A service-oriented data access control model
NASA Astrophysics Data System (ADS)
Meng, Wei; Li, Fengmin; Pan, Juchen; Song, Song; Bian, Jiali
2017-01-01
The development of mobile computing, cloud computing and distributed computing meets the growing individual service needs. Facing with complex application system, it's an urgent problem to ensure real-time, dynamic, and fine-grained data access control. By analyzing common data access control models, on the basis of mandatory access control model, the paper proposes a service-oriented access control model. By regarding system services as subject and data of databases as object, the model defines access levels and access identification of subject and object, and ensures system services securely to access databases.
A Privacy Access Control Framework for Web Services Collaboration with Role Mechanisms
NASA Astrophysics Data System (ADS)
Liu, Linyuan; Huang, Zhiqiu; Zhu, Haibin
With the popularity of Internet technology, web services are becoming the most promising paradigm for distributed computing. This increased use of web services has meant that more and more personal information of consumers is being shared with web service providers, leading to the need to guarantee the privacy of consumers. This paper proposes a role-based privacy access control framework for Web services collaboration, it utilizes roles to specify the privacy privileges of services, and considers the impact on the reputation degree of the historic experience of services in playing roles. Comparing to the traditional privacy access control approaches, this framework can make the fine-grained authorization decision, thus efficiently protecting consumers' privacy.
Access Control in Location-Based Services
NASA Astrophysics Data System (ADS)
Ardagna, Claudio A.; Cremonini, Marco; de Capitani di Vimercati, Sabrina; Samarati, Pierangela
Recent enhancements in location technologies reliability and precision are fostering the development of a new wave of applications that make use of the location information of users. Such applications introduces new aspects of access control which should be addressed. On the one side, precise location information may play an important role and can be used to develop Location-based Access Control (LBAC) systems that integrate traditional access control mechanisms with conditions based on the physical position of users. On the other side, location information of users can be considered sensitive and access control solutions should be developed to protect it against unauthorized accesses and disclosures. In this chapter, we address these two aspects related to the use and protection of location information, discussing existing solutions, open issues, and some research directions.
47 CFR 95.645 - Control accessibility.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 47 Telecommunication 5 2013-10-01 2013-10-01 false Control accessibility. 95.645 Section 95.645 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES Technical Regulations Certification Requirements § 95.645 Control accessibility. (a) No control...
47 CFR 95.645 - Control accessibility.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 47 Telecommunication 5 2014-10-01 2014-10-01 false Control accessibility. 95.645 Section 95.645 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES Technical Regulations Certification Requirements § 95.645 Control accessibility. (a) No control...
47 CFR 95.645 - Control accessibility.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 5 2010-10-01 2010-10-01 false Control accessibility. 95.645 Section 95.645 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES Technical Regulations Certification Requirements § 95.645 Control accessibility. (a) No control...
47 CFR 95.645 - Control accessibility.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 47 Telecommunication 5 2011-10-01 2011-10-01 false Control accessibility. 95.645 Section 95.645 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES PERSONAL RADIO SERVICES Technical Regulations Certification Requirements § 95.645 Control accessibility. (a) No control...
A Flexible Component based Access Control Architecture for OPeNDAP Services
NASA Astrophysics Data System (ADS)
Kershaw, Philip; Ananthakrishnan, Rachana; Cinquini, Luca; Lawrence, Bryan; Pascoe, Stephen; Siebenlist, Frank
2010-05-01
Network data access services such as OPeNDAP enable widespread access to data across user communities. However, without ready means to restrict access to data for such services, data providers and data owners are constrained from making their data more widely available. Even with such capability, the range of different security technologies available can make interoperability between services and user client tools a challenge. OPeNDAP is a key data access service in the infrastructure under development to support the CMIP5 (Couple Model Intercomparison Project Phase 5). The work is being carried out as part of an international collaboration including the US Earth System Grid and Curator projects and the EU funded IS-ENES and Metafor projects. This infrastructure will bring together Petabytes of climate model data and associated metadata from over twenty modelling centres around the world in a federation with a core archive mirrored at three data centres. A security system is needed to meet the requirements of organisations responsible for model data including the ability to restrict data access to registered users, keep them up to date with changes to data and services, audit access and protect finite computing resources. Individual organisations have existing tools and services such as OPeNDAP with which users in the climate research community are already familiar. The security system should overlay access control in a way which maintains the usability and ease of access to these services. The BADC (British Atmospheric Data Centre) has been working in collaboration with the Earth System Grid development team and partner organisations to develop the security architecture. OpenID and MyProxy were selected at an early stage in the ESG project to provide single sign-on capability across the federation of participating organisations. Building on the existing OPeNDAP specification an architecture based on pluggable server side components has been developed at the BADC
Accessibility, Textbooks, and Access Services
ERIC Educational Resources Information Center
Kahler, Janice E.
2017-01-01
Putting access in Access Services is the goal. The Course Reserves unit is the place. Textbooks are the focus. Electronic technologies are the future. Patron-centric services will be our standard. Access to textbooks by all patrons will be the achievement. Course Reserves located in Library West at the University of Florida George A. Smathers…
Accessible transit services for all.
DOT National Transportation Integrated Search
2014-12-01
Ensuring the provision of accessible transit services for all requires that both accessible fixed-route transit services and Americans with Disabilities Act (ADA) complementary paratransit services be provided. Significant progress has been made on b...
Access Control of Web- and Java-Based Applications
NASA Technical Reports Server (NTRS)
Tso, Kam S.; Pajevski, Michael J.
2013-01-01
Cybersecurity has become a great concern as threats of service interruption, unauthorized access, stealing and altering of information, and spreading of viruses have become more prevalent and serious. Application layer access control of applications is a critical component in the overall security solution that also includes encryption, firewalls, virtual private networks, antivirus, and intrusion detection. An access control solution, based on an open-source access manager augmented with custom software components, was developed to provide protection to both Web-based and Javabased client and server applications. The DISA Security Service (DISA-SS) provides common access control capabilities for AMMOS software applications through a set of application programming interfaces (APIs) and network- accessible security services for authentication, single sign-on, authorization checking, and authorization policy management. The OpenAM access management technology designed for Web applications can be extended to meet the needs of Java thick clients and stand alone servers that are commonly used in the JPL AMMOS environment. The DISA-SS reusable components have greatly reduced the effort for each AMMOS subsystem to develop its own access control strategy. The novelty of this work is that it leverages an open-source access management product that was designed for Webbased applications to provide access control for Java thick clients and Java standalone servers. Thick clients and standalone servers are still commonly used in businesses and government, especially for applications that require rich graphical user interfaces and high-performance visualization that cannot be met by thin clients running on Web browsers
Context-aware access control for pervasive access to process-based healthcare systems.
Koufi, Vassiliki; Vassilacopoulos, George
2008-01-01
Healthcare is an increasingly collaborative enterprise involving a broad range of healthcare services provided by many individuals and organizations. Grid technology has been widely recognized as a means for integrating disparate computing resources in the healthcare field. Moreover, Grid portal applications can be developed on a wireless and mobile infrastructure to execute healthcare processes which, in turn, can provide remote access to Grid database services. Such an environment provides ubiquitous and pervasive access to integrated healthcare services at the point of care, thus improving healthcare quality. In such environments, the ability to provide an effective access control mechanism that meets the requirement of the least privilege principle is essential. Adherence to the least privilege principle requires continuous adjustments of user permissions in order to adapt to the current situation. This paper presents a context-aware access control mechanism for HDGPortal, a Grid portal application which provides access to workflow-based healthcare processes using wireless Personal Digital Assistants. The proposed mechanism builds upon and enhances security mechanisms provided by the Grid Security Infrastructure. It provides tight, just-in-time permissions so that authorized users get access to specific objects according to the current context. These permissions are subject to continuous adjustments triggered by the changing context. Thus, the risk of compromising information integrity during task executions is reduced.
A dynamic access control method based on QoS requirement
NASA Astrophysics Data System (ADS)
Li, Chunquan; Wang, Yanwei; Yang, Baoye; Hu, Chunyang
2013-03-01
A dynamic access control method is put forward to ensure the security of the sharing service in Cloud Manufacturing, according to the application characteristics of cloud manufacturing collaborative task. The role-based access control (RBAC) model is extended according to the characteristics of cloud manufacturing in this method. The constraints are considered, which are from QoS requirement of the task context to access control, based on the traditional static authorization. The fuzzy policy rules are established about the weighted interval value of permissions. The access control authorities of executable service by users are dynamically adjusted through the fuzzy reasoning based on the QoS requirement of task. The main elements of the model are described. The fuzzy reasoning algorithm of weighted interval value based QoS requirement is studied. An effective method is provided to resolve the access control of cloud manufacturing.
Service composition towards increasing end-user accessibility.
Kaklanis, Nikolaos; Votis, Konstantinos; Tzovaras, Dimitrios
2015-01-01
This paper presents the Cloud4all Service Synthesizer Tool, a framework that enables efficient orchestration of accessibility services, as well as their combination into complex forms, providing more advanced functionalities towards increasing the accessibility of end-users with various types of functional limitations. The supported services are described formally within an ontology, enabling, thus, semantic service composition. The proposed service composition approach is based on semantic matching between services specifications on the one hand and user needs/preferences and current context of use on the other hand. The use of automatic composition of accessibility services can significantly enhance end-users' accessibility, especially in cases where assistive solutions are not available in their device.
Diabetes care and service access among elderly Vietnamese with type 2 diabetes.
Carolan-Olah, Mary C; Cassar, Angie; Quiazon, Regina; Lynch, Sean
2013-10-29
Vietnamese patients are disproportionately represented in type 2 diabetes mellitus statistics and also incur high rates of diabetes complications. This situation is compounded by limited access to health care. The aim of this project was to gain a deeper understanding of the difficulties Vietnamese patients experience when accessing services and managing their type 2 diabetes mellitus, and to identify factors that are important in promoting health service use. Three focus groups with 15 Vietnamese participants with type 2 diabetes mellitus, 60 to >70 years of age, were conducted in Vietnamese. Open-ended questions were used and focussed on experiences of living with diabetes and access to healthcare services in the Inner Northwest Melbourne region. Audio recordings were transcribed and then translated into English. Data were analysed using a thematic analysis framework. Findings indicate four main themes, which together provide some insight into the experiences of living with diabetes and accessing ongoing care and support, for elderly Vietnamese with type 2 diabetes. Themes included: (1) the value of being healthy; (2) controlling diabetes; (3) staying healthy; and (4) improving services and information access. Participants in this study were encouraged to adhere to diabetes self-management principles, based largely on a fear of medical complications. Important aspects of healthcare access were identified as; being treated with respect, having their questions answered and having access to interpreters and information in Vietnamese. Attention to these details is likely to lead to improved access to healthcare services and ultimately to improve glycemic control and overall health status for this community.
BioServices: a common Python package to access biological Web Services programmatically.
Cokelaer, Thomas; Pultz, Dennis; Harder, Lea M; Serra-Musach, Jordi; Saez-Rodriguez, Julio
2013-12-15
Web interfaces provide access to numerous biological databases. Many can be accessed to in a programmatic way thanks to Web Services. Building applications that combine several of them would benefit from a single framework. BioServices is a comprehensive Python framework that provides programmatic access to major bioinformatics Web Services (e.g. KEGG, UniProt, BioModels, ChEMBLdb). Wrapping additional Web Services based either on Representational State Transfer or Simple Object Access Protocol/Web Services Description Language technologies is eased by the usage of object-oriented programming. BioServices releases and documentation are available at http://pypi.python.org/pypi/bioservices under a GPL-v3 license.
Cruz-Piris, Luis; Rivera, Diego; Marsa-Maestre, Ivan; de la Hoz, Enrique; Velasco, Juan R
2018-03-20
Internet growth has generated new types of services where the use of sensors and actuators is especially remarkable. These services compose what is known as the Internet of Things (IoT). One of the biggest current challenges is obtaining a safe and easy access control scheme for the data managed in these services. We propose integrating IoT devices in an access control system designed for Web-based services by modelling certain IoT communication elements as resources. This would allow us to obtain a unified access control scheme between heterogeneous devices (IoT devices, Internet-based services, etc.). To achieve this, we have analysed the most relevant communication protocols for these kinds of environments and then we have proposed a methodology which allows the modelling of communication actions as resources. Then, we can protect these resources using access control mechanisms. The validation of our proposal has been carried out by selecting a communication protocol based on message exchange, specifically Message Queuing Telemetry Transport (MQTT). As an access control scheme, we have selected User-Managed Access (UMA), an existing Open Authorization (OAuth) 2.0 profile originally developed for the protection of Internet services. We have performed tests focused on validating the proposed solution in terms of the correctness of the access control system. Finally, we have evaluated the energy consumption overhead when using our proposal.
2018-01-01
Internet growth has generated new types of services where the use of sensors and actuators is especially remarkable. These services compose what is known as the Internet of Things (IoT). One of the biggest current challenges is obtaining a safe and easy access control scheme for the data managed in these services. We propose integrating IoT devices in an access control system designed for Web-based services by modelling certain IoT communication elements as resources. This would allow us to obtain a unified access control scheme between heterogeneous devices (IoT devices, Internet-based services, etc.). To achieve this, we have analysed the most relevant communication protocols for these kinds of environments and then we have proposed a methodology which allows the modelling of communication actions as resources. Then, we can protect these resources using access control mechanisms. The validation of our proposal has been carried out by selecting a communication protocol based on message exchange, specifically Message Queuing Telemetry Transport (MQTT). As an access control scheme, we have selected User-Managed Access (UMA), an existing Open Authorization (OAuth) 2.0 profile originally developed for the protection of Internet services. We have performed tests focused on validating the proposed solution in terms of the correctness of the access control system. Finally, we have evaluated the energy consumption overhead when using our proposal. PMID:29558406
Hanna, Timothy P; Kangolle, Alfred C T
2010-10-13
Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) PROCESS: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) OUTCOME: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political
2010-01-01
Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. Summary There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international
Rosenheck, R; Morrissey, J; Lam, J; Calloway, M; Johnsen, M; Goldman, H; Randolph, F; Blasinsky, M; Fontana, A; Calsyn, R; Teague, G
1998-11-01
This study evaluated the hypothesis that greater integration and coordination between agencies within service systems is associated with greater accessibility of services and improved client housing outcomes. As part of the Access to Community Care and Effective Services and Supports program, data were obtained on baseline client characteristics, service use, and 3-month and 12-month outcomes from 1832 clients seen at 18 sites during the first year of program operation. Data on interorganizational relationships were obtained from structured interviews with key informants from relevant organizations in each community (n = 32-82 at each site). Complete follow-up data were obtained from 1340 clients (73%). After control for baseline characteristics, service system integration was associated with superior housing outcomes at 12 months, and this relationship was mediated through greater access to housing agencies. Service system integration is related to improved access to housing services and better housing outcomes among homeless people with mental illness.
News from ESO Archive Services: Next Generation Request Handler and Data Access Delegation
NASA Astrophysics Data System (ADS)
Fourniol, N.; Lockhart, J.; Suchar, D.; Tacconi-Garman, L. E.; Moins, C.; Bierwirth, T.; Eglitis, P.; Vuong, M.; Micol, A.; Delmotte, N.; Vera, I.; Dobrzycki, A.; Forchì, V.; Lange, U.; Sogni, F.
2012-09-01
We present the new ESO Archive services which improve the electronic data access via the Download Manager and also provide PIs with the option to delegate data access to their collaborators via the Data Access Control.
Wilson, Emma; Free, Caroline; Morris, Tim P; Syred, Jonathan; Ahamed, Irrfan; Menon-Johansson, Anatole S; Palmer, Melissa J; Barnard, Sharmani; Rezel, Emma; Baraitser, Paula
2017-12-01
Internet-accessed sexually transmitted infection testing (e-STI testing) is increasingly available as an alternative to testing in clinics. Typically this testing modality enables users to order a test kit from a virtual service (via a website or app), collect their own samples, return test samples to a laboratory, and be notified of their results by short message service (SMS) or telephone. e-STI testing is assumed to increase access to testing in comparison with face-to-face services, but the evidence is unclear. We conducted a randomised controlled trial to assess the effectiveness of an e-STI testing and results service (chlamydia, gonorrhoea, HIV, and syphilis) on STI testing uptake and STI cases diagnosed. The study took place in the London boroughs of Lambeth and Southwark. Between 24 November 2014 and 31 August 2015, we recruited 2,072 participants, aged 16-30 years, who were resident in these boroughs, had at least 1 sexual partner in the last 12 months, stated willingness to take an STI test, and had access to the internet. Those unable to provide consent and unable to read English were excluded. Participants were randomly allocated to receive 1 text message with the web link of an e-STI testing and results service (intervention group) or to receive 1 text message with the web link of a bespoke website listing the locations, contact details, and websites of 7 local sexual health clinics (control group). Participants were free to use any other services or interventions during the study period. The primary outcomes were self-reported STI testing at 6 weeks, verified by patient record checks, and self-reported STI diagnosis at 6 weeks, verified by patient record checks. Secondary outcomes were the proportion of participants prescribed treatment for an STI, time from randomisation to completion of an STI test, and time from randomisation to treatment of an STI. Participants were sent a £10 cash incentive on submission of self-reported data. We completed all
SIDECACHE: Information access, management and dissemination framework for web services.
Doderer, Mark S; Burkhardt, Cory; Robbins, Kay A
2011-06-14
Many bioinformatics algorithms and data sets are deployed using web services so that the results can be explored via the Internet and easily integrated into other tools and services. These services often include data from other sites that is accessed either dynamically or through file downloads. Developers of these services face several problems because of the dynamic nature of the information from the upstream services. Many publicly available repositories of bioinformatics data frequently update their information. When such an update occurs, the developers of the downstream service may also need to update. For file downloads, this process is typically performed manually followed by web service restart. Requests for information obtained by dynamic access of upstream sources is sometimes subject to rate restrictions. SideCache provides a framework for deploying web services that integrate information extracted from other databases and from web sources that are periodically updated. This situation occurs frequently in biotechnology where new information is being continuously generated and the latest information is important. SideCache provides several types of services including proxy access and rate control, local caching, and automatic web service updating. We have used the SideCache framework to automate the deployment and updating of a number of bioinformatics web services and tools that extract information from remote primary sources such as NCBI, NCIBI, and Ensembl. The SideCache framework also has been used to share research results through the use of a SideCache derived web service.
Accessible Bus Service in Palm Beach County, Florida
DOT National Transportation Integrated Search
1983-03-01
The Palm Beach County Transportation Authority introduced accessible fixed-route service on its countywide CoTran bus service in May 1980. CoTran provided 100% (full-fleet) accessible service, using 23 retrofitted buses and 40 new buses, all equipped...
47 CFR 36.213 - Network access services revenues.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 2 2010-10-01 2010-10-01 false Network access services revenues. 36.213 Section 36.213 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Income Accounts Operating Revenues § 36.213 Network access services revenues. (a) End User Revenue...
47 CFR 36.213 - Network access services revenues.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 47 Telecommunication 2 2011-10-01 2011-10-01 false Network access services revenues. 36.213 Section 36.213 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Income Accounts Operating Revenues § 36.213 Network access services revenues. (a) End User Revenue...
A federated capability-based access control mechanism for internet of things (IoTs)
NASA Astrophysics Data System (ADS)
Xu, Ronghua; Chen, Yu; Blasch, Erik; Chen, Genshe
2018-05-01
The prevalence of Internet of Things (IoTs) allows heterogeneous embedded smart devices to collaboratively provide intelligent services with or without human intervention. While leveraging the large-scale IoT-based applications like Smart Gird and Smart Cities, IoT also incurs more concerns on privacy and security. Among the top security challenges that IoTs face is that access authorization is critical in resource and information protection over IoTs. Traditional access control approaches, like Access Control Lists (ACL), Role-based Access Control (RBAC) and Attribute-based Access Control (ABAC), are not able to provide a scalable, manageable and efficient mechanisms to meet requirement of IoT systems. The extraordinary large number of nodes, heterogeneity as well as dynamicity, necessitate more fine-grained, lightweight mechanisms for IoT devices. In this paper, a federated capability-based access control (FedCAC) framework is proposed to enable an effective access control processes to devices, services and information in large scale IoT systems. The federated capability delegation mechanism, based on a propagation tree, is illustrated for access permission propagation. An identity-based capability token management strategy is presented, which involves registering, propagation and revocation of the access authorization. Through delegating centralized authorization decision-making policy to local domain delegator, the access authorization process is locally conducted on the service provider that integrates situational awareness (SAW) and customized contextual conditions. Implemented and tested on both resources-constrained devices, like smart sensors and Raspberry PI, and non-resource-constrained devices, like laptops and smart phones, our experimental results demonstrate the feasibility of the proposed FedCAC approach to offer a scalable, lightweight and fine-grained access control solution to IoT systems connected to a system network.
45 CFR 1624.5 - Accessibility of legal services.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 45 Public Welfare 4 2010-10-01 2010-10-01 false Accessibility of legal services. 1624.5 Section 1624.5 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PROHIBITION AGAINST DISCRIMINATION ON THE BASIS OF DISABILITY § 1624.5 Accessibility of legal services. (a) No...
45 CFR 1624.5 - Accessibility of legal services.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 45 Public Welfare 4 2011-10-01 2011-10-01 false Accessibility of legal services. 1624.5 Section 1624.5 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PROHIBITION AGAINST DISCRIMINATION ON THE BASIS OF DISABILITY § 1624.5 Accessibility of legal services. (a) No...
45 CFR 1624.5 - Accessibility of legal services.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 45 Public Welfare 4 2014-10-01 2014-10-01 false Accessibility of legal services. 1624.5 Section 1624.5 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PROHIBITION AGAINST DISCRIMINATION ON THE BASIS OF DISABILITY § 1624.5 Accessibility of legal services. (a) No...
45 CFR 1624.5 - Accessibility of legal services.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 45 Public Welfare 4 2013-10-01 2013-10-01 false Accessibility of legal services. 1624.5 Section 1624.5 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PROHIBITION AGAINST DISCRIMINATION ON THE BASIS OF DISABILITY § 1624.5 Accessibility of legal services. (a) No...
39 CFR 3055.91 - Consumer access to postal services.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 39 Postal Service 1 2011-07-01 2011-07-01 false Consumer access to postal services. 3055.91 Section 3055.91 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL SERVICE PERFORMANCE AND CUSTOMER SATISFACTION REPORTING Reporting of Customer Satisfaction § 3055.91 Consumer access to postal services. (a) The...
42 CFR 422.114 - Access to services under an MA private fee-for-service plan.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 42 Public Health 3 2012-10-01 2012-10-01 false Access to services under an MA private fee-for... Benefits and Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must...
