué proporción de ellas forma parte de las montañas, sin olvidar las figuras internacionales de protección como Patrimonio de la Humanidad y Reservas de Biosfera. Para terminar, se discuten los problemas de gestión actuales y futuros de estas áreas tan especiales

  9. Plutonium focus area

    International Nuclear Information System (INIS)

    1996-08-01

    To ensure research and development programs focus on the most pressing environmental restoration and waste management problems at the U.S. Department of Energy (DOE), the Assistant Secretary for the Office of Environmental Management (EM) established a working group in August 1993 to implement a new approach to research and technology development. As part of this new approach, EM developed a management structure and principles that led to the creation of specific Focus Areas. These organizations were designed to focus the scientific and technical talent throughout DOE and the national scientific community on the major environmental restoration and waste management problems facing DOE. The Focus Area approach provides the framework for intersite cooperation and leveraging of resources on common problems. After the original establishment of five major Focus Areas within the Office of Technology Development (EM-50, now called the Office of Science and Technology), the Nuclear Materials Stabilization Task Group (EM-66) followed the structure already in place in EM-50 and chartered the Plutonium Focus Area (PFA). The following information outlines the scope and mission of the EM, EM-60, and EM-66 organizations as related to the PFA organizational structure

  10. Local Area Networks.

    Science.gov (United States)

    Marks, Kenneth E.; Nielsen, Steven

    1991-01-01

    Discusses cabling that is needed in local area networks (LANs). Types of cables that may be selected are described, including twisted pair, coaxial cables (or ethernet), and fiber optics; network topologies, the manner in which the cables are laid out, are considered; and cable installation issues are discussed. (LRW)

  11. Subsurface contaminants focus area

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-08-01

    The US Department of Enregy (DOE) Subsurface Contaminants Focus Area is developing technologies to address environmental problems associated with hazardous and radioactive contaminants in soil and groundwater that exist throughout the DOE complex, including radionuclides, heavy metals; and dense non-aqueous phase liquids (DNAPLs). More than 5,700 known DOE groundwater plumes have contaminated over 600 billion gallons of water and 200 million cubic meters of soil. Migration of these plumes threatens local and regional water sources, and in some cases has already adversely impacted off-site rsources. In addition, the Subsurface Contaminants Focus Area is responsible for supplying technologies for the remediation of numerous landfills at DOE facilities. These landfills are estimated to contain over 3 million cubic meters of radioactive and hazardous buried Technology developed within this specialty area will provide efective methods to contain contaminant plumes and new or alternative technologies for development of in situ technologies to minimize waste disposal costs and potential worker exposure by treating plumes in place. While addressing contaminant plumes emanating from DOE landfills, the Subsurface Contaminants Focus Area is also working to develop new or alternative technologies for the in situ stabilization, and nonintrusive characterization of these disposal sites.

  12. Plutonium focus area

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-08-01

    To ensure research and development programs focus on the most pressing environmental restoration and waste management problems at the U.S. Department of Energy (DOE), the Assistant Secretary for the Office of Environmental Management (EM) established a working group in August 1993 to implement a new approach to research and technology development. As part of this new approach, EM developed a management structure and principles that led to the creation of specific Focus Areas. These organizations were designed to focus the scientific and technical talent throughout DOE and the national scientific community on the major environmental restoration and waste management problems facing DOE. The Focus Area approach provides the framework for intersite cooperation and leveraging of resources on common problems. After the original establishment of five major Focus Areas within the Office of Technology Development (EM-50, now called the Office of Science and Technology), the Nuclear Materials Stabilization Task Group (EM-66) followed the structure already in place in EM-50 and chartered the Plutonium Focus Area (PFA). The following information outlines the scope and mission of the EM, EM-60, and EM-66 organizations as related to the PFA organizational structure.

  13. Opportunities and improvisations: a pediatric surgeon's suggestions for successful short-term surgical volunteer work in resource-poor areas.

    Science.gov (United States)

    Meier, Donald

    2010-05-01

    There is a paucity of trained pediatric surgeons in resource-poor areas, and many children never receive care for debilitating problems that could readily be managed by surgeons with proper training, supplies, and instrumentation. This article, written from the perspective of a surgeon who has been both the recipient of and the provider of volunteer surgical services, is intended to encourage surgeons in technologically advanced locations to volunteer in underserved areas and to assist them in the implementation of such endeavors. Concepts are presented with an emphasis on pediatric surgery, but most are relevant for volunteers in all surgical specialties. Volunteer paradigms include, but are not limited to, the "surgical brigade" model, where a large group of health care professionals take all needed equipment and supplies for the duration of their stint, and the "minimalist" model, where a single volunteer works with local personnel using locally available equipment. For a successful volunteer endeavor the host needs to have a perceived need for the volunteer's services, and the volunteer must be flexible in adapting to meet overwhelming needs with limited resources. It is suggested that appropriate technology, such as the inexpensive anal stimulator presented herein, should be employed whenever possible. With proper planning, realistic expectations, and a cooperative and helpful attitude, volunteer trips can be rewarding experiences for both volunteers and host physicians and lead to lasting relationships that improve children's lives globally.

  14. Cleanup of contaminated areas

    International Nuclear Information System (INIS)

    Beone, G.; Carbone, A.I.; Zagaroli, M.

    1989-01-01

    The paper deals with the problem of contaminated areas cleanup, in order to eliminate every possible damage for man safety and environment and to site recovery for some utilization, The first step of cleanup operation is site characterization, that is followed by a pianificazion activity for a better definition of staff qualification, technology to be used, protection and prevention instruments for the risks due to contaminants handling. The second section describes the different remedial technologies for contaminated sites. Remedial technologies may be divided into on-site/off-site and in-situ treatments, according to whether materials (waste, soil, water) are moved to another location or not, respectively. Finally, it is outlined that contaminated areas cleanup is a typical multidisciplinary activity because very different competences are required. (author)

  15. Bronchoscopy in Rural Areas?

    Directory of Open Access Journals (Sweden)

    Reidar Berntsen

    2012-01-01

    Full Text Available Quality of bronchoscopy performed by one single pulmonologist in a scarcely populated subarctic area was compared to the guidelines provided by the British Thoracic Society (BTS. 103 patients underwent bronchoscopy. Diagnostic yield was increased to 76.6% when the first bronchoscopy was supplemented by bronchial washing fluid and brush cytology and to 86.7% (BTS guidelines >80% after a second bronchoscopy. Median time from referral to bronchoscopy was 10 days and 8 days from positive bronchoscopy to operative referral to another hospital. 1% of patients that underwent transbronchial lung biopsy had minor complications. One pulmonologist had rate of correct diagnosis based on visible endobronchial tumors that was comparable to the rates of numerous pulmonologists at larger centers performing the same procedure. Time delay was short. Rate of complications was comparable. Bronchoscopy performed by one pulmonologist alone could, in organized settings, be carried out at local hospitals in areas of scattered settlement.

  16. Areaplanning in marginal areas

    OpenAIRE

    Janneau, Thibaut; Arborg, Pernille; Sandberg, Rina

    2007-01-01

    This project is also a comparative analysis between two cases: Lolland Kommune and Venise Verte, having both a marginal characteristic. The analyze of these two marginal areas makes us able to found out some dilemmas showing the crucial issues of planners between economic development, social equity, cultural evolution and finally environmental enhancer. We also tried to see the different views of nature between two paradigms: widleness of nature and cultural landscapes as well as graduate dif...

  17. High surface area calcite

    Science.gov (United States)

    Schultz, L. N.; Andersson, M. P.; Dalby, K. N.; Müter, D.; Okhrimenko, D. V.; Fordsmand, H.; Stipp, S. L. S.

    2013-05-01

    Calcite (CaCO3) is important in many fields—in nature, because it is a component of aquifers, oil reservoirs and prospective CO2 storage sites, and in industry, where it is used in products as diverse as paper, toothpaste, paint, plastic and aspirin. It is difficult to obtain high purity calcite with a high surface area but such material is necessary for industrial applications and for fundamental calcite research. Commercial powder is nearly always contaminated with growth inhibitors such as sugars, citrate or pectin and most laboratory synthesis methods deliver large precipitates, often containing vaterite or aragonite. To address this problem, we (i) adapted the method of carbonating a Ca(OH)2 slurry with CO2 gas to develop the first simple, cheap, safe and reproducible procedure using common laboratory equipment, to obtain calcite that reproducibly had a surface area of 14-17 m2/g and (ii) conducted a thorough characterization of the product. Scanning electron microscopy (SEM) revealed nanometer scale, rhombohedral crystals. X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and infrared spectroscopy (IR) confirmed highly crystalline, pure calcite that more closely resembles the dimensions of the biogenic calcite produced by algae in coccoliths than other methods for synthesizing calcite. We suggest that this calcite is useful when purity and high surface area are important.

  18. Frostbites in circumpolar areas

    Directory of Open Access Journals (Sweden)

    Tiina Maria Ikäheimo

    2011-10-01

    Full Text Available Circumpolar areas are associated with prolonged cold exposure where wind, precipitation, and darkness further aggravate the environmental conditions and the associated risks. Despite the climate warming, cold climatic conditions will prevail in circumpolar areas and contribute to adverse health effects. Frostbite is a freezing injury where localized damage affects the skin and other tissues. It occurs during occupational or leisure-time activities and is common in the general population among men and women of various ages. Industries of the circumpolar areas where frostbite occurs frequently include transportation, mining, oil, and gas industry, construction, agriculture, and military operations. Cold injuries may also occur during leisure-time activities involving substantial cold exposure, such as mountaineering, skiing, and snowmobiling. Accidental situations (occupational, leisure time often contribute to adverse cooling and cold injuries. Several environmental (temperature, wind, wetness, cold objects, and altitude and individual (behavior, health, and physiology predisposing factors are connected with frostbite injuries. Vulnerable populations include those having a chronic disease (cardiovascular, diabetes, and depression, children and the elderly, or homeless people. Frostbite results in sequelae causing different types of discomfort and functional limitations that may persist for years. A frostbite injury is preventable, and hence, unacceptable from a public health perspective. Appropriate cold risk management includes awareness of the adverse effects of cold, individual adjustment of cold exposure and clothing, or in occupational context different organizational and technical measures. In addition, vulnerable population groups need customized information and care for proper prevention of frostbites.

  19. All Conservation Opportunity Areas (ECO.RES.ALL_OP_AREAS)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The All_OP_Areas GIS layer are all the Conservation Opportunity Areas identified by MoRAP (produced for EPA Region 7). They designate areas with potential for...

  20. Underserved parents, underserved youth: Considering foster parent willingness to foster substance-using adolescents

    Science.gov (United States)

    Meyers, Kathleen; Kaynak, Övgü; Clements, Irene; Bresani, Elena; White, Tammy

    2014-01-01

    Adolescents involved with foster care are five times more likely to receive a drug dependence diagnosis when compared to adolescents in the general population. Prior research has shown that substance use is often hidden from providers, negating any chance for treatment and almost guaranteeing poor post-foster care outcomes. There are virtually no studies that examine the willingness (and its determinants) to foster youth with substance abuse problems. The current study conducted a nationally-distributed survey of 752 currently licensed foster care parents that assessed willingness to foster youth overall and by type of drug used, and possible correlates of this decision (e.g., home factors, system factors, and individual foster parent factors such as ratings of perceived difficulty in fostering this population). Overall, willingness to foster a youth involved with alcohol and other drugs (AOD) was contingent upon the types of drugs used. The odds that a parent would foster an AOD-involved youth were significantly increased by being licensed as a treatment foster home, having fostered an AOD-involved youth in the past, having AOD-specific training and past agency-support when needed, and self-efficacy with respect to positive impact. Surprisingly, when religion played a large part in the decision to foster any child, the odds of willingness to foster an AOD-involved youth dropped significantly. These results suggest that a large proportion of AOD-involved youth who find themselves in the foster care system will not have foster families willing to parent them, thereby forcing placement into a variety of congregate care facilities (e.g., residential treatment facilities, group homes). Specific ways in which the system can address these issues to improve placement and permanency efforts is provided. PMID:25878368

  1. Small Area Fair Market Rent

    Data.gov (United States)

    Department of Housing and Urban Development — Due to the increasing demand for more localized rents for a variety of purposes, HUD is making Small Area FMRs for all metropolitan areas available. Small Area FMRs...

  2. Sociodemographic Factors Associated With Trans*female Youth's Access to Health Care in the San Francisco Bay Area.

    Science.gov (United States)

    Johns, Elizabeth A; Jin, Harry; Auerswald, Colette L; Wilson, Erin C

    2017-08-01

    Trans*female youth (TFY) are an underserved population at risk for a variety of poor health outcomes, in part related to barriers to accessing health and mental health care. We conducted a secondary analysis of data collected with 250 TFY aged 16-24 years in the San Francisco Bay Area from 2012 to 2014. Logistic regression was used to test associations between sociodemographic variables and barriers to gender identity-based medical and mental health care. Having a history of unstable housing was associated with significantly higher odds of problems accessing both medical care (odds ratio: 2.16, 95% confidence interval: 1.12-4.13) and mental health care due to gender identity (odds ratio 2.65, 95% confidence interval: 1.08-6.45). Conversely, identifying as genderqueer/genderfluid, Latina, or living in dependent housing was associated with access to either medical or mental health care. Interventions are needed to address housing and discrimination barring access to health care among TFY. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  3. MANAGEMENT IN RURAL AREAS

    Directory of Open Access Journals (Sweden)

    Danimir Štros

    2015-07-01

    Full Text Available Croatia has been seeking to achive pre-war results in tourism since its independence. Rural tourism in Croatia based on family farma faces a number of problems legal foundations, the involement of local communities, inadequate entepreneur support etc. The political will for development exists, but there is lack of willingness and the ability to get things started, which results in the closure of family farma who cannot cope with the parallel job of agriculture and tourism. Arriving guests certainly want a new type of tourism: peace, clean environment, cultural intangible and tangible treasures, all without the noise and stress; and Croatia can definitely offer it, either in coastal or inland areas with traditional food and drinks. The destinations connection is not satisfactora. there is also an evident lack of legislation and regional spatial development plans for sustainable tourism which is a prerequisite for successful tourism. With these plans presumptins accepted, Croatian tourism would become distinctive and inland and coastal branches of tourism could complement each other so that the customer can spend his vacation both in the continental ant the maritime part of the country, getting to know our culture and enjoy the traditional cousine.

  4. Summary of Synoptic Meteorological Observations. Indonesian Coastal Marine Areas. Volume 1. Area 1 - Southeast Sumatra. Area 2 - Christmas Island. Area 3 - Sunda Strait. Area 4 - Northwest Java Sea. Area 5 - Bangka Island Northwest. Area 6 - Natuna Island. Area 7 - Sarawak

    Science.gov (United States)

    1975-04-01

    CHRISTMAS ISLAND. AREA 3 - SUNDA STRAIT. AREA 4 - NORTHWEST JAVA SEA. AREA 5 - BANGKA ISLAND NORTHWEST. AREA 6 - NATUNA ISLAND. AREA 7 - SARAWAK Naval...1.4. 2.3 .0 . .7 1.0 6.8 Z-,7 ,0 .. ) ’Co.: 22CE .2 JANUARY PERIO0I (PPIMAPY$ 1914-1973 AREA 0005 BANGKA ISLAND NORTHWEST (OVER-ALL) 1$55-1?73 TASLE 10...0005 BANGKA ISLAND NORTHWE)T (CVER-ALL) 1858-1973 TAILF 4 s79 105.OE PERCENTAGE FRLOUENCY F WINDO SPEFD BY HOUR CGOT) WIND SPEED IKNOTS) PCT TOTAL HJUR

  5. Reclamation of urban areas

    International Nuclear Information System (INIS)

    Roed, J.

    1986-02-01

    A literature study was conducted in order to compare the effectiveness and cost of different reclamation procedures that may be employed after an accident on a nuclear facility takes place in which radioactive material is released to the atmosphere. A substantial amount of work has been done on reclaming soil and snow-covered surfaces. Using scrapers or other soil-moving equipment decontamination factors are 10-100. (The decontamination factor is the ratio of the contamination before to that after the decontamination procedure). However, information on decontamination of paved areas by simple methods such as firehosing and vacuum sweeping are poorly documented. Therefore, only a very uncertain figure in the range 2-10 can be given for the decontamination factor here. It is recommended that a major effort be made in the future to investigate the efficiency of these simple methods, because of their relatively low cost. Also, more expensive methods for reducing the dose such as vacuuming, road planing and deep plowing are treated because of their feasibility under certain circumstances. Using these methods dose reduction factors in the 2-100 range can be obtained. Very expensive techniques, such as sandblasting, water cannon, flame spalling, etc. are justifiable usable only in special situations and are therefore considered very briefly here. The methods vary widely in cost. A simple method like vacuum sweeping costs $0.004 per square meter of surface; whereas one like road planing can reach $4 per square meter. A more sophisticated technique like flame spalling costs as much as $100 per square meter. (author)

  6. Catchment areas for public transport

    DEFF Research Database (Denmark)

    Andersen, Jonas Lohmann Elkjær; Landex, Alex

    2008-01-01

    /from stations. The article also shows how the refinement of the Service Area approach with additional time resistance results in smaller catchment areas when the feeder routes cross stairs. It is concluded that GIS-based catchment area analyses are a multiple decision support tool for planning of public...... the simplest approach. The Service Area approach is based on searches in road networks and represents the actual feeder routes and is thereby a more detailed approach. The Service Area approach can be refined by adding additional resistance to certain points in the road network, e.g. stairways. Differences...... between the Circular Buffer approach and the Service Area approach are illustrated and a comparison between the sizes of the catchment areas is made. The strength of the Service Area approach and the impact on the catchment area when adding additional time resistance to crossing of stairways...

  7. Water Service Areas - Public Water Supplier's (PWS) Service Areas

    Data.gov (United States)

    NSGIC Education | GIS Inventory — Boundaries of current public water supplier's (PWS) service areas. This data set contains the present service area boundary of the water system and does not contain...

  8. All Conservation Opportunity Areas (ECO.RES.ALL_OP_AREAS)

    Science.gov (United States)

    The All_OP_Areas GIS layer are all the Conservation Opportunity Areas identified by MoRAP (produced for EPA Region 7). They designate areas with potential for forest, grassland and forest/grassland mosaic conservation. These are areas of natural or semi-natural forest land cover that are at least 75 meters away from roads and away from patch edges. OAs were modeled by creating distance grids using the National Land Cover Database and the Census Bureau's TIGER roads files.

  9. [Syntactic Processing in Broca's Area: Brodmann Areas 44 and 45].

    Science.gov (United States)

    Yamada, Atora; Sakai, Kuniyoshi L

    2017-04-01

    Brodmann areas 44 and 45 are known as Broca's area; however, their true functional roles are still unknown. Recent developments in neuroimaging techniques revealed the structures and functions of Broca's area in detail. More specifically regarding language functions, sufficient evidence has been accumulated that this region subserves the center of syntactic processing, not necessarily motor functions. Here, we review a role of Broca's area as the grammar center, including other roles in nonlinguistic functions.

  10. 5 CFR 591.207 - Which areas are COLA areas?

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Which areas are COLA areas? 591.207 Section 591.207 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Cost-of-Living Allowance and Post Differential-Nonforeign Areas Cost-Of-Living...

  11. Living in Prone Flooding Area: in Coastal Areas of Semarang

    Science.gov (United States)

    Tyas, W. P.

    2018-02-01

    When settlements are not able to provide a comfort area to live in, in this case because of a periodic threat of tidal flood coming to certain settlement areas, it is likely that the people still cannot leave the area. This paper explores the leading factors of the attachment of people to the areas, from economic, physical, social and psychological factors, including a place attachment. Therefore, the approach of the problem solution to tackle the tidal flooding in the areas should be also concern and have considerations relate to the factors.

  12. VT Designated Neighborhood Development Area

    Data.gov (United States)

    Vermont Center for Geographic Information — The Neighborhood Development Area designation encourages municipalities and/or developers to plan for new and infill housing in the area within walking distance of...

  13. LIHTC Difficult to Develop Areas

    Data.gov (United States)

    Department of Housing and Urban Development — A Difficult Development Area (DDA) for the Low Income Housing Tax Credit program is an area designated by the U.S. Department of Housing and Urban Development (HUD)...

  14. Area monitoring intelligent system - SIMA

    International Nuclear Information System (INIS)

    Bhoem, P.; Hisas, F.; Gelardi, G.

    1990-01-01

    The area monitoring intelligent system (SIMA) is an equipment to be used in radioprotection. SIMA has the function of monitoring the radiation levels of determined areas of the installations where radioactive materials are handled. (Author) [es

  15. VT - Vermont Rational Service Areas

    Data.gov (United States)

    Vermont Center for Geographic Information — Data Layer Name: Vermont Rational Service Areas (RSAs)Alternate Name: Vermont RSAsOverview:Rational Service Areas (RSAs), originally developed in 2001 and revised in...

  16. World Area Forecast System (WAFS)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The World Area Forecast System (WAFS) is a worldwide system by which world area forecast centers provide aeronautical meteorological en-route forecasts in uniform...

  17. Catch-In-Areas Main

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Catch-In-Areas database integrates catch data from the Catch Accounting System (which has the spatial resolution of a NMFS Reporting Area) into a database that...

  18. 77 FR 12761 - Special Regulations; Areas of the National Park System, Saguaro National Park, Bicycle Route

    Science.gov (United States)

    2012-03-02

    ... underserved youth to the Park and the NPS via mountain bike and educational fieldtrips as part of the ``Trips... effect of $100 million or more on the economy. It will not adversely affect in a material way the economy.... This rule: a. Does not have an annual effect on the economy of $100 million or more. b. Would not cause...

  19. DINKEY LAKES ROADLESS AREA, CALIFORNIA.

    Science.gov (United States)

    Dodge, F.C.W.; Federspiel, F.E.

    1984-01-01

    The Dinkey Lakes Roadless Area occupies an area of about 184 sq mi on the western slope of the Sierra Nevada, California. The results of a mineral survey show that parts of the area have substantiated resource potential for tungsten and marble and probable resource potential for quartz crystal gemstones. A probable resource potential for geothermal energy exists in one small area. No potential for other metallic mineral or energy resources was identified in this study.

  20. Evaluating a County-Sponsored Social Marketing Campaign to Increase Mothers’ Initiation of HPV Vaccine for their Pre-teen Daughters in a Primarily Rural Area

    Science.gov (United States)

    Cates, Joan R.; Shafer, Autumn; Diehl, Sandra J.; Deal, Allison M.

    2011-01-01

    Routine vaccination against human papillomavirus (HPV), the main cause of cervical cancer, is recommended for 11–12 year old girls, yet vaccine uptake is low. This study evaluates a social marketing campaign initiated by 13 North Carolina counties to raise awareness among parents and reduce barriers to accessing the vaccine in a primarily rural area. The 3-month campaign targeted mothers of girls ages 11–12 and healthcare practices serving pre-teen girls in four counties. Principles of social marketing were: product (recommended vaccine against HPV), price (cost, perception of safety and efficacy, and access), promotion (posters, brochures, website, news releases, doctor’s recommendation), and place (doctors’ offices, retail outlets). We analyzed (1) website traffic, hotline calls, and media placement; (2) cross-sectional surveys of mothers and providers; and (3) HPV immunization rates in intervention versus non-intervention counties. Of respondent mothers (n=225), 82% heard or saw campaign messages or materials. Of respondent providers (n=35), 94% used campaign brochures regularly or occasionally in conversations with parents. HPV vaccination rates within six months of campaign launch were 2% higher for 9–13 year old girls in two of the four intervention counties compared to 96 non-intervention counties. This evaluation supports campaign use in other primarily rural and underserved areas. PMID:21804767

  1. Evaluating a County-Sponsored Social Marketing Campaign to Increase Mothers' Initiation of HPV Vaccine for their Pre-teen Daughters in a Primarily Rural Area.

    Science.gov (United States)

    Cates, Joan R; Shafer, Autumn; Diehl, Sandra J; Deal, Allison M

    2011-01-01

    Routine vaccination against human papillomavirus (HPV), the main cause of cervical cancer, is recommended for 11-12 year old girls, yet vaccine uptake is low. This study evaluates a social marketing campaign initiated by 13 North Carolina counties to raise awareness among parents and reduce barriers to accessing the vaccine in a primarily rural area. The 3-month campaign targeted mothers of girls ages 11-12 and healthcare practices serving pre-teen girls in four counties. Principles of social marketing were: product (recommended vaccine against HPV), price (cost, perception of safety and efficacy, and access), promotion (posters, brochures, website, news releases, doctor's recommendation), and place (doctors' offices, retail outlets). We analyzed (1) website traffic, hotline calls, and media placement; (2) cross-sectional surveys of mothers and providers; and (3) HPV immunization rates in intervention versus non-intervention counties. Of respondent mothers (n=225), 82% heard or saw campaign messages or materials. Of respondent providers (n=35), 94% used campaign brochures regularly or occasionally in conversations with parents. HPV vaccination rates within six months of campaign launch were 2% higher for 9-13 year old girls in two of the four intervention counties compared to 96 non-intervention counties. This evaluation supports campaign use in other primarily rural and underserved areas.

  2. MPLS for metropolitan area networks

    CERN Document Server

    Tan, Nam-Kee

    2004-01-01

    METROPOLITAN AREA NETWORKS AND MPLSRequirements of Metropolitan Area Network ServicesMetropolitan Area Network OverviewThe Bandwidth DemandThe Metro Service Provider's Business ApproachesThe Emerging Metro Customer Expectations and NeedsSome Prevailing Metro Service OpportunitiesService Aspects and RequirementsRoles of MPLS in Metropolitan Area NetworksMPLS PrimerMPLS ApplicationsTRAFFIC ENGINEERING ASPECTS OF METROPOLITAN AREA NETWORKSTraffic Engineering ConceptsNetwork CongestionHyper Aggregation ProblemEasing CongestionNetwork ControlTactical versus Strategic Traffic EngineeringIP/ATM Overl

  3. Catchment areas for public transport

    DEFF Research Database (Denmark)

    Andersen, Jonas Lohmann Elkjær; Landex, Alex

    2008-01-01

    In the planning of public transport catchment areas of stops are often included to estimate potential number of travellers. There are different approaches to GIS-based catchment area analyses depending on the desired level of detail. The Circular Buffer approach is the fundamental, but also....../from stations. The article also shows how the refinement of the Service Area approach with additional time resistance results in smaller catchment areas when the feeder routes cross stairs. It is concluded that GIS-based catchment area analyses are a multiple decision support tool for planning of public...... transport where the level of detail can be suited to the purpose....

  4. Fractal cartography of urban areas.

    Science.gov (United States)

    Encarnação, Sara; Gaudiano, Marcos; Santos, Francisco C; Tenedório, José A; Pacheco, Jorge M

    2012-01-01

    In a world in which the pace of cities is increasing, prompt access to relevant information is crucial to the understanding and regulation of land use and its evolution in time. In spite of this, characterization and regulation of urban areas remains a complex process, requiring expert human intervention, analysis and judgment. Here we carry out a spatio-temporal fractal analysis of a metropolitan area, based on which we develop a model which generates a cartographic representation and classification of built-up areas, identifying (and even predicting) those areas requiring the most proximate planning and regulation. Furthermore, we show how different types of urban areas identified by the model co-evolve with the city, requiring policy regulation to be flexible and adaptive, acting just in time. The algorithmic implementation of the model is applicable to any built-up area and simple enough to pave the way for the automatic classification of urban areas worldwide.

  5. Fire Hazards Analysis for the 200 Area Interim Storage Area

    International Nuclear Information System (INIS)

    JOHNSON, D.M.

    2000-01-01

    This documents the Fire Hazards Analysis (FHA) for the 200 Area Interim Storage Area. The Interim Storage Cask, Rad-Vault, and NAC-1 Cask are analyzed for fire hazards and the 200 Area Interim Storage Area is assessed according to HNF-PRO-350 and the objectives of DOE Order 5480 7A. This FHA addresses the potential fire hazards associated with the Interim Storage Area (ISA) facility in accordance with the requirements of DOE Order 5480 7A. It is intended to assess the risk from fire to ensure there are no undue fire hazards to site personnel and the public and to ensure property damage potential from fire is within acceptable limits. This FHA will be in the form of a graded approach commensurate with the complexity of the structure or area and the associated fire hazards

  6. Geothermal resource area 9: Nye County. Area development plan

    Energy Technology Data Exchange (ETDEWEB)

    Pugsley, M.

    1981-01-01

    Geothermal Resource area 9 encompasses all of Nye County, Nevada. Within this area there are many different known geothermal sites ranging in temperature from 70/sup 0/ to over 265/sup 0/ F. Fifteen of the more major sites have been selected for evaluation in this Area Development Plan. Various potential uses of the energy found at each of the resource sites discussed in this Area Development Plan were determined after evaluating the area's physical characteristics, land ownership and land use patterns, existing population and projected growth rates, and transportation facilities, and comparing those with the site specific resource characteristics. The uses considered were divided into five main categories: electrical generation, space heating, recreation, industrial process heat, and agriculture. Within two of these categories certain subdivisions were considered separately. The findings about each of the 15 geothermal sites considered in this Area Development Plan are summarized.

  7. Planning approaches for rurban areas

    DEFF Research Database (Denmark)

    Busck, Anne Gravsholt; Hidding, Marjan; Kristensen, Søren Bech Pilgaard

    2009-01-01

    Urban growth and sprawl have long put pressure on rural areas, leading to a growing zone of ‘rurban areas' where a multitude of functions, urban or rural, compete for land. The development is acknowledged in European spatial planning documents, which also recommend common solutions. E.......g. the spatial policy discussed and recommended in the European Spatial Development Perspective (ESDP) emphasises the compact city concept, rural-urban linkages and conservation of nature and cultural heritage. This paper compares planning practice for rurban areas in three cases: Roskilde municipality (Denmark......), Staffanstorp municipality (Sweden) and Werv-area (the Netherlands). All three areas belong to the rurban zone and are selected to exemplify pro-active planning. The analysis focuses on how the concept of compact city is perceived and implemented, how rurban areas are managed in order to avoid further urban...

  8. Incidents malignant neoplasias maxillofacial area.

    Science.gov (United States)

    Goiato, Marcelo Coelho; Haddad, Marcela Filié; dos Santos, Daniela Micheline; Pesqueira, Aldiéres Alves; Filho, Humberto Gennari; Pellizzer, Eduardo Piza

    2009-07-01

    Cancer is regarded as abnormal cellular multiplication; it is not controlled by the organism, and its cells present a differentiated DNA. Initially, the disease does not show clinical signs, but it can be diagnosed by laboratory examinations. When tumors are present in the maxillofacial area, the carrier can lose structures in this area, resulting to the carrier's social environment exclusion. This article aims to show incidences and causes of malignant neoplasias in the maxillofacial area.

  9. Small Engine & Accessory Test Area

    Data.gov (United States)

    Federal Laboratory Consortium — The Small Engine and Accessories Test Area (SEATA) facilitates testaircraft starting and auxiliary power systems, small engines and accessories. The SEATA consists...

  10. Future Area Burned in Canada

    International Nuclear Information System (INIS)

    Flannigan, M.D.; Logan, K.A.; Stocks, B.J.; Amiro, B.D.; Skinner, W.R.

    2005-01-01

    Historical relationships between weather, the Canadian fire weather index (FWI) system components and area burned in Canadian ecozones were analysed on a monthly basis in tandem with output from the Canadian and the Hadley Centre GCMs to project future area burned. Temperature and fuel moisture were the variables best related to historical monthly area burned with 36-64% of the variance explained depending on ecozone. Our results suggest significant increases in future area burned although there are large regional variations in fire activity. This was especially true for the Canadian GCM where some ecozones show little change in area burned, however area burned was not projected to decrease in any of the ecozones modelled. On average, area burned in Canada is projected to increase by 74-118% by the end of this century in a 3 x CO2 scenario. These estimates do not explicitly take into account any changes in vegetation, ignitions, fire season length, and human activity (fire management and land use activities) that may influence area burned. However, the estimated increases in area burned would have significant ecological, economic and social impacts for Canada

  11. Runoff estimation in residencial area

    Directory of Open Access Journals (Sweden)

    Meire Regina de Almeida Siqueira

    2013-12-01

    Full Text Available This study aimed to estimate the watershed runoff caused by extreme events that often result in the flooding of urban areas. The runoff of a residential area in the city of Guaratinguetá, São Paulo, Brazil was estimated using the Curve-Number method proposed by USDA-NRCS. The study also investigated current land use and land cover conditions, impermeable areas with pasture and indications of the reforestation of those areas. Maps and satellite images of Residential Riverside I Neighborhood were used to characterize the area. In addition to characterizing land use and land cover, the definition of the soil type infiltration capacity, the maximum local rainfall, and the type and quality of the drainage system were also investigated. The study showed that this neighborhood, developed in 1974, has an area of 792,700 m², a population of 1361 inhabitants, and a sloping area covered with degraded pasture (Guaratinguetá-Piagui Peak located in front of the residential area. The residential area is located in a flat area near the Paraiba do Sul River, and has a poor drainage system with concrete pipes, mostly 0.60 m in diameter, with several openings that capture water and sediments from the adjacent sloping area. The Low Impact Development (LID system appears to be a viable solution for this neighborhood drainage system. It can be concluded that the drainage system of the Guaratinguetá Riverside I Neighborhood has all of the conditions and characteristics that make it suitable for the implementation of a low impact urban drainage system. Reforestation of Guaratinguetá-Piagui Peak can reduce the basin’s runoff by 50% and minimize flooding problems in the Beira Rio neighborhood.

  12. coffee growing areas in Ethiopia

    African Journals Online (AJOL)

    food deficit areas, migration of people, government policies and technological innovations which facilitated surplus production' (Hinderink and Sterkenburg, 1987). Households in the study areas are heavily dependent on coffee, both as a source of cash income and livelihood. Compared to the national average, they ...

  13. Harvesting Options for Riparian Areas

    Science.gov (United States)

    James A. Mattson; John E. Baumgras; Charles R. Blinn; Michael A. Thompson

    1999-01-01

    As the chapters in this book demonstate, forested riparian areas provide many important functions and values, including wildlife habitat, recreation, water, timber production, and cultural resources. The high soil moisture and nutrient availability in these areas make them highly productive sites for plant and animal life, including trees, and this, coupled with the...