42 CFR 422.114 - Access to services under an MA private fee-for-service plan.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 42 Public Health 3 2014-10-01 2014-10-01 false Access to services under an MA private fee-for... Benefits and Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must...
42 CFR 422.114 - Access to services under an MA private fee-for-service plan.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 42 Public Health 3 2013-10-01 2013-10-01 false Access to services under an MA private fee-for... Benefits and Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must...
Access Control of Web and Java Based Applications
NASA Technical Reports Server (NTRS)
Tso, Kam S.; Pajevski, Michael J.; Johnson, Bryan
2011-01-01
Cyber security has gained national and international attention as a result of near continuous headlines from financial institutions, retail stores, government offices and universities reporting compromised systems and stolen data. Concerns continue to rise as threats of service interruption, and spreading of viruses become ever more prevalent and serious. Controlling access to application layer resources is a critical component in a layered security solution that includes encryption, firewalls, virtual private networks, antivirus, and intrusion detection. In this paper we discuss the development of an application-level access control solution, based on an open-source access manager augmented with custom software components, to provide protection to both Web-based and Java-based client and server applications.
42 CFR 422.114 - Access to services under an MA private fee-for-service plan.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false Access to services under an MA private fee-for... Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must demonstrate to CMS...
42 CFR 422.114 - Access to services under an MA private fee-for-service plan.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 42 Public Health 3 2011-10-01 2011-10-01 false Access to services under an MA private fee-for... Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must demonstrate to CMS...
Authenticated IGMP for Controlling Access to Multicast Distribution Tree
NASA Astrophysics Data System (ADS)
Park, Chang-Seop; Kang, Hyun-Sun
A receiver access control scheme is proposed to protect the multicast distribution tree from DoS attack induced by unauthorized use of IGMP, by extending the security-related functionality of IGMP. Based on a specific network and business model adopted for commercial deployment of IP multicast applications, a key management scheme is also presented for bootstrapping the proposed access control as well as accounting and billing for CP (Content Provider), NSP (Network Service Provider), and group members.
Access Services Are Human Services: Collaborating to Provide Textbook Access to Students
ERIC Educational Resources Information Center
McElroy, Kelly; Moore, Dan; Hilterbrand, Lori; Hindes, Nicole
2017-01-01
Despite the clear negative impact of high textbook costs on students, limits--including space, funding, and policies--prevent many academic libraries from fully supporting textbook collections. Partnering with other campus units on textbook lending requires creative thinking but can provide students access to other services in addition to the…
Access to Jobs and Workers via Transit - Service
A collection of performance indicators and regional benchmarks for consistently comparing neighborhoods (census block groups) across the US in regards to their accessibility to jobs or workers via public transit service. Accessibility was modeled by calculating total travel time between block group centroids inclusive of walking to/from transit stops, wait times, and transfers. Block groups that can be accessed in 45 minutes or less from the origin block group are considered accessible. Indicators reflect public transit service in December 2012 and employment/worker counts in 2010. Coverage is limited to census block groups within metropolitan regions served by transit agencies who share their service data in a standardized format called GTFS.
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
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 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. Results 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. Conclusions 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
47 CFR 54.807 - Interstate access universal service support.
Code of Federal Regulations, 2011 CFR
2011-10-01
... supported service within the study area of a price cap local exchange carrier shall receive Interstate Access Universal Service Support for each line that it serves within that study area. (b) In any study... Service Support Per Line by dividing Study Area Access Universal Service Support by twelve times all...
EARS: Electronic Access to Reference Service.
Weise, F O; Borgendale, M
1986-10-01
Electronic Access to Reference Service (EARS) is a front end to the Health Sciences Library's electronic mail system, with links to the online public catalog. EARS, which became operational in September 1984, is accessed by users at remote sites with either a terminal or microcomputer. It is menu-driven, allowing users to request: a computerized literature search, reference information, a photocopy of a journal article, or a book. This paper traces the history of EARS and discusses its use, its impact on library staff and services, and factors that influence the diffusion of new technology.
SWS: accessing SRS sites contents through Web Services.
Romano, Paolo; Marra, Domenico
2008-03-26
Web Services and Workflow Management Systems can support creation and deployment of network systems, able to automate data analysis and retrieval processes in biomedical research. Web Services have been implemented at bioinformatics centres and workflow systems have been proposed for biological data analysis. New databanks are often developed by taking into account these technologies, but many existing databases do not allow a programmatic access. Only a fraction of available databanks can thus be queried through programmatic interfaces. SRS is a well know indexing and search engine for biomedical databanks offering public access to many databanks and analysis tools. Unfortunately, these data are not easily and efficiently accessible through Web Services. We have developed 'SRS by WS' (SWS), a tool that makes information available in SRS sites accessible through Web Services. Information on known sites is maintained in a database, srsdb. SWS consists in a suite of WS that can query both srsdb, for information on sites and databases, and SRS sites. SWS returns results in a text-only format and can be accessed through a WSDL compliant client. SWS enables interoperability between workflow systems and SRS implementations, by also managing access to alternative sites, in order to cope with network and maintenance problems, and selecting the most up-to-date among available systems. Development and implementation of Web Services, allowing to make a programmatic access to an exhaustive set of biomedical databases can significantly improve automation of in-silico analysis. SWS supports this activity by making biological databanks that are managed in public SRS sites available through a programmatic interface.
Interoperable Data Access Services for NOAA IOOS
NASA Astrophysics Data System (ADS)
de La Beaujardiere, J.
2008-12-01
The Integrated Ocean Observing System (IOOS) is intended to enhance our ability to collect, deliver, and use ocean information. The goal is to support research and decision-making by providing data on our open oceans, coastal waters, and Great Lakes in the formats, rates, and scales required by scientists, managers, businesses, governments, and the public. The US National Oceanic and Atmospheric Administration (NOAA) is the lead agency for IOOS. NOAA's IOOS office supports the development of regional coastal observing capability and promotes data management efforts to increase data accessibility. Geospatial web services have been established at NOAA data providers including the National Data Buoy Center (NDBC), the Center for Operational Oceanographic Products and Services (CO-OPS), and CoastWatch, and at regional data provider sites. Services established include Open-source Project for a Network Data Access Protocol (OpenDAP), Open Geospatial Consortium (OGC) Sensor Observation Service (SOS), and OGC Web Coverage Service (WCS). These services provide integrated access to data holdings that have been aggregated at each center from multiple sources. We wish to collaborate with other groups to improve our service offerings to maximize interoperability and enhance cross-provider data integration, and to share common service components such as registries, catalogs, data conversion, and gateways. This paper will discuss the current status of NOAA's IOOS efforts and possible next steps.
Simple measurement-based admission control for DiffServ access networks
NASA Astrophysics Data System (ADS)
Lakkakorpi, Jani
2002-07-01
In order to provide good Quality of Service (QoS) in a Differentiated Services (DiffServ) network, a dynamic admission control scheme is definitely needed as an alternative to overprovisioning. In this paper, we present a simple measurement-based admission control (MBAC) mechanism for DiffServ-based access networks. Instead of using active measurements only or doing purely static bookkeeping with parameter-based admission control (PBAC), the admission control decisions are based on bandwidth reservations and periodically measured & exponentially averaged link loads. If any link load on the path between two endpoints is over the applicable threshold, access is denied. Link loads are periodically sent to Bandwidth Broker (BB) of the routing domain, which makes the admission control decisions. The information needed in calculating the link loads is retrieved from the router statistics. The proposed admission control mechanism is verified through simulations. Our results prove that it is possible to achieve very high bottleneck link utilization levels and still maintain good QoS.
28 CFR 115.182 - Access to emergency medical services.
Code of Federal Regulations, 2013 CFR
2013-07-01
... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Access to emergency medical services. 115...
28 CFR 115.182 - Access to emergency medical services.
Code of Federal Regulations, 2014 CFR
2014-07-01
... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Access to emergency medical services. 115...
28 CFR 115.182 - Access to emergency medical services.
Code of Federal Regulations, 2012 CFR
2012-07-01
... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Access to emergency medical services. 115...
42 CFR 422.112 - Access to services.
Code of Federal Regulations, 2010 CFR
2010-10-01
... services in accordance with § 422.113. (10) Prevailing patterns of community health care delivery... 42 Public Health 3 2010-10-01 2010-10-01 false Access to services. 422.112 Section 422.112 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...
Access to dental public services by disabled persons.
Leal Rocha, Lyana; Vieira de Lima Saintrain, Maria; Pimentel Gomes Fernandes Vieira-Meyer, Anya
2015-03-13
According to the World Health Organization, one in every 10 people has a disability, and more than two-thirds of them do not receive any type of oral dental care. The Brazilian Constitution of 1988 guarantees all civilians including disabled people the right to healthcare, shaping the guidelines of the Brazilian National Health Care System (Sistema Único de Saúde--SUS). However, there is limited information about the true accessibility of dental services. This study evaluated the accessibility of public dental services to persons with disabilities in Fortaleza, Ceará, which has the third highest disability rate in Brazil. A cross-sectional quantitative study using structured questionnaires was administered to dentists (n = 89) and people with disabilities (n = 204) to evaluate the geographical, architectural, and organizational accessibility of health facilities, the communication between professionals and patients with disabilities, the demand for dental services, and factors influencing the use of dental services by people with motor, visual, and hearing impairments. 43.1% of people with disabilities do not recognize their service as a priority of Basic Health Units (BHU), 52.5% do not usually seek dental care, and of those who do (n = 97), 76.3% find it difficult to receive care and 84.5% only seek care on an emergency basis. Forty-five percent are unaware of the services offered in the BHU. Of the dentists, 56.2% reported difficulty in communicating with deaf patients, and 97.8% desired interpreters stationed in the BHU. People with disabilities gave better accessibility ratings than dentists (p = 0.001). 37.3% of the patients and 43.8% of dentists reported inadequate physical access infrastructure (including doors, hallways, waiting rooms, and offices). Dentists (60%) reported unsafe environments and transportation difficulties as geographical barriers, while most people with disabilities did not report noticing these barriers. While access to dental
Wilson, Paul M; Farley, Kate; Bickerdike, Liz; Booth, Alison; Chambers, Duncan; Lambert, Mark; Thompson, Carl; Turner, Rhiannon; Watt, Ian S
2017-02-14
The Health and Social Care Act mandated research use as a core consideration of health service commissioning arrangements in England. We undertook a controlled before and after study to evaluate whether access to a demand-led evidence briefing service improved the use of research evidence by commissioners compared with less intensive and less targeted alternatives. Nine Clinical Commissioning Groups (CCGs) in the North of England received one of three interventions: (A) access to an evidence briefing service; (B) contact plus an unsolicited push of non-tailored evidence; or (C) unsolicited push of non-tailored evidence. Data for the primary outcome measure were collected at baseline and 12 months using a survey instrument devised to assess an organisations' ability to acquire, assess, adapt and apply research evidence to support decision-making. Documentary and observational evidence of the use of the outputs of the service were sought. Over the course of the study, the service addressed 24 topics raised by participating CCGs. At 12 months, the evidence briefing service was not associated with increases in CCG capacity to acquire, assess, adapt and apply research evidence to support decision-making, individual intentions to use research findings or perceptions of CCG relationships with researchers. Regardless of intervention received, participating CCGs indicated that they remained inconsistent in their research-seeking behaviours and in their capacity to acquire research. The informal nature of decision-making processes meant that there was little traceability of the use of evidence. Low baseline and follow-up response rates and missing data limit the reliability of the findings. Access to a demand-led evidence briefing service did not improve the uptake and use of research evidence by NHS commissioners compared with less intensive and less targeted alternatives. Commissioners appear well intentioned but ad hoc users of research. Further research is required on
Pilot evaluation of a web-based intervention targeting sexual health service access.
Brown, K E; Newby, K; Caley, M; Danahay, A; Kehal, I
2016-04-01
Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among 13-19-year olds are reported. A pre-post questionnaire-based design was used. Matched baseline and follow-up data were identified from 148 respondents aged 13-18 years. Outcome measures were self-reported service access, self-reported intention to access services and beliefs about services and service access identified through needs analysis. Objective service access data provided by local sexual health services were also analyzed. Analysis suggests the intervention had a significant positive effect on psychological barriers to and antecedents of service access among females. Males, who reported greater confidence in service access compared with females, significantly increased service access by time 2 follow-up. Available objective service access data support the assertion that the intervention may have led to increases in service access. There is real promise for this novel digital intervention. Further evaluation is planned as the model is licensed to and rolled out by other local authorities in the United Kingdom. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
EARS: Electronic Access to Reference Service.
Weise, F O; Borgendale, M
1986-01-01
Electronic Access to Reference Service (EARS) is a front end to the Health Sciences Library's electronic mail system, with links to the online public catalog. EARS, which became operational in September 1984, is accessed by users at remote sites with either a terminal or microcomputer. It is menu-driven, allowing users to request: a computerized literature search, reference information, a photocopy of a journal article, or a book. This paper traces the history of EARS and discusses its use, its impact on library staff and services, and factors that influence the diffusion of new technology. PMID:3779167
AEROSAT Access Control Summary
DOT National Transportation Integrated Search
1976-10-01
The report consists of three basic sections. Section 2 is a discussion of the communications concepts germane to AEROSAT access control. It defines and reviews the principles of multiplexing, multiple access, demand access, and access control and rel...
Aerosat Access Control Summary
DOT National Transportation Integrated Search
1976-10-01
The report consists of three basic sections. Section 2 is a discussion of the communications concepts germane to AEROSAT access control. It defines and reviews the principles of multiplexing, multiple access, demand access, and access control and rel...
Access to specialty mental health services among women in California.
Kimerling, Rachel; Baumrind, Nikki
2005-06-01
The Anderson behavioral model was used to investigate racial and ethnic disparities in access to specialty mental health services among women in California as well as factors that might account for such disparities. The study was a cross-sectional examination of a probability sample of 3,750 California women. The main indicators of access to services were perceived need, service seeking, and service use. Multivariate models were constructed that accounted for need and enabling and demographic variables. Significant racial and ethnic variations in access to specialty mental health services were observed. African-American, Hispanic, and Asian women were significantly less likely to use specialty mental health services than white women. Multivariate analyses showed that Hispanic and Asian women were less likely than white women to report perceived need, even after frequent mental distress had been taken into account. Among women with perceived need, African-American and Asian women were less likely than white women to seek mental health services after differences in insurance status had been taken into account. Among women who sought services, Hispanic women were less likely than white women to obtain services after adjustment for the effects of poverty. Need and enabling factors did not entirely account for the observed disparities in access to services. Additional research is needed to identify gender- and culture-specific models for access to mental health services in order to decrease disparities in access. Factors such as perceived need and decisions to seek services are important factors that should be emphasized in future studies.
The Future of Access Services: Should There Be One?
ERIC Educational Resources Information Center
Hersey, Denise P.
2004-01-01
The creation of "Access Services" departments in academic libraries did not translate into the creation or offering of new services for patrons. Instead, it was typically just the combination of three already existing departments. Recent changes and trends in Access Services, including new NCIP and ISO standards, an increase in the use of…
Making Spatial Statistics Service Accessible On Cloud Platform
NASA Astrophysics Data System (ADS)
Mu, X.; Wu, J.; Li, T.; Zhong, Y.; Gao, X.
2014-04-01
Web service can bring together applications running on diverse platforms, users can access and share various data, information and models more effectively and conveniently from certain web service platform. Cloud computing emerges as a paradigm of Internet computing in which dynamical, scalable and often virtualized resources are provided as services. With the rampant growth of massive data and restriction of net, traditional web services platforms have some prominent problems existing in development such as calculation efficiency, maintenance cost and data security. In this paper, we offer a spatial statistics service based on Microsoft cloud. An experiment was carried out to evaluate the availability and efficiency of this service. The results show that this spatial statistics service is accessible for the public conveniently with high processing efficiency.
42 CFR 422.112 - Access to services.
Code of Federal Regulations, 2013 CFR
2013-10-01
... Access to services. (a) Rules for coordinated care plans. An MA organization that offers an MA... organization ensures that all covered services, including supplemental services contracted for by (or on behalf... organization must meet the following requirements: (1) Provider network. (i) Maintain and monitor a network of...
42 CFR 422.112 - Access to services.
Code of Federal Regulations, 2012 CFR
2012-10-01
... Access to services. (a) Rules for coordinated care plans. An MA organization that offers an MA... organization ensures that all covered services, including supplemental services contracted for by (or on behalf... organization must meet the following requirements: (1) Provider network. (i) Maintain and monitor a network of...
42 CFR 422.112 - Access to services.
Code of Federal Regulations, 2014 CFR
2014-10-01
... Access to services. (a) Rules for coordinated care plans. An MA organization that offers an MA... organization ensures that all covered services, including supplemental services contracted for by (or on behalf... organization must meet the following requirements: (1) Provider network. (i) Maintain and monitor a network of...
Accessing Geospatial Services in Limited Bandwidth Service-Oriented Architecture (SOA) Environments
ERIC Educational Resources Information Center
Boggs, James D.
2013-01-01
First responders are continuously moving at an incident site and this movement requires them to access Service-Oriented Architecture services, such as a Web Map Service, via mobile wireless networks. First responders from inside a building often have problems in communicating to devices outside that building due to propagation obstacles. Dynamic…
Reflective Database Access Control
ERIC Educational Resources Information Center
Olson, Lars E.
2009-01-01
"Reflective Database Access Control" (RDBAC) is a model in which a database privilege is expressed as a database query itself, rather than as a static privilege contained in an access control list. RDBAC aids the management of database access controls by improving the expressiveness of policies. However, such policies introduce new interactions…
Transparent data service with multiple wireless access
NASA Technical Reports Server (NTRS)
Dean, Richard A.; Levesque, Allen H.
1993-01-01
The rapid introduction of digital wireless networks is an important part of the emerging digital communications scene. The introduction of Digital Cellular, LEO and GEO Satellites, and Personal Communications Services poses both a challenge and an opportunity for the data user. On the one hand wireless access will introduce significant new portable data services such as personal notebooks, paging, E-mail, and fax that will put the information age in the user's pocket. On the other hand the challenge of creating a seamless and transparent environment for the user in multiple access environments and across multiple network connections is formidable. A summary of the issues associated with developing techniques and standards that can support transparent and seamless data services is presented. The introduction of data services into the radio world represents a unique mix of RF channel problems, data protocol issues, and network issues. These problems require that experts from each of these disciplines fuse the individual technologies to support these services.
Language Barriers Impact Access to Services for Children with Autism Spectrum Disorders.
St Amant, Helaine G; Schrager, Sheree M; Peña-Ricardo, Carolina; Williams, Marian E; Vanderbilt, Douglas L
2018-02-01
Racial and ethnic disparities in accessing health care have been described in children with autism spectrum disorder (ASD). In a retrospective chart review of 152 children with ASD, children of parents whose primary language was English were significantly more likely to have both social skills and communication goals within their individualized education plan (IEP) compared to children of parents whose primary language was not English. Additionally, children of primary English speakers received significantly more hours of direct services from their state disability program. After controlling for demographic covariates, findings suggest that language barriers may negatively affect parents' abilities to access health care services for their child with ASD. Acculturation factors must therefore be considered when analyzing disparities in autism.
The availability of community health center services and access to medical care.
Kirby, James B; Sharma, Ravi
2017-12-01
Community Health Centers (CHCs) funded by Section 330 of the Public Health Service Act are an essential part of the health care safety net in the US. The Patient Protection and Affordable Care Act expanded the program significantly, but the extent to which the availability of CHCs improve access to care in general is not clear. In this paper, we examine the associations between the availability of CHC services in communities and two key measures of ambulatory care access - having a usual source of care and having any office-based medical visits over a one year period. We pooled six years of data from the Medical Expenditure Panel Survey (2008-2013) and linked it to geographic data on CHCs from Health Resources and Services Administration's Health Center Program Uniform Data System. We also link other community characteristics from the Area Health Resource File and the Dartmouth Institute's data files. The associations between CHC availability and our access measures are estimated with logistic regression models stratified by insurance status. The availability of CHC services was positively associated with both measures of access among those with no insurance coverage. Additionally, it was positively associated with having a usual source of care among those with Medicaid and private insurance. These findings persist after controlling for key individual- and community-level characteristics. Our findings suggest that an enhanced CHC program could be an important resource for supporting the efficacy of expanded Medicaid coverage under the Affordable Care Act and, ultimately, improving access to quality primary care for underserved Americans. Published by Elsevier Inc.
[Accessibility of health services for users].
Sousa-Fragoso, M A; Villarreal-Ríos, E
2000-01-01
To measure the accessibility to health services and determine a model to explain this accessibility. All states of the Mexican Republic were included. The measurement of accessibility considers the availability of resources and the perception of barriers. Place of residence, education, participation in the work forces and household conditions were included in the model. The average of availability resources was 64.59% sd 15.68 (range 42 to 100) and the average corresponding to perception of barriers, 87.61% SD 4.04 (range 79.23 to 95.65). Accessibility was 71.50% SD 10.74 (range 56 to 96). The states with highest accessibility were the Federal District and Baja California Sur and the lowest, Chiapas and Oaxaca. The model included education and labor participation (R2 = 0.67, p < 0.05). Accessibility was determined by socioeconomic factors.
Ke, Chih-Kun; Lin, Zheng-Hua
2015-09-01
The progress of information and communication technologies (ICT) has promoted the development of healthcare which has enabled the exchange of resources and services between organizations. Organizations want to integrate mobile devices into their hospital information systems (HIS) due to the convenience to employees who are then able to perform specific healthcare processes from any location. The collection and merage of healthcare data from discrete mobile devices are worth exploring possible ways for further use, especially in remote districts without public data network (PDN) to connect the HIS. In this study, we propose an optimal mobile service which automatically synchronizes the telecare file resources among discrete mobile devices. The proposed service enforces some technical methods. The role-based access control model defines the telecare file resources accessing mechanism; the symmetric data encryption method protects telecare file resources transmitted over a mobile peer-to-peer network. The multi-criteria decision analysis method, ELECTRE (Elimination Et Choice Translating Reality), evaluates multiple criteria of the candidates' mobile devices to determine a ranking order. This optimizes the synchronization of telecare file resources among discrete mobile devices. A prototype system is implemented to examine the proposed mobile service. The results of the experiment show that the proposed mobile service can automatically and effectively synchronize telecare file resources among discrete mobile devices. The contribution of this experiment is to provide an optimal mobile service that enhances the security of telecare file resource synchronization and strengthens an organization's mobility.