  14. Tech Area II: A history

    Energy Technology Data Exchange (ETDEWEB)

    Ullrich, R. [Ktech Corp., Albuquerque, NM (United States)

    1998-07-01

    This report documents the history of the major buildings in Sandia National Laboratories` Technical Area II. It was prepared in support of the Department of Energy`s compliance with Section 106 of the National Historic Preservation Act. Technical Area II was designed and constructed in 1948 specifically for the final assembly of the non-nuclear components of nuclear weapons, and was the primary site conducting such assembly until 1952. Both the architecture and location of the oldest buildings in the area reflect their original purpose. Assembly activities continued in Area II from 1952 to 1957, but the major responsibility for this work shifted to other sites in the Atomic Energy Commission`s integrated contractor complex. Gradually, additional buildings were constructed and the original buildings were modified. After 1960, the Area`s primary purpose was the research and testing of high-explosive components for nuclear weapons. In 1994, Sandia constructed new facilities for work on high-explosive components outside of the original Area II diamond-shaped parcel. Most of the buildings in the area are vacant and Sandia has no plans to use them. They are proposed for decontamination and demolition as funding becomes available.

  15. USE OF THE PICNIC AREA

    CERN Multimedia

    Relations with the Host States Service

    2001-01-01

    On the Prévessin site CERN has provided a picnic area which is available for use by persons working on its site subject to prior reservation. The person in charge of this picnic area is Mr Yves CHEVRET ST/TFM. Following a fresh outbreak of incidents (damage to CERN equipment and to trees and plants, privately owned sheep killed or maimed by dogs belonging to users of the picnic area, etc.),   The following measures have been taken: a report on the state of the picnic area will be drawn up before and after use, the cost of any damage noted will be borne by the person making the reservation, dogs and other domestic animals are strictly forbidden in the picnic area.

  16. Water Service Areas - MDC_WaterServiceArea

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — The Water and Sewer Service Area layer was derived from the original paper based sketches which contained both water and sewer utility boundary information. This...

  17. 5 CFR 591.205 - Which areas are nonforeign areas?

    Science.gov (United States)

    2010-01-01

    ... ALLOWANCES AND DIFFERENTIALS Cost-of-Living Allowance and Post Differential-Nonforeign Areas Cost-Of-Living... contiguous 48 states to which the U.S. Government reserves claim. Cost-of-Living Allowances ...

  18. Sewerage Service Areas - MDC_SewerServiceArea

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — The Water and Sewer Service Area layer was derived from the original paper based sketches which contained both water and sewer utility boundary information. This...

  19.   Transformation of the industrial harbor areas to housing areas

    DEFF Research Database (Denmark)

    Rehder, Meike

    2009-01-01

    Research question: How to read the universal (understood as the common and the social) and the individual (understood as the specific, private and intimate) in the meeting between urban and housing space? Questions in the project: How do the exterior spaces in these new harbour areas come to being......? What influences are at play in the development of them? What influences the approval and the functioning of these housing areas?...

  20. Selection of material balance areas and item control areas

    International Nuclear Information System (INIS)

    1975-04-01

    Section 70.58, ''Fundamental Nuclear Material Controls,'' of 10 CFR Part 70, ''Special Nuclear Material,'' requires certain licensees authorized to possess more than one effective kilogram of special nuclear material to establish Material Balance Areas (MBAs) or Item Control Areas (ICAs) for the physical and administrative control of nuclear materials. This section requires that: (1) each MBA be an identifiable physical area such that the quantity of nuclear material being moved into or out of the MBA is represented by a measured value; (2) the number of MBAs be sufficient to localize nuclear material losses or thefts and identify the mechanisms; (3) the custody of all nuclear material within an MBA or ICA be the responsibility of a single designated individual; and (4) ICAs be established according to the same criteria as MBAs except that control into and out of such areas would be by item identity and count for previously determined special nuclear material quantities, the validity of which must be ensured by tamper-safing unless the items are sealed sources. This guide describes bases acceptable to the NRC staff for the selection of material balance areas and item control areas. (U.S.)

  1. BREAD LOAF ROADLESS AREA, VERMONT.

    Science.gov (United States)

    Slack, John F.; Bitar, Richard F.

    1984-01-01

    On the basis of mineral-resource survey the Bread Loaf Roadless Area, Vermont, is considered to have probable resource potential for the occurrence of volcanogenic massive sulfide deposits of copper, zinc, and lead, particularly in the north and northeastern section of the roadless area. Nonmetallic commodities include minor deposits of sand and gravel, and abundant rock suitable for crushing. However, large amounts of these materials in more accessible locations are available outside the roadless area. A possibility exists that oil or natural gas resources may be present at great depth.

  2. Analysis of context factors in compulsory and incentive strategies for improving attraction and retention of health workers in rural and remote areas: a systematic review.

    Science.gov (United States)

    Liu, Xiaoyun; Dou, Lixia; Zhang, Huan; Sun, Yang; Yuan, Beibei

    2015-07-21

    Current literature systematically reports that interventions to attract and retain health workers in underserved areas need to be context specific but rarely defines what that means. In this systematic review, we try to summarize and analyse context factors influencing the implementation of interventions to attract and retain rural health workers. We searched online databases, relevant websites and reference lists of selected literature to identify studies on compulsory rural service programmes and financial incentives. Forty studies were selected. Information regarding context factors at macro, meso and micro levels was extracted and synthesized. Macro-level context factors include political, economic and social factors. Meso-level factors include health system factors such as maldistribution of health workers, growing private sector, decentralization and health financing. Micro-level factors refer to the policy implementation process including funding sources, administrative agency, legislation process, monitoring and evaluation. Macro-, meso- and micro-level context factors can play different roles in agenda setting, policy formulation and implementation of health interventions to attract and retain rural health workers. These factors should be systematically considered in the different stages of policy process and evaluation.

  3. Inequalities in access and utilization of dental services: a cross-sectional study in an area covered by the Family Health Strategy

    Directory of Open Access Journals (Sweden)

    Márcia Helena Baldani

    2011-01-01

    Full Text Available This cross-sectional study aimed to investigate the presence of inequalities in the access and use of dental services for people living in the coverage area of the Family Health Strategy (FHS in Ponta Grossa, Paraná State, Brazil, and to assess individual determinants related to them. The sample consisted of 747 individuals who answered a pre-tested questionnaire. Data analysis was performed by chi-square test and Poisson regression analysis, obtaining explanatory models for recent use and, by limiting the analysis to those who sought dental care, for effective access. Results showed that 41% of the sample had recent dental visits. The lowest visit rates were observed among preschoolers and elderly people. The subjects who most identified the FHS as a regular source of dental care were children. Besides age, better socioeconomic conditions and the presence of a regular source of dental care were positively associated to recent dental visits. We identified inequalities in use and access to dental care, reinforcing the need to promote incentives to improve access for underserved populations.

  4. Revitalization Areas By Block Group

    Data.gov (United States)

    Department of Housing and Urban Development — Single Family Revitalization areas are HUD-designated neighborhoods in need of economic and community development and where there is already a strong commitment by...

  5. Ozone Nonattainment Areas - 1 Hour

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data layer identifies areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for Ozone - 1hour (Legacy...

  6. Technical standards in nuclear area

    International Nuclear Information System (INIS)

    Grimberg, M.

    1978-01-01

    The technical standardization in nuclear area is discussed. Also, the competence of CNEN in standardization pursuit is analysed. Moreover, the process of working up of technical standards is explained; in addition, some kinds of technical standards are discussed. (author) [pt

  7. VT - Vermont Hospital Service Areas

    Data.gov (United States)

    Vermont Center for Geographic Information — Hospital service areas (HSAs) are organized by towns and are based on inpatient discharges where the diagnosis indicated the need for immediate care. Plurality...

  8. Allegheny County Soil Type Areas

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset contains soil type and soil classification, by area. Additional info at: http://mcdc.cas.psu.edu/datawiz.htm;...

  9. Suisun Marsh Secondary Management Area

    Data.gov (United States)

    California Department of Resources — Suisun Marsh or the 'Marsh' means tidal marsh, water-covered areas, diked-off wetlands, seasonal marshes, lowland grasslands, upland grasslands, and cultivated lands...

  10. Suisun Marsh Primary Management Area

    Data.gov (United States)

    California Natural Resource Agency — Suisun Marsh or the 'Marsh' means tidal marsh, water-covered areas, diked-off wetlands, seasonal marshes, lowland grasslands, upland grasslands, and cultivated lands...

  11. Suisun Marsh Primary Management Area

    Data.gov (United States)

    California Department of Resources — Suisun Marsh or the 'Marsh' means tidal marsh, water-covered areas, diked-off wetlands, seasonal marshes, lowland grasslands, upland grasslands, and cultivated lands...

  12. Cafeterias/Food-Service Areas.

    Science.gov (United States)

    American School & University, 2002

    2002-01-01

    Describes the design of notable school cafeterias and food service areas, including the educational context and design goals. Includes information on architects, suppliers, and cost, as well as photographs. (EV)

  13. Allegheny County Land Cover Areas

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The Land Cover dataset demarcates 14 land cover types by area; such as Residential, Commercial, Industrial, Forest, Agriculture, etc. If viewing this description on...

  14. FEMA DFIRM Flood Hazard Areas

    Data.gov (United States)

    Minnesota Department of Natural Resources — FEMA flood hazard delineations are used by the Federal Emergency Management Agency (FEMA) to designate the Special Flood Hazard Area (SFHA) and for insurance rating...

  15. Allegheny County Wooded Area Boundaries

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This dataset demarcates stands of trees (coniferous and deciduous) too numerous to plot as individual trees. The area is delineated following a generalized line...

  16. Allegheny County Land Use Areas

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Allegheny County land use as ascribed to areas of land. The Land Use Feature Dataset contains photogrammetrically compiled information concerning vegetation and...

  17. Allegheny County Environmental Justice Areas

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Environmental Justice areas in this guide have been defined by the Pennsylvania Department of Environmental Protection. The Department defines an environmental...

  18. Sustainable development in urban areas

    OpenAIRE

    Górecki, Jarosław; Czaplewska, Ewa

    2016-01-01

    Like in other EU countries, in Poland can be observed many ecological activities that play an important role in a balanced development of the society. Bicycle-sharing systems get more and more popular. In urban areas, tramway lines are being constructed. Local governments promote healthier and faster means of public transport. However, there are many problems waiting to be solved. This article describes a complexity of problems related to the sustainable development in urban areas. This ki...

  19. Installation of LHC experimental areas

    CERN Document Server

    Butin, F; Lacarrère, D; Osborne, J; CERN. Geneva. TS Department

    2005-01-01

    Following handover by the civil engineering contractors, the new LHC experimental areas are being fitted-out with appropriate infrastructure and technical services. In parallel, and in order to make up for the short time available, the installation of the detectors has already started in the experimental caverns. In addition, the LHC machine installation now has a non-negligible impact on the experimental area activities. Four Experimental Area Teams have been set up in order to coordinate all this work, organize the logistic resources and ensure the proper safety of personnel and material. This paper will focus on the status of installation in all areas and define the technical challenges coming in the next months. Illustrations from the new areas at Point 1 and Point 5 will be presented and compared to those from existing areas at Point 2 and Point 8, custom built for and inherited from LEP. The successes and difficulties encountered so far will be reviewed and the conclusions that have been drawn from this...

  20. Geothermal resource area 3: Elko County. Area development plan

    Energy Technology Data Exchange (ETDEWEB)

    Pugsley, M.

    1981-01-01

    Geothermal Resource Area 3 includes all of the land in Elko County, Nevada. There are in excess of 50 known thermal anomalies in this area. Several of the more major resources have been selected for detailed description and evaluation in this Area Development Plan. The other resources are considered too small, too low in temperature, or too remote to be considered for development in the near future. Various potential uses of the energy found at each of the studied resource sites in Elko County were determined after evaluating the area's physical characteristics; the land ownership and land use patterns; existing population and projected growth rates; transportation facilities and energy requirements. These factors were then compared with resource site specific data to determine the most likely uses of the resource. The uses considered in this evaluation were divided into five main categories: electrical generation, space heating, recreation, industrial process heat, and agriculture. Within two of these categories several subdivisions were considered separately. It was determined that several of the geothermal resources evaluated in the Area Development Plan could be commercially developed. The potential for development for the seven sites considered in this study is summarized.

  1. Multitemporal burnt area mapping using Landsat 8: merging multiple burnt area indices to highlight burnt areas

    CSIR Research Space (South Africa)

    Vhengani, L

    2015-07-01

    Full Text Available stream_source_info Vhengani_2015_ABSTRACT.pdf.txt stream_content_type text/plain stream_size 1055 Content-Encoding ISO-8859-1 stream_name Vhengani_2015_ABSTRACT.pdf.txt Content-Type text/plain; charset=ISO-8859-1 2015... IEEE International Geoscience and Remote Sensing Symposium (IGARSS), Milan, Italy, 26-31 July 2015 Multitemporal burnt area mapping using Landsat 8: Merging multiple burnt area indices to highlight burnt areas Lufuno Vhengani, Philip Frost...

  2. Protected area gap analysis of important bird areas in Tanzania

    DEFF Research Database (Denmark)

    Sritharan, Shakthi; Burgess, Neil David

    2012-01-01

    Analyses of gaps in protected area (PA) coverage of species distributions have been carried out extensively for the past two decades, aiming to better locate new PAs and conserve species. In this study, progress to close gaps in the protection of the Important Bird Areas (IBAs) of Tanzania...... that there has been a 5.3% increase (7615.1 km2) in protection of IBAs between 2007 and 2009. Of the 27 remaining IBA protection gaps, three are of high, nine of medium and fifteen of low priority for action. The current IBA "gap area" of 17,133.3 km2 contains around 26% forest, 13% shrubland, 9% grassland, 36......% wetland and 12% agricultural land. This analysis provides a simple template for defining where further action to protect remaining IBA sites in Tanzania would lead to enhanced conservation of avian biodiversity in that country and provides a methodology for analysis leading to conservation action...

  3. Notes on the area theorem

    International Nuclear Information System (INIS)

    Park, Mu-In

    2008-01-01

    Hawking's area theorem can be understood from a quasi-stationary process in which a black hole accretes positive energy matter, independent of the details of the gravity action. I use this process to study the dynamics of the inner as well as the outer horizons for various black holes which include the recently discovered exotic black holes and three-dimensional black holes in higher derivative gravities as well as the usual BTZ black hole and the Kerr black hole in four dimensions. I find that the area for the inner horizon 'can decrease', rather than increase, with the quasi-stationary process. However, I find that the area for the outer horizon 'never decreases' such that the usual area theorem still works in our examples, though this is quite non-trivial in general. There exists an instability problem of the inner horizons but it seems that the instability is not important in my analysis. I also find a generalized area theorem by combining those of the outer and inner horizons

  4.   Transformation of the industrial harbor areas to housing areas

    DEFF Research Database (Denmark)

    Rehder, Meike

    2009-01-01

    Research question: How to read the universal (understood as the common and the social) and the individual (understood as the specific, private and intimate) in the meeting between urban and housing space? Questions in the project: How do the exterior spaces in these new harbour areas come to being...

  5. The Visual What For Area

    DEFF Research Database (Denmark)

    Starrfelt, Randi; Gerlach, Christian

    2007-01-01

    An area in the left fusiform gyrus labelled the Visual Word Form Area (VWFA) is claimed to be especially, or even selectively, responsive to words. We explored how stimulus type and task demands affect activity in this area by conducting a PET experiment where words and pictures were presented...... in two conditions that differed in demands on shape processing: colour decision and categorization. The subjects also performed an object decision task with pictures only. The imaging data revealed a main effect of stimulus type: rCBF was higher during word compared with picture processing. When compared...... individually for colour decision and categorization, the difference between words and pictures was only significant during colour decision, although a trend was present during categorization also. rCBF in the VWFA was highest during the object decision task, where only pictures were presented. Our findings...

  6. 100 Areas CERCLA ecological investigations

    International Nuclear Information System (INIS)

    Landeen, D.S.; Sackschewsky, M.R.; Weiss, S.

    1993-09-01

    This document reports the results of the field terrestrial ecological investigations conducted by Westinghouse Hanford Company during fiscal years 1991 and 1992 at operable units 100-FR-3, 100-HR-3, 100-NR-2, 100-KR-4, and 100-BC-5. The tasks reported here are part of the Remedial Investigations conducted in support of the Comprehensive Environmental Response, compensation, and Liability Act of 1980 studies for the 100 Areas. These ecological investigations provide (1) a description of the flora and fauna associated with the 100 Areas operable units, emphasizing potential pathways for contaminants and species that have been given special status under existing state and/or federal laws, and (2) an evaluation of existing concentrations of heavy metals and radionuclides in biota associated with the 100 Areas operable units

  7. Heat Pumps in Subarctic Areas

    DEFF Research Database (Denmark)

    Atlason, Reynir Smari; Oddsson, Gudmundur Valur; Unnthorsson, Runar

    2017-01-01

    Geothermal heat pumps use the temperature difference between inside and outside areas to modify a refrigerant, either for heating or cooling. Doing so can lower the need for external heating energy for a household to some extent. The eventual impact depends on various factors, such as the external...... source for heating or cooling and the temperature difference. The use of geothermal heat pumps, and eventual benefits has not been studied in the context of frigid areas, such as in Iceland. In Iceland, only remote areas do not have access to district heating from geothermal energy where households may...... therefor benefit from using geothermal heat pumps. It is the intent of this study to explore the observed benefits of using geothermal heat pumps in Iceland, both financially and energetically. This study further elaborates on incentives provided by the Icelandic government. Real data was gathered from...

  8. 100 Areas CERCLA ecological investigations

    Energy Technology Data Exchange (ETDEWEB)

    Landeen, D.S.; Sackschewsky, M.R.; Weiss, S.

    1993-09-01

    This document reports the results of the field terrestrial ecological investigations conducted by Westinghouse Hanford Company during fiscal years 1991 and 1992 at operable units 100-FR-3, 100-HR-3, 100-NR-2, 100-KR-4, and 100-BC-5. The tasks reported here are part of the Remedial Investigations conducted in support of the Comprehensive Environmental Response, compensation, and Liability Act of 1980 studies for the 100 Areas. These ecological investigations provide (1) a description of the flora and fauna associated with the 100 Areas operable units, emphasizing potential pathways for contaminants and species that have been given special status under existing state and/or federal laws, and (2) an evaluation of existing concentrations of heavy metals and radionuclides in biota associated with the 100 Areas operable units.

  9. Suburban areas and urban life

    DEFF Research Database (Denmark)

    Melgaard, Bente

    Danish suburbs are facing major challenges trying to coping with demographic changes, with structural changes in retail businesses and especially with sustainability-related challenges that have to do with cutting back on energy consumption for heating and transportation. Also climate changes...... and counteracting the segregation of the suburbs into sharply socially-separated residential areas are major challenges. Therefore, in these years the post-war era’s suburban areas are being revitalized and the suburb urban life and urban qualities are concepts, which are often brought up in this context....... In this paper I will explore the concepts “suburb” and “urban life”. More than half of the Danish population live in suburban areas, and the majority of suburbs were built in a short and hectic period in the years from 1960 to 1975 and in conformity with the functionalist ideals that gave rise to a number...

  10. Plutonium focus area: Technology summary

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-03-01

    To ensure research and development programs focus on the most pressing environmental restoration and waste management problems at the U.S. Department of Energy (DOE), the Assistant Secretary for the Office of Environmental Management (EM) established a working group in August 1993 to implement a new approach to research and technology development. As part of this approach, EM developed a management structure and principles that led to creation of specific focus areas. These organizations were designed to focus scientific and technical talent throughout DOE and the national scientific community on major environmental restoration and waste management problems facing DOE. The focus area approach provides the framework for inter-site cooperation and leveraging of resources on common problems. After the original establishment of five major focus areas within the Office of Technology Development (EM-50), the Nuclear Materials Stabilization Task Group (NMSTG, EM-66) followed EM-50`s structure and chartered the Plutonium Focus Area (PFA). NMSTG`s charter to the PFA, described in detail later in this book, plays a major role in meeting the EM-66 commitments to the Defense Nuclear Facilities Safety Board (DNFSB). The PFA is a new program for FY96 and as such, the primary focus of revision 0 of this Technology Summary is an introduction to the Focus Area; its history, development, and management structure, including summaries of selected technologies being developed. Revision 1 to the Plutonium Focus Area Technology Summary is slated to include details on all technologies being developed, and is currently planned for release in August 1996. The following report outlines the scope and mission of the Office of Environmental Management, EM-60, and EM-66 organizations as related to the PFA organizational structure.

  11. Plutonium focus area: Technology summary

    International Nuclear Information System (INIS)

    1996-03-01

    To ensure research and development programs focus on the most pressing environmental restoration and waste management problems at the U.S. Department of Energy (DOE), the Assistant Secretary for the Office of Environmental Management (EM) established a working group in August 1993 to implement a new approach to research and technology development. As part of this approach, EM developed a management structure and principles that led to creation of specific focus areas. These organizations were designed to focus scientific and technical talent throughout DOE and the national scientific community on major environmental restoration and waste management problems facing DOE. The focus area approach provides the framework for inter-site cooperation and leveraging of resources on common problems. After the original establishment of five major focus areas within the Office of Technology Development (EM-50), the Nuclear Materials Stabilization Task Group (NMSTG, EM-66) followed EM-50's structure and chartered the Plutonium Focus Area (PFA). NMSTG's charter to the PFA, described in detail later in this book, plays a major role in meeting the EM-66 commitments to the Defense Nuclear Facilities Safety Board (DNFSB). The PFA is a new program for FY96 and as such, the primary focus of revision 0 of this Technology Summary is an introduction to the Focus Area; its history, development, and management structure, including summaries of selected technologies being developed. Revision 1 to the Plutonium Focus Area Technology Summary is slated to include details on all technologies being developed, and is currently planned for release in August 1996. The following report outlines the scope and mission of the Office of Environmental Management, EM-60, and EM-66 organizations as related to the PFA organizational structure

  12. AGUA TIBIA PRIMITIVE AREA, CALIFORNIA.

    Science.gov (United States)

    Irwin, William P.; Thurber, Horace K.

    1984-01-01

    The Agua Tibia Primitive Area in southwestern California is underlain by igneous and metamorphic rocks that are siilar to those widely exposed throughout much of the Peninsular Ranges. To detect the presence of any concealed mineral deposits, samples of stream sediments were collected along the various creeks that head in the mountain. As an additional aid in evaluating the mineral potential, an aeromagnetic survey was made and interpreted. A search for records of past or existing mining claims within the primitive area was made but none was found. Evidence of deposits of metallic or nonmetallic minerals was not seen during the study.

  13. Integrated Assessment of Coastal Areas

    Science.gov (United States)

    Nicholls, R. J.

    2016-12-01

    Coastal areas are experiencing change due to a range of natural and human-induced drivers. Of particular concern is climate change, particularly sea-level rise (SLR). In low gradient coastal areas, small changes in water levels can have profound consequences. Hence SLR is rightly considered a major threat. However, to properly diagnose a problem and find sustainable solutions, a systems approach is essential as the impacts of SLR will be modified by the other drivers. This paper will consider these issues from a multi-disciplinary perspective drawing on examples from around the world.

  14. Modelling burned area in Africa

    Directory of Open Access Journals (Sweden)

    V. Lehsten

    2010-10-01

    Full Text Available The simulation of current and projected wildfires is essential for predicting crucial aspects of vegetation patterns, biogeochemical cycling as well as pyrogenic emissions across the African continent. This study uses a data-driven approach to parameterize two burned area models applicable to dynamic vegetation models (DVMs and Earth system models (ESMs. We restricted our analysis to variables for which either projections based on climate scenarios are available, or that are calculated by DVMs, and we consider a spatial scale of one degree as the scale typical for DVMs and ESMs. By using the African continent here as an example, an analogue approach could in principle be adopted for other regions, for global scale dynamic burned area modelling.

    We used 9 years of data (2000–2008 for the variables: precipitation over the last dry season, the last wet season and averaged over the last 2 years, a fire-danger index (the Nesterov index, population density, and annual proportion of area burned derived from the MODIS MCD45A1 product. Two further variables, tree and herb cover were only available for 2001 as a remote sensing product. Since the effect of fires on vegetation depends strongly on burning conditions, the timing of wildfires is of high interest too, and we were able to relate the seasonal occurrence of wildfires to the daily Nesterov index.

    We parameterized two generalized linear models (GLMs, one with the full variable set (model VC and one considering only climate variables (model C. All introduced variables resulted in an increase in model performance. Model VC correctly predicts the spatial distribution and extent of fire prone areas though the total variability is underrepresented. Model VC has a much lower performance in both aspects (correlation coefficient of predicted and observed ratio of burned area: 0.71 for model VC and 0.58 for model C. We expect the remaining variability to be attributed to additional

  15. Bicycle traffic in urban areas

    Directory of Open Access Journals (Sweden)

    Anđelković Zorica

    2015-01-01

    Full Text Available Cycling is a term describing the use of bicycles, but also any mean of transport driven solely by human power. Development of bicycle traffic in urban areas involves construction of cycling infrastructure, adapting streets and other traffic infrastructure to a form suitable for cycling and other means of transport (individual motorized traffic, public transport, walking, ensuring the adequate budget and systematic planning and development of sustainable transport in cities. The paper presents basic settings and conditions as input elements to plan bicycle traffic in urban areas, as well as program- design conditions which lead the activities of planners and designers of urban roads in connection with cyclists.

  16. 100 Areas water treatment specifications

    Energy Technology Data Exchange (ETDEWEB)

    Greninger, A.B.

    1952-07-11

    This memorandum discussed review of the data from tests using alum in the treatment of pile process water, and using activated silica as a coagulant aid during period of low water temperature, which shows that this method should be substituted for the present method of treating pile process water in all 100 Areas. It was recommended that the water treatment procedures and specifications attached to this memorandum be initiated as standard practice in all 100 Areas as soon as it is possible to make the necessary equipment modifications and installations.

  17. Sediment problems in urban areas

    Science.gov (United States)

    Guy, Harold P.

    1970-01-01

    A recognition of and solution to sediment problems in urban areas is necessary if society is to have an acceptable living environment. Soil erosion and sediment deposition in urban areas are as much an environmental blight as badly paved and littered streets, dilapidated buildings, billboard clutter, inept land use, and air, water, and noise pollution. In addition, sediment has many direct and indirect effects on streams that may be either part of or very remote from the urban environment. Sediment, for example, is widely recognized as a pollutant of streams and other water bodies.

  18. Semenic Mountains’ alpine skiing area

    Directory of Open Access Journals (Sweden)

    Petru BANIAȘ

    2017-03-01

    Full Text Available The present paper presents, after a short history of alpine skiing which describes apparition, necessity, utility and universality of skiing during time, a comparative study referring to the alpine skiing domain in the Semenic Mountains area. In the paper are also presented general notions about alpine skiing methodology together with an ample description of the plateau area form Semenic Mountains, describing localization and touristic potential. Based on the SWOT analysis made for each slope, was realized a complex analysis of the entire skiing domain, an analysis which includes technical, financial, climatic and environmental aspects, along with an analysis of the marketing policy applied for the specific zone.

  19. Main challenges of residential areas

    Directory of Open Access Journals (Sweden)

    Oana Luca

    2017-06-01

    Full Text Available The present article is a position paper aiming to initiate a professional debate related to the aspects related to the urban dysfunctions leading to the wear of the residential areas. The paper proposes a definition of the wear process, identify the main causes leading to its occurrence and propose a number of solutions to neutralise the dysfunctions. The three wearing phases of residential areas components are emphasized, exploring their lifecycle. In order to perform the study of urban wear, the status of the residential areas components can be established and monitored, and also the variables of the function that can mathematically model the specific wear process may be considered. The paper is considered a first step for the model adjustment, to be tested and validated in the following steps. Based on the mathematical method and model, there can be created, in a potential future research, the possibility of determining the precarity degree for residential areas/neighbourhoods and cities, by minimising the subjective component of the analyses preceding the decision for renovation or regeneration.

  20. Upgrading of the West Area

    CERN Multimedia

    1983-01-01

    The rejigged main hall (EHW1) in the West Area: on background, below the crane, is the brown yoke of the Omega magnet which had been resited. The upgrading was completed by the time in July when 400 GeV protons arrived. See Annual Report 1983 p. 107.

  1. Michigan's Fourth Forest Inventory: Area.

    Science.gov (United States)

    John S. Jr. Spencer

    1983-01-01

    The fourth inventory of Michigan's forest resources found 17.5 million acres of commercial forest, down 7% from the 18.9 million found in 1966. This bulletin analyzes findings from the inventory and presents detailed tables of forest area.

  2. Open areas and open access

    International Nuclear Information System (INIS)

    Thorndike, A.M.

    1979-01-01

    The main objective of the two open areas in the present ISABELLE design has been to provide flexibility with respect to the size and shape of experimental equipment that would eventually be installed there. No permanent building would be installed initially. One possibility would be to enclose each experiment in a temporary structure that would provide weatherproofing and shielding; another possibility would be to erect a permanent building at a later time, when experience has made the needs clearer than they are at present. The secondary objective of the design of open areas has been to keep initial costs as low as practicable. Another objective might be added, however, which we indicate by the term ''open access.'' This note will explore this idea and some design concepts based on it. In the ISABELLE 1977 summer workshop there was considerable discussion of the importance of techniques for inserting large pieces of experimental equipment quickly and removing them with equal ease and speed. Since enclosed halls have certain restrictions in this respect, open areas may be helpful in providing this feature. If the mechanical and electrical aspects could be handled quickly, one might even attempt to reduce the time spent on bureaucratic procedures in order to expedite the introduction of new experiments and new ideas in these areas

  3. Forest Area in Nebraska, 1983

    Science.gov (United States)

    Thomas L. Castonguay

    1984-01-01

    The 1982 forest inventory of Nebraska showed that 1.5 percent of the total land area is forested. Commercial forest land accounted for 75 percent or 537,837 acres of the forest land and ponderosa pine is the major forest type. An important Nebraska resouce is the 262,230 acres of natural wooded strips.

  4. Forest Area in Kansas, 1981

    Science.gov (United States)

    Ronald L. Hackett

    1983-01-01

    The 1981 forest inventory of Kansas showed that 2.6 percent of the total land area is forested. Commercial forest land accounted for 89 percent or 1,207,900 acres of the forest land and oak-hickory is the major forest type. An important Kansas resource are the 150,000 acres of natural wooded strips.

  5. Climatic change in Mediterranean area

    International Nuclear Information System (INIS)

    Manos, A.

    1991-01-01

    United Nations Environmental Program (UNEP) studies on forecasted greenhouse climatic effects on the Mediterranean coastal and marine ecosystems and regional socio-economic framework have indicated the need for a concerted plan of protective and remedial action. The studies considered rises of 1.5 degrees in ambient temperature and 20 centimeters in sea level occurring before the year 2025. A regional, as opposed to a global area, study approach was adopted since the severity of climatic effects is expected to vary greatly from one part of the world to another. The specific areas investigated were the Po River Delta and Venezia Lagoon in Italy, the Nile Delta, Camargue, the Ebro Delta, the Tunisian National Park area, and the Thermaicos Gulf in Greece. The rise in average temperature is expected to negatively effect Mediterranean agricultural production and the coastal and marine ecosystems due to prolonged periods of drought and exceptional rainfall. It is suggested that a system of dikes be constructed to protect the coastal areas which are heavily dependent on tourism and agriculture

  6. Environmental information document: Y Area

    International Nuclear Information System (INIS)

    Cook, J.R.; Grant, M.W.

    1986-01-01

    Site selection, facility descriptions, and alternative operations are described for disposal/storage of concentrated waste streams resulting from waste treatment facilities at the Savannah River Plant. Performance assessments and cost estimates for these alternatives are presented. The new disposal site for this waste will be designated Y Area

  7. AREAs or ErioPia

    African Journals Online (AJOL)

    and Constraints for further commercialisation. Therefore, any agricultural commercialisation strategy should be customized for different groups of femers. Pespite the relatively high degree of market orientation in the study areas, the size of market (per selle) is very thin. The volume of trade is constrained by low per capite.

  8. GPS measurements in Satakunta area

    International Nuclear Information System (INIS)

    Poutanen, M.; Nyberg, S.; Ahola, J.

    2010-10-01

    The Finnish Geodetic Institute, the Geological Survey of Finland, Posiva Ltd and municipalities in the district of Satakunta launched the GeoSatakunta research program in 2002 to carry out interdisciplinary studies on regional bedrock stress field and to apply the results e.g. in land use planning in the Satakunta area. The area was chosen for many reasons. Its geological diversity, extensive multi-disciplinary data coverage, and various interests of participants made the area suitable for the project. The purpose of the GPS observations is to get detailed information on recent crustal deformations in the area. The Finnish Geodetic Institute maintains e.g. national GPS network, FinnRef, and since 1995 a local research network in the Olkiluoto area. The Satakunta network differs from these, and this is the first time to obtain such detailed information of a regional network in Finland. The Satakunta GPS network consists of 13 concrete pillars for episodic GPS campaigns and the Olkiluoto permanent GPS station in the FinnRef network. The distances between the concrete pillars are 10-15 km, and the sites were chosen in a co-operation with the Geological Survey of Finland taking into account the geological structures in the area. The City of Pori made the final reconnaissance in the field and constructed eight pillars in 2003. The original network was expanded in 2005-2006 in Eurajoki and Rauma, and at the City of Rauma joined the co-operation. The five new pillars join the previous Olkiluoto network into the Satakunta network. There have been three annual GPS campaigns in 2003-2008. Time series of the Satakunta network are shorter than in the Olkiluoto network, and also the distances are longer. Therefore, the same accuracy than in Olkiluoto has not yet achieved. However, mm-sized movements can be excluded. Estimated velocities were small (0.2 mm/a) and mostly statistically insignificant because of relatively short time series. In this publication we describe the

  9. [Emotion and Brodmann's areas: special reference on area 12].