Yi, Meng; Chen, Qingkui; Xiong, Neal N
2016-11-03
This paper considers the distributed access and control problem of massive wireless sensor networks' data access center for the Internet of Things, which is an extension of wireless sensor networks and an element of its topology structure. In the context of the arrival of massive service access requests at a virtual data center, this paper designs a massive sensing data access and control mechanism to improve the access efficiency of service requests and makes full use of the available resources at the data access center for the Internet of things. Firstly, this paper proposes a synergistically distributed buffer access model, which separates the information of resource and location. Secondly, the paper divides the service access requests into multiple virtual groups based on their characteristics and locations using an optimized self-organizing feature map neural network. Furthermore, this paper designs an optimal scheduling algorithm of group migration based on the combination scheme between the artificial bee colony algorithm and chaos searching theory. Finally, the experimental results demonstrate that this mechanism outperforms the existing schemes in terms of enhancing the accessibility of service requests effectively, reducing network delay, and has higher load balancing capacity and higher resource utility rate.
Yi, Meng; Chen, Qingkui; Xiong, Neal N.
2016-01-01
This paper considers the distributed access and control problem of massive wireless sensor networks’ data access center for the Internet of Things, which is an extension of wireless sensor networks and an element of its topology structure. In the context of the arrival of massive service access requests at a virtual data center, this paper designs a massive sensing data access and control mechanism to improve the access efficiency of service requests and makes full use of the available resources at the data access center for the Internet of things. Firstly, this paper proposes a synergistically distributed buffer access model, which separates the information of resource and location. Secondly, the paper divides the service access requests into multiple virtual groups based on their characteristics and locations using an optimized self-organizing feature map neural network. Furthermore, this paper designs an optimal scheduling algorithm of group migration based on the combination scheme between the artificial bee colony algorithm and chaos searching theory. Finally, the experimental results demonstrate that this mechanism outperforms the existing schemes in terms of enhancing the accessibility of service requests effectively, reducing network delay, and has higher load balancing capacity and higher resource utility rate. PMID:27827878
Making public mental-health services accessible to deaf consumers: Illinois Deaf Services 2000.
Munro-Ludders, Bruce; Simpatico, Thomas; Zvetina, Daria
2004-01-01
Illinois Deaf Services 2000 (IDS2000), a public/private partnership, promotes the creation and implementation of strategies to develop and increase access to mental health services for deaf, hard of hearing, late-deafened, and deaf-blind consumers. IDS2000 has resulted in the establishment of service accessibility standards, a technical support and adherence monitoring system, and the beginnings of a statewide telepsychiatry service. These system modifications have resulted in increase by 60% from baseline survey data in the number of deaf, hard of hearing, late-deafened, and deaf-blind consumers identified in community mental-health agencies in Illinois. Depending on the situation of deaf services staff and infrastructure, much of IDS2000 could be replicated in other states in a mostly budget-neutral manner.
Demonstrate provider accessibility with desktop and online services.
2001-10-01
It's available on personal computers with a CD or through Internet access. Assess instantly the accessibility of your provider network or the most promising areas to establish a health service with new GIS tools.
Recommendations for a service framework to access astronomical archives
NASA Technical Reports Server (NTRS)
Travisano, J. J.; Pollizzi, J.
1992-01-01
There are a large number of astronomical archives and catalogs on-line for network access, with many different user interfaces and features. Some systems are moving towards distributed access, supplying users with client software for their home sites which connects to servers at the archive site. Many of the issues involved in defining a standard framework of services that archive/catalog suppliers can use to achieve a basic level of interoperability are described. Such a framework would simplify the development of client and server programs to access the wide variety of astronomical archive systems. The primary services that are supplied by current systems include: catalog browsing, dataset retrieval, name resolution, and data analysis. The following issues (and probably more) need to be considered in establishing a standard set of client/server interfaces and protocols: Archive Access - dataset retrieval, delivery, file formats, data browsing, analysis, etc.; Catalog Access - database management systems, query languages, data formats, synchronous/asynchronous mode of operation, etc.; Interoperability - transaction/message protocols, distributed processing mechanisms (DCE, ONC/SunRPC, etc), networking protocols, etc.; Security - user registration, authorization/authentication mechanisms, etc.; Service Directory - service registration, lookup, port/task mapping, parameters, etc.; Software - public vs proprietary, client/server software, standard interfaces to client/server functions, software distribution, operating system portability, data portability, etc. Several archive/catalog groups, notably the Astrophysics Data System (ADS), are already working in many of these areas. In the process of developing StarView, which is the user interface to the Space Telescope Data Archive and Distribution Service (ST-DADS), these issues and the work of others were analyzed. A framework of standard interfaces for accessing services on any archive system which would benefit
Accessibility to health services among migrant workers in the Northeast of Thailand.
Khongthanachayopit, Suprawee; Laohasiriwong, Wongsa
2017-01-01
Background . There is an increasing trend of trans-border migration from neighboring countries to Thailand. According to human rights laws, everyone must have access to health services, even if they are from other nationalities. However, a small minority of health personnel in Thailand discriminate against immigrant workers, as they are from a lower financial bracket. Methods . This cross-sectional study aims to determine the prevalence of accessibility to health services and factors associated with access to health services among migrant workers who work along the Northeast border of Thailand. A total of 621 legal migrant workers were randomly selected to respond to a structured questionnaire about the satisfaction of health services, using the 5As of health services: availability; accessibility; accommodation; affordability; acceptability. Associations between independent variables and access to health services were analysed using multiple logistic regression analysis. Results . The results indicated that the majority of these registered migrant workers were female (63.9%) with an average age of 29± 8.61 years old, and were married (54.3%). Most of the workers worked at restaurants (80%), whereas only 20% were in agricultural sectors. Only 14% (95% CI: 11-17%) of migrant workers had access to health services. The factors that were significantly associated with accessibility to health service experienced ill health during the past one year (OR = 2.48; 95%CI; 1.54-3.97; p-value<0.001) ; have been married (OR = 2.32; 95% CI: 1.40 - 3.90; p-value <0.001). Conclusions . Most of the migrant workers could not access health services. The ones who did access health services were married or ill.
42 CFR 422.112 - Access to services.
Code of Federal Regulations, 2011 CFR
2011-10-01
... services. (a) Rules for coordinated care plans. An MA organization that offers an MA coordinated care plan may specify the networks of providers from whom enrollees may obtain services if the MA organization... Medicare enrollee, are available and accessible under the plan. To accomplish this, the MA organization...
Empowering citizens with access control mechanisms to their personal health resources.
Calvillo, J; Román, I; Roa, L M
2013-01-01
Advancements in information and communication technologies have allowed the development of new approaches to the management and use of healthcare resources. Nowadays it is possible to address complex issues such as meaningful access to distributed data or communication and understanding among heterogeneous systems. As a consequence, the discussion focuses on the administration of the whole set of resources providing knowledge about a single subject of care (SoC). New trends make the SoC administrator and responsible for all these elements (related to his/her demographic data, health, well-being, social conditions, etc.) and s/he is granted the ability of controlling access to them by third parties. The subject of care exchanges his/her passive role without any decision capacity for an active one allowing to control who accesses what. We study the necessary access control infrastructure to support this approach and develop mechanisms based on semantic tools to assist the subject of care with the specification of access control policies. This infrastructure is a building block of a wider scenario, the Person-Oriented Virtual Organization (POVO), aiming at integrating all the resources related to each citizen's health-related data. The POVO covers the wide range and heterogeneity of available healthcare resources (e.g., information sources, monitoring devices, or software simulation tools) and grants each SoC the access control to them. Several methodological issues are crucial for the design of the targeted infrastructure. The distributed system concept and focus are reviewed from the service oriented architecture (SOA) perspective. The main frameworks for the formalization of distributed system architectures (Reference Model-Open Distributed Processing, RM-ODP; and Model Driven Architecture, MDA) are introduced, as well as how the use of the Unified Modelling Language (UML) is standardized. The specification of access control policies and decision making mechanisms
[Public control and equity of access to hospitals under non-State public administration].
Carneiro Junior, Nivaldo; Elias, Paulo Eduardo
2006-10-01
To analyze social health organizations in the light of public control and the guarantee of equity of access to health services. Utilizing the case study technique, two social health organizations in the metropolitan region of São Paulo were selected. The analytical categories were equity of access and public control, and these were based on interviews with key informants and technical-administrative reports. It was observed that the overall funding and administrative control of the social health organizations are functions of the state administrator. The presence of a local administrator is important for ensuring equity of access. Public control is expressed through supervisory actions, by means of accounting and financial procedures. Equity of access and public control are not taken into consideration in the administration of these organizations. The central question lies in the capacity of the public authorities to have a presence in implementing this model at the local level, thereby ensuring equity of access and taking public control into consideration.
47 CFR 9.7 - Access to 911 and E911 service capabilities.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 47 Telecommunication 1 2013-10-01 2013-10-01 false Access to 911 and E911 service capabilities. 9.7 Section 9.7 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL INTERCONNECTED VOICE OVER INTERNET PROTOCOL SERVICES § 9.7 Access to 911 and E911 service capabilities. (a) Access. Subject to the...
47 CFR 9.7 - Access to 911 and E911 service capabilities.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 47 Telecommunication 1 2014-10-01 2014-10-01 false Access to 911 and E911 service capabilities. 9.7 Section 9.7 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL INTERCONNECTED VOICE OVER INTERNET PROTOCOL SERVICES § 9.7 Access to 911 and E911 service capabilities. (a) Access. Subject to the...
47 CFR 9.7 - Access to 911 and E911 service capabilities.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 47 Telecommunication 1 2012-10-01 2012-10-01 false Access to 911 and E911 service capabilities. 9.7 Section 9.7 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL INTERCONNECTED VOICE OVER INTERNET PROTOCOL SERVICES § 9.7 Access to 911 and E911 service capabilities. (a) Access. Subject to the...
Access to Health Care Services among Young People Exchanging Sex in Detroit.
Knittel, Andrea K; Graham, Louis F; Peterson, Jerry; Lopez, William; Snow, Rachel C
2018-04-05
Within the related epidemics of sex exchange, drug use, and poverty, access to health care is shaped by intersecting identities, policy, and infrastructure. This study uses a unique survey sample of young adults in Detroit, who are exchanging sex on the street, in strip clubs, and at after-hours parties and other social clubs. Factors predicting access to free or affordable health care services, such as venue, patterns of sexual exchange influence, drug use and access to transportation, were examined using multivariable logistic regression and qualitative comparative analysis. The most significant predictors of low access to health care services were unstable housing and lack of access to reliable transportation. In addition, working on the street was associated with decreased access to services. Coordinated policy and programming changes are needed to increase health care access to this group, including improved access to transportation, housing, and employment, and integration of health care services.
Discussing the Issues: A Report on the 2013 Ivies + Access Services Symposium
ERIC Educational Resources Information Center
Wilson, Andrew M.
2014-01-01
As access services emerges as a discrete discipline within the field of librarianship, opportunities for access services librarians to meet and discuss the issues facing today's libraries continue to grow. One annual meeting that has attracted less attention over the years is the Ivies + Access Services Symposium. Held at various member…
Hierarchy Bayesian model based services awareness of high-speed optical access networks
NASA Astrophysics Data System (ADS)
Bai, Hui-feng
2018-03-01
As the speed of optical access networks soars with ever increasing multiple services, the service-supporting ability of optical access networks suffers greatly from the shortage of service awareness. Aiming to solve this problem, a hierarchy Bayesian model based services awareness mechanism is proposed for high-speed optical access networks. This approach builds a so-called hierarchy Bayesian model, according to the structure of typical optical access networks. Moreover, the proposed scheme is able to conduct simple services awareness operation in each optical network unit (ONU) and to perform complex services awareness from the whole view of system in optical line terminal (OLT). Simulation results show that the proposed scheme is able to achieve better quality of services (QoS), in terms of packet loss rate and time delay.
A Network Access Control Framework for 6LoWPAN Networks
Oliveira, Luís M. L.; Rodrigues, Joel J. P. C.; de Sousa, Amaro F.; Lloret, Jaime
2013-01-01
Low power over wireless personal area networks (LoWPAN), in particular wireless sensor networks, represent an emerging technology with high potential to be employed in critical situations like security surveillance, battlefields, smart-grids, and in e-health applications. The support of security services in LoWPAN is considered a challenge. First, this type of networks is usually deployed in unattended environments, making them vulnerable to security attacks. Second, the constraints inherent to LoWPAN, such as scarce resources and limited battery capacity, impose a careful planning on how and where the security services should be deployed. Besides protecting the network from some well-known threats, it is important that security mechanisms be able to withstand attacks that have not been identified before. One way of reaching this goal is to control, at the network access level, which nodes can be attached to the network and to enforce their security compliance. This paper presents a network access security framework that can be used to control the nodes that have access to the network, based on administrative approval, and to enforce security compliance to the authorized nodes. PMID:23334610
Riggs, Elisha; Davis, Elise; Gibbs, Lisa; Block, Karen; Szwarc, Jo; Casey, Sue; Duell-Piening, Philippa; Waters, Elizabeth
2012-05-15
Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH) service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0-6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refugee backgrounds. This study aims to explore experiences of using MCH services, from the perspective of families from refugee backgrounds and service providers. We used a qualitative study design informed by the socioecological model of health and a cultural competence approach. Two geographical areas of Melbourne were selected to invite participants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived an average of 4.7 years in Australia (range one month-18 years). Participants had a total of 249 children, of these 150 were born in Australia. Four focus groups and five interviews were conducted with MCH nurses, other healthcare providers and bicultural workers. Four themes were identified: facilitating access to MCH services; promoting continued engagement with the MCH service; language challenges; and what is working well and could be done better. Several processes were identified that facilitated initial access to the MCH service but there were implications for continued use of the service. The MCH service was not formally notified of new parents arriving with young children. Pre-arranged group appointments by MCH nurses for parents who attended playgroups worked well to increase ongoing service engagement. Barriers for parents in using MCH services included access to transportation, lack of confidence in speaking English and making phone bookings. Service users and providers reported that
Access to abortion: what women want from abortion services.
Wiebe, Ellen R; Sandhu, Supna
2008-04-01
Whether Canadian physicians can refuse to refer women for abortion and whether private clinics can charge for abortions are matters of controversy. We sought to identify barriers to access for women seeking therapeutic abortion and to have them identify what they considered to be most important about access to abortion services. Women presenting for abortion over a two-month period at two free-standing abortion clinics, one publicly funded and the other private, were invited to participate in the study. Phase I of the study involved administration of a questionnaire seeking information about demographics, perceived barriers to access to abortion, and what the women wanted from abortion services. Phase II involved semi-structured interviews of a convenience sample of women to record their responses to questions about access. Responses from Phase I questionnaires were compared between the two clinics, and qualitative analysis was performed on the interview responses. Of 423 eligible women, 402 completed questionnaires, and of 45 women approached, 39 completed interviews satisfactorily. Women received information about abortion services from their physicians (60.0%), the Internet (14.8%), a telephone directory (7.8%), friends or family (5.3%), or other sources (12.3%). Many had negative experiences in gaining access. The most important issue regarding access was the long wait time; the second most important issue was difficulty in making appointments. In the private clinic, 85% of the women said they were willing to pay for shorter wait times, compared with 43.5% in the public clinic. Physicians who failed to refer patients for abortion or provide information about obtaining an abortion caused distress and impeded access for a significant minority of women requesting an abortion. Management of abortion services should be prioritized to reflect what women want: particularly decreased wait times for abortion and greater ease and convenience in booking appointments
Code of Federal Regulations, 2011 CFR
2011-10-01
... to have access to its directory assistance services, including directory assistance databases, so... provider, including transfer of the LECs' directory assistance databases in readily accessible magnetic.... Updates to the directory assistance database shall be made in the same format as the initial transfer...
Barriers to accessing low vision services.
Pollard, Tamara L; Simpson, John A; Lamoureux, Ecosse L; Keeffe, Jill E
2003-07-01
To investigate barriers to accessing low vision services in Australia. Adults with a vision impairment (<6/12 in the better eye and/or significant visual field defect), who were current patients at the Royal Victorian Eye and Ear Hospital (RVEEH), were interviewed. The questions investigated self-perceived vision difficulties, duration of vision loss and satisfaction with vision and also examined issues of awareness of low vision services and referral to services. Focus groups were also conducted with vision impaired (<6/12 in the better eye) patients from the RVEEH, listeners of the Radio for the Print Handicapped and peer workers at Vision Australia Foundation. The discussions were recorded and transcribed. The questionnaire revealed that referral to low vision services was associated with a greater degree of vision loss (p = 0.002) and a greater self-perception of low vision (p = 0.005) but that referral was not associated with satisfaction (p = 0.144) or difficulties related to vision (p = 0.169). Participants with mild and moderate vision impairment each reported similar levels of difficulties with daily activities and satisfaction with their vision (p > 0.05). However, there was a significant difference in the level of difficulties experienced with daily activities between those with mild-moderate and severe vision impairment (p < 0.05). The participants of the focus groups identified barriers to accessing low vision services related to awareness of services among the general public and eye care professionals, understanding of low vision and the services available, acceptance of low vision, the referral process, and transport. In addition to the expected difficulties with lack of awareness of services by people with low vision, many people do not understand what the services provide and do not identify themselves as having low vision. Knowledge of these barriers, from the perspective of people with low vision, can now be used to guide the development and
Access to primary health care services for Indigenous peoples: A framework synthesis.
Davy, Carol; Harfield, Stephen; McArthur, Alexa; Munn, Zachary; Brown, Alex
2016-09-30
Indigenous peoples often find it difficult to access appropriate mainstream primary health care services. Securing access to primary health care services requires more than just services that are situated within easy reach. Ensuring the accessibility of health care for Indigenous peoples who are often faced with a vast array of additional barriers including experiences of discrimination and racism, can be complex. This framework synthesis aimed to identify issues that hindered Indigenous peoples from accessing primary health care and then explore how, if at all, these were addressed by Indigenous health care services. To be included in this framework synthesis papers must have presented findings focused on access to (factors relating to Indigenous peoples, their families and their communities) or accessibility of Indigenous primary health care services. Findings were imported into NVivo and a framework analysis undertaken whereby findings were coded to and then thematically analysed using Levesque and colleague's accessibility framework. Issues relating to the cultural and social determinants of health such as unemployment and low levels of education influenced whether Indigenous patients, their families and communities were able to access health care. Indigenous health care services addressed these issues in a number of ways including the provision of transport to and from appointments, a reduction in health care costs for people on low incomes and close consultation with, if not the direct involvement of, community members in identifying and then addressing health care needs. Indigenous health care services appear to be best placed to overcome both the social and cultural determinants of health which hamper Indigenous peoples from accessing health care. Findings of this synthesis also suggest that Levesque and colleague's accessibility framework should be broadened to include factors related to the health care system such as funding.
Chabot, Marina J.; Navarro, Sandy; Swann, Diane; Darney, Philip; Thiel de Bocanegra, Heike
2014-01-01
Objectives. We examined the association of adolescent birthrates (ABRs) with access to and receipt of publicly funded family planning services in California counties provided through 2 state programs: Medi-Cal, California’s Medicaid program, and the Family Planning, Access, Care, and Treatment (Family PACT) program. Methods. Our key data sources included the California Health Interview Survey and California Women’s Health Survey, Medi-Cal and Family PACT claims data, and the Birth Statistical Master File. We constructed a linear regression analysis measuring the relationship of access to and receipt of family planning services with ABRs when controlling for counties’ select covariates. Results. The regression analysis indicated that a higher access rate to Family PACT in a county was associated with a lower ABR (B = −0.19; P < .01) when controlling for unemployment rate, percentage of foreign-born adolescents, and percentage of adult low-income births. Conclusions. Efforts to reduce ABRs, specifically in counties that had persistently high rates are critical to achieving a healthy future for the state and the nation. Family PACT played a crucial role in helping adolescents avoid unintended and early childbearing. PMID:24354841
2012-01-01
Background Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH) service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0–6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refugee backgrounds. This study aims to explore experiences of using MCH services, from the perspective of families from refugee backgrounds and service providers. Methods We used a qualitative study design informed by the socioecological model of health and a cultural competence approach. Two geographical areas of Melbourne were selected to invite participants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived an average of 4.7 years in Australia (range one month-18 years). Participants had a total of 249 children, of these 150 were born in Australia. Four focus groups and five interviews were conducted with MCH nurses, other healthcare providers and bicultural workers. Results Four themes were identified: facilitating access to MCH services; promoting continued engagement with the MCH service; language challenges; and what is working well and could be done better. Several processes were identified that facilitated initial access to the MCH service but there were implications for continued use of the service. The MCH service was not formally notified of new parents arriving with young children. Pre-arranged group appointments by MCH nurses for parents who attended playgroups worked well to increase ongoing service engagement. Barriers for parents in using MCH services included access to transportation, lack of confidence in speaking English and making phone bookings. Service users
DOT National Transportation Integrated Search
1974-06-01
The report synthesizes a set of satellite communications systems configurations to provide services to aircraft flying oceanic routes. These configurations are combined with access control methods to form complete systems. These systems are analyzed ...
Improving School Access Control
ERIC Educational Resources Information Center
National Clearinghouse for Educational Facilities, 2008
2008-01-01
Few things are more important for school safety and security than controlling access to buildings and grounds. It is relatively easy to incorporate effective access control measures in new school designs but more difficult in existing schools, where most building and site features cannot be readily altered or reconfigured. The National…
Mold, Freda; de Lusignan, Simon
2015-01-01
Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems. PMID:26690225
Mold, Freda; de Lusignan, Simon
2015-12-04
Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.
Unifying Access to National Hydrologic Data Repositories via Web Services
NASA Astrophysics Data System (ADS)
Valentine, D. W.; Jennings, B.; Zaslavsky, I.; Maidment, D. R.
2006-12-01
The CUAHSI hydrologic information system (HIS) is designed to be a live, multiscale web portal system for accessing, querying, visualizing, and publishing distributed hydrologic observation data and models for any location or region in the United States. The HIS design follows the principles of open service oriented architecture, i.e. system components are represented as web services with well defined standard service APIs. WaterOneFlow web services are the main component of the design. The currently available services have been completely re-written compared to the previous version, and provide programmatic access to USGS NWIS. (steam flow, groundwater and water quality repositories), DAYMET daily observations, NASA MODIS, and Unidata NAM streams, with several additional web service wrappers being added (EPA STORET, NCDC and others.). Different repositories of hydrologic data use different vocabularies, and support different types of query access. Resolving semantic and structural heterogeneities across different hydrologic observation archives and distilling a generic set of service signatures is one of the main scalability challenges in this project, and a requirement in our web service design. To accomplish the uniformity of the web services API, data repositories are modeled following the CUAHSI Observation Data Model. The web service responses are document-based, and use an XML schema to express the semantics in a standard format. Access to station metadata is provided via web service methods, GetSites, GetSiteInfo and GetVariableInfo. The methdods form the foundation of CUAHSI HIS discovery interface and may execute over locally-stored metadata or request the information from remote repositories directly. Observation values are retrieved via a generic GetValues method which is executed against national data repositories. The service is implemented in ASP.Net, and other providers are implementing WaterOneFlow services in java. Reference implementation of
Use, access, and equity in health care services in São Paulo, Brazil.
Monteiro, Camila Nascimento; Beenackers, Mariëlle A; Goldbaum, Moisés; Barros, Marilisa Berti de Azevedo; Gianini, Reinaldo José; Cesar, Chester Luiz Galvão; Mackenbach, Johan P
2017-05-18
The study analyzed how socioeconomic factors are associated with seeking, access, use, and quality of health care services in São Paulo, Brazil. Data were obtained from two household health surveys in São Paulo. We used logistic regression to analyze associations between socioeconomic factors and seeking, access, use, and quality of health care services. Access to health care services was high among those who sought it (94.91% in 2003 and 94.98% in 2008). The proportion of access to and use of health care services did not change significantly from 2003 to 2008. Use of services in the public sector was more frequent in lower socioeconomic groups. There were some socioeconomic differences in seeking health care and resolution of health problems. The study showed almost universal access to health care services, but the results suggest problems in quality of services and differences in quality experienced by lower socioeconomic groups, who mostly use the Brazilian Unified National Health System (SUS).
Accessing the SEED genome databases via Web services API: tools for programmers.
Disz, Terry; Akhter, Sajia; Cuevas, Daniel; Olson, Robert; Overbeek, Ross; Vonstein, Veronika; Stevens, Rick; Edwards, Robert A
2010-06-14
The SEED integrates many publicly available genome sequences into a single resource. The database contains accurate and up-to-date annotations based on the subsystems concept that leverages clustering between genomes and other clues to accurately and efficiently annotate microbial genomes. The backend is used as the foundation for many genome annotation tools, such as the Rapid Annotation using Subsystems Technology (RAST) server for whole genome annotation, the metagenomics RAST server for random community genome annotations, and the annotation clearinghouse for exchanging annotations from different resources. In addition to a web user interface, the SEED also provides Web services based API for programmatic access to the data in the SEED, allowing the development of third-party tools and mash-ups. The currently exposed Web services encompass over forty different methods for accessing data related to microbial genome annotations. The Web services provide comprehensive access to the database back end, allowing any programmer access to the most consistent and accurate genome annotations available. The Web services are deployed using a platform independent service-oriented approach that allows the user to choose the most suitable programming platform for their application. Example code demonstrate that Web services can be used to access the SEED using common bioinformatics programming languages such as Perl, Python, and Java. We present a novel approach to access the SEED database. Using Web services, a robust API for access to genomics data is provided, without requiring large volume downloads all at once. The API ensures timely access to the most current datasets available, including the new genomes as soon as they come online.
Proximity-based access control for context-sensitive information provision in SOA-based systems
NASA Astrophysics Data System (ADS)
Rajappan, Gowri; Wang, Xiaofei; Grant, Robert; Paulini, Matthew
2014-06-01
Service Oriented Architecture (SOA) has enabled open-architecture integration of applications within an enterprise. For net-centric Command and Control (C2), this elucidates information sharing between applications and users, a critical requirement for mission success. The Information Technology (IT) access control schemes, which arbitrate who gets access to what information, do not yet have the contextual knowledge to dynamically allow this information sharing to happen dynamically. The access control might prevent legitimate users from accessing information relevant to the current mission context, since this context may be very different from the context for which the access privileges were configured. We evaluate a pair of data relevance measures - proximity and risk - and use these as the basis of dynamic access control. Proximity is a measure of the strength of connection between the user and the resource. However, proximity is not sufficient, since some data might have a negative impact, if leaked, which far outweighs importance to the subject's mission. For this, we use a risk measure to quantify the downside of data compromise. Given these contextual measures of proximity and risk, we investigate extending Attribute-Based Access Control (ABAC), which is used by the Department of Defense, and Role-Based Access Control (RBAC), which is widely used in the civilian market, so that these standards-based access control models are given contextual knowledge to enable dynamic information sharing. Furthermore, we consider the use of such a contextual access control scheme in a SOA-based environment, in particular for net-centric C2.
Efficient Access Control in Multimedia Social Networks
NASA Astrophysics Data System (ADS)
Sachan, Amit; Emmanuel, Sabu
Multimedia social networks (MMSNs) have provided a convenient way to share multimedia contents such as images, videos, blogs, etc. Contents shared by a person can be easily accessed by anybody else over the Internet. However, due to various privacy, security, and legal concerns people often want to selectively share the contents only with their friends, family, colleagues, etc. Access control mechanisms play an important role in this situation. With access control mechanisms one can decide the persons who can access a shared content and who cannot. But continuously growing content uploads and accesses, fine grained access control requirements (e.g. different access control parameters for different parts in a picture), and specific access control requirements for multimedia contents can make the time complexity of access control to be very large. So, it is important to study an efficient access control mechanism suitable for MMSNs. In this chapter we present an efficient bit-vector transform based access control mechanism for MMSNs. The proposed approach is also compatible with other requirements of MMSNs, such as access rights modification, content deletion, etc. Mathematical analysis and experimental results show the effectiveness and efficiency of our proposed approach.
Geographic Disparities in Access to Agencies Providing Income-Related Social Services.
Bauer, Scott R; Monuteaux, Michael C; Fleegler, Eric W
2015-10-01
Geographic location is an important factor in understanding disparities in access to health-care and social services. The objective of this cross-sectional study is to evaluate disparities in the geographic distribution of income-related social service agencies relative to populations in need within Boston. Agency locations were obtained from a comprehensive database of social services in Boston. Geographic information systems mapped the spatial relationship of the agencies to the population using point density estimation and was compared to census population data. A multivariate logistic regression was conducted to evaluate factors associated with categories of income-related agency density. Median agency density within census block groups ranged from 0 to 8 agencies per square mile per 100 population below the federal poverty level (FPL). Thirty percent (n = 31,810) of persons living below the FPL have no access to income-related social services within 0.5 miles, and 77 % of persons living below FPL (n = 83,022) have access to 2 or fewer agencies. 27.0 % of Blacks, 30.1 % of Hispanics, and 41.0 % of non-Hispanic Whites with incomes below FPL have zero access. In conclusion, some neighborhoods in Boston with a high concentration of low-income populations have limited access to income-related social service agencies.
Accessibility and distribution of the Norwegian National Air Emergency Service: 1988-1998.
Heggestad, Torhild; Børsheim, Knut Yngve
2002-01-01
To evaluate the accessibility and distribution of the Norwegian National Air Emergency Service in the 10-year period from 1988 to 1998. The primary material was annual standardized activity data that included all helicopter missions. A multivariate model of determinants for use of the helicopter service was computed by linear regression. Accessibility was measured as the percentage of the population reached in different flying times, and we evaluated the service using a simulation of alternative locations for the helicopter bases. The helicopter service (HEMS) has short access times, with a mean reaction time of 8 minutes and a mean response time of 26 minutes for acute missions. Nearly all patients (98%) are reached within 1 hour. A simulation that tested alternative locations of the helicopter bases compared with current locations showed no increase in accessibility. The use of the service shows large regional differences. Multivariate analyses showed that the distances of the patients from the nearest helicopter base and the nearest hospital are significant determinants for the use of HEMS. Establishment of a national service has given the Norwegian population better access to highly qualified prehospital emergency services. Furthermore, the HEMS has a compensating effect in adjusting for differences in traveling distances to a hospital. Safety, cost-containment, and gatekeeper functions remain challenges.
The cost of accessing infant HIV medications and health services in Uganda.
Bergmann, Julie N; Wanyenze, Rhoda K; Stockman, Jamila K
2017-11-01
Patient costs are a critical barrier to the elimination of mother to child HIV transmission. Despite the Ugandan government providing free public HIV services, infant antiretroviral (ARV) prophylaxis coverage remains low (25%). To understand costs mothers incur in accessing ARV prophylaxis for their infants, we conducted a mixed methods study to quantify and identify their direct costs. We used cross-sectional survey data and focus group discussions from 49 HIV-positive mothers in Uganda. Means and standard deviations were calculated for the direct costs (e.g., transportation, caretaker, services/medications) involved in accessing infant HIV services. The direct cost of attending HIV clinic visits averaged $3.71 (SD = $3.52). Focus group discussions identified two costs hindering access to infant HIV services: transportation costs and informal service charges. All participants reported significant costs associated with accessing infant HIV services - the equivalent of 2-3 days' income. To address transportation costs, community and home care models should be explored. Additionally, stricter policies and oversight should be implemented to prevent informal HIV service charges.
Web service activities at the IRIS DMC to support federated and multidisciplinary access
NASA Astrophysics Data System (ADS)
Trabant, Chad; Ahern, Timothy K.
2013-04-01
At the IRIS Data Management Center (DMC) we have developed a suite of web service interfaces to access our large archive of, primarily seismological, time series data and related metadata. The goals of these web services include providing: a) next-generation and easily used access interfaces for our current users, b) access to data holdings in a form usable for non-seismologists, c) programmatic access to facilitate integration into data processing workflows and d) a foundation for participation in federated data discovery and access systems. To support our current users, our services provide access to the raw time series data and metadata or conversions of the raw data to commonly used formats. Our services also support simple, on-the-fly signal processing options that are common first steps in many workflows. Additionally, high-level data products derived from raw data are available via service interfaces. To support data access by researchers unfamiliar with seismic data we offer conversion of the data to broadly usable formats (e.g. ASCII text) and data processing to convert the data to Earth units. By their very nature, web services are programmatic interfaces. Combined with ubiquitous support for web technologies in programming & scripting languages and support in many computing environments, web services are very well suited for integrating data access into data processing workflows. As programmatic interfaces that can return data in both discipline-specific and broadly usable formats, our services are also well suited for participation in federated and brokered systems either specific to seismology or multidisciplinary. Working within the International Federation of Digital Seismograph Networks, the DMC collaborated on the specification of standardized web service interfaces for use at any seismological data center. These data access interfaces, when supported by multiple data centers, will form a foundation on which to build discovery and access mechanisms
Access to care for autism-related services.
Thomas, Kathleen C; Ellis, Alan R; McLaurin, Carolyn; Daniels, Julie; Morrissey, Joseph P
2007-11-01
This paper identifies family characteristics associated with use of autism-related services. A telephone or in-person survey was completed during 2003-2005 by 383 North Carolina families with a child 11 years old or younger with ASD. Access to care is limited for racial and ethnic minority families, with low parental education, living in nonmetropolitan areas, and not following a major treatment approach. Service use is more likely when parents have higher stress. Families use a broad array of services; the mix varies with child ASD diagnosis and age group. Disparities in service use associated with race, residence and education point to the need to develop policy, practice and family-level interventions that can address barriers to services for children with ASD.
Utilizing Syllabi to Support Access Services and Beyond: A Case Study
ERIC Educational Resources Information Center
Parrott, Justin; Lindsay, Beth Daniel
2017-01-01
New York University Abu Dhabi (NYUAD) Library receives copies of all course syllabi to provide a number of services to faculty and students related to acquisitions, access, collection development, subject liaison, and library instruction. Access services and acquisitions staff, as well as subject liaison librarians, work together using specific…
NASA Astrophysics Data System (ADS)
Kershaw, Philip; Lawrence, Bryan; Lowe, Dominic; Norton, Peter; Pascoe, Stephen
2010-05-01
CEDA (Centre for Environmental Data Archival) based at STFC Rutherford Appleton Laboratory is host to the BADC (British Atmospheric Data Centre) and NEODC (NERC Earth Observation Data Centre) with data holdings of over half a Petabyte. In the coming months this figure is set to increase by over one Petabyte through the BADC's role as one of three data centres to host the CMIP5 (Coupled Model Intercomparison Project Phase 5) core archive of climate model data. Quite apart from the problem of managing the storage of such large volumes there is the challenge of collating the data together from the modelling centres around the world and enabling access to these data for the user community. An infrastructure to support this is being developed under the US Earth System Grid (ESG) and related projects bringing together participating organisations together in a federation. The ESG architecture defines Gateways, the web interfaces that enable users to access data and data serving applications organised into Data Nodes. The BADC has been working in collaboration with US Earth System Grid team and other partners to develop a security system to restrict access to data. This provides single sign-on via both OpenID and PKI based means and uses role based authorisation facilitated by SAML and OpenID based interfaces for attribute retrieval. This presentation will provide an overview of the access control architecture and look at how this has been implemented for CEDA. CEDA has developed an expertise in data access and information services over several years through a number of projects to develop and enhance these capabilities. Participation in CMIP5 comes at a time when a number of other software development activities are coming to fruition. New services are in the process of being deployed alongside services making up the system for ESG. The security system must apply access control across this heterogeneous environment of different data services and technologies. One strand
45 CFR 152.22 - Access to services.
Code of Federal Regulations, 2010 CFR
2010-10-01
... CONDITION INSURANCE PLAN PROGRAM Benefits § 152.22 Access to services. (a) General rule. A PCIP may specify... failure to obtain immediate treatment could present a serious risk to his or her life or health; and (2...
A Pacific population's access to and use of health services in Dunedin.
Sopoaga, Faafetai; Parkin, Lianne; Gray, Andrew
2012-10-26
Pacific peoples in New Zealand (mostly of Samoan, Tongan, or Cook Islands origin) have poor health compared to the total New Zealand population. Understanding their access to and use of health services is important in resolving this. A survey of Pacific peoples in Dunedin obtained information about their access to and use of health services. 372 questionnaires were analysed. Approximately one-quarter did not have a regular doctor or health service. At least 50% used hospital emergency services for non-urgent illnesses. Nearly two-thirds used a "walk-in" primary care service. A significant proportion of Pacific peoples did not have a regular GP or health service in Dunedin. It was surprising students were more likely to be in this category because student health services should be more affordable. A "walk-in" primary care facility has a role in the delivery of primary care services. Pacific organisations can assist primary care providers to encourage access to and the appropriate use of health services.
Migrant's access to preventive health services in five EU countries.
Rosano, Aldo; Dauvrin, Marie; Buttigieg, Sandra C; Ronda, Elena; Tafforeau, Jean; Dias, Sonia
2017-08-23
Preventive health services (PHSs) form part of primary healthcare with the aim of screening to prevent disease. Migrants show significant differences in lifestyle, health beliefs and risk factors compared with the native populations. This can have a significant impact on migrants' access to health systems and participation in prevention programmes. Even in countries with widely accessible healthcare systems, migrants' access to PHSs may be difficult. The aim of the study was to compare access to preventive health services between migrants and native populations in five European Union (EU) countries. Information from Health Interview Surveys of Belgium, Italy, Malta, Portugal and Spain were used to analyse access to mammography, Pap smear tests, colorectal cancer screening and flu vaccination among migrants. The comparative risk of not accessing PHSs was calculated using a mixed-effects multilevel model, adjusting for potential confounding factors (sex, education and the presence of disability). Migrant status was defined according to citizenship, with a distinction made between EU and non-EU countries. Migrants, in particular those from non-EU countries, were found to have poorer access to PHSs. The overall risk of not reporting a screening test or a flu vaccination ranged from a minimum of 1.8 times (colorectal cancer screening), to a high of 4.4 times (flu vaccination) for migrants. The comparison among the five EU countries included in the study showed similarities, with particularly limited access recorded in Italy and in Belgium for non-EU migrants. The findings of this study are in accordance with evidence from the scientific literature. Poor organization of health services, in Italy, and lack of targeted health policies in Belgium may explain these findings. PHSs should be responsive to patient diversity, probably more so than other health services. There is a need for diversity-oriented, migrant-sensitive prevention. Policies oriented to removing
Index of Access: a new innovative and dynamic tool for rural health service and workforce planning.
McGrail, Matthew R; Russell, Deborah J; Humphreys, John S
2017-10-01
Objective Improving access to primary health care (PHC) remains a key issue for rural residents and health service planners. This study aims to show that how access to PHC services is measured has important implications for rural health service and workforce planning. Methods A more sophisticated tool to measure access to PHC services is proposed, which can help health service planners overcome the shortcomings of existing measures and long-standing access barriers to PHC. Critically, the proposed Index of Access captures key components of access and uses a floating catchment approach to better define service areas and population accessibility levels. Moreover, as demonstrated through a case study, the Index of Access enables modelling of the effects of workforce supply variations. Results Hypothetical increases in supply are modelled for a range of regional centres, medium and small rural towns, with resulting changes of access scores valuable to informing health service and workforce planning decisions. Conclusions The availability and application of a specific 'fit-for-purpose' access measure enables a more accurate empirical basis for service planning and allocation of health resources. This measure has great potential for improved identification of PHC access inequities and guiding redistribution of PHC services to correct such inequities. What is known about the topic? Resource allocation and health service planning decisions for rural and remote health settings are currently based on either simple measures of access (e.g. provider-to-population ratios) or proxy measures of access (e.g. standard geographical classifications). Both approaches have substantial limitations for informing rural health service planning and decision making. What does this paper add? The adoption of a new improved tool to measure access to PHC services, the Index of Access, is proposed to assist health service and workforce planning. Its usefulness for health service planning is
Disability in post-earthquake Haiti: prevalence and inequality in access to services.
Danquah, Lisa; Polack, Sarah; Brus, Aude; Mactaggart, Islay; Houdon, Claire Perrin; Senia, Patrick; Gallien, Pierre; Kuper, Hannah
2015-01-01
To assess the prevalence of disability and service needs in post-earthquake Haiti, and to compare the inclusion and living conditions of people with disabilities to those without disabilities. A population-based prevalence survey of disability was undertaken in 2012 in Port-au-Prince region, which was at the centre of the earthquake in 2010. Sixty clusters of 50 people aged 5 + years were selected with probability proportionate to size sampling and screened for disability (Washington Group short set questionnaire). A case-control study was undertaken, nested within the survey, matching cases to controls by age, gender and cluster. There was additional case finding to identify further children with disabilities. Information was collected on: socioeconomic status, education, livelihood, health, activities, participation and barriers. The prevalence of disability was 4.1% (3.4-4.7%) across 3132 eligible individuals. The earthquake was the second leading cause of disability. Disability was more common with increasing age, but unrelated to poverty. Large gaps existed in access of services for people with disabilities. Adults with disabilities were less likely to be literate or work and more likely to visit health services than adults without disabilities. Children with disabilities were less likely to be currently enrolled at school compared to controls. Children and adults with disabilities reported more activity limitations and participation restriction. Further focus is needed to improve inclusion of people with disabilities in post-earthquake Haiti to ensure that their rights are fulfilled. Almost one in six households in this region of Haiti included a person with a disability, and the earthquake was the second leading cause of disability. Fewer than half of people who reported needing medical rehabilitation had received this service. The leading reported barriers to the uptake of health services included financial constraints (50%) and difficulties with
10 CFR 36.23 - Access control.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 10 Energy 1 2011-01-01 2011-01-01 false Access control. 36.23 Section 36.23 Energy NUCLEAR... Requirements for Irradiators § 36.23 Access control. (a) Each entrance to a radiation room at a panoramic... radiation room at a panoramic irradiator must have an independent backup access control to detect personnel...
10 CFR 36.23 - Access control.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 10 Energy 1 2013-01-01 2013-01-01 false Access control. 36.23 Section 36.23 Energy NUCLEAR... Requirements for Irradiators § 36.23 Access control. (a) Each entrance to a radiation room at a panoramic... radiation room at a panoramic irradiator must have an independent backup access control to detect personnel...
10 CFR 36.23 - Access control.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 10 Energy 1 2012-01-01 2012-01-01 false Access control. 36.23 Section 36.23 Energy NUCLEAR... Requirements for Irradiators § 36.23 Access control. (a) Each entrance to a radiation room at a panoramic... radiation room at a panoramic irradiator must have an independent backup access control to detect personnel...
The Role of the Access Services Manager in the Virtual Library
ERIC Educational Resources Information Center
Jetton, Lora Lennertz; Bailey, Alberta S.
2010-01-01
This article updates a previous article published in 1992 that described the role of the access services manager in policy formation. Since that time, the access services department and mission has matured and evolved to a prominent position within the library organization. Technological changes and innovation in the marketplace of wired and…
Access Services: Organization and Management. SPEC Kit #179.
ERIC Educational Resources Information Center
Steel, Virginia, Comp.
This Systems and Exchange Center (SPEC) kit begins with a summary by Virginia Steel of the findings of a survey of Association of Research Libraries (ARL) member libraries that was conducted in 1991 to determine the prevalence of the organizational model of access services--i.e., a department or division responsible for the services and operations…
Zaidi, Shehla; Riaz, Atif; Rabbani, Fauziah; Azam, Syed Iqbal; Imran, Syeda Nida; Pradhan, Nouhseen Akber; Khan, Gul Nawaz
2015-11-25
The case of contracting out government health services to non-governmental organizations (NGOs) has been weak for maternal, newborn, and child health (MNCH) services, with documented gains being mainly in curative services. We present an in-depth assessment of the comparative advantages of contracting out on MNCH access, quality, and equity, using a case study from Pakistan. An end-line, cross-sectional assessment was conducted of government facilities contracted out to a large national NGO and government-managed centres serving as controls, in two remote rural districts of Pakistan. Contracting out was specific for augmenting MNCH services but without contractual performance incentives. A household survey, a health facility survey, and focus group discussions with client and spouses were used for assessment. Contracted out facilities had a significantly higher utilization as compared to control facilities for antenatal care, delivery, postnatal care, emergency obstetric care, and neonatal illness. Contracted facilities had comparatively better quality of MNCH services but not in all aspects. Better household practices were also seen in the district where contracting involved administrative control over outreach programs. Contracting was also faced with certain drawbacks. Facility utilization was inequitably higher amongst more educated and affluent clients. Contracted out catchments had higher out-of-pocket expenses on MNCH services, driven by steeper transport costs and user charges for additional diagnostics. Contracting out did not influence higher MNCH service coverage rates across the catchment. Physical distances, inadequate transport, and low demand for facility-based care in non-emergency settings were key client-reported barriers. Contracting out MNCH services at government health facilities can improve facility utilization and bring some improvement in quality of services. However, contracting out of health facilities is insufficient to increase
DOT National Transportation Integrated Search
1974-06-01
The report presents a summary of a study conducted for the Transportation Systems Center of promising access control techniques which are applicable to an aeronautical satellite system. Several frequency division multiple access (FDMA) and time divis...