    Science.gov (United States)

    Kawamura, Mitsuru

    2010-11-01

    Brodmann's brain maps, assembled in 1909, are still in use, but understanding of their animal-human homology is uncertain. Furthermore, in 1909, Brodmann did not identify human Area 12 (BA12); a location now important to understanding of frontotemporal lobar degeneration (FTLD) and emotional function. We found Brodmann did identify human BA12 in later maps (1910 and 1914), not in the 1909 monograph. Because of its current link with FTLD, BA 12's translation from animal (1909) to human (1910 and 1914) is not only an historical puzzle. It impacts how Brodmann's areas, based on comparative animal-human cyto-architecture, are widely used in current research as functional loci in human brain. If Brodmann's maps are of current value, then an accurate rather than a generic Brodmann number is in order.

  10. Multifunctional centers in rural areas

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase

    2009-01-01

    , and facilities for local associations as theatre scenes and sports halls. The centers should be designed to secure both economies of scale and geographic proximity. Empirical evidence indicates that such large meeting places in fact foster physical and social cohesion, as well as human capital and informal...... invest in multifunctional centers in which the local public school is the dynamo. This in order to increase local levels of social as well as human capital. Ideally, such centers should contain both public services such as school, library and health care, private enterprises as hairdressers and banks...... such a model: Multifunctional centers. Such a model reflects a long tradition of local centralization in rural areas, that is, a golden compromise between ruralization and urbanization. First, I argue that governments should actively invest in rural areas rather than practicing laissez-faire. Second, I trace...

  11. Landscape evaluation in industrial areas

    International Nuclear Information System (INIS)

    Luud, A.; Liblik, V.; Sepp, M.

    2003-01-01

    In the North-East of Estonia, the landscape is contrasting: different natural and man-made landforms exist together. In this area, oil shale mining and processing have essentially changed the landscape, and as a result, different man-made industrial landscape forms have come into being. The attitude of local inhabitants towards the heritage of oil shale industry has been traditionally negative. Nevertheless, the artificial 'mountainous' and 'hilly' relief offers also a positive effect, having some expressive image in the background of the natural plain landscape forms. For protection of cultural landscapes from damages, 32 landscapes that are more valuable were selected, whereat the historical, cultural, natural, recreational, aesthetic, scientific, etc. factors were taken into account. In the future the status of industrial landscapes needs a more exact defining,and special means must be worked out to protect and manage those valuable cultural areas. (author)

  12. Tank Focus Area pretreatment activities

    International Nuclear Information System (INIS)

    McGinnis, C.P.; Welch, T.D.; Manke, K.L.

    1997-01-01

    Plans call for the high-level wastes to be retrieved from the tanks and immobilized in a stable waste form suitable for long-term isolation. Chemistry and chemical engineering operations are required to retrieve the wastes, to condition the wastes for subsequent steps, and to reduce the costs of the waste management enterprise. Pretreatment includes those processes between retrieval and immobilization, and includes preparation of suitable feed material for immobilization and separations to partition the waste into streams that yield lower life-cycle costs. Some of the technologies being developed by the Tank Focus Area (TFA) to process these wastes are described. These technologies fall roughly into three areas: (1) solid/liquid separation (SLS), (2) sludge pretreatment, and (3) supernate pretreatment

  13. [Endemic zoonosis in Mediterranean area].

    Science.gov (United States)

    Fenga, Concettina; Pugliese, Michela

    2013-01-01

    The Mediterranean is historically considered an area of high concentration of zoonoses. Mediterranean countries socio-economic features have favoured, over time, the onset of different types of zoonosis. Many of these may affect many occupational categories, first of all farmers, people working in abattoirs and processing products of animal origin. New farming activities and technologies have generated new occupational and zoonotic risks. These changes have influenced zoonosis epidemiology and have led to a gradual decrease in the number of diseases and to a reduction of some biological risks. However, brucellosis, Q fever, bovine tuberculosis cystic echinococcosis remain a strong example of zoonosis and a real risk, in the Mediterranean area especially. Therefore, an interdisciplinary collaboration between Veterinary Service, Public Health and Occupational medicine is necessary in order to plan territorial prevention.

  14. Speleogenesis in Dinaric karst area

    Science.gov (United States)

    Garasic, Mladen; Garasic, Davor

    2015-04-01

    Dinaric Karst is one of the largest karst regions in Europe and in the World. It is the paramount karst of Europe and type site of many karst features. Dinaric Karst Area covers an extensive part of the Dinarides, a mountain chain in Southern Europe named after Dinara Mt., an impressive and outstanding rocky wall on the border between Dalmatian part of Croatia and Bosnia and Herzegovina. The Dinaric Karst occupies an area from the Friuli Plain (Doberdo Karst Plateau) and Slovenian mountains near Postojna cave on the northwest, to Skadar Lake and Prokletije Mt. on the southeast, from Central Bosnian Mountains on the northeast, and the Adriatic Sea seafloor with its islands. The Dinarides outspread in a so-called "Dinaric strike" (NW-SE) for 650 km in length and are up to 150 km wide across SW-NE. The biggest part of the Dinaric Karst Area is situated within Croatian territory (continental, Adriatic coastal and seafloor karst) comprising all karst features with exceptional examples exposed on the surface as well as in the underground. Classical karst area is the one situated in Slovenia, where typical karst features were described for the first time. Presentation of the outstanding values of Dinaric karst is based on the values that can be met in Italy, Bosnia and Herzegovina, Montenegro, Serbia and Albania, too. Dinaric Karst is the World's natural heritage because of its unique and outstanding geological characteristics and its living world; some of them are of outstanding natural beauty. Dinaric karst is an integral, compact karst area with extremely great thickness of carbonate rocks of predominantly Mesozoic age which in some areas exceeds 8.000 m. It bears several cycles of karstification thus giving world uniqueness to the area, especially regarding the wealth of submerged karst phenomena, among which vruljes are world unique features. Dinaric karst is one of the largest karst regions in the World. From the scientific perspective, the Dinaric Karst is one of

  15. Benzene exposures in urban areas

    International Nuclear Information System (INIS)

    Valerio, F.; Pala, M.; Cipolla, M.; Stella, A.

    2001-01-01

    Benzene exposures in urban areas were reviewed. Available data confirm that both in USA and Europe, benzene concentrations measured by fixed outdoor monitoring stations underestimate personal exposures of urban residents. Indoor sources, passive smoke and the high exposures during commuting time may explain this difference. Measures in European towns confirm that very frequently mean daily personal exposures to benzene exceed 10 μg/m 3 , current European air quality guideline for this carcinogenic compound [it

  16. Money Laundering Through Offshore Areas

    OpenAIRE

    Roxana Ispas

    2009-01-01

    In the present study we have started from the premise that from the analysis of the "money laundering", the money resulted from this is circulating in the whole world, through some geographical and institutional channels. Starting from the characteristics of "tax haven", we have made a parallel between it and the financial paradise. In the second part of the work we have explored offshore areas, adding the methods for placement of revenue in those countries and the necessary conclusions.

  17. Diaper area and disposable diapers.

    Science.gov (United States)

    Erasala, G N; Romain, C; Merlay, I

    2011-01-01

    Since the 1960s, cloth diapers have been replaced by disposable diapers. The evolution of healthier skin in the diaper area has been demonstrated in parallel to that of disposable diapers. The improvements of disposable diapers--fit, dryness, comfort--have been based on the understanding of factors playing a role in the development of diaper dermatitis. Copyright © 2011 S. Karger AG, Basel.

  18. Innovation investment area: Technology summary

    Energy Technology Data Exchange (ETDEWEB)

    1994-03-01

    The mission of Environmental Management`s (EM) Office of Technology Development (OTD) Innovation Investment Area is to identify and provide development support for two types of technologies that are developed to characterize, treat and dispose of DOE waste, and to remediate contaminated sites. They are: technologies that show promise to address specific EM needs, but require proof-of-principle experimentation; and (2) already proven technologies in other fields that require critical path experimentation to demonstrate feasibility for adaptation to specific EM needs. The underlying strategy is to ensure that private industry, other Federal Agencies, universities, and DOE National Laboratories are major participants in developing and deploying new and emerging technologies. To this end, about 125 different new and emerging technologies are being developed through Innovation Investment Area`s (IIA) two program elements: RDDT&E New Initiatives (RD01) and Interagency Agreements (RD02). Both of these activities are intended to foster research and development partnerships so as to introduce innovative technologies into other OTD program elements for expedited evaluation.

  19. Progress on large area GEMs

    CERN Document Server

    Pinto, Serge Duarte; Alfonsi, Matteo; Brock, Ian; Croci, Gabriele; David, Eric; De Oliveira, Rui; Ropelewski, Leszek; van Stenis, Miranda

    2009-01-01

    In 2008, a triple GEM detector prototype with an area of ~2000 cm2 has been constructed, based on foils of 66*66 cm. GEMs of such dimensions had not been made before, and innovations to the existing technology were introduced to build this detector. This paper discusses these innovations and presents further work on large area GEM development. A single-mask technique overcomes the cumbersome practice of alignment of two masks, which limits the achievable lateral size. The holes obtained with this technique are conical, and have a so-called rim, a small insulating clearance around the hole in the substrate. Further refinements of this technique allow greater control over the shape of holes and the size of rims. Also, an improvement in homogeneity over large areas is expected. Simulation studies have been done to examine the effect of hole shape on the behavior of GEMs. Such studies can help understanding how to use new enhancements of the technique to optimize performance. Many potential applications for large...

  20. The problem with areas: Asia and Area studies

    Directory of Open Access Journals (Sweden)

    Victor T. King

    2012-09-01

    Full Text Available Review of:Goh Beng Lan (ed., Decentring & diversifying Southeast Asian Studies: Perspectives from the region. Singapore: ISEAS, 2011, xiii + 304 pp. ISBN 9789814311564, price: USD 34.90 (paperback; 9789814311571, USD 45.90 (hardback.Terence Wesley-Smith and Jon Goss (eds, Remaking Area studies: Teaching and learning across Asia and the Pacific. Honolulu: University of Hawai‘i Press, 2010, xxvii + 243 pp. ISBN 9780824833213. Price: USD 45.00 (hardback.Jacob Edmond, Henry Johnson and Jacqueline Leckie (eds, Recentring Asia: Histories, encounters, identities, xv + 339 pp. Leiden/Boston: Brill, Global Oriental: 2011. ISBN 9781906876258. Price: EUR 80.00 (hardback.

  1. RAINWATER MANAGEMENT IN PROTECTED AREAS

    Directory of Open Access Journals (Sweden)

    Wioletta Żarnowiec

    2017-03-01

    Full Text Available The aim of the study was to find out whether the climate of the southern Poland allows for removing rainwater from industrial areas by evaporation from roof surfaces. The study covered the premises of a Logistics Centre with an approximate area of 34 hectares, located in the catchment of the Wedonka stream and in the region of water intake for Kraków at the Rudawa river. In the future, the Centre will comprise nine large warehouses. Road traffic associated with the project will cause potential risks for groundwater and surface water of this protected area. Therefore, the Centre’s investor decided to evaporate rainwater from the premises. To establish advisability of this plan, the study team designed and built a unique experimental station consisting of experimental roof, tank for collecting water for the sprinkler system, system for delivering, distributing and discharging water from the roof, measuring tilt tray, automatic meteorological station, and electronic devices for recording measurement data. The research on the experimental station was carried out from April to October in 2011 and 2012 and included continuous measurements of the volume of water supplied to and discharged from the roof. Moreover, the temperature of the roof and water in the tank and a number of important meteorological parameters were measured. The difference between supplied and discharged water, divided by the wetted surface of the roof, helped to determine thickness of the evaporation layer in millimeters. The study confirmed the possibility of removing potentially contaminated rainwater by evaporating it from roof surfaces of the Logistics Centre located near Kraków at an average rate of 5.9 dm3·m–2.d–1. However, due to high seasonal variability of rainfall and air temperature, it is necessary to temporarily collect water in an expansion tank of suitable capacity.

  2. Rurality study of restricted areas

    Directory of Open Access Journals (Sweden)

    Sergio Rivaroli

    2011-02-01

    Full Text Available Two main perspectives of investigation emerge from the study of a territory’s rurality: a geographical approach and a sociological approach. The research examines the sub-regional study case of ‘Nuovo circondario imolese’. The analysis shows that the combination of traditional institutional criteria with detailed informations about the territory, generates more accurate results which determine a better comprehension of the characteristics of restricted areas’ rurality. Over the period 1991-2001, the study highlights an increase in rural areas. This result could be interpreted as an effect of urban sprawl’s intensification, that increases the competition between non-farm residences and agricultural activities.

  3. History of 100-B Area

    International Nuclear Information System (INIS)

    Wahlen, R.K.

    1989-10-01

    The initial three production reactors and their support facilities were designated as the 100-B, 100-D, and 100-F areas. In subsequent years, six additional plutonium-producing reactors were constructed and operated at the Hanford Site. Among them was one dual-purpose reactor (100-N) designed to supply steam for the production of electricity as a by-product. Figure 1 pinpoints the location of each of the nine Hanford Site reactors along the Columbia River. This report documents a brief description of the 105-B reactor, support facilities, and significant events that are considered to be of historical interest. 21 figs

  4. An Incomplete Optimal Currency Area

    DEFF Research Database (Denmark)

    Dreyer, Johannes Kabderian; Graversen, Mads Byskov

    2014-01-01

    The main objective of this study is to test if the Eurozone a decade after its launch can be considered an optimal currency area (OCA) as defined by Mundell (1961). In an OCA, asymmetric shocks – as the ones experienced by the Eurozone following the recent financial crisis – may be dampened by two...... on migration rates. We use panel regressions to test these relationships and find out that migration between member states is very low after the Euro’s first decade. Combined with the lack of significant fiscal transfers we conclude that the currency union is still not an OCA....

  5. Carlsbad Area Office strategic plan

    International Nuclear Information System (INIS)

    1995-10-01

    This edition of the Carlsbad Area Office Strategic Plan captures the U.S. Department of Energy's new focus, and supercedes the edition issued previously in 1995. This revision reflects a revised strategy designed to demonstrate compliance with environmental regulations earlier than the previous course of action; and a focus on the selected combination of scientific investigations, engineered alternatives, and waste acceptance criteria for supporting the compliance applications. An overview of operations and historical aspects of the Waste Isolation Pilot Plant near Carlsbad, New Mexico is presented

  6. Large area and flexible electronics

    CERN Document Server

    Caironi, Mario

    2015-01-01

    From materials to applications, this ready reference covers the entire value chain from fundamentals via processing right up to devices, presenting different approaches to large-area electronics, thus enabling readers to compare materials, properties and performance.Divided into two parts, the first focuses on the materials used for the electronic functionality, covering organic and inorganic semiconductors, including vacuum and solution-processed metal-oxide semiconductors, nanomembranes and nanocrystals, as well as conductors and insulators. The second part reviews the devices and applicatio

  7. AEC controlled area safety program

    International Nuclear Information System (INIS)

    Hendricks, D.W.

    1969-01-01

    The detonation of underground nuclear explosives and the subsequent data recovery efforts require a comprehensive pre- and post-detonation safety program for workers within the controlled area. The general personnel monitoring and environmental surveillance program at the Nevada Test Site are presented. Some of the more unusual health-physics aspects involved in the operation of this program are also discussed. The application of experience gained at the Nevada Test Site is illustrated by description of the on-site operational and safety programs established for Project Gasbuggy. (author)

  8. Home area networks and IPTV

    CERN Document Server

    Rémy, Jean-Gabriel

    2013-01-01

    The field of Home Area Networks (HAN), a dedicated residential subset of LAN technologies for home-based use, is fast becoming the next frontier for the communications industry.This book describes the various technologies involved in the implementation of a HAN: high-speed Internet connections, indoor implementations, services, software, and management packages. It also reviews multimedia applications (which are increasingly the most important and complex aspects of most HANs) with a detailed description of IPTV technology. It highlights the main technologies used for HANs: information tra

  9. Western Areas new U plant

    International Nuclear Information System (INIS)

    Anon.

    1982-01-01

    On March 30, 1982 Western Areas Gold Mining Company Limited's uranium plant was officialy opened. The plant is designed to treat 100 000t/month of uranium bearing ore. The majority of this ore is from the Middle Elsburg series, while the miner part comes from routing upgrated Upper Elsburg products into the uranium plant treatment route. The forward leach concept of gold and uranium extraction is adopted, i.e. the gold is extracted before the uranium. The flow of work, instrumentation, electrical installation and other facilities at the plant are also discussed

  10. Empowering Factors Among Breast Cancer Screening Compliant Underserved Populations

    Science.gov (United States)

    2005-10-01

    litnssswus intermest itsý their doctor to maintain gorod breas heaLth health, and snssversý rhteir questi trs They alsoblelievesl haote Eneottiage...which encouraged children learning programs, and addressed socio-cultural, racial and new immigrant issues. Member, National Committee on Heath

  11. Overlooked and underserved: Widowed fathers with dependent-age children.

    Science.gov (United States)

    Yopp, Justin M; Park, Eliza M; Edwards, Teresa; Deal, Allison; Rosenstein, Donald L

    2015-10-01

    Widowed fathers and their children are at heightened risk for poor coping and maladaptive psychosocial outcomes. This exploratory study is the first to explicitly examine the psychological characteristics of this population of fathers. Some 259 fathers (mean age = 46.81; 90% Caucasian) with dependent-age children and whose wives had died from cancer within the previous five years completed a web-based survey that consisted of demographic questions, the Center for Epidemiologic Studies Depression Scale (CES-D), the Texas Inventory of Grief-Revised (TRIG-R), the Psychological Adaptation Scale (PAS), the Kansas Parental Satisfaction Scale (KPSS), and items assessing perceived parental efficacy. Fathers were found to have elevated depressive (CES-D mean = 22.6) and grief (TRIG-R mean = 70.3) symptomatology, low adaptation (PAS mean = 3.2), and high levels of stress related to their parenting role. They reported being satisfied with their parenting (KPSS mean = 15.8) and having met their own parental expectations. Multivariate analyses revealed an association between father's age and depression (p = fathers reporting greater depressive symptoms. Psychological adaptation was positively correlated with being in a romantic relationship (p = 0.02) and age of oldest child (p = 0.02). The results of our exploratory study suggest that, while widowed fathers perceive themselves as meeting their parental responsibilities, it comes at a substantial psychological cost, with particularly high stress related to being a sole parent. These findings may help guide interventions for this neglected population and underscore the importance of developing targeted therapies and research protocols to address their needs.

  12. AIDS Prevention for the Underserved Majority : the Choice Disabled ...

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

    With HIV rates as high as 33%, prevention should be a central component of strategies to tackle the HIV/AIDS epidemic in sub-Saharan Africa. Yet health resources are generally poorly optimized for prevention and almost without exception focused on the decision-enabled: those who have the agency to take preventive ...

  13. Deconstructing "Bistro 24" for a Traditionally Underserved Student Population

    Science.gov (United States)

    Thomas, Charles E.

    2016-01-01

    The "Journal of Legal Studies Education" article, "Step Away from the Syllabus: Engaging Students on the First Day of Legal Environment," encouraged instructors to rethink their approaches to the initial class session. The exercise offers an opportunity to introduce the relevance of the legal environment course within the…

  14. AIDS Prevention for the Underserved Majority : the Choice Disabled ...

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

    Renforcement de la capacité de mener des essais de prévention de la transmission du VIH au personnel de la santé. Les travailleurs de la santé constituent un groupe prioritaire pour les essais de prévention de la transmission du VIH puisqu'ils représentent un nombre relativement important de personnes à.

  15. Focus Cities : Improving the Living Environment in Underserved ...

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

    ... the Colombo city team seeks to address the problem of environmental degradation through action research on improved urban service delivery in Gothamipura district. Of particular interest to the city team is the link between land tenure, and water and sanitation services. Through consultation with the community, the team ...

  16. Refractive error in underserved adults: causes and potential solutions.

    Science.gov (United States)

    Jeganathan, V Swetha E; Robin, Alan L; Woodward, Maria A

    2017-07-01

    To evaluate the epidemiology of uncorrected refractive errors (URE) in adults both in the United States and globally, health outcomes impacted by URE, common barriers to treatment, and propose potential interventions. URE is the main cause of visual impairment and the second leading cause of blindness globally. Rates of URE are rising, and cause disability that reduces productivity, economic earnings, and the quality of life of affected individuals. Economic barriers, healthcare access, and sociocultural constraints are among the most fundamental barriers to correcting URE. However, innovative approaches are poised to lower rates of URE. URE is a leading cause of preventable visual impairment with serious health consequences. Numerous social and financial barriers are associated with the high prevalence of URE in low-income adults. Novel delivery programs for eyeglasses and programs to provide refractive surgery to correct refractive error could decrease rates of URE.

  17. Field research with underserved minorities: the ideal and the real.

    Science.gov (United States)

    Stiffman, Arlene Rubin; Freedenthal, Stacey; Brown, Eddie; Ostmann, Emily; Hibbeler, Patricia

    2005-06-01

    The realities of doing field research with high-risk, minority, or indigenous populations may be quite different than the guidelines presented in research training. There are overlapping and competing demands created by cultural and research imperatives. A National Institute on Drug Abuse (NIDA)-funded study of American Indian youth illustrates competing pressures between research objectives and cultural sensitivity. This account of the problems that were confronted and the attempts made to resolve them will hopefully fill a needed gap in the research literature and serve as a thought-provoking example for other researchers. This study built cross-cultural bridges. Researchers worked as a team with stakeholders to modify the instruments and methods to achieve cultural appropriateness. The researchers agreed to the communities' demands for increased service access and rights of refusal for all publications and presentations. Data indicate that these compromises did not substantially harm the first year of data collection completeness or the well-being of the youth. To the contrary, it enhanced the ability to disseminate results to those community leaders with the most vested interests. The conflicts between ideal research requirements and cultural demands confronted by the researchers and interviewers in the American Indian community were not necessarily different from issues faced by researchers in other communities. Of major import is the recognition that there are no easy answers to such issues within research.

  18. Focus Cities : Improving the Living Environment in Underserved ...

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

    IDRC's Focus Cities research program brings together researchers, municipal authorities, civil society organizations, the private sector and the poor to engage in urban environmental research with the goal of alleviating urban poverty. This project was selected as one of the four highest ranked in the 2005 Focus Cities ...

  19. Underserved populations in science education: Enhancement through learning community participation

    Science.gov (United States)

    Gray, Jennifer Emily

    A positive relationship between college anatomy students' achievement and academic language proficiency in the context of a learning community was established. For many students the barrier to learning science is language. A relationship exists between low academic language proficiency and lack of success among students, in particular failure among at-risk minority and language-minority students. The sample consisted of Anatomy classes during the Fall semesters of the academic years, 2000, 2001, and 2002 at a community college in Central California having a high percentage of culturally and linguistically diverse students. Students from each semester participated in the academic language proficiency and science achievement studies. Twenty-two of the Fall 2002 students (n = 65) enrolled in the Learning Community (LC) that included instruction in academic language in the context of the anatomy course content. Fall 2002 students (n = 19) also participated in Peer-led Support (PLS) sessions. Fall 2001 students participated in a textbook use study (n = 44) and in a Cooperative-Learning (CL) (n = 35) study. Students in the LC and Non-LC groups took the academic language assessment; their results were correlated with course grades and attendance. Fall 2002 students were compared for: (1) differences regarding self-expectations, (2) program impressions, and (3) demographics. Fall 2001 student reading habits and CL participation were analyzed. Results identified: (1) selected academic language tasks as good predictors of science success, (2) a significant positive relationship between science success and participation in support interventions, (3) no differences in self expectations or demographic characteristics of participants and non-participants in the LC group, and (4) poor textbook reading habits. Results showed a significant positive relationship between academic language proficiency and science achievement in participatory instruction.

  20. AIDS Prevention for the Underserved Majority : the Choice Disabled ...

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

    Researchers will document the extent of choice-disability, including sexual violence, and identify protective associations with local AIDS prevention efforts. Using a pragmatic randomized controlled trial (RCT), they will test the impact of various AIDS prevention interventions on the choice-disabled, with a special focus on ...

  1. Myths and misconceptions about abortion among marginalized underserved community.

    Science.gov (United States)

    Thapa, K; Karki, Y; Bista, K P

    2009-01-01

    Unsafe abortion remains a huge problem in Nepal even after legalization of abortion. Various myths and misconceptions persist which prompt women towards unsafe abortive practices. A qualitative study was conducted among different groups of women using focus group discussions and in depth interviews. Perception and understanding of the participants on abortion, methods and place of abortion were evaluated. A number of misconceptions were prevalent like drinking vegetable and herbal juices, and applying hot pot over the abdomen could abort pregnancy. However, many participants also believed that health care providers should be consulted for abortion. Although majority of the women knew that they should seek medical aid for abortion, they were still possessed with various misconceptions. Merely legalizing abortion services is not enough to reduce the burden of unsafe abortion. Focus has to be given on creating awareness and proper advocacy in this issue.

  2. Mammographic Breast Density in a Cohort of Medically Underserved Women

    Science.gov (United States)

    2015-12-01

    diagnosis or treatment (n = 190, response rate 97.0%). Controls of Hispanic ethnicity, aged 30–79, were randomly selected from women receiving a...than postmenopausal women. Premenopausal women were also more likely to have undergone menarche at a later age , to be nulliparous and obese , and to have...was a training year and during Years 2 through 4 a case-control study of obesity , insulin resistance and mammographic breast density was conducted. A

  3. Impediments to mortgage borrowing for the under-served urban ...

    African Journals Online (AJOL)

    This paper examines impediments to mortgage borrowing in South Africa. The analysis is premised on the fact that, despite South Africa's relatively sophisticated financial system compared to other countries in sub Saharan Africa, its housing finance system has not been able to replicate for the low to moderate income ...

  4. Organizational Dysfunctions: Sources and Areas

    Directory of Open Access Journals (Sweden)

    Jacek Pasieczny

    2016-12-01

    Full Text Available Objective:The purpose of this article is to identify and describe various types and sources of organizational dysfunctions. Research Design & Methods: The findings are based on literature review and an ongoing empirical research project conducted in private sector organisations. The empirical study can be situated within interpretative approach. In this qualitative project open interviews and observations were used to collect data. Findings: The study indicates that various types and sources of organizational dysfunctions can be identified in organizations operating in Poland. The sources of dysfunctions may be found both within the organization and its environment. Regardless of its specific features, most of the dysfunctions may be interpreted as an undesirable goal displacement. Very often areas of these dysfunctions are strongly interconnected and create a system that hinders organizational performance. Yet, it is difficult to study these phenomena as respondents are unwilling, for various reasons, to disclose the problems faced by their organizations. Implications & Recommendations: The results imply that the issue of organisational dysfunctions requires open, long-lasting and comparative studies. Recommendations for further studies are formulated in the last section of the paper. Contribution & Value Added: The paper provides insight into "the dark side of organising" by identifying sources and areas of dysfunctions. It also reveals difficulties connected with conducting research on dysfunctions in the Polish context.

  5. 300 Area signal cable study

    International Nuclear Information System (INIS)

    Whattam, J.W.

    1994-01-01

    This report was prepared to discuss the alternatives available for removing the 300 Area overhead signal cable system. This system, installed in 1969, has been used for various monitoring and communication signaling needs throughout the 300 Area. Over the years this cabling system has deteriorated, has been continually reconfigured, and has been poorly documented to the point of nonreliability. The first step was to look at the systems utilizing the overhead signal cable that are still required for operation. Of the ten systems that once operated via the signal cable, only five are still required; the civil defense evacuation alarms, the public address (PA) system, the criticality alarms, the Pacific Northwest Laboratory Facilities Management Control System (FMCS), and the 384 annunciator panel. Of these five, the criticality alarms and the FMCS have been dealt with under other proposals. Therefore, this study focused on the alternatives available for the remaining three systems (evacuation alarms, PA system, and 384 panel) plus the accountability aid phones. Once the systems to be discussed were determined, then three alternatives for providing the signaling pathway were examined for each system: (1) re-wire using underground communication ducts, (2) use the Integrated Voice/Data Telecommunications System (IVDTS) already installed and operated by US West, and (3) use radio control. Each alternative was developed with an estimated cost, advantages, and disadvantages. Finally, a recommendation was provided for the best alternative for each system

  6. Innovation investment area: Technology summary

    International Nuclear Information System (INIS)

    1994-03-01

    The mission of Environmental Management's (EM) Office of Technology Development (OTD) Innovation Investment Area is to identify and provide development support for two types of technologies that are developed to characterize, treat and dispose of DOE waste, and to remediate contaminated sites. They are: technologies that show promise to address specific EM needs, but require proof-of-principle experimentation; and (2) already proven technologies in other fields that require critical path experimentation to demonstrate feasibility for adaptation to specific EM needs. The underlying strategy is to ensure that private industry, other Federal Agencies, universities, and DOE National Laboratories are major participants in developing and deploying new and emerging technologies. To this end, about 125 different new and emerging technologies are being developed through Innovation Investment Area's (IIA) two program elements: RDDT ampersand E New Initiatives (RD01) and Interagency Agreements (RD02). Both of these activities are intended to foster research and development partnerships so as to introduce innovative technologies into other OTD program elements for expedited evaluation

  7. IMAGE INTERPRETATION OF COASTAL AREAS

    Directory of Open Access Journals (Sweden)

    M. A. Lazaridou

    2012-07-01

    Full Text Available Coasts were formed with the overall shape of earth's surface. Τhey represent a landform, as determined by the science of geomorphology. Being the boundary between land and sea, they present important features – particularities such as water currents, waves, winds, estuaries, drainage network, pollution etc. Coasts are examined at various levels: continents – oceans, states – large seas, as for example Mediterranean Sea. Greece, because of its horizontal and vertical partitioning, presents great extent and variety of coasts as mainland, peninsulas and islands. Depending on geomorphology, geology, soils, hydrology, land use of the inland and the coasts themselves, these are very diverse. Photogrammetry and Remote Sensing (defined by Statute II of ISPRS is the art, science, and technology of obtaining reliable information from non-contact imaging and other sensor systems about the Earth and its environment, and other physical objects and of processes through recording, measuring, analyzing and representation. This paper concerns critical considerations on the above. It also includes the case of Thessaloniki coasts in Greece, particularly river estuaries areas (river delta. The study of coastal areas of the wide surroundings of Thessaloniki city includes visual image interpretation – digital image processing techniques on satellite data of high spatial resolution.

  8. Geodiversity assessment in urban areas

    Science.gov (United States)

    Ilic, Marina; Stojković, Sanja; Rundić, Ljupko; Ćalić, Jelena; Sandić, Dejan

    2017-04-01

    Conflict over natural resources figured prominently in the urban areas. On the one hand there is a constant need for space for the construction of new buildings for housing, agriculture and industrial production, and on the other hand the resources need protection because of the threat of degradation or even complete destruction. Considering the fact that urbanization is one of the most serious threats to geodiversity, it is important that this issue is taken into account in spatial development plans and georesource management strategies in urban areas. The geodiversity, as well as natural resource, must be managed in a sustainable manner in which it is very important its protection. The mapping of specific categories of geodiversity (geological, geomorphological, hydrological and soil) on the basis of quantitative assessment with the use of Geographic Information Systems (GIS) can allow spatial planners and managers to take further steps that would reduce threats and protect the natural values. This work presents the application of geodiversity evaluation method by using the geodiversity index (Gd), based on the quantity of abiotic elements and relief roughness within a spatial unit in the case of the City of Belgrade, Serbia. The acquired results are analyzed in the context of sustainable use of georesources and the threats to which geodiversity is exposed due to the development of the city.

  9. Open areas and open access

    International Nuclear Information System (INIS)

    Thorndike, A.M.

    1978-01-01

    One objective of the two open areas in the present ISABELLE design is to provide flexibility with respect to the size and shape of experimental equipment that would eventually be installed there. No permanent building would be installed initially. A second objective of the design of open areas is to keep initial costs as low as practicable. Another objective is open access. This note explores this idea and some design concepts based on it. It would permit inserting large pieces of experimental equipment quickly and removing them with equal ease and speed. Entire experiments would be moved in a single piece (or a few) by building them on movable platforms with capacities of up to about 1000 tons per platform. Most experiments could be built on a single platform or on a few. The shielding must also be moved. It must also be organized into a small number of large units. A scheme using large tanks filled with water is described. It is important to make the equipment on a given platform as complete and self-contained as possible, with a minimum of interconnections for power, coolant, controls, data transmission, etc. 5 figures

  10. Regionally Significant Ecological Areas - MLCCS derived 2008

    Data.gov (United States)

    Minnesota Department of Natural Resources — This is an analysis of regionally significant Terrestrial and Wetland Ecological Areas in the seven county metropolitan area. Individual forest, grassland and...

  11. Central Region Regionally Ecological Significant Areas

    Data.gov (United States)

    Minnesota Department of Natural Resources — This is an analysis of regionally significant Terrestrial and Wetland Ecological Areas in the seven county metropolitan area. Individual forest, grassland and...

  12. Resource area environment/energy

    International Nuclear Information System (INIS)

    1994-01-01

    The document comprises a detailed analysis of the business economics of resources related to energy and the environment. Non-domestic and domestic conditions influencing the business economics of this subject area, its infrastructure, problems and future perspectives are dealt with. Tables (amongst other forms of information) indicate the turnover, exports, and numbers of involved employees, workplaces and firms involved in supply, general production, consultancy and production connected with the building sector. The energy sector is the most significant in this respect, giving 30,000 employed (18% in state institutions), a turnover of 63 billion Danish kroner, and with an export of 16 billion Danish kroner. The environmental sector employs 15,000 (29% in the public sector), the total turnover is 20 billion Danish kroner and of this 3 billion Danish kroner is related to export. Many firms are relatively small. A number of firms could compete internationally and this number is growing. (AB) (79 refs.)