Shah, Tayyab Ikram; Milosavljevic, Stephan; Bath, Brenna
2017-06-01
This research is focused on methodological challenges and considerations associated with the estimation of the geographical aspects of access to healthcare with a focus on rural and remote areas. With the assumption that GIS-based accessibility measures for rural healthcare services will vary across geographic units of analysis and estimation techniques, which could influence the interpretation of spatial access to rural healthcare services. Estimations of geographical accessibility depend on variations of the following three parameters: 1) quality of input data; 2) accessibility method; and 3) geographical area. This research investigated the spatial distributions of physiotherapists (PTs) in comparison to family physicians (FPs) across Saskatchewan, Canada. The three-steps floating catchment areas (3SFCA) method was applied to calculate the accessibility scores for both PT and FP services at two different geographical units. A comparison of accessibility scores to simple healthcare provider-to-population ratios was also calculated. The results vary considerably depending on the accessibility methods used and the choice of geographical area unit for measuring geographical accessibility for both FP and PT services. These findings raise intriguing questions regarding the nature and extent of technical issues and methodological considerations that can affect GIS-based measures in health services research and planning. This study demonstrates how the selection of geographical areal units and different methods for measuring geographical accessibility could affect the distribution of healthcare resources in rural areas. These methodological issues have implications for determining where there is reduced access that will ultimately impact health human resource priorities and policies. Copyright © 2017 Elsevier Ltd. All rights reserved.
47 CFR 64.1508 - Blocking access to 900 service.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 3 2010-10-01 2010-10-01 false Blocking access to 900 service. 64.1508 Section 64.1508 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Interstate Pay-Per-Call and Other Information...
Hospital-Based Outpatient Direct Access to Physical Therapist Services: Current Status in Wisconsin.
Boissonnault, William G; Lovely, Karen
2016-11-01
Direct access to physical therapist services is available in all 50 states, with reported benefits including reduced health care costs, enhanced patient satisfaction, and no apparent compromised patient safety. Despite the benefits and legality of direct access, few data exist regarding the degree of model adoption, implementation, and utilization. The purposes of the study were: (1) to investigate the extent of implementation and utilization of direct access to outpatient physical therapist services in Wisconsin hospitals and medical centers, (2) to identify barriers to and facilitators for the provisioning of such services, and (3) to identify potential differences between facilities that do and do not provide direct access services. A descriptive survey was conducted. Eighty-nine survey questionnaires were distributed via email to the directors of rehabilitation services at Wisconsin hospitals and medical centers. The survey investigated facility adoption of the direct access model, challenges to and resources utilized during model implementation, and current barriers affecting model utilization. Forty-seven (52.8%) of the 89 survey questionnaires were completed and returned. Forty-two percent of the survey respondents (20 of 47) reported that their facility offered direct access to physical therapist services, but fewer than 10% of patients were seen via direct access at 95% of the facilities offering such services. The most frequently reported obstacles to model implementation and utilization were lack of health care provider, administrator, and patient knowledge of direct access; its legality in Wisconsin; and physical therapists' differential diagnosis and medical screening abilities. Potential respondent bias and limited generalizability of the results are limitations of the study. These findings apply to hospitals and medical centers located in Wisconsin, not to facilities located in other geographic regions. Respondents representing direct access
2013-01-01
Introduction There is a great health services disparity between urban and rural areas in China. The percentage of people who are unable to access health services due to long travel times increases. This paper takes Donghai County as the study unit to analyse areas with physician shortages and characteristics of the potential spatial accessibility of health services. We analyse how the unequal health services resources distribution and the New Cooperative Medical Scheme affect the potential spatial accessibility of health services in Donghai County. We also give some advice on how to alleviate the unequal spatial accessibility of health services in areas that are more remote and isolated. Methods The shortest traffic times of from hospitals to villages are calculated with an O-D matrix of GIS extension model. This paper applies an enhanced two-step floating catchment area (E2SFCA) method to study the spatial accessibility of health services and to determine areas with physician shortages in Donghai County. The sensitivity of the E2SFCA for assessing variation in the spatial accessibility of health services is checked using different impedance coefficient valuesa. Geostatistical Analyst model and spatial analyst method is used to analyse the spatial pattern and the edge effect of potential spatial accessibility of health services. Results The results show that 69% of villages have access to lower potential spatial accessibility of health services than the average for Donghai County, and 79% of the village scores are lower than the average for Jiangsu Province. The potential spatial accessibility of health services diminishes greatly from the centre of the county to outlying areas. Using a smaller impedance coefficient leads to greater disparity among the villages. The spatial accessibility of health services is greater along highway in the county. Conclusions Most of villages are in underserved health services areas. An unequal distribution of health service
Accessibility of Catering Service Venues and Adolescent Drinking in Beijing, China.
Lu, Shijun; Du, Songming; Ren, Zhoupeng; Zhao, Jing; Chambers, Christina; Wang, Jinfeng; Ma, Guansheng
2015-06-26
This study assessed the association between accessibility of catering service venues and adolescents' alcohol use over the previous 30 days. The data were collected from cross-sectional surveys conducted in 2014, 2223 students at 27 high schools in Chaoyang and Xicheng districts, Beijing using self-administered questionnaires to collect the adolescents information on socio-demographic characteristics and recent alcohol experiences. The accessibility of, and proximity to, catering service venues were summarized by weights, which were calculated by multiplication of the type-weight and the distance-weight. All sampled schools were categorized into three subgroups (low, middle, and high geographic density) based on the tertile of nearby catering service venues, and a multi-level logistic regression analysis was performed to explore variance between the school levels. Considering the setting characteristics, the catering service venues weighted value was found to account for 8.6% of the school level variance of adolescent alcohol use. The odds ratios (OR) and 95% confidence intervals (CI) of drinking over the past 30-days among adolescents with medium and high accessibility of catering service venues were 1.17 (0.86, 1.57) and 1.47 (1.06, 2.02), respectively (p < 0.001 for trend test). This study addressed a gap in the adolescent drinking influence by the catering service venues around schools in China. Results suggest that the greater accessibility of catering service venues around schools is associated with a growing risk of recent drinking.
Accessibility of Catering Service Venues and Adolescent Drinking in Beijing, China
Lu, Shijun; Du, Songming; Ren, Zhoupeng; Zhao, Jing; Chambers, Christina; Wang, Jinfeng; Ma, Guansheng
2015-01-01
This study assessed the association between accessibility of catering service venues and adolescents’ alcohol use over the previous 30 days. The data were collected from cross-sectional surveys conducted in 2014, 2223 students at 27 high schools in Chaoyang and Xicheng districts, Beijing using self-administered questionnaires to collect the adolescents information on socio-demographic characteristics and recent alcohol experiences. The accessibility of, and proximity to, catering service venues were summarized by weights, which were calculated by multiplication of the type-weight and the distance-weight. All sampled schools were categorized into three subgroups (low, middle, and high geographic density) based on the tertile of nearby catering service venues, and a multi-level logistic regression analysis was performed to explore variance between the school levels. Considering the setting characteristics, the catering service venues weighted value was found to account for 8.6% of the school level variance of adolescent alcohol use. The odds ratios (OR) and 95% confidence intervals (CI) of drinking over the past 30-days among adolescents with medium and high accessibility of catering service venues were 1.17 (0.86, 1.57) and 1.47 (1.06, 2.02), respectively (p < 0.001 for trend test). This study addressed a gap in the adolescent drinking influence by the catering service venues around schools in China. Results suggest that the greater accessibility of catering service venues around schools is associated with a growing risk of recent drinking. PMID:26132475
Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley
2015-03-01
Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King's Fund, Nuffield Health, PsycINFO, OpenGrey (1999-2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of record access and use by specific ethnic and socioeconomic groups
Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley
2015-01-01
Background Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. Aim To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. Design and setting A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Method Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King’s Fund, Nuffield Health, PsycINFO, OpenGrey (1999–2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. Results A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. Conclusion While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of
Norman, Wendy V.; Hestrin, Barbara; Dueck, Royce
2014-01-01
Background. Providing equitable access to the full range of reproductive health services over wide geographic areas presents significant challenges to any health system. We present a review of a service provision model which has provided improved access to abortion care; support for complex issues experienced by women seeking nonjudgmental family planning health services; and a mechanism to collect information on access barriers. The toll-free pregnancy options service (POS) of British Columbia Women's Hospital and Health Centre sought to improve access to services and overcome barriers experienced by women seeking abortion. Methods. We describe the development and implementation of a province-wide toll-free telephone counseling and access facilitation service, including establishment of a provincial network of local abortion service providers in the Canadian province of British Columbia from 1998 to 2010. Results. Over 2000 women annually access service via the POS line, networks of care providers are established and linked to central support, and central program planners receive timely information on new service gaps and access barriers. Conclusion. This novel service has been successful in addressing inequities and access barriers identified as priorities before service establishment. The service provided unanticipated benefits to health care planning and monitoring of provincial health care related service delivery and gaps. This model for low cost health service delivery may realize similar benefits when applied to other health care systems where access and referral barriers exist. PMID:24693291
Barriers to health service access among female migrant Ugandan sex workers in Guangzhou, China.
Davis, Alissa; Meyerson, Beth E; Aghaulor, Blessing; Brown, Katherine; Watson, Adisyn; Muessig, Kathryn E; Yang, Ligang; Tucker, Joseph D
2016-10-14
Increased trade between China and Uganda has fueled trafficking of female Ugandans into China. These women may face challenges accessing health services. This study focused on examining barriers to health care access among female Ugandan sex workers in China. In 2014, we undertook in-depth interviews with 19 female Ugandan sex workers in Guangzhou, China. Interviews focused on barriers to health service access and were analyzed using an a priori coding framework followed by open-coding to capture emergent themes. Out of 19 women, 12 women reported a history of being trafficked into China. None of the women had a valid Chinese visa. Fear of being arrested for lack of documentation discouraged women in this sample from accessing hospital services. Low pay, housing exploitation, and remittances contributed to participants' lack of financial resources, which further inhibited their ability to access health services. Participants expressed feeling social isolation from the local community and reported mistrust of local individuals and organizations, including hospitals. Ugandan sex workers in China faced substantial structural barriers that limited health service access. Policy changes and the development of new programs are urgently needed to ensure these women have improved access to health services.
Kuupiel, Desmond; Bawontuo, Vitalis; Mashamba-Thompson, Tivani P
2017-11-29
Access to point-of-care (POC) diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs) and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings.
Kuupiel, Desmond; Bawontuo, Vitalis
2017-01-01
Access to point-of-care (POC) diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs) and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings. PMID:29186013
NASA Astrophysics Data System (ADS)
Shukla, Nagesh; Wickramasuriya, Rohan; Miller, Andrew; Perez, Pascal
2015-05-01
This paper proposes an integrated modelling process to assess the population accessibility to radiotherapy treatment services in future based on future cancer incidence and road network-based accessibility. Previous research efforts assessed travel distance/time barriers affecting access to cancer treatment services, as well as epidemiological studies that showed that cancer incidence rates vary with population demography. It is established that travel distances to treatment centres and demographic profiles of the accessible regions greatly influence the demand for cancer radiotherapy (RT) services. However, an integrated service planning approach that combines spatially-explicit cancer incidence projections, and the RT services accessibility based on patient road network have never been attempted. This research work presents this novel methodology for the accessibility assessment of RT services and demonstrates its viability by modelling New South Wales (NSW) cancer incidence rates for different age-sex groups based on observed cancer incidence trends; estimating the road network-based access to current NSW treatment centres; and, projecting the demand for RT services in New South Wales, Australia from year 2011 to 2026.
Nurse practitioners and controlled substances prescriptive authority: improving access to care.
Ambrose, Michelle A; Tarlier, Denise S
2013-03-01
In 2007, Health Canada proposed a new framework to regulate prescriptive authority for controlled substances, titled New Classes of Practitioners Regulations (NCPR). The new regulatory framework was passed in November 2012; it gives nurse practitioners (NPs), midwives and podiatrists the authority to prescribe controlled medications under the Controlled Drugs and Substances Act. It is expected that authorizing NPs to write prescriptions for certain controlled substances commonly used in primary care will enhance flexibility and timeliness in primary care service delivery. Studies from the United States have shown positive outcomes in primary care access, decreased healthcare costs and the evolution and advancement of the NP role when prescriptive authority was expanded to include controlled substances. The purpose of this paper is to examine how NPs' prescriptive authority for controlled substances affects access to primary care and NP role development. Three key issues identified from the experience of one group of NPs in the United States (access to care, professional autonomy and prescriber knowledge) offer insight into the practice changes that may be anticipated for NPs in Canada now that they have acquired prescriptive authority for controlled substances. Recommendations are offered to assist nurse leaders and educators to best support NPs as they take on this new and important role responsibility.
Organizing uninsured safety-net access to specialist physician services.
Hall, Mark A
2013-05-01
Arranging referrals for specialist services is often the greatest difficulty that safety-net access programs face in attempting to provide fairly comprehensive services for the uninsured. When office-based community specialists are asked to care for uninsured patients, they cite the following barriers: difficulty determining which patients merit charity care, having to arrange for services patients need from other providers, and concerns about liability for providing inadequate care. Solutions to these barriers to specialist access can be found in the same institutional arrangements that support primary care and hospital services for the uninsured. These safety-net organization structures can be extended to include specialist physician care by funding community health centers to contract for specialist referrals, using free-standing referral programs to subsidize community specialists who accept uninsured patients at discounted rates, and encouraging hospitals through tax exemption or disproportionate share funding to require specialists on their medical staffs to accept an allocation of uninsured office-based referrals.
7 CFR 1755.500 - RUS standard for service installations at customers access locations.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 7 Agriculture 11 2010-01-01 2010-01-01 false RUS standard for service installations at customers... customers access locations. (a) Sections 1755.501 through 1755.510 cover service installations at permanent or mobile home customer access locations. Sections 1755.501 through 1755.510 do not cover service...
Service Accessibility for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth
ERIC Educational Resources Information Center
Acevedo-Polakovich, Ignacio David; Bell, Bailey; Gamache, Peter; Christian, Allison S.
2013-01-01
Although Lesbian, Gay, Bisexual, Transgender, Queer and/or Questioning (LGBTQ) youth experience alarming rates of behavioral and social problems, service use among these youth is disproportionately low. It is likely that decreased service accessibility plays a causal role in service underutilization among LGBTQ youth. To expand the existing…
Access to Dental Services for People Using a Wheelchair
Nicolau, Belinda; Bedos, Christophe
2015-01-01
Objectives. We investigated the perspectives of people using a wheelchair and their difficulties in accessing dental services. Methods. Our participatory research was on the basis of a partnership between people using a wheelchair, dental professionals, and academic researchers. Partners were involved in a committee that provided advice at all stages of the project. Our team adopted a qualitative descriptive design. Between October 2011 and October 2012 we conducted semistructured individual interviews with 13 adults who lived in Montreal, Québec, Canada, and used a wheelchair full time. We audio-recorded and transcribed verbatim interviews, and we interpreted data using an inductive thematic analysis. Results. Oral health is of heightened importance to this group of people, who tend to use their mouth as a “third hand.” We identified successive challenges in accessing dental services: finding a dentist and being accepted, organizing transportation, entering the building and circulating inside, interacting with the dental staff, transferring and overcoming discomfort on the dental chair, and paying for the treatments. Conclusions. Governments, dental professional bodies, dental schools, and researchers should work with groups representing wheelchair users to improve access to dental services. PMID:26378836
Moving beyond the Amalgam: Restructuring Access Services
ERIC Educational Resources Information Center
Austin, Brice
2010-01-01
At least since the early 1990s, academic libraries have been merging Circulation and various other related functions into a single department typically labeled "Access Services." In many cases, however, that merger has proven to be administrative rather than functional, with minimal integration of common workflows. This article describes…
Assessment and Evaluation Methods for Access Services
ERIC Educational Resources Information Center
Long, Dallas
2014-01-01
This article serves as a primer for assessment and evaluation design by describing the range of methods commonly employed in library settings. Quantitative methods, such as counting and benchmarking measures, are useful for investigating the internal operations of an access services department in order to identify workflow inefficiencies or…
An Introduction to Services Accessible on the Internet.
ERIC Educational Resources Information Center
Giguere, Marlene
1992-01-01
Provides an overview of the INTERNET and INTERNET services of interest to libraries, including electronic mail, bulletin boards, electronic publishing, online public access catalogs and databases, and downloaded texts and software. (16 references) (MES)
Palmer, Jennifer J; Kelly, Ann H; Surur, Elizeous I; Checchi, Francesco; Jones, Caroline
2014-11-01
For several decades, control programmes for human African trypanosomiasis (HAT, or sleeping sickness) in South Sudan have been delivered almost entirely as humanitarian interventions: large, well-organised, externally-funded but short-term programmes with a strategic focus on active screening. When attempts to hand over these programmes to local partners fail, resident populations must actively seek and negotiate access to tests at hospitals via passive screening. However, little is known about the social impact of such humanitarian interventions or the consequences of withdrawal on access to and utilisation of remaining services by local populations. Based on qualitative and quantitative fieldwork in Nimule, South Sudan (2008-2010), where passive screening necessarily became the predominant strategy, this paper investigates the reasons why, among two ethnic groups (Madi returnees and Dinka displaced populations), service uptake was so much higher among the latter. HAT tests were the only form of clinical care for which displaced Dinka populations could self-refer; access to all other services was negotiated through indigenous area workers. Because of the long history of conflict, these encounters were often morally and politically fraught. An open-door policy to screening supported Dinka people to 'try' HAT tests in the normal course of treatment-seeking, thereby empowering them to use HAT services more actively. This paper argues that in a context like South Sudan, where HAT control increasingly depends upon patient-led approaches to case-detection, it is imperative to understand the cultural values and political histories associated with the practice of testing and how medical humanitarian programmes shape this landscape of care, even after they have been scaled down. Copyright © 2014 Elsevier Ltd. All rights reserved.
Postpolio Survivors: Needs for and Access to Social and Health Care Services.
ERIC Educational Resources Information Center
Foster, Larry W.; And Others
1993-01-01
Needs assessment survey of 268 polio survivors explored incidence of postpolio syndrome and perceived need for and access to social and health care services. Large proportion of respondents reported experiencing postpolio syndrome. Most perceived that they had no access to knowledgeable physicians or social and health care services, and most were…
Alencar Albuquerque, Grayce; de Lima Garcia, Cintia; da Silva Quirino, Glauberto; Alves, Maria Juscinaide Henrique; Belém, Jameson Moreira; dos Santos Figueiredo, Francisco Winter; da Silva Paiva, Laércio; do Nascimento, Vânia Barbosa; da Silva Maciel, Érika; Valenti, Vitor Engrácia; de Abreu, Luiz Carlos; Adami, Fernando
2016-01-14
The relationship between users and health services is considered essential to strengthen the quality of care. However, the Lesbian, Gay, Bisexual, and Transgender population suffer from prejudice and discrimination in access and use of these services. This study aimed to identify the difficulties associated with homosexuality in access and utilization of health services. A systematic review conducted using PubMed, Cochrane, SciELO, and LILACS, considering the period from 2004 to 2014. The studies were evaluated according to predefined inclusion and exclusion criterias. Were included manuscripts written in English or Portuguese, articles examining the Lesbian, Gay, Bisexual, and Transgender population's access to health services and original articles with full text available online. The electronic databases search resulted in 667 studies, of which 14 met all inclusion criteria. Quantitative articles were predominant, showing the country of United States of America to be the largest producer of research on the topic. The studies reveal that the homosexual population have difficulties of access to health services as a result of heteronormative attitudes imposed by health professionals. The discriminatory attendance implies in human rights violations in access to health services. The non-heterosexual orientation was a determinant factor in the difficulties of accessing health care. A lot must still be achieved to ensure access to health services for sexual minorities, through the adoption of holistic and welcoming attitudes. The results of this study highlight the need for larger discussions about the theme, through new research and debates, with the aim of enhancing professionals and services for the health care of Lesbian, Gay, Bisexual, and Transgender Persons.
What systems participants know about access and service entry and why managers should listen.
Duncombe, Rohena
2017-08-01
Objective The present study looked at the views of people directly involved in the entry process for community health counselling using the frame of the health access literature. The concurrence of system participants' views with the access literature highlights access issues, particularly for people who are vulnerable or disadvantaged. The paper privileges the voices of the system participants, inviting local health services to consider using participatory design to improve access at the entry point. Methods People involved in the entry process for community health counselling explored the question, 'What, for you, are the features of a good intake system?' They also commented on themes identified during pilot interviews. These were thematically analysed for each participant group by the researcher to develop a voice for each stakeholder group. Results People accessing the service could be vulnerable and the entry process failed to take that into account. People directly involved in the counselling service entry system, system participants, consisted of: professionals referring in, people seeking services and reception staff taking first enquiries. They shared substantially the same concerns as each other. The responses from these system participants are consistent with the international literature on access and entry into health services. Conclusion Participatory service design could improve primary healthcare service entry at the local level. Canvassing the experiences of system participants is important for delivering services to those who have the least access and, in that way, could contribute to health equity. What is known about the topic? People with the highest health needs receive the fewest services. Health inequality is increasing. What does this paper add? System participants can provide advice consistent with the academic research literature that is useful for improving service entry at the local level. What are the implications for practitioners
[Access to oral health services in children under twelve years of age in Peru, 2014].
Hernández-Vásquez, Akram; Azañedo, Diego; Díaz-Seijas, Deysi; Bendezú-Quispe, Guido; Arroyo-Hernández, Hugo; Vilcarromero, Stalin; Agudelo-Suárez, Andrés A
2016-01-01
The aim of the study was to explore the patterns of dental health services access in children under twelve years of age in Peru. Data from 25,285 children under 12 years who participated in the Demographic and Family Health Survey of 2014 were reviewed. An exploratory spatial analysis was performed to project the proportions of children with access to dental health services, according to national regions, type of health service and urban or rural place of residence. The results show that of the total sample, 26.7% had access to dental health services in the last six months, 39.6% belonged to the age group 0-4 years, 40.6% lived in the Andean region and 58.3% lived in urban areas. The regions of Huancavelica, Apurimac, Ayacucho, Lima and Pasco had the highest percentages of access nationwide. In conclusion, there is low access to dental health services in the population under 12 years of age in Peru. The spatial distribution of access to dental health services allows regions to be identified and grouped according to similar access patterns, in order to better focus public health actions.
Fertility decline and social service access: reconciling behavioral and medical models.
Weinstein, J
1978-01-01
In this summary of fertility literature the author attempts to differentiate between the effects of behavioral and medical models of family planning programs on the fertility rate. This is done by determining the effects of access to social welfare services by assessment of: the function of children within the family life survey conducted in the Cameroons are also used. It was found that 7 interdependent elements of social service are involved: 1) general health care; 2) social security for sick and aged; 3) employment training and opportunities for adults; 4) literacy and education; 5) communication and transportation systems; 6) housing and infrastructure; 7) child care and welfare. The presence of these elements is shown to accompany low fertility while their absence is expressed in high rates of child bearing. These elements are major variables in both the nomological and public policy senses. 2 additional components are knowledge of and favorable attitudes towards effective means of fertility control plus effective mechanical, chemical, or natural means of limiting fertility. The concept of fertility norm and its impact on the fertility rate is explained as being the result of the collective force which social affiliations exert on people to reproduce in a certain way. The "stopping rule" is that which will fulfill the fertility norm. An example of this is a culture which continues child bearing until a son has been born and then controls reproduction after this has happened. Such factors must be considered for family planning programs to succeed in these cultures. Therefore fertility levels are found to be the product of prevailing norms and technical ability to achieve these norms. Improvement in levels of access to social services can bring about the lowering of these norms.
Support Services for Remote Users of Online Public Access Catalogs.
ERIC Educational Resources Information Center
Kalin, Sally W.
1991-01-01
Discusses the needs of remote users of online public access catalogs (OPACs). User expectations are discussed; problems encountered by remote-access users are examined, including technical problems and searching problems; support services are described, including instruction, print guides, and online help; and differences from the needs of…
47 CFR 54.621 - Access to advanced telecommunications and information services.
Code of Federal Regulations, 2012 CFR
2012-10-01
... cannot obtain toll-free access to an Internet service provider shall be entitled to receive the lesser of... monthly cost of eligible Internet access shall be eligible for universal support. Health care providers shall certify that the Internet access selected is the most cost-effective method for their health care...
Feasibility Assessment of a Fine-Grained Access Control Model on Resource Constrained Sensors.
Uriarte Itzazelaia, Mikel; Astorga, Jasone; Jacob, Eduardo; Huarte, Maider; Romaña, Pedro
2018-02-13
Upcoming smart scenarios enabled by the Internet of Things (IoT) envision smart objects that provide services that can adapt to user behavior or be managed to achieve greater productivity. In such environments, smart things are inexpensive and, therefore, constrained devices. However, they are also critical components because of the importance of the information that they provide. Given this, strong security is a requirement, but not all security mechanisms in general and access control models in particular are feasible. In this paper, we present the feasibility assessment of an access control model that utilizes a hybrid architecture and a policy language that provides dynamic fine-grained policy enforcement in the sensors, which requires an efficient message exchange protocol called Hidra. This experimental performance assessment includes a prototype implementation, a performance evaluation model, the measurements and related discussions, which demonstrate the feasibility and adequacy of the analyzed access control model.
Feasibility Assessment of a Fine-Grained Access Control Model on Resource Constrained Sensors
Huarte, Maider; Romaña, Pedro
2018-01-01
Upcoming smart scenarios enabled by the Internet of Things (IoT) envision smart objects that provide services that can adapt to user behavior or be managed to achieve greater productivity. In such environments, smart things are inexpensive and, therefore, constrained devices. However, they are also critical components because of the importance of the information that they provide. Given this, strong security is a requirement, but not all security mechanisms in general and access control models in particular are feasible. In this paper, we present the feasibility assessment of an access control model that utilizes a hybrid architecture and a policy language that provides dynamic fine-grained policy enforcement in the sensors, which requires an efficient message exchange protocol called Hidra. This experimental performance assessment includes a prototype implementation, a performance evaluation model, the measurements and related discussions, which demonstrate the feasibility and adequacy of the analyzed access control model. PMID:29438338
Linear Time Algorithms to Restrict Insider Access using Multi-Policy Access Control Systems
Mell, Peter; Shook, James; Harang, Richard; Gavrila, Serban
2017-01-01
An important way to limit malicious insiders from distributing sensitive information is to as tightly as possible limit their access to information. This has always been the goal of access control mechanisms, but individual approaches have been shown to be inadequate. Ensemble approaches of multiple methods instantiated simultaneously have been shown to more tightly restrict access, but approaches to do so have had limited scalability (resulting in exponential calculations in some cases). In this work, we take the Next Generation Access Control (NGAC) approach standardized by the American National Standards Institute (ANSI) and demonstrate its scalability. The existing publicly available reference implementations all use cubic algorithms and thus NGAC was widely viewed as not scalable. The primary NGAC reference implementation took, for example, several minutes to simply display the set of files accessible to a user on a moderately sized system. In our approach, we take these cubic algorithms and make them linear. We do this by reformulating the set theoretic approach of the NGAC standard into a graph theoretic approach and then apply standard graph algorithms. We thus can answer important access control decision questions (e.g., which files are available to a user and which users can access a file) using linear time graph algorithms. We also provide a default linear time mechanism to visualize and review user access rights for an ensemble of access control mechanisms. Our visualization appears to be a simple file directory hierarchy but in reality is an automatically generated structure abstracted from the underlying access control graph that works with any set of simultaneously instantiated access control policies. It also provide an implicit mechanism for symbolic linking that provides a powerful access capability. Our work thus provides the first efficient implementation of NGAC while enabling user privilege review through a novel visualization approach. This
Gonzalez, Eleazar U; Sable, Marjorie R; Campbell, James D; Dannerbeck, Anne
2010-08-01
It is commonly assumed that Hispanic immigrants in the United States subscribe to a patriarchal ideology that keeps women subordinated to men, often through violence and exploitative reproductive behaviors. If this assumption is true, we might expect to find that in the Hispanic culture patriarchal males control decision-making about access to and use of birth control. Structured interviews of 100 Hispanic men and 100 Hispanic women who were recent immigrants to a Midwest community were conducted to examine this assumption. Results did not support this assumption among this study population. We found no patriarchal ideology supporting women's subordination to men, violence as a mechanism of control, reproduction as a way of exploitation, or cultural influences discouraging access to and use of birth control in the Hispanic community. Rather, these immigrants revealed adequate knowledge of birth control use and positive perceptions of gender equality. Gaining a better understanding of the limited influence of patriarchal ideology on the use of birth control and family planning services among this Hispanic community may inform the development of family planning services tailored for new Hispanic immigrants.
African Americans' Access to Vocational Rehabilitation Services after Antidiscrimination Legislation
ERIC Educational Resources Information Center
Mwachofi, Ari K.
2008-01-01
The purpose of this study was to determine changes in African Americans' access to occasional rehabilitation (VR) services subsequent to landmark legislative and judicial antidiscrimination provisions of the mid-20th century. This study compared African American VR access before the antidiscrimination legislation in 1937 and after the legislation…
CAS. Controlled Access Security
DOE Office of Scientific and Technical Information (OSTI.GOV)
Martinez, B.; Pomeroy, G.
1989-12-01
The Security Alarm System is a data acquisition and control system which collects data from intrusion sensors and displays the information in a real-time environment for operators. The Access Control System monitors and controls the movement of personnel with the use of card readers and biometrics hand readers.
Improving access to urologists through an electronic consultation service
Witherspoon, Luke; Liddy, Clare; Afkham, Amir; Keely, Erin; Mahoney, John
2017-01-01
Introduction Access to specialist services is limited by wait times and geographic availability. Champlain Building Access to Specialist Advice (BASE) has been implemented in our service region to facilitate access to specialists by primary care providers (PCPs). Through a secure web-based system, PCPs are able to send eConsults instead of requesting a formal in-office consultation. Methods Urology eConsults completed through the Champlain BASE service from March 2013 to January 2015 were analyzed. Each consult was characterized in regard to the type of question asked by the referring physician and the clinical content of the referral. Using the mandatory close-out surveys, we analyzed rates of referral avoidance, physician satisfaction, and overall impact on patient care. Results Of 190 eConsultations, 70% were completed in less than 10 minutes. The most common clinical questions related to the interpretation of imaging reports (16%) and tests to choose for investigating a condition (15%). The most common diagnoses were hematuria (13%) and renal mass (8%). In 35% of cases, referral to a urologist had originally been contemplated and was avoided. In 8% of cases, a PCP did not believe a consultation was initially needed, but a referral was ultimately initiated after the eConsultation. Conclusions Our study shows that although certain clinical presentations still require a formal in-person urological consultation, eConsultations can potentially reduce unnecessary clinic visits while identifying patients who may benefit from early urological consultation. Through both these mechanisms, we may improve timely access to urologists. PMID:28798830
An Attribute Based Access Control Framework for Healthcare System
NASA Astrophysics Data System (ADS)
Afshar, Majid; Samet, Saeed; Hu, Ting
2018-01-01
Nowadays, access control is an indispensable part of the Personal Health Record and supplies for its confidentiality by enforcing policies and rules to ensure that only authorized users gain access to requested resources in the system. In other words, the access control means protecting patient privacy in healthcare systems. Attribute-Based Access Control (ABAC) is a new access control model that can be used instead of other traditional types of access control such as Discretionary Access Control, Mandatory Access Control, and Role-Based Access Control. During last five years ABAC has shown some applications in both recent academic fields and industry purposes. ABAC by using user’s attributes and resources, makes a decision according to an access request. In this paper, we propose an ABAC framework for healthcare system. We use the engine of ABAC for rendering and enforcing healthcare policies. Moreover, we handle emergency situations in this framework.
Access control for electronic patient records.
Glagola, M J
1998-01-01
The transition from hardcopy records to electronic records is in the forefront for healthcare today. For healthcare facilities, a major issue is determining who can access patients' medical information and how access to this information can be controlled. There are three components to access control: identification, authentication and authorization. Checking proof of identity is a means of authenticating someone--through a driver's license, passport or their fingerprints. Similar processes are needed in a computer environment, through the use of passwords, one-time passwords or smartcards, encryption and kerberos, and call-back procedures. New in the area of access control are biometric devices, which are hardware/software combinations that digitize a physical characteristic and compare the sample with previously stored samples. Fingerprints, voiceprints and facial features are examples. Their cost is currently prohibitive, but in time, they may become more common. Digital certificates and certification authorities are other means used to authenticate identify. When a system challenges a user's identity at log on, the user provides a certification that tells the system to go to the issuing certification authority and find proof the user's claim is valid. Low-level certifications offer little value for sensitive data, but high-level certification is now being introduced. It requires more specific, detailed information on the applicant. Authorization, the final component of access control, establishes what a specific user can and cannot access. To have effective access control, transaction logging and system monitoring are needed to ensure the various techniques are being used and performing properly.
Access to hyperacute stroke services across Canadian provinces: a geospatial analysis
Eswaradass, Prasanna Venkatesan; Swartz, Richard H.; Rosen, Jamey; Hill, Michael D.; Lindsay, M. Patrice
2017-01-01
Background: Canada's vast geography creates challenges for ensuring prompt transport to hospital of patients who have had a stroke. We sought to determine the proportion of people across various Canadian provinces for whom hyperacute stroke services are accessible within evidence-based time targets. Methods: We calculated, for the 8 provinces with available data, drive-time polygons on a map of Canada that delineated the area around stroke centres and emergency medical services (EMS) base centres to which one can drive in 3.5-6 hours. We calculated the proportional area of each forward sortation area (first 3 digits of the postal code) contained within a drive-time polygon. We applied this ratio to the 2011 Canadian census population of the forward sortation area to estimate the population that can reach a stroke centre in a designated time. Results: A total of 47.1%-96.4% of Canadians live within a 4.5-hour drive to a stroke centre via road EMS, and 53.3%-96.8% live within a 6-hour drive. Assuming a total travel time of 5 hours by EMS from base centre to patient and patient to hospital, 84.7%-99.8% of the population has access to a current or proposed endovascular thrombectomy site. Interpretation: Most Canadians live within 6 hours' road access to a stroke centre. Geospatial mapping could be used to inform decisions for additional sites and identify gaps in service accessibility. Coordinated systems of care and ambulance bypass agreements must continue to evolve to ensure maximal access to time-sensitive emergency stroke services. PMID:28615192
Scheim, Ayden I; Santos, Glenn-Milo; Arreola, Sonya; Makofane, Keletso; Do, Tri D; Hebert, Patrick; Thomann, Matthew; Ayala, George
2016-01-01
Free or low-cost HIV testing, condoms, and lubricants are foundational HIV prevention strategies, yet are often inaccessible for men who have sex with men (MSM). In the global context of stigma and poor healthcare access, transgender (trans) MSM may face additional barriers to HIV prevention services. Drawing on data from a global survey of MSM, we aimed to describe perceived access to prevention services among trans MSM, examine associations between stigma and access, and compare access between trans MSM and cisgender (non-transgender) MSM. The 2014 Global Men's Health and Rights online survey was open to MSM (inclusive of trans MSM) from any country and available in seven languages. Baseline data (n=3857) were collected from July to October 2014. Among trans MSM, correlations were calculated between perceived service accessibility and anti-transgender violence, healthcare provider stigma, and discrimination. Using a nested matched-pair study design, trans MSM were matched 4:1 to cisgender MSM on age group, region, and HIV status, and conditional logistic regression models compared perceived access to prevention services by transgender status. About 3.4% of respondents were trans men, of whom 69 were included in the present analysis. The average trans MSM participant was 26 to 35 years old (56.5%); lived in western Europe, North America, or Oceania (75.4%); and reported being HIV-negative (98.6%). HIV testing, condoms, and lubricants were accessible for 43.5, 53.6, and 26.1% of trans MSM, respectively. Ever having been arrested or convicted due to being trans and higher exposure to healthcare provider stigma in the past six months were associated with less access to some prevention services. Compared to matched cisgender controls, trans MSM reported significantly lower odds of perceived access to HIV testing (OR=0.57, 95% CI=0.33, 0.98) and condom-compatible lubricants (OR=0.54, 95% CI=0.30, 0.98). This first look at access to HIV prevention services for trans MSM
Mapping mental health service access: achieving equity through quality improvement.
Green, Stuart A; Poots, Alan J; Marcano-Belisario, Jose; Samarasundera, Edgar; Green, John; Honeybourne, Emmi; Barnes, Ruth
2013-06-01
Improving access to psychological therapies (IAPTs) services deliver evidence-based care to people with depression and anxiety. A quality improvement (QI) initiative was undertaken by an IAPT service to improve referrals providing an opportunity to evaluate equitable access. QI methodologies were used by the clinical team to improve referrals to the service. The collection of geo-coded data allowed referrals to be mapped to small geographical areas according to deprivation. A total of 6078 patients were referred to the IAPT service during the period of analysis and mapped to 120 unique lower super output areas (LSOAs). The average weekly referral rate rose from 17 during the baseline phase to 43 during the QI implementation phase. Spatial analysis demonstrated all 15 of the high deprivation/low referral LSOAs were converted to high deprivation/high or medium referral LSOAs following the QI initiative. This work highlights the importance of QI in developing clinical services aligned to the needs of the population through the analysis of routine data matched to health needs. Mapping can be utilized to communicate complex information to inform the planning and organization of clinical service delivery and evaluate the progress and sustainability of QI initiatives.
2013-01-01
Background Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability. Methods Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community. Results Seventeen health and social service providers representing local area government and non-government-funded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people. Conclusions Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a number of
Public and Private Adoption: A Comparison of Service and Accessibility.
ERIC Educational Resources Information Center
Daly, Kerry J.; Sobol, Michael P.
1994-01-01
Used data from national survey of public and private adoption service providers in Canada to examine similarities and differences with respect to clients served, issues associated with adoption accessibility, and nature of postadoption services. Found high degree of homogeneity that cut across public and private division, with typical adoptive…
Scatena, Lúcia Marina; Villa, Tereza Cristina Scatena; Netto, Antonio Ruffino; Kritski, Afrânio Lineu; Figueiredo, Tânia Maria Ribeiro Monteiro de; Vendramini, Silvia Helena Figueiredo; Assis, Marluce Maria de Araújo; Motta, Maria Catarina Salvador da
2009-06-01
To assess difficulties in the accessibility to tuberculosis diagnoses in the health services in Brazil. The study was carried out in 2007 and surveyed tuberculosis patients treated in the primary care services in the cities of Ribeirão Preto, São José do Rio Preto, Itaboraí (these three in Southeastern Brazil), Campina Grande and Feira de Santana (these two in Northeastern Brazil). The instrument 'Primary Care Assessment Tool' was used, adapted to assess tuberculosis care in Brazil. Tuberculosis diagnosis in the health services was assessed by means of multiple correspondence factor analysis. The accessibility to the diagnosis was represented by the dimensions 'locomotion to the health service' and 'assistance service' in the factorial plan. The patients from Ribeirão Preto and Itaboraí were associated with more favorable conditions to the dimension 'locomotion to the health service' and the patients from Campina Grande and Feira de Santana were associated with less favorable conditions. Ribeirão Preto presented more favorable conditions to the dimension 'assistance service', followed by Itaboraí, Feira de Santana and Campina Grande. São José do Rio Preto presented less favorable conditions to both dimensions, 'locomotion to the health service' and 'assistance service', compared to the other cities. The factor analysis enabled the visualization of the organizational characteristics of the services that provide tuberculosis care. The decentralization of the actions to the family health program and reference centers seems not to present a satisfactory performance regarding accessibility to the tuberculosis diagnosis, as the form of services organization was not a determinant factor to guarantee the accessibility to the early diagnosis of the illness.
Accessibility, affordability and use of health services in an urban area in South Africa.
Stellenberg, Ethelwynn L
2015-03-10
Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right. The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured) population in the Western Cape, South Africa. A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6%) was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data. The hypothesis was accepted. The statistical association between affordability (p = < 0.01), accessibility (p = < 0.01) and the use of health services was found to be significant using the Chi-square (χ²) test. The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly.
76 FR 26341 - Medicaid Program; Methods for Assuring Access to Covered Medicaid Services
Federal Register 2010, 2011, 2012, 2013, 2014
2011-05-06
... Medicare & Medicaid Services 42 CFR Part 447 Medicare Program; Methods for Assuring Access to Covered... Services 42 CFR Part 447 [CMS 2328-P] RIN 0938-AQ54 Medicaid Program; Methods for Assuring Access to... design the procedures for enrolling providers of such care, and to set the methods for establishing...
Porterfield, Shirley L; McBride, Timothy D
2007-02-01
We examined the association between several variables and the use of specialist physician services, developmental therapies, and prescription medications among children with special health care needs (N=38866). We used a bivariate probit model to estimate whether a given child needed specialized services and whether that child accessed those services; we controlled for activity limitations and severity of special needs. Variables included family income, mother's (or other caregiver's) educational level, health insurance coverage, and perceived need for specialized services. We used data from the 2001 National Survey of Children with Special Health Care Needs. Lower-income and less-educated parents were less likely than higher-income and more-educated parents to say their special needs children needed specialized health services. The probability of accessing specialized health services-when needed-increased with both higher family income and insurance coverage. Children with special health care needs have less access to health services because their parents do not recognize the need for those services. An intervention in the form of information at the family level may be an appropriate policy response.
Programmatic access to data and information at the IRIS DMC via web services
NASA Astrophysics Data System (ADS)
Weertman, B. R.; Trabant, C.; Karstens, R.; Suleiman, Y. Y.; Ahern, T. K.; Casey, R.; Benson, R. B.
2011-12-01
The IRIS Data Management Center (DMC) has developed a suite of web services that provide access to the DMC's time series holdings, their related metadata and earthquake catalogs. In addition, services are available to perform simple, on-demand time series processing at the DMC prior to being shipped to the user. The primary goal is to provide programmatic access to data and processing services in a manner usable by and useful to the research community. The web services are relatively simple to understand and use and will form the foundation on which future DMC access tools will be built. Based on standard Web technologies they can be accessed programmatically with a wide range of programming languages (e.g. Perl, Python, Java), command line utilities such as wget and curl or with any web browser. We anticipate these services being used for everything from simple command line access, used in shell scripts and higher programming languages to being integrated within complex data processing software. In addition to improving access to our data by the seismological community the web services will also make our data more accessible to other disciplines. The web services available from the DMC include ws-bulkdataselect for the retrieval of large volumes of miniSEED data, ws-timeseries for the retrieval of individual segments of time series data in a variety of formats (miniSEED, SAC, ASCII, audio WAVE, and PNG plots) with optional signal processing, ws-station for station metadata in StationXML format, ws-resp for the retrieval of instrument response in RESP format, ws-sacpz for the retrieval of sensor response in the SAC poles and zeros convention and ws-event for the retrieval of earthquake catalogs. To make the services even easier to use, the DMC is developing a library that allows Java programmers to seamlessly retrieve and integrate DMC information into their own programs. The library will handle all aspects of dealing with the services and will parse the returned
PKI-based secure mobile access to electronic health services and data.
Kambourakis, G; Maglogiannis, I; Rouskas, A
2005-01-01
Recent research works examine the potential employment of public-key cryptography schemes in e-health environments. In such systems, where a Public Key Infrastructure (PKI) is established beforehand, Attribute Certificates (ACs) and public key enabled protocols like TLS, can provide the appropriate mechanisms to effectively support authentication, authorization and confidentiality services. In other words, mutual trust and secure communications between all the stakeholders, namely physicians, patients and e-health service providers, can be successfully established and maintained. Furthermore, as the recently introduced mobile devices with access to computer-based patient record systems are expanding, the need of physicians and nurses to interact increasingly with such systems arises. Considering public key infrastructure requirements for mobile online health networks, this paper discusses the potential use of Attribute Certificates (ACs) in an anticipated trust model. Typical trust interactions among doctors, patients and e-health providers are presented, indicating that resourceful security mechanisms and trust control can be obtained and implemented. The application of attribute certificates to support medical mobile service provision along with the utilization of the de-facto TLS protocol to offer competent confidentiality and authorization services is also presented and evaluated through experimentation, using both the 802.11 WLAN and General Packet Radio Service (GPRS) networks.
Dementia and the Deaf community: knowledge and service access.
Ferguson-Coleman, Emma; Keady, John; Young, Alys
2014-01-01
This study concerns culturally Deaf people in the United Kingdom who use British Sign Language (BSL). Its objective was to explore how Deaf people's knowledge about dementia and access to services is mediated by their minoritised cultural-linguistic status. Twenty-six members of the Deaf community participated in one of three Deaf-led focus groups in BSL corresponding with the sample of: Deaf people over the age of 60 without dementia; Deaf people aged 18-60 working professional roles unconnected with dementia services; ordinary members of the Deaf community aged 18-60. Data were subjected to a thematic content analysis. Participants' concerns about their poor levels of knowledge and understanding of dementia were augmented by their awareness that without sustained social contact in BSL opportunities for earlier recognition of dementia would be lost. Although primary care services were identified as the first port of call for dementia-related concerns, there was widespread mistrust of their effectiveness because of failures in communication and cultural competence. Confirmed diagnosis of dementia was not viewed as a gateway to services and support because Deaf organisations, dementia-related organisations and mainstream adult services were perceived to be ill-equipped to respond to the needs of Deaf people with dementia. Locating problems of late diagnosis within the Deaf community's poor awareness and knowledge of dementia fails to recognise the structural barriers Deaf people face in timely access to services and accurate recognition of dementia-related changes.
Personnel Management in Access Services: A General Overview of the Literature, 1990-2002
ERIC Educational Resources Information Center
Lee, Leslie A.; Wu, Michelle M.
2003-01-01
Access services is not unique in its need for effective personnel management. A review of the literature indicates that there are many publications on or relating to library personnel administration; however, relatively few of them are dedicated to the narrow topic of access services. As such, this review encompasses literature that is general to…
Ringard, Ånen
2012-02-01
During the 1980s and 1990s, increased waiting times for elective surgery was perceived to be a major accessibility problem in many countries. In an attempt to improve access, hospital choice reforms were introduced in a number of countries. In Norway, a nationwide reform to improve access came into effect in 2001. At the same time, renewed support was expressed for the long-standing political aim of ensuring equal access to healthcare services for all citizens regardless of their social position. The current aim is to analyse the relationship of the hospital choice reform and the goal of equitable access to hospital services. A survey conducted among Norwegian patients in 2004 provided information about whether a choice of hospital had been made. Information from the survey was merged with administrative data from the hospital that performed the treatment. The survey provided data on patients' socioeconomic position. Demographics, medical need, and prior use of healthcare services were controlled for to determine the effect of socioeconomic position on hospital choice. The patient's socioeconomic position, measured by education, was found to be significantly associated with hospital choice. The relationship resembled that of a social gradient. Patients with a primary education were less likely to have made a choice, followed by those with secondary education or a lower university degree. Patients with higher university education were most likely to have chosen. Hospital selection is a demanding task for many patients. Policymakers should therefore focus on crafting and implementing tools necessary for supporting uptake of choice in disadvantaged groups.
Secure Access Control and Large Scale Robust Representation for Online Multimedia Event Detection
Liu, Changyu; Li, Huiling
2014-01-01
We developed an online multimedia event detection (MED) system. However, there are a secure access control issue and a large scale robust representation issue when we want to integrate traditional event detection algorithms into the online environment. For the first issue, we proposed a tree proxy-based and service-oriented access control (TPSAC) model based on the traditional role based access control model. Verification experiments were conducted on the CloudSim simulation platform, and the results showed that the TPSAC model is suitable for the access control of dynamic online environments. For the second issue, inspired by the object-bank scene descriptor, we proposed a 1000-object-bank (1000OBK) event descriptor. Feature vectors of the 1000OBK were extracted from response pyramids of 1000 generic object detectors which were trained on standard annotated image datasets, such as the ImageNet dataset. A spatial bag of words tiling approach was then adopted to encode these feature vectors for bridging the gap between the objects and events. Furthermore, we performed experiments in the context of event classification on the challenging TRECVID MED 2012 dataset, and the results showed that the robust 1000OBK event descriptor outperforms the state-of-the-art approaches. PMID:25147840
Secure access control and large scale robust representation for online multimedia event detection.
Liu, Changyu; Lu, Bin; Li, Huiling
2014-01-01
We developed an online multimedia event detection (MED) system. However, there are a secure access control issue and a large scale robust representation issue when we want to integrate traditional event detection algorithms into the online environment. For the first issue, we proposed a tree proxy-based and service-oriented access control (TPSAC) model based on the traditional role based access control model. Verification experiments were conducted on the CloudSim simulation platform, and the results showed that the TPSAC model is suitable for the access control of dynamic online environments. For the second issue, inspired by the object-bank scene descriptor, we proposed a 1000-object-bank (1000OBK) event descriptor. Feature vectors of the 1000OBK were extracted from response pyramids of 1000 generic object detectors which were trained on standard annotated image datasets, such as the ImageNet dataset. A spatial bag of words tiling approach was then adopted to encode these feature vectors for bridging the gap between the objects and events. Furthermore, we performed experiments in the context of event classification on the challenging TRECVID MED 2012 dataset, and the results showed that the robust 1000OBK event descriptor outperforms the state-of-the-art approaches.
2014-01-01
Introduction Despite the universal right to access the same range, quality and standard of free or affordable health care and programs as provided to other persons, people with physical disabilities (PWPDs) continue to experience challenges in accessing these services. This article presents the challenges faced by PWPDs in accessing sexual and reproductive health (SRH) services in Kampala, Uganda. Methods This was a qualitative study that was conducted with male and female PWPDs in Kampala in 2007. Data on the challenges experienced by PWPDs in accessing SRH services were collected using in-depth interviews with 40 PWPDs and key informant interviews with 10 PWPDs’ representatives, staff of agencies supporting PWPDs and health workers. All data were captured verbatim using an audio-tape recorder, entered into a Microsoft Word computer program and analyzed manually following a content thematic approach. Results The study findings show that PWPDs face a multitude of challenges in accessing SRH services including negative attitudes of service providers, long queues at health facilities, distant health facilities, high costs of services involved, unfriendly physical structures and the perception from able-bodied people that PWPDs should be asexual. Conclusion People with physical disabilities (PWPDs) face health facility-related (service provider and facility-related challenges), economic and societal challenges in accessing SRH services. These findings call for a need to sensitize service providers on SRH needs of PWPDs for better support and for the government to enforce the provision of PWPD-friendly services in all health facilities. PMID:25086444
Ahumuza, Sharon Eva; Matovu, Joseph K B; Ddamulira, John Bosco; Muhanguzi, Florence Kyoheirwe
2014-08-02
Despite the universal right to access the same range, quality and standard of free or affordable health care and programs as provided to other persons, people with physical disabilities (PWPDs) continue to experience challenges in accessing these services. This article presents the challenges faced by PWPDs in accessing sexual and reproductive health (SRH) services in Kampala, Uganda. This was a qualitative study that was conducted with male and female PWPDs in Kampala in 2007. Data on the challenges experienced by PWPDs in accessing SRH services were collected using in-depth interviews with 40 PWPDs and key informant interviews with 10 PWPDs' representatives, staff of agencies supporting PWPDs and health workers. All data were captured verbatim using an audio-tape recorder, entered into a Microsoft Word computer program and analyzed manually following a content thematic approach. The study findings show that PWPDs face a multitude of challenges in accessing SRH services including negative attitudes of service providers, long queues at health facilities, distant health facilities, high costs of services involved, unfriendly physical structures and the perception from able-bodied people that PWPDs should be asexual. People with physical disabilities (PWPDs) face health facility-related (service provider and facility-related challenges), economic and societal challenges in accessing SRH services. These findings call for a need to sensitize service providers on SRH needs of PWPDs for better support and for the government to enforce the provision of PWPD-friendly services in all health facilities.
Impact of service delivery model on health care access among HIV-positive women in New York City.
Pillai, Nandini V; Kupprat, Sandra A; Halkitis, Perry N
2009-01-01
As the New York City HIV=AIDS epidemic began generalizing beyond traditionally high-risk groups in the early 1990s, AIDS Service Organizations (ASO) sought to increase access to medical care and broaden service offerings to incorporate the needs of low-income women and their families. Strategies to achieve entry into and retention in medical care included the development of integrated care facilities, case management, and a myriad of supportive service offerings. This study examines a nonrandom sample of 60 HIV-positive women receiving case management and supportive services at New York City ASOs. Over 55% of the women interviewed reported high access to care, 43% reported the ability to access urgent care all of the time and 94% reported high satisfaction with obstetrics=gynecology (OB=GYN) care. This held true across race=ethnicity, income level, medical coverage, and service delivery model.Women who accessed services at integrated care facilities offering onsite medical care and case management=supportive services perceived lower access to medical specialists as compared to those who received services at nonintegrated sites. Data from this analysis indicate that supportive services increase access to and satisfaction with both HIV and non-HIV-related health care. Additionally, women who received services at a medical model agency were more likely to report accessing non-HIV care at a clinic compared to those receiving services at a nonmedical model agencies, these women were more likely to report receiving non-HIV care at a hospital.
Case Study of an Aboriginal Community-Controlled Health Service in Australia
Baum, Fran; Lawless, Angela; Labonté, Ronald; Sanders, David; Boffa, John; Edwards, Tahnia; Javanparast, Sara
2016-01-01
Abstract Universal health coverage provides a framework to achieve health services coverage but does not articulate the model of care desired. Comprehensive primary health care includes promotive, preventive, curative, and rehabilitative interventions and health equity and health as a human right as central goals. In Australia, Aboriginal community-controlled health services have pioneered comprehensive primary health care since their inception in the early 1970s. Our five-year project on comprehensive primary health care in Australia partnered with six services, including one Aboriginal community-controlled health service, the Central Australian Aboriginal Congress. Our findings revealed more impressive outcomes in several areas—multidisciplinary work, community participation, cultural respect and accessibility strategies, preventive and promotive work, and advocacy and intersectoral collaboration on social determinants of health—at the Aboriginal community-controlled health service compared to the other participating South Australian services (state-managed and nongovernmental ones). Because of these strengths, the Central Australian Aboriginal Congress’s community-controlled model of comprehensive primary health care deserves attention as a promising form of implementation of universal health coverage by articulating a model of care based on health as a human right that pursues the goal of health equity. PMID:28559679
Common Badging and Access Control System (CBACS)
NASA Technical Reports Server (NTRS)
Dischinger, Portia
2005-01-01
This slide presentation presents NASA's Common Badging and Access Control System. NASA began a Smart Card implementation in January 2004. Following site surveys, it was determined that NASA's badging and access control systems required upgrades to common infrastructure in order to provide flexibly, usability, and return on investment prior to a smart card implantation. Common Badging and Access Control System (CBACS) provides the common infrastructure from which FIPS-201 compliant processes, systems, and credentials can be developed and used.
Logical Access Control Mechanisms in Computer Systems.
ERIC Educational Resources Information Center
Hsiao, David K.
The subject of access control mechanisms in computer systems is concerned with effective means to protect the anonymity of private information on the one hand, and to regulate the access to shareable information on the other hand. Effective means for access control may be considered on three levels: memory, process and logical. This report is a…
2011-01-01
Background This article considers how health services access and equity documents represent the problem of access to health services and what the effects of that representation might be for lesbian, gay, bisexual and transgender (LGBT) communities. We conducted a critical discourse analysis on selected access and equity documents using a gender-based diversity framework as determined by two objectives: 1) to identify dominant and counter discourses in health services access and equity literature; and 2) to develop understanding of how particular discourses impact the inclusion, or not, of LGBT communities in health services access and equity frameworks.The analysis was conducted in response to public health and clinical research that has documented barriers to health services access for LGBT communities including institutionalized heterosexism, biphobia, and transphobia, invisibility and lack of health provider knowledge and comfort. The analysis was also conducted as the first step of exploring LGBT access issues in home care services for LGBT populations in Ontario, Canada. Methods A critical discourse analysis of selected health services access and equity documents, using a gender-based diversity framework, was conducted to offer insight into dominant and counter discourses underlying health services access and equity initiatives. Results A continuum of five discourses that characterize the health services access and equity literature were identified including two dominant discourses: 1) multicultural discourse, and 2) diversity discourse; and three counter discourses: 3) social determinants of health (SDOH) discourse; 4) anti-oppression (AOP) discourse; and 5) citizen/social rights discourse. Conclusions The analysis offers a continuum of dominant and counter discourses on health services access and equity as determined from a gender-based diversity perspective. The continuum of discourses offers a framework to identify and redress organizational assumptions
Daley, Andrea E; Macdonnell, Judith A
2011-09-29
This article considers how health services access and equity documents represent the problem of access to health services and what the effects of that representation might be for lesbian, gay, bisexual and transgender (LGBT) communities. We conducted a critical discourse analysis on selected access and equity documents using a gender-based diversity framework as determined by two objectives: 1) to identify dominant and counter discourses in health services access and equity literature; and 2) to develop understanding of how particular discourses impact the inclusion, or not, of LGBT communities in health services access and equity frameworks.The analysis was conducted in response to public health and clinical research that has documented barriers to health services access for LGBT communities including institutionalized heterosexism, biphobia, and transphobia, invisibility and lack of health provider knowledge and comfort. The analysis was also conducted as the first step of exploring LGBT access issues in home care services for LGBT populations in Ontario, Canada. A critical discourse analysis of selected health services access and equity documents, using a gender-based diversity framework, was conducted to offer insight into dominant and counter discourses underlying health services access and equity initiatives. A continuum of five discourses that characterize the health services access and equity literature were identified including two dominant discourses: 1) multicultural discourse, and 2) diversity discourse; and three counter discourses: 3) social determinants of health (SDOH) discourse; 4) anti-oppression (AOP) discourse; and 5) citizen/social rights discourse. The analysis offers a continuum of dominant and counter discourses on health services access and equity as determined from a gender-based diversity perspective. The continuum of discourses offers a framework to identify and redress organizational assumptions about, and ideological commitments to
Beyond 'flood hotspots': Modelling emergency service accessibility during flooding in York, UK
NASA Astrophysics Data System (ADS)
Coles, Daniel; Yu, Dapeng; Wilby, Robert L.; Green, Daniel; Herring, Zara
2017-03-01
This paper describes the development of a method that couples flood modelling with network analysis to evaluate the accessibility of city districts by emergency responders during flood events. We integrate numerical modelling of flood inundation with geographical analysis of service areas for the Ambulance Service and the Fire & Rescue Service. The method was demonstrated for two flood events in the City of York, UK to assess the vulnerability of care homes and sheltered accommodation. We determine the feasibility of emergency services gaining access within the statutory 8- and 10-min targets for high-priority, life-threatening incidents 75% of the time, during flood episodes. A hydrodynamic flood inundation model (FloodMap) simulates the 2014 pluvial and 2015 fluvial flood events. Predicted floods (with depth >25 cm and areas >100 m2) were overlain on the road network to identify sites with potentially restricted access. Accessibility of the city to emergency responders during flooding was quantified and mapped using; (i) spatial coverage from individual emergency nodes within the legislated timeframes, and; (ii) response times from individual emergency service nodes to vulnerable care homes and sheltered accommodation under flood and non-flood conditions. Results show that, during the 2015 fluvial flood, the area covered by two of the three Fire & Rescue Service stations reduced by 14% and 39% respectively, while the remaining station needed to increase its coverage by 39%. This amounts to an overall reduction of 6% and 20% for modelled and observed floods respectively. During the 2014 surface water flood, 7 out of 22 care homes (32%) and 15 out of 43 sheltered accommodation nodes (35%) had modelled response times above the 8-min threshold from any Ambulance station. Overall, modelled surface water flooding has a larger spatial footprint than fluvial flood events. Hence, accessibility of emergency services may be impacted differently depending on flood mechanism
A DTN-Based Multiple Access Fast Forward Service for the NASA Space Network
NASA Technical Reports Server (NTRS)
Israel, David; Davis, Faith; Marquart. Jane
2011-01-01
The NASA Space Network provides a demand access return link service capable of providing users a space link "on demand". An equivalent service in the forward link direction is not possible due to Tracking and Data Relay Spacecraft (TDRS) constraints. A Disruption Tolerant Networking (DTN)-based Multiple Access Fast Forward (MAFF) service has been proposed to provide a forward link to a user as soon as possible. Previous concept studies have identified a basic architecture and implementation approach. This paper reviews the user scenarios and benefits of an MAFF service and proposes an implementation approach based on the use of DTN protocols.
Atom-Role-Based Access Control Model
NASA Astrophysics Data System (ADS)
Cai, Weihong; Huang, Richeng; Hou, Xiaoli; Wei, Gang; Xiao, Shui; Chen, Yindong
Role-based access control (RBAC) model has been widely recognized as an efficient access control model and becomes a hot research topic of information security at present. However, in the large-scale enterprise application environments, the traditional RBAC model based on the role hierarchy has the following deficiencies: Firstly, it is unable to reflect the role relationships in complicated cases effectively, which does not accord with practical applications. Secondly, the senior role unconditionally inherits all permissions of the junior role, thus if a user is under the supervisor role, he may accumulate all permissions, and this easily causes the abuse of permission and violates the least privilege principle, which is one of the main security principles. To deal with these problems, we, after analyzing permission types and role relationships, proposed the concept of atom role and built an atom-role-based access control model, called ATRBAC, by dividing the permission set of each regular role based on inheritance path relationships. Through the application-specific analysis, this model can well meet the access control requirements.
[Indigenous peoples' access to health services in Cuiabá, Mato Grosso State, Brazil].
Gomes, Silvana Cardoso; Esperidião, Monique Azevedo
2017-06-12
This study aimed to evaluate indigenous peoples' access to medium and high-complexity health services in the municipality of Cuiabá, Mato Grosso State, Brazil, through the Casa de Saúde Indígena or Indigenous Peoples' Clinic (CASAI Cuiabá). A single case study with a qualitative approach was conducted at CASAI Cuiabá. Data were obtained from observation of the work routines at CASAI Cuiabá, semi-structured interviews with health professionals and administrators from the Cuiabá Special Indigenous Health District (DSEI) and CASAI Cuiabá, and document analysis. Data analysis used a matrix derived from the theoretical and logical model of accessibility, validated by the Delphi method with a group of experts on indigenous peoples' health. Despite advances achieved by CASAI in improving indigenous peoples' access, there are persistent social, organizational, cultural, and geographic barriers in access to medium and high-complexity health services in Cuiabá. The study highlights the need for specific strategies to improve access to health services by indigenous peoples in Mato Grosso State.
Code of Federal Regulations, 2010 CFR
2010-10-01
... access universal service support for areas served by price cap local exchange carriers. 54.806 Section 54... Administrator of interstate access universal service support for areas served by price cap local exchange... calculate the Interstate Access Universal Service Support for areas served by price cap local exchange...
Access to fertility services by transgender persons: an Ethics Committee opinion.
2015-11-01
This statement explores the ethical considerations surrounding the provision of fertility services to transgender individuals and concludes that denial of access to fertility services is not justified. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
A JEE RESTful service to access Conditions Data in ATLAS
NASA Astrophysics Data System (ADS)
Formica, Andrea; Gallas, E. J.
2015-12-01
Usage of condition data in ATLAS is extensive for offline reconstruction and analysis (e.g. alignment, calibration, data quality). The system is based on the LCG Conditions Database infrastructure, with read and write access via an ad hoc C++ API (COOL), a system which was developed before Run 1 data taking began. The infrastructure dictates that the data is organized into separate schemas (assigned to subsystems/groups storing distinct and independent sets of conditions), making it difficult to access information from several schemas at the same time. We have thus created PL/SQL functions containing queries to provide content extraction at multi-schema level. The PL/SQL API has been exposed to external clients by means of a Java application providing DB access via REST services, deployed inside an application server (JBoss WildFly). The services allow navigation over multiple schemas via simple URLs. The data can be retrieved either in XML or JSON formats, via simple clients (like curl or Web browsers).
Access to low-vision rehabilitation services: barriers and enablers.
Matti, Albert I; Pesudovs, Konrad; Daly, Andrew; Brown, Margaret; Chen, Celia S
2011-03-01
The current mismatch between the need for and uptake of low-vision services has been attributed to various barriers including different service delivery models and referral pathways. This study evaluates the referral pathway and low-vision service provision of the Royal Society for the Blind (RSB) in South Australia. All new referrals from the 2008-2009 financial year to the RSB were reviewed. Initially, patients were contacted by a triage officer within one week of referral. Initial appointments were made in the Low Vision Clinic with a multidisciplinary team. Reasons for declining the appointment or non-attendance were tracked via telephone. There were 1116 patients referred over a 12-month period and 1082 (97 per cent) were reviewed in the Low Vision Clinic. Most attendees (92 per cent) lived within 50 kilometres of the clinic. There were 34 referred patients, who declined or did not attend the assessment. All non-attendees also lived within 50 kilometres of the Low Vision Centre. Concurrent major health problems (27 per cent) and patients not feeling the need for low-vision rehabilitation (27 per cent) were the most common reasons for not accessing the service. Only 125 patients (11.6 per cent) accessed volunteer transport services and only 24 patients (2.2 per cent) needed an interpreter service. The attendance rate is significantly higher than in other published studies. The distance to travel or transport difficulties were not significant barriers. Patient perception that either the service was not required or would not help them was the main barrier. The referral and triage process appeared to be a major enabler of low-vision service uptake. © 2010 The Authors. Clinical and Experimental Optometry © 2010 Optometrists Association Australia.
Hannah, Chona T; Lê, Quynh
2012-10-01
Access to health care services is vital for every migrant's health and wellbeing. However, migrants' cultural health beliefs and views can hinder their ability to access available services. This study examined factors affecting access to healthcare services for intermarried Filipino women in rural Tasmania, Australia. A qualitative approach using semi-structured interviews was employed to investigate the factors affecting access to healthcare services for 30 intermarried Filipino women in rural Tasmania. The study used grounded theory and thematic analysis for its data analysis. Nvivo v8 (www.qsrinternational.com) was also used to assist the data coding process and analysis. Five influencing factors were identified: (1) language or communication barriers; (2) area of origin in the Philippines; (3) cultural barriers; (4) length of stay in Tasmania; and (5) expectations of healthcare services before and after migration. Factors affecting intermarried Filipino women in accessing healthcare services are shaped by their socio-demographic and cultural background. The insights gained from this study are useful to health policy-makers, healthcare professionals and to intermarried female migrants. The factors identified can serve as a guide to improve healthcare access for Filipino women and other migrants.
Globus Identity, Access, and Data Management: Platform Services for Collaborative Science
NASA Astrophysics Data System (ADS)
Ananthakrishnan, R.; Foster, I.; Wagner, R.
2016-12-01
Globus is software-as-a-service for research data management, developed at, and operated by, the University of Chicago. Globus, accessible at www.globus.org, provides high speed, secure file transfer; file sharing directly from existing storage systems; and data publication to institutional repositories. 40,000 registered users have used Globus to transfer tens of billions of files totaling hundreds of petabytes between more than 10,000 storage systems within campuses and national laboratories in the US and internationally. Web, command line, and REST interfaces support both interactive use and integration into applications and infrastructures. An important component of the Globus system is its foundational identity and access management (IAM) platform service, Globus Auth. Both Globus research data management and other applications use Globus Auth for brokering authentication and authorization interactions between end-users, identity providers, resource servers (services), and a range of clients, including web, mobile, and desktop applications, and other services. Compliant with important standards such as OAuth, OpenID, and SAML, Globus Auth provides mechanisms required for an extensible, integrated ecosystem of services and clients for the research and education community. It underpins projects such as the US National Science Foundation's XSEDE system, NCAR's Research Data Archive, and the DOE Systems Biology Knowledge Base. Current work is extending Globus services to be compliant with FEDRAMP standards for security assessment, authorization, and monitoring for cloud services. We will present Globus IAM solutions and give examples of Globus use in various projects for federated access to resources. We will also describe how Globus Auth and Globus research data management capabilities enable rapid development and low-cost operations of secure data sharing platforms that leverage Globus services and integrate them with local policy and security.
Measuring Equity in Access to Pharmaceutical Services Using Concentration Curve; Model Development.
Davari, Majid; Khorasani, Elahe; Bakhshizade, Zahra; Jafarian Jazi, Marzie; Ghaffari Darab, Mohsen; Maracy, Mohammad Reza
2015-01-01
This paper has two objectives. First, it establishes a model for scoring the access to pharmaceutical services. Second, it develops a model for measuring socioeconomic indicators independent of the time and place of study. These two measures are used for measuring equity in access to pharmaceutical services using concentration curve. We prepared an open-ended questionnaire and distributed it to academic experts to get their ideas to form access indicators and assign score to each indicator based on the pharmaceutical system. An extensive literature review was undertaken for the selection of indicators in order to determine the socioeconomic status (SES) of individuals. Experts' opinions were also considered for scoring these indicators. These indicators were weighted by the Stepwise Adoption of Weights and were used to develop a model for measuring SES independent of the time and place of study. Nine factors were introduced for assessing the access to pharmaceutical services, based on pharmaceutical systems in middle-income countries. Five indicators were selected for determining the SES of individuals. A model for income classification based on poverty line was established. Likewise, a model for scoring home status based on national minimum wage was introduced. In summary, five important findings emerged from this study. These findings may assist researchers in measuring equity in access to pharmaceutical services and also could help them to apply a model for determining SES independent of the time and place of study. These also could provide a good opportunity for researchers to compare the results of various studies in a reasonable way; particularly in middle-income countries.
Deficits in Young Men's Knowledge about Accessing Sexual and Reproductive Health Services
ERIC Educational Resources Information Center
Bersamin, Melina; Fisher, Deborah A.; Marcell, Arik V.; Finan, Laura J.
2017-01-01
Objective: The current study aimed to examine (1) gender differences in college students' knowledge of sexual and reproductive health care (K-SRHC) service access points, and (2) the relationship between demographic and psychosocial factors and college students' overall K-SRHC service access points. Methods and Participants: Self-report online…
Telemental health technology in deaf and general mental-health services: access and use.
Austen, Sally; McGrath, Melissa
2006-01-01
Long-distance travel to provide mental health services for deaf people has implications for efficiency, safety, and equality of service. However, uptake of Telemental Health (TMH) has been slow in both deaf and general mental health services. A quantitative study was used to investigate access to TMH and whether staff confidence, experience, or demographics affect TMH use. It was concluded that staff in neither deaf mental health services nor general mental health services had adequate knowledge of or access to TMH. Staff expressed concerns over TMH's appropriateness in their work. Previous use of videoconferencing was assosciated significantly with confidence, but previous use of videophones was not. Neither staff in deaf services nor deaf staff were more experienced with or more confident about videoconferencing, whereas, within deaf services, deaf staff were significantly more confident about videophone use. Training implications are discussed.
ERIC Educational Resources Information Center
Iowa State Dept. of Public Instruction, Des Moines.
This model policy is designed to help local school officials provide vendors with the greatest reasonable opportunity to compete for access to the school community, while protecting the school's need for reasonable control of that access, so that students, parents, and staff can obtain the best goods and services at the best price. It is offered…
Hill, Harry; Birch, Stephen; Tickle, Martin; McDonald, Ruth; Donaldson, Michael; O'Carolan, Donncha; Brocklehurst, Paul
2017-03-06
In May 2009, the Northern Ireland government introduced General Dental Services (GDS) contracts based on capitation in dental practices newly set up by a corporate dental provider to promote access to dental care in populations that had previously struggled to secure service provision. Dental service provision forms an important component of general health services for the population, but the implications of health system financing on care delivered and the financial cost of services has received relatively little attention in the research literature. The aim of this study is to evaluate the policy effect capitation payment in recently started corporate practices had on the delivery of primary oral healthcare in Northern Ireland and access to services. We analysed the policy initiative in Northern Ireland as a natural experiment to find the impact on healthcare delivery of the newly set up corporate practices that use a prospective capitation system to remunerate primary care dentists. Data was collected from GDS claim forms submitted to the Business Services Organisation (BSO) between April 2011 and October 2014. Health and Social Care Board (HSCB) practices operating within a capitation system were matched to a control group, who were remunerated using a retrospective fee-for-service system. No evidence of patient selection was found in the HSCB practices set up by a corporate provider and operated under capitation. However, patients were less likely to visit the dentist and received less treatment when they did attend, compared to those belonging to the control group (P < 0.05). The extent of preventive activity offered and the patient payment charge revenue did not differ between the two practice groups. Although remunerating NHS primary care dentists in newly set up corporate practices using a prospective capitation system managed costs within healthcare, there is evidence that this policy may have reduced access to care of registered patients.
Access control mechanism of wireless gateway based on open flow
NASA Astrophysics Data System (ADS)
Peng, Rong; Ding, Lei
2017-08-01
In order to realize the access control of wireless gateway and improve the access control of wireless gateway devices, an access control mechanism of SDN architecture which is based on Open vSwitch is proposed. The mechanism utilizes the features of the controller--centralized control and programmable. Controller send access control flow table based on the business logic. Open vSwitch helps achieve a specific access control strategy based on the flow table.
Applying Service-Oriented Architecture to Archiving Data in Control and Monitoring Systems
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nogiec, J. M.; Trombly-Freytag, K.
Current trends in the architecture of software systems focus our attention on building systems using a set of loosely coupled components, each providing a specific functionality known as service. It is not much different in control and monitoring systems, where a functionally distinct sub-system can be identified and independently designed, implemented, deployed and maintained. One functionality that renders itself perfectly to becoming a service is archiving the history of the system state. The design of such a service and our experience of using it are the topic of this article. The service is built with responsibility segregation in mind, therefore,more » it provides for reducing data processing on the data viewer side and separation of data access and modification operations. The service architecture and the details concerning its data store design are discussed. An implementation of a service client capable of archiving EPICS process variables (PV) and LabVIEW shared variables is presented. Data access tools, including a browser-based data viewer and a mobile viewer, are also presented.« less
Perceived Barriers Affecting Access to Preventive Dental Services: Application of DEMATEL Method.
Bahadori, Mohammadkarim; Ravangard, Ramin; Asghari, Baratali
2013-08-01
Identifying perceived access barriers to preventive dental services is one of the basic steps to improve the public health. This study aimed to determine the perceived barriers affecting access to preventive dental services in one of Tehran dental clinics in 2012. This research was a cross-sectional descriptive-analytical study conducted in one of Tehran dental clinics in 2012 using decision-making trial and evaluation laboratory (DEMATEL) method. The study sample included all patients (100 patients) who had referred to the endodontic treatment department from 26 - 31 May, 2012. The required data were collected using a questionnaire. Collected data were analyzed using SPSS 18.0 and MATLAB 7.9.0 SPSSS 18.0, as well as, some descriptive and analytical tests including Mean, Standard Deviation (SD), and Independent T- Test. The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access to dental services among which the cost and patient-dentist relationship were identified as the first and last priorities with the coordinates (1.4 and 1.4) and (1.25 and -0.65), respectively. High cost of dental care has led to not referring patients to the clinic. Oral health costs are too high; however insurance organizations have no commitment to support such services. Policymakers, administrators, and insurance organizations have a major role in improving access to dental services. These decision-makers in making their policies can provide the required financial resources, shift the available resources towards preventive care and periodic checkups, and consider providing proper and sufficient places for dental care facilities.
Contract management in USA hospitals: service duplication and access within local markets.
Carey, Kathleen; Dor, Avi
2008-08-01
This paper examines the extent to which hospitals that are under external contract management engage in service duplication, as well as the degree to which the various services they offer contribute to or detract from community access. The study incorporates all USA hospitals using data from the American Hospital Association Annual Survey Database, supplemented by county level measures obtained from the area resource file (ARF). Using data on the 3794 hospitals classified as acute care facilities in 2002, we performed a set of logistic regressions that analyzed whether a hospital offered each of 74 distinct services. For each service (regression), key independent variables measured the number of other hospitals in the local market area that also offered the service. Local area market definitions are the areas circumscribed by the hospital within distances of 10 and 20 miles. Results suggest that contract-managed (CM) hospitals display a more competitive pattern (service duplication) than hospitals in general, but CM hospitals that are the sole provider of services locally are less likely to offer services than traditionally managed sole hospital providers. Contract management does not appear to offer any particular advantages in improving access to hospital services.
Access Control Management for SCADA Systems
NASA Astrophysics Data System (ADS)
Hong, Seng-Phil; Ahn, Gail-Joon; Xu, Wenjuan
The information technology revolution has transformed all aspects of our society including critical infrastructures and led a significant shift from their old and disparate business models based on proprietary and legacy environments to more open and consolidated ones. Supervisory Control and Data Acquisition (SCADA) systems have been widely used not only for industrial processes but also for some experimental facilities. Due to the nature of open environments, managing SCADA systems should meet various security requirements since system administrators need to deal with a large number of entities and functions involved in critical infrastructures. In this paper, we identify necessary access control requirements in SCADA systems and articulate access control policies for the simulated SCADA systems. We also attempt to analyze and realize those requirements and policies in the context of role-based access control that is suitable for simplifying administrative tasks in large scale enterprises.
Data Access Services that Make Remote Sensing Data Easier to Use
NASA Technical Reports Server (NTRS)
Lynnes, Christopher
2010-01-01
This slide presentation reviews some of the processes that NASA uses to make the remote sensing data easy to use over the World Wide Web. This work involves much research into data formats, geolocation structures and quality indicators, often to be followed by coding a preprocessing program. Only then are the data usable within the analysis tool of choice. The Goddard Earth Sciences Data and Information Services Center is deploying a variety of data access services that are designed to dramatically shorten the time consumed in the data preparation step. On-the-fly conversion to the standard network Common Data Form (netCDF) format with Climate-Forecast (CF) conventions imposes a standard coordinate system framework that makes data instantly readable through several tools, such as the Integrated Data Viewer, Gridded Analysis and Display System, Panoply and Ferret. A similar benefit is achieved by serving data through the Open Source Project for a Network Data Access Protocol (OPeNDAP), which also provides subsetting. The Data Quality Screening Service goes a step further in filtering out data points based on quality control flags, based on science team recommendations or user-specified criteria. Further still is the Giovanni online analysis system which goes beyond handling formatting and quality to provide visualization and basic statistics of the data. This general approach of automating the preparation steps has the important added benefit of enabling use of the data by non-human users (i.e., computer programs), which often make sub-optimal use of the available data due to the need to hard-code data preparation on the client side.
28 CFR 115.253 - Resident access to outside confidential support services.
Code of Federal Regulations, 2014 CFR
2014-07-01
... with access to outside victim advocates for emotional support services related to sexual abuse by... confidential emotional support services related to sexual abuse. The agency shall maintain copies of agreements... communications will be monitored and the extent to which reports of abuse will be forwarded to authorities in...
28 CFR 115.253 - Resident access to outside confidential support services.
Code of Federal Regulations, 2012 CFR
2012-07-01
... with access to outside victim advocates for emotional support services related to sexual abuse by... confidential emotional support services related to sexual abuse. The agency shall maintain copies of agreements... communications will be monitored and the extent to which reports of abuse will be forwarded to authorities in...
28 CFR 115.253 - Resident access to outside confidential support services.
Code of Federal Regulations, 2013 CFR
2013-07-01
... with access to outside victim advocates for emotional support services related to sexual abuse by... confidential emotional support services related to sexual abuse. The agency shall maintain copies of agreements... communications will be monitored and the extent to which reports of abuse will be forwarded to authorities in...
Access to and Use of Eye Care Services in Rural Arkansas
ERIC Educational Resources Information Center
Kilmer, Greta; Bynum, LaTonya; Balamurugan, Appathurai
2010-01-01
Context: Rural residents are more likely to be uninsured and have low income. Purpose: To determine if rural residents in Arkansas have decreased access to eye care services and use them less frequently than urban residents. Methods: Data from the 2006 Visual Impairment and Access to Eye Care Module from the Arkansas Behavioral Risk Factor…
Whetten, Justin; van der Goes, David N; Tran, Huy; Moffett, Maurice; Semper, Colin; Yonas, Howard
2018-04-01
Access to Critical Cerebral Emergency Support Services (ACCESS) was developed as a low-cost solution to providing neuro-emergent consultations to rural hospitals in New Mexico that do not offer comprehensive stroke care. ACCESS is a two-way audio-visual program linking remote emergency department physicians and their patients to stroke specialists. ACCESS also has an education component in which hospitals receive training from stroke specialists on the triage and treatment of patients. This study assessed the clinical and economic outcomes of the ACCESS program in providing services to rural New Mexico from a healthcare payer perspective. A decision tree model was constructed using findings from the ACCESS program and existing literature, the likelihood that a patient will receive a tissue plasminogen activator (tPA), cost of care, and resulting quality adjusted life years (QALYs). Data from the ACCESS program includes emergency room patients in rural New Mexico from May 2015 to August 2016. Outcomes and costs have been estimated for patients who were taken to a hospital providing neurological telecare and patients who were not. The use of ACCESS decreased neuro-emergent stroke patient transfers from rural hospitals to urban settings from 85% to 5% (no tPA) and 90% to 23% (tPA), while stroke specialist reading of patient CT/MRI imaging within 3 h of onset of stroke symptoms increased from 2% to 22%. Results indicate that use of ACCESS has the potential to save $4,241 ($3,952-$4,438) per patient and increase QALYs by 0.20 (0.14-0.22). This increase in QALYs equates to ∼73 more days of life at full health. The cost savings and QALYs are expected to increase when moving from a 90-day model to a lifetime model. The analysis demonstrates potential savings and improved quality-of-life associated with the use of ACCESS for patients presenting to rural hospitals with acute ischemic stroke (AIS).
Zickafoose, Joseph S.; DeCamp, Lisa R.; Prosser, Lisa A.
2013-01-01
Objectives To measure the prevalence of enhanced access services in pediatric primary care and to assess whether enhanced access services are associated with lower emergency department (ED) utilization. Study design Internet-based survey of a national sample of parents (n=820, response rate 41%). We estimated the prevalence of reported enhanced access services and ED use in the prior 12 months. We then used multivariate negative binomial regression to assess associations between enhanced access services and ED use. Results The majority of parents reported access to advice by telephone during office hours (80%), same-day sick visits (79%), and advice by telephone outside office hours (54%). Fewer than one-half of parents reported access to their child’s primary care office on weekends (47%), after 5:00 pm on any night (23%), or by email (13%). Substantial proportions of parents reported that they did not know if these services were available (7-56%, depending on service). Office hours after 5:00 pm on ≥5 nights a week was the only service significantly associated with ED utilization in multivariate analysis (adjusted incidence rate ratio: 0.51 [95% CI 0.28-0.92]). Conclusions The majority of parents report enhanced access to their child’s primary care office during office hours, but many parents do not have access or do not know if they have access outside of regular office hours. Extended office hours may be the most effective practice change to reduce emergency department use. Primary care practices should prioritize the most effective enhanced access services and communicate existing services to families. PMID:23759421
Ahmed, Nizam U; Alam, Mohammed M; Sultana, Fadia; Sayeed, Shahana N; Pressman, Aliza M; Powers, Mary Beth
2006-12-01
The NGO Service Delivery Program (NSDP), a USAID-funded programme, is the largest NGO programme in Bangladesh. Its strategic flagship activity is the essential services package through which healthcare services are administered by NGOs in Bangladesh. The overall goal of the NSDP is to increase access to essential healthcare services by communities, especially the poor. Recognizing that the poorest in the community often have no access to essential healthcare services due to various barriers, a study was conducted to identify what the real barriers to access by the poor are. This included investigations to further understand the perceptions of the poor of real or imagined barriers to accessing healthcare; ways for healthcare centres to maximize services to the poor; how healthcare providers can maximize service-use; inter-personal communication between healthcare providers and those seeking healthcare among the poor; and ways to improve the capacity of service providers to reach the poorest segment of the community. The study, carried out in two phases, included 24 static and satellite clinics within the catchment areas of eight NGOs under the NSDP in Bangladesh, during June-September 2003. Participatory urban and rural appraisal techniques, focus-group discussions, and in-depth interviews were employed as research methods in the study. The target populations in the study included males and females, service-users and non-users, and special groups, such as fishermen, sex workers, potters, Bedes (river gypsies), and lower-caste people-all combined representing a heterogeneous community. The following four major categories of barriers emerged as roadblocks to accessing quality healthcare for the poor: (a) low income to be able to afford healthcare, (b) lack of awareness of the kind of healthcare services available, (c) deficiencies and inconsistencies in the quality of services, and (d) lack of close proximity to the healthcare facility. Those interviewed perceived
Using Technology to Improve Access to Mental Health Services.
Cortelyou-Ward, Kendall; Rotarius, Timothy; Honrado, Jed C
Mental ill-health is a public health threat that is prevalent throughout the United States. Tens of millions of Americans have been diagnosed along the continuum of mental ill-health, and many more millions of family members and friends are indirectly affected by the pervasiveness of mental ill-health. Issues such as access and the societal stigma related to mental health issues serve as deterrents to patients receiving their necessary care. However, technological advances have shown the potential to increase access to mental health services for many patients.
Access to HIV prevention services among gender based violence survivors in Tanzania
Mboya, Beati; Temu, Florence; Awadhi, Bayoum; Ngware, Zubeda; Ndyetabura, Elly; Kiondo, Gloria; Maridadi, Janneth
2012-01-01
Introduction Currently, Tanzania's HIV prevalence is 5.7%. Gender inequality and Gender Based Violence (GBV) are among factors fuelling the spread of HIV in Tanzania. This study was conducted to assess universal access to HIV prevention services among GBV survivors in Iringa and Dar-es-Salaam where HIV prevalence is as high as 14.7% and 9% respectively compared to a national average of 5.7%. Methods In 2010, a mixed methods study using triangulation model was conducted in Iringa and Dar-es-Salaam regions to represent rural and urban settings respectively. Questionnaires were administered to 283 randomly selected survivors and 37 health providers while 28 in-depth interviews and 16 focus group discussions were conducted among various stakeholders. Quantitative data was analyzed in SPSS by comparing descriptive statistics while qualitative data was analyzed using thematic framework approach. Results Counseling and testing was the most common type of HIV prevention services received by GBV survivors (29%). Obstacles for HIV prevention among GBV survivors included: stigma, male dominance culture and fear of marital separation. Bribery in service delivery points, lack of confidentiality, inadequate GBV knowledge among health providers, and fear of being involved in legal matters were mentioned to be additional obstacles to service accessibility by survivors. Reported consequences of GBV included: psychological problems, physical trauma, chronic illness, HIV infection. Conclusion GBV related stigma and cultural norms are obstacles to HIV services accessibility. Initiation of friendly health services, integration of GBV into HIV services and community based interventions addressing GBV related stigma and cultural norms are recommended. PMID:23467278
Access to HIV prevention services among gender based violence survivors in Tanzania.
Mboya, Beati; Temu, Florence; Awadhi, Bayoum; Ngware, Zubeda; Ndyetabura, Elly; Kiondo, Gloria; Maridadi, Janneth
2012-01-01
Currently, Tanzania's HIV prevalence is 5.7%. Gender inequality and Gender Based Violence (GBV) are among factors fuelling the spread of HIV in Tanzania. This study was conducted to assess universal access to HIV prevention services among GBV survivors in Iringa and Dar-es-Salaam where HIV prevalence is as high as 14.7% and 9% respectively compared to a national average of 5.7%. In 2010, a mixed methods study using triangulation model was conducted in Iringa and Dar-es-Salaam regions to represent rural and urban settings respectively. Questionnaires were administered to 283 randomly selected survivors and 37 health providers while 28 in-depth interviews and 16 focus group discussions were conducted among various stakeholders. Quantitative data was analyzed in SPSS by comparing descriptive statistics while qualitative data was analyzed using thematic framework approach. Counseling and testing was the most common type of HIV prevention services received by GBV survivors (29%). Obstacles for HIV prevention among GBV survivors included: stigma, male dominance culture and fear of marital separation. Bribery in service delivery points, lack of confidentiality, inadequate GBV knowledge among health providers, and fear of being involved in legal matters were mentioned to be additional obstacles to service accessibility by survivors. Reported consequences of GBV included: psychological problems, physical trauma, chronic illness, HIV infection. GBV related stigma and cultural norms are obstacles to HIV services accessibility. Initiation of friendly health services, integration of GBV into HIV services and community based interventions addressing GBV related stigma and cultural norms are recommended.
The Relationship between Critical Thinking Disposition and Locus of Control in Pre-Service Teachers
ERIC Educational Resources Information Center
Oguz, Aytunga; Sariçam, Hakan
2016-01-01
The aim of the current research study was to examine the link between critical thinking dispositions and locus of control in pre-service teachers. The participants of this study were selected via easily accessible sampling technique. The participants consist of 347 pre-service teachers (203 female, 144 male) in Kütahya, Turkey. The Rotter…
Perceived Barriers Affecting Access to Preventive Dental Services: Application of DEMATEL Method
Bahadori, Mohammadkarim; Ravangard, Ramin; Asghari, Baratali
2013-01-01
Background Identifying perceived access barriers to preventive dental services is one of the basic steps to improve the public health. Objectives This study aimed to determine the perceived barriers affecting access to preventive dental services in one of Tehran dental clinics in 2012. Patients and Methods This research was a cross-sectional descriptive-analytical study conducted in one of Tehran dental clinics in 2012 using decision–making trial and evaluation laboratory (DEMATEL) method. The study sample included all patients (100 patients) who had referred to the endodontic treatment department from 26 - 31 May, 2012. The required data were collected using a questionnaire. Collected data were analyzed using SPSS 18.0 and MATLAB 7.9.0 SPSSS 18.0, as well as, some descriptive and analytical tests including Mean, Standard Deviation (SD), and Independent T- Test. Results The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access to dental services among which the cost and patient-dentist relationship were identified as the first and last priorities with the coordinates (1.4 and 1.4) and (1.25 and -0.65), respectively. Conclusions High cost of dental care has led to not referring patients to the clinic. Oral health costs are too high; however insurance organizations have no commitment to support such services. Policymakers, administrators, and insurance organizations have a major role in improving access to dental services. These decision-makers in making their policies can provide the required financial resources, shift the available resources towards preventive care and periodic checkups, and consider providing proper and sufficient places for dental care facilities. PMID:24578831
Accessibility to Specialized Public Oral Health Services from the Perspective of Brazilian Users
de Castro, Ricardo Dias; Rangel, Marianne de Lucena; da Silva, Marcos André Azevedo; de Lucena, Brunna Thaís Lucwu; Cavalcanti, Alessandro Leite; Bonan, Paulo Rogério Ferreti; Oliveira, Julyana de Araújo
2016-01-01
The Specialized Dental Clinics (SDCs) represent the first government initiative in Latin America aimed at providing specialized oral health services. This study sought