  13. Ashland Area Support Substation Project

    International Nuclear Information System (INIS)

    1992-06-01

    The Bonneville Power Administration (BPA) provides wholesale electric service to the City of Ashland (the City) by transferring power over Pacific Power ampersand Light Company's (PP ampersand L) 115-kilovolt (kV) transmission lines and through PP ampersand L's Ashland and Oak Knoll Substations. The City distributes power over a 12.5-kV system which is heavily loaded during winter peak periods and which has reached the limit of its ability to serve peak loads in a reliable manner. Peak loads under normal winter conditions have exceeded the ratings of the transformers at both the Ashland and Oak Knoll Substations. In 1989, the City modified its distribution system at the request of PP ampersand L to allow transfer of three megawatts (MW's) of electric power from the overloaded Ashland Substation to the Oak Knoll Substation. In cooperation with PP ampersand L, BPA installed a temporary 6-8 megavolt-amp (MVA) 115-12.5-kV transformer for this purpose. This additional transformer, however, is only a temporary remedy. BPA needs to provide additional, reliable long-term service to the Ashland area through additional transformation in order to keep similar power failures from occurring during upcoming winters in the Ashland area. The temporary installation of another 20-MVA mobile transformer at the Ashland Substation and additional load curtailment are currently being studied to provide for sustained electrical service by the peak winter period 1992. Two overall electrical plans-of-service are described and evaluated in this report. One of them is proposed for action. Within that proposed plan-of-service are location options for the substation. Note that descriptions of actions that may be taken by the City of Ashland are based on information provided by them

  14. Safety analysis, 200 Area, Savannah River Plant: Separations area operations

    International Nuclear Information System (INIS)

    Perkins, W.C.; Lee, R.; Allen, P.M.; Gouge, A.P.

    1991-01-01

    The nev HB-Line, located on the fifth and sixth levels of Building 221-H, is designed to replace the aging existing HB-Line production facility. The nev HB-Line consists of three separate facilities: the Scrap Recovery Facility, the Neptunium Oxide Facility, and the Plutonium Oxide Facility. There are three separate safety analyses for the nev HB-Line, one for each of the three facilities. These are issued as supplements to the 200-Area Safety Analysis (DPSTSA-200-10). These supplements are numbered as Sup 2A, Scrap Recovery Facility, Sup 2B, Neptunium Oxide Facility, Sup 2C, Plutonium Oxide Facility. The subject of this safety analysis, the, Plutonium Oxide Facility, will convert nitrate solutions of 238 Pu to plutonium oxide (PuO 2 ) powder. All these new facilities incorporate improvements in: (1) engineered barriers to contain contamination, (2) barriers to minimize personnel exposure to airborne contamination, (3) shielding and remote operations to decrease radiation exposure, and (4) equipment and ventilation design to provide flexibility and improved process performance

  15. Safety analysis, 200 Area, Savannah River Plant: Separations area operations

    Energy Technology Data Exchange (ETDEWEB)

    Perkins, W.C.; Lee, R.; Allen, P.M.; Gouge, A.P.

    1991-07-01

    The nev HB-Line, located on the fifth and sixth levels of Building 221-H, is designed to replace the aging existing HB-Line production facility. The nev HB-Line consists of three separate facilities: the Scrap Recovery Facility, the Neptunium Oxide Facility, and the Plutonium Oxide Facility. There are three separate safety analyses for the nev HB-Line, one for each of the three facilities. These are issued as supplements to the 200-Area Safety Analysis (DPSTSA-200-10). These supplements are numbered as Sup 2A, Scrap Recovery Facility, Sup 2B, Neptunium Oxide Facility, Sup 2C, Plutonium Oxide Facility. The subject of this safety analysis, the, Plutonium Oxide Facility, will convert nitrate solutions of {sup 238}Pu to plutonium oxide (PuO{sub 2}) powder. All these new facilities incorporate improvements in: (1) engineered barriers to contain contamination, (2) barriers to minimize personnel exposure to airborne contamination, (3) shielding and remote operations to decrease radiation exposure, and (4) equipment and ventilation design to provide flexibility and improved process performance.

  16. Malaysia (country/area statements).

    Science.gov (United States)

    1985-09-01

    According to this statement presented to the Committee on Population of the UN Economic and Social Commission for Asia and the Pacific, Malaysia by 1984 achieved a crude death rate of 5.3/1000, an infant mortality rate of 17/1000 live births, and a 1983 life expectancy at birth of 67.6 for males and 72.3 for females due primarily to socioeconomic development, better nutrition, and a health system covering 95% of the rural population. Substantial mortality differentials still exist between Peninsular Malaysia, Sabah, and Sarawak, between urban and rural areas, and among ethnic groups. Differences in the coverage and quality of mortality statistics also exist. 83.2% of Malaysia's total population of 15.5 million is in Peninsular Malaysia, 7.3% in Sabah, and 9.5% in Sarawak. In Peninsular Malaysia, 55.1% are Malays, 33.9% Chinese, and 10.3% Indians. About 40% of the population is urban, and 39% is under age 15. The average annual rate of growth declined from 2.6% in the 1960s to 2.3% in the 1970s. The total fertility rate fell from 5.1 children in 1970 to 4.1 in 1980. A rise in age at 1st marriage and reduction in marital fertility have been partly offset by an increase in the proportion of women of childbearing age. The population is projected to grow to about 22 million by the year 2000. Chinese and Indians are expected to approach replacement level fertility by that year, but Malay fertility is expected to remain high for some time. Internal migration, 45% of which is intrarural, increased markedly in the 1970s, probably due to rapid modernization, industrialization, land development, and regional imbalances in economic development. In absolute terms a total of 410,000 persons moved from rural to urban areas during the 1970s. Important progress has been made in regional development programs, but further regional development requires resolution of problems related to internal migration and greater efforts to relocate industries in the less developed areas. The

  17. 47 CFR 101.1401 - Service areas.

    Science.gov (United States)

    2010-10-01

    ... Designated Market Areas (DMAs). The 214 DMA service areas are based on the 210 Designated Market Areas delineated by Nielsen Media Research and published in its publication entitled U.S. Television Household Estimates, September 2002, plus four FCC-defined DMA-like service areas. (a) Alaska—Balance of State (all...

  18. 76 FR 45710 - Pay in Nonforeign Areas

    Science.gov (United States)

    2011-08-01

    ... cost-of-living allowances (COLAs) in evaluating the need for special rates, special rate supplements to... in the nonforeign areas while phasing out nonforeign area cost-of-living allowances (COLAs...) Locality pay authorized under 5 U.S.C. 5304 for the area involved; (5) A nonforeign area cost-of-living...

  19. Alaska research natural areas: 1. Mount Prindle.

    Science.gov (United States)

    G.P. Juday

    1988-01-01

    The 2412-hectare Mount Prindle Research Natural Area is located in central Alaska on the border of the Steese National Conservation Area and White Mountains National Recreation Area. It is managed by the U.S. Department of the Interior, Bureau of Land Management, Steese-White Mountains District. Mount Prindle was selected as a Research Natural Area (RNA) because it...

  20. A unique radiation area monitoring system

    International Nuclear Information System (INIS)

    Murphy, P.C.; Allen, G.C.

    1978-01-01

    The Remote Area Monitoring Systems (RAMS) monitors four radiation areas with two independent systems in each area. Each system consists of power supplies, four ionization chambers, and four analog and digital circuits. The first system controls the warning beacons, horns, annunciation panel and interlocks. The second system presents a quantitative dose rate indication at the console and in the radiation area

  1. ROCK RIVER CANYON WILDERNESS STUDY AREA, MICHIGAN.

    Science.gov (United States)

    Whitlow, Jesse W.; Morey, Peter C.

    1984-01-01

    A mineral survey of the Rock River Canyon Wilderness study area, Alger County, Michigan, concluded that there is little promise for the occurrence of metallic mineral resources in the study area. High silica sand and crushed rock from quartzose sandstone that is bedrock for much of the area occur but are available in more accessible areas outside of the wilderness.

  2. A model for lightning in littoral areas

    NARCIS (Netherlands)

    Blaj, M.A.; Leferink, Frank Bernardus Johannes

    2009-01-01

    The littoral or coastal areas are different compared to the maritime or continental areas considering lightning. Only the last years some research about these areas has been carried out. The need for a model, regarding the lightning activity in these areas is much needed. And now, with the changes

  3. Hydrological regimes in Balkan Area

    International Nuclear Information System (INIS)

    Stanescu, Viorel Alexandru

    2004-01-01

    Physical considerations of the deemed area are first considered in the paper. Then the regime types around the Balkan rivers are described in terms of the following characteristic features: -Types of the regimes defined by the timing of the high and low flow phases; -Regionalisation of the 'micro-types' -Stability of the river flow regimes. The available mean monthly discharge data of the representative rivers allows characterising the river regime of the Balkan area covered by WOISYDES and BALWOIS projects. The classification of the hydrological regimes (types of regimes) was done by assessing the discriminant periods (descriptors of the regime phases) defined by the first, the second and the third highest and lowest monthly values of flows. As sufficient data has been provided by countries involved in the Woisydes/Balwois Project a hydrological regionalisation is performed all around the considered space. The existence of different zones, which are quasi- homogeneous in terms of physiographical properties, the latter especially being expressed by their mean altitudes and the climatic features, allowed to carry out a hydrological regionalisation of the river flow regime types. The regionalisation of the river flow regimes is presented as hydrological maps both referring to each Balkan country and for the entire region as an overall map. The stability of a certain flow regime is an important descriptor of the ecological state of the river during the year. It may be quantitatively expressed by the stability coefficient determined by Corbus and Stanescu as the product between the frequency of the occurrence of any discriminant value in m subsequent month (m = 1,12) and a distribution coefficient along the period that depend on the length of the considered discriminant period. The advantage of this method stands in the fact that for several combinations of subsequent months, the maximisation of the stability coefficient leads to the assessment of the characteristic

  4. AIR POLLUTION OF URBAN AREAS

    Directory of Open Access Journals (Sweden)

    MAKAROVA V. N.

    2016-04-01

    Full Text Available Raising of problem. Any manufacturing processes related to the generation of waste. Year after year, a growing mass of waste is one of the main factors reducing the quality of the environment and destruction of natural landscapes. Industrial development inevitably enhances human impacts on the environment and disrupts the ecological balance [3]. Atmospher air is a vital element of the environment. The development of industry, the growth of cities, increasing the number of transport, active exploration of near-Earth space lead to a change in the gas composition of the atmosphere and disruption of its natural balance. Air quality affects the health of the population [5]. Without water or food a person can do for a while, but without air he can not live a few minutes, therefore saving air breathable is an urgent problem. Purpose. The results of geological studies clearly indicate that the contamination of the surface layer of the atmosphere is the most powerful permanent factor of influence on the human food chain and the environment. This problem was reflected in the scientific literature [2; 3; 6], and the second significant indicator of ecological well-being of the region is the number of generation and accumulation of waste. According to this indicator, Dnipropetrovsk region is in the lead, as relates to the industrialized regions. The idea of the article is to consider the air pollution of the urban environment in terms of the accumulation of waste in the territory of enterprises, in particular slag dumps metallurgical production. Conclusion. Slag dumps located on the premises are a significant source of air pollution urbanized areas due to the permanent nature of the spread of contamination. Slag dump of PAT "Nikopol Ferroalloy Plant" is a source of manganese, zinc, nickel emissions. As a conclusion about the magnitude of pollution of the atmospheric boundary layer can say the following: on the border of the sanitary protection zone (SPZ, in

  5. Saraniyadhamma Community knowledge Incubator area

    Directory of Open Access Journals (Sweden)

    Siripong Arundechachai

    2017-03-01

    Full Text Available The purposes of this research were to 1 study the situation of the community knowledge incubator area at the past to the present time in Banhad,Tambon banhad, Amphoe banhad Changwat KhonKaen, 2 study guidelines Buddhadhamma “Saraniyadhamma” revised by Community knowledge application Banhad, Tambon banhad, Amphoe banhad Changwat KhonKaen, 3 study workflow of Saraniyadhamma that led to the creation of the network community knowledge incubator area together with another community. The target groups used in this research of the purposive sampling family farmers of 10, in Tambon banhad,Amphoe banhad Changwat KhonKaen. the Qualitative research.was used in this Study The results showed that 1 diversing issues in the Community live action of the relationships or occupations experience can be passed down, as well as the risk of loss the relationships between the people and people, people and supernatural. After people and nature lost in the community, but thay Continue to Perform, because community has strengths given the importance of all, to themselves, to others, generous, generosity, mounting traditions, Led to the creation Community Knowledge Incubator 2 adopting Buddhism’s “Saraniyadhamma 6” that applied to community Knowledge Incubator by giving to make immunity community. Strong The six fetures, were Principle 1: Metta-kayakamma, feature on sacrifiction, unity and synergy. Principle 2: Metta-manokamma, feature on mercifulness, collective sacrification. Principle 3: Metta-kayakamma, feature on good things, speak well, good action. Principle 4: Sadharana-bhogi, feature on humane society, mutual respect. Principle 5 Sila-samannata, feature on, follow the rules of society. Principle 5 Metta-manokamma feature on rationality, listening to the opinion of others. It found that there were process-driven learning and following six rules of saraniyadhamma, and immunity system, risk Decoupled. 3 Networks Saraniyadhamma learnt together with other

  6. Cortical areas involved in Arabic number reading.

    Science.gov (United States)

    Roux, F-E; Lubrano, V; Lauwers-Cances, V; Giussani, C; Démonet, J-F

    2008-01-15

    Distinct functional pathways for processing words and numbers have been hypothesized from the observation of dissociated impairments of these categories in brain-damaged patients. We aimed to identify the cortical areas involved in Arabic number reading process in patients operated on for various brain lesions. Direct cortical electrostimulation was prospectively used in 60 brain mappings. We used object naming and two reading tasks: alphabetic script (sentences and number words) and Arabic number reading. Cortical areas involved in Arabic number reading were identified according to location, type of interference, and distinctness from areas associated with other language tasks. Arabic number reading was sustained by small cortical areas, often extremely well localized (area (Brodmann area 45), the anterior part of the dominant supramarginal gyrus (Brodmann area 40; p area (Brodmann area 37; p areas.

  7. Cerrejon North Area, Environmental Administration

    International Nuclear Information System (INIS)

    Preteft Emiliani, Antonio

    1993-01-01

    The carboniferous complex of The Cerrejon North Area, it is located to the north of Colombia in the Atlantic coast, in the Guajira Department. The complex carboniferous has with three units: the mine, the railway and the shipment port. The associate companies, they have developed a series of plans to achieve that the ecosystem of the region like the life of the residents of the near towns to the carboniferous complex, don't be affected by the operation activities. From the beginning of the operations and according to the environmental impact study, was designed and it implanted a program of ecological protection with control actions and of monitory for the soil resources, water and air, of equal form, programs of social action were designed that allow that the realization of a work like this contributes benefits and non sacrifices to the human population, vegetable and animal of the region. The associates commit to make permanent efforts to improve the environmental acting in all the activities of their business, it will stimulate the respect and the concern for the environment, natural and social, and it will emphasize each employee's individual responsibility in the environmental acting

  8. Sistem Rantai Pasok Pupuk Area

    Directory of Open Access Journals (Sweden)

    Harry Rahmadi Putra

    2011-10-01

    Full Text Available PT. Pupuk Kaltim is biggest manure manufacturer in Indonesia, where its market area covering entire Sulawesi, Bali, some of Kalimantan East Java, Papua, Japan, Taiwan, India, and Australia. Main produced product of PT Pupuk Kaltim is based fertilizer. To meet the demand, PT Kaltim produce up to 2,3 million tons per year.Identifiaction process of supply chain done by accesing company website of PT Kaltim. Then it is outlined each step of supply chain from aggregate planning, production process, suppliers selection, quality mangement, warehousing, performance measure and used transportation unit. From that criteria would visible supply chain of based-fertilizer in PT Pupuk Kaltim. By having long and wide supply chain, PT Pupuk Kaltim still have bullwhip effect because of inacurate in forecasting cause over-stock or out of stock in many production period. In quality, PT Kaltim had got ISO 9001, ISO 14001 and ISO 17025 certification in production management and sea-port. Keywords: Fertilizer, supply chain, analysis

  9. A large area GEM detector

    CERN Document Server

    Duarte Pinto, Serge; Brock, Ian; Croci, Gabriele; David, Eric; de Oliveira, Rui; Pinchasik, Bat-El; Ropelewski, Leszek; Sauli, Fabio; van Stenis, Miranda

    2009-01-01

    A prototype triple GEM detector has been constructed with an area of similar to 2000 cm(2), based on foils of 66 cm x 66 cm. GEMS of such dimensions have not been made before, and innovations to the existing technology were made to build this detector. A single-mask technique overcomes the cumbersome practice of alignment of two masks, which limits the achievable lateral size. Refinement of this technique results in foils with performance similar to traditional GEMS, while lowering cost and complexity of production. In a splicing procedure, foils are glued over a narrow seam, thus obtaining a larger foil. This procedure was shown not to affect the performance of the GEMS. The seam can be as narrow as 2 mm, mechanically strong enough to withstand the necessary stretching tension, and sufficiently flat to maintain homogeneous electric fields in the gas volumes above and below the foil. These innovations should make the manufacture Of GEM foils of 1 m(2) and beyond possible. With the planned high luminosity upgr...

  10. China (country/area statements).

    Science.gov (United States)

    1985-09-01

    According to this statement presented to the Committee on Population of the UN Economic and Social Commission for Asia and the Pacific, China is similar to other countries in the region in that its rate of population growth has declined due to government family planning efforts while the absolute size of the population continues to increase because of the widening population base. However, China's enormous population of over 1 billion sets it apart and places great strain on economic development efforts. In the past decade the Chinese government has provided population education for the masses, explaining the relationship between population and socioeconomic development, and its overall family planning program has helped reduce population growth from 24.82/1000 in 1974 to 10.81/1000 in 1984. The net population increase has been over 100 million in the past 10 years, and if the present rate of increase with a total fertility rate of 2.1 is maintained for another 15 years, the total population would exceed 1.3 billion by 2000, posing a grave threat to China's socioeconomic development. The nucleus of China's population policy is its birth policy, whose main points are to promote family planning so that population growth will be in keeping with socioeconomic development and the utilization of natural resources and environmental protection. The policy is in line with the principles and objectives of the World Population Plan of Action adopted in 1974. The government has advocated the practice of "1 couple, 1 child" since 1979 to carry out the population policy and limit the total population to about 1.2 billion by the century's end. 28.17 million couples, 18.25% of the 150 million married couples of childbearing age, had received 1-child certificates by the end of 1984. Generally speaking, most couples in urban areas would be satisfied with 1 child, while those in rural areas usually prefer 2 children. The family planning program is carried out through publicity

  11. Disparities in the use of mobile phone for seeking childbirth services among women in the urban areas: Bangladesh Urban Health Survey.

    Science.gov (United States)

    Bishwajit, Ghose; Hoque, Md Rakibul; Yaya, Sanni

    2017-12-29

    In Bangladesh, similar to its other South Asian counterparts, shortage of health workers along with inadequate infrastructure constitute some of the major obstacles for the equitable provision of reproductive healthcare services, particularly among the marginalized and underserved neighbourhoods. However, given the rapidly expanding broadband communication and mobile phone market in the country, the application of eHealth and mHealth technologies offer a window of opportunities to minimise the impact of socioeconomic barriers and promote the utilization of maternal healthcare services thereby. In the present study we aimed to investigate 1) the prevalence of usage of mobile phones for seeking childbirth services, 2) neighbourhood and socioeconomic disparities in the use, and 3) association between using mobile phones and the uptake of postnatal care among mothers and neonates. Data for the present study came from Bangladesh Urban Health Survey 2013. Study subjects were 9014 married women aged between 15 and 49 years. The overall rate of use of mobile phone was highest in City Corporation non-Slum areas (16.2%) and lowest in City Corporation Slum areas (7.4%). The odds of using mobile for seeking childbirth services were significantly higher among those who were living in non-slum areas, and lower among those who never attended school and lived in poorer households. Results also indicated that women in the slum areas who used mobile phone for childbirth service seeking, were 4.3 times [OR = 4.250;95% CI = 1.856-9.734] more likely to receive postnatal care for themselves, and those from outside the city-corporation areas were 2.7 times [OR = 2.707;95% CI = 1.712-4.279] more likely to receive postnatal care for the newborn. Neighbourhood, educational and economic factors were significantly associated with the mobile phone utilization status among urban women. Promoting access to better education and sustainable income earning should be regarded as an

  12. Vulnerability of intertropical littoral areas

    Science.gov (United States)

    Manighetti, Isabelle; De Wit, Rutger; Duvail, Stéphanie; Seyler, Patrick

    2017-10-01

    The coastal zone is of very high importance for human development and human wellbeing. Half of the global urban population lives in the coastal zone, where it has access to both continental and marine ecosystem services and to maritime transport. These urban populations coexist with rural and traditional coastal populations, some of which still possess good traditional ecological knowledge of the coastal ecosystems. Marine biodiversity and favourable environmental conditions sustain fisheries and aquaculture, represent a source of inspiration for humankind and provide numerous opportunities for recreation and tourism. In addition, coastal areas provide nursery functions for juvenile fish and invertebrates, which is important for the fish and crayfish stocks exploited offshore. Located at the interface between marine energy and continental processes, the coastal landscapes are dynamic environments. Nevertheless, the destruction of habitats and the increasing exploitation of the coastal zone represent serious threats to the ecosystems. Moreover, human land use and modifications in the watersheds have strong impacts on the coastal zone primarily by contributing to their pollution and nutrient over-enrichment. Damming and creation of reservoirs upstream also heavily modify the hydrology of the watersheds and often dramatically reduce the delivery of sediments to the coastal zone. In addition to these regional and local anthropogenic impacts, the coastal zone is vulnerable to global change among which sea level rise and climate change are particularly important drivers. Many coastal zones extend along giant faults and subduction zones, which makes them particularly exposed to earthquakes and tsunami hazards. Other forms of natural hazards are caused by hurricanes and cyclones that develop at sea and whose trajectories often hit the coastlines.

  13. Plague in the genomic area.

    Science.gov (United States)

    Drancourt, M

    2012-03-01

    With plague being not only a subject of interest for historians, but still a disease of public health concern in several countries, mainly in Africa, there were hopes that analyses of the Yersinia pestis genomes would put an end to this deadly epidemic pathogen. Genomics revealed that Y. pestis isolates evolved from Yersinia pseudotuberculosis in Central Asia some millennia ago, after the acquisition of two Y. pestis-specific plasmids balanced genomic reduction parallel with the expansion of insertion sequences, illustrating the modern concept that, except for the acquisition of plasmid-borne toxin-encoding genes, the increased virulence of Y. pestis resulted from gene loss rather than gene acquisition. The telluric persistence of Y. pestis reminds us of this close relationship, and matters in terms of plague epidemiology. Whereas biotype Orientalis isolates spread worldwide, the Antiqua and Medievalis isolates showed more limited expansion. In addition to animal ectoparasites, human ectoparasites such as the body louse may have participated in this expansion and in devastating historical epidemics. The recent analysis of a Black Death genome indicated that it was more closely related to the Orientalis branch than to the Medievalis branch. Modern Y. pestis isolates grossly exhibit the same gene content, but still undergo micro-evolution in geographically limited areas by differing in the genome architecture, owing to inversions near insertion sequences and the stabilization of the YpfPhi prophage in Orientalis biotype isolates. Genomics have provided several new molecular tools for the genotyping and phylogeographical tracing of isolates and description of plague foci. However, genomics and post-genomics approaches have not yet provided new tools for the prevention, diagnosis and management of plague patients and the plague epidemics still raging in some sub-Saharan countries. © 2012 The Author. Clinical Microbiology and Infection © 2012 European Society of

  14. The metro area of Montreal.

    Science.gov (United States)

    1986-10-01

    Montreal, one of the most civilized and cosmopolitan of North American cities, is the 2nd city in Canada in size and the largest French-speaking city. Of the 2.8 million people who lived there at census time in 1981, 45% chose both French and English as their official language, 41% chose French, and 1% used some other language. Fully 68% of Montreal residents said their mother tongue was French, and 68% also said they spoke French at home. The importance of bilingualism to the business culture of Montreal cannot be overemphasized. In the last decade, French-Canadians have taken an increasingly stronger role in business. Upper-middle-class suburbs that as little as 10 years ago had only 10% of their residents who were of French-Canadian descent now have as many as 50-60% of their residents who are French-Canadians. Most residents of Montreal willingly learn 2 languages. US firms should assume that all representatives who are sent to Montreal should be fluent in both French and English. Montreal's 2,828,349 people create a population density of 1004.9 persons per square kilometer. Montreal has 665 census tracts, which are described in the Metropolitan Atlas Series. Nearly 62% of Montreal's population fall between the ages of 20 and 64--the prime working ages. Although Montreal is 79% Catholic, it does not have the high fertility levels often associated with Catholic areas. There were 1,026,920 households in Montreal in 1981 with an average of 2.7 persons per household. 71% of these were census family households. Montreal had 1,026,895 occupied dwellings in 1985 with an average of 5 rooms each. About 71% of the population aged 15 and over that were not in school were in the labor force; 41% of the labor force was female. The largest employment category for men was manufacturing (16%) and the largest for women was clerical work (39%).

  15. Archiving a Software Development Project

    Science.gov (United States)

    2013-04-01

    standard covers all types of storage media including paper, audiovisual material, microforms and machine-readable formats. It represents a code of best...management, particularly in the area of production of strategic estimates. Peter’s research interests are in the way people acquire, use and...CC3ID Chief of C3ID CD Compact Disk – a form of optical storage media See: http://en.wikipedia.org/wiki/Compact_Disc) Collection The

  16. Philippines (country/area statements).

    Science.gov (United States)

    1985-09-01

    According to this statement presented to the Committee on Population of the UN Economic and Social Commission for Asia and the Pacific, the 1980 Philippine census enumerated 48.1 million persons, a more than 6-fold increase over the 7.6 million of 1903. The 1913-39 average intercensal growth rate of 2.22% declined during World War II but soared to 3.06% from 1948-60. The growth rate was 2.71% between 1975-80. The median age was 20.2 in 1903, 16.9 in 1970 and 18.6 in 1980. The crude birth rate declined from 46.0/1000 in 1960 to 34.8 in 1975, while the crude death rate declined from 13.7/1000 in 1960 to 9.3 in 1975. The average age of Filipino women at marriage increased from 23.2 in 1975 to 24 in 1978, causing a decline of the total fertility rate from 5.89 to 4.70. The infant mortality rate was expected to decline from 59.3 in 1983 to 54.2 in 1987. The Philippines was still 63% rural in 1980 despite the concentration of urban growth in Manila. As of 1983, the Philippine Overseas Employment Administration had processed 434,207 employment contracts, of which 65.5% were for production process workers, transport equipment operators, and laborers, 15.3% were for service workers, and 13.9% were for professional and technical workers. The Philippine Family Planning program aims to reduce population growth from an estimated 2.54% in 1983 to 1.92% by 1993 and to achieve replacement level fertility by 2010. As a result of the 1978 review of the Philippine Population Programme, the focus is now on longterm planning to ensure more significant and perceptible demographic impact of development programs and policies. The Population Education Program aims to inculcate values supporting family planning in the areas of family size and welfare, responsible parenthood, and delayed marriage, while the Adolescent Fertility Program seeks to reduce the incidence of early marriage and pregnancy. 3496 clinics, hospitals, and sterilization centers provide family planning and related services

  17. Important Bird Areas California Audubon [ds485

    Data.gov (United States)

    California Natural Resource Agency — The objective of this project was to digitally map the boundaries of Audubon California's Important Bird Areas (IBA). Existing Important Bird Areas identify critical...

  18. Elephant Butte Special Flood Hazard Areas (SFHA)

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — This vector dataset depicts the 1% annual flood boundary (otherwise known as special flood hazard area or 100 year flood boundary) for its specified area. The data...

  19. Hawaii ESI: MGT (Management Area Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains management area data for artificial reefs, designated critical habitats, national parks, marine sanctuaries, special management areas,...

  20. Mandatory Class 1 Federal Areas Web Service

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web service contains the following layers: Mandatory Class 1 Federal Area polygons and Mandatory Class 1 Federal Area labels in the United States. The polygon...

  1. AgSat Areas of Interest

    Data.gov (United States)

    Farm Service Agency, Department of Agriculture — The AgSat Areas of Interest map contains area polygons where satellite imagery will be collected for the Farm Service Agency (FSA) to provide imagery coverage for...

  2. Examination of catchment areas for public transport

    DEFF Research Database (Denmark)

    Landex, Alex; Hansen, Stephen; Andersen, Jonas Lohmann Elkjær

    2006-01-01

    simple method using only the Euclidean distance from the examined stop and the paper describes the differences in detail-level of the results. Furthermore, the paper describes how the Service Area method can be used to examine increments in the catchment areas by adding extra entrances to stations...... or by making changes in the street network around the station. The paper also discusses the degree of realism in the used GIS networks and how it can affect the size of the catchment areas. It is concluded that the Service Area method improves the detail-level and accuracy in catchment area analyses......The paper presents a method to examine the catchment areas for stops in high quality public transport systems based on the street network in the examined area. This is achieved by implementing the Service Area functions from the ArcGIS extension Network Analyst. The method is compared to a more...

  3. Coding Theory, Cryptography and Related Areas

    DEFF Research Database (Denmark)

    Buchmann, Johannes; Stichtenoth, Henning; Tapia-Recillas, Horacio

    Proceedings of anInternational Conference on Coding Theory, Cryptography and Related Areas, held in Guanajuato, Mexico. in april 1998......Proceedings of anInternational Conference on Coding Theory, Cryptography and Related Areas, held in Guanajuato, Mexico. in april 1998...

  4. Area spectrum of slowly rotating black holes

    OpenAIRE

    Myung, Yun Soo

    2010-01-01

    We investigate the area spectrum for rotating black holes which are Kerr and BTZ black holes. For slowly rotating black holes, we use the Maggiore's idea combined with Kunstatter's method to derive their area spectra, which are equally spaced.

  5. 50 CFR 665.198 - Management area.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES IN THE WESTERN PACIFIC Hawaii Fisheries § 665.198 Management area. The Hawaii fishery management area is the EEZ seaward of the State of Hawaii, including the Main...

  6. 50 CFR 665.398 - Management area.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES IN THE WESTERN PACIFIC Mariana Archipelago Fisheries § 665.398 Management area. The Mariana fishery management area is the EEZ seaward of Guam and CNMI with the inner...

  7. American Samoa ESI: MGT (Management Area Polygons)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains management area data for special management areas, marine parks, marine sanctuaries, national parks, and wildlife refuges in American Samoa....

  8. DNR Division of Enforcement Officer Patrol Areas

    Data.gov (United States)

    Minnesota Department of Natural Resources — This theme shows the DNR Division of Enforcement Office Patrol Areas as of January 1, 2003. Patrol areas were defined and verified by Patrol Officers during the fall...

  9. West Coast Rockfish Conservation Areas, 2015

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These data delineate Rockfish Conservation Areas (RCA) off the West Coast of the United States for 2015. There are three types of areas closures depicted in this...

  10. 7 CFR 983.25 - Production area.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements..., ARIZONA, AND NEW MEXICO Definitions § 983.25 Production area. Production Area means the States of California, Arizona, and New Mexico. ...

  11. Climate change threatens European conservation areas

    DEFF Research Database (Denmark)

    Bastos Araujo, Miguel; Alagador, Diogo; Cabeza, Mar

    2011-01-01

    Europe has the world's most extensive network of conservation areas. Conservation areas are selected without taking into account the effects of climate change. How effectively would such areas conserve biodiversity under climate change? We assess the effectiveness of protected areas and the Natura...... 2000 network in conserving a large proportion of European plant and terrestrial vertebrate species under climate change. We found that by 2080, 58 ± 2.6% of the species would lose suitable climate in protected areas, whereas losses affected 63 ± 2.1% of the species of European concern occurring...... in Natura 2000 areas. Protected areas are expected to retain climatic suitability for species better than unprotected areas (P...

  12. Science and Technology Business Area Strategic Plan

    National Research Council Canada - National Science Library

    Paul, Richard

    2000-01-01

    The S&T Business Area Strategic Plan has been updated to include lessons learned over the last two years, identifies areas that need to be reviewed further, addresses business opportunities and threats...

  13. Sustainable Rest Area Design and Operations

    Science.gov (United States)

    2017-10-01

    One way in which State Departments of Transportation (DOTs) can modernize their rest areas while reducing operations and maintenance costs is by incorporating sustainable practices into rest area design and operations. Sustainability practices that D...

  14. 33 CFR 156.310 - Prohibited areas.

    Science.gov (United States)

    2010-07-01

    ...″, and thence to the point of beginning. (NAD 83) (c) Ewing—prohibited area. This prohibited area... waters bounded by a line connecting the following points beginning at: Latitude N. Longitude W. 28°15′00...′00″, and thence to the point of beginning. (NAD 83) (b) Flower Garden—prohibited area. This...

  15. 7 CFR 955.4 - Production area.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Production area. 955.4 Section 955.4 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Definitions § 955.4 Production area. Production area means that part of the State of Georgia enclosed by the...

  16. 50 CFR 665.598 - Management area.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES IN THE WESTERN PACIFIC Pacific Remote Island Area Fisheries § 665.598 Management area. The PRIA fishery management area is the EEZ seaward of Palmyra Atoll, Kingman Reef, Jarvis Island, Baker Island, Howland Island, Johnston Atoll, and Wake Island, Pacific Remote...

  17. 50 CFR 665.422 - Management area.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES IN THE WESTERN PACIFIC Mariana Archipelago Fisheries § 665.422 Management area. The Mariana coral reef management area consists of the U.S. EEZ around Guam and the offshore area of the CNMI or that portion of the U.S. EEZ around CNMI between three nautical miles offshore and...

  18. 50 CFR 665.798 - Management area.

    Science.gov (United States)

    2010-10-01

    ..., possess, or transship western Pacific pelagic fishery MUS within the EEZ waters around American Samoa..., DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES IN THE WESTERN PACIFIC Western Pacific Pelagic Fisheries § 665.798 Management area. The western Pacific Pelagic fishery management area includes all areas of fishing...

  19. 30 CFR 57.11052 - Refuge areas.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Refuge areas. 57.11052 Section 57.11052 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND... Escapeways-Underground Only § 57.11052 Refuge areas. Refuge areas shall be— (a) Of fire-resistant...

  20. Transport and mobility in protected areas

    Directory of Open Access Journals (Sweden)

    Cirillo C

    2006-01-01

    Full Text Available Mobility is an essential feature of the social, economic and productive structure of any area, and become crucial for protected or high naturalistic value areas, where the transport system should have low environmental impact. Suitable tools aimed to avoid, reduce or counterbalance negative effects of transportation in protected areas are discussed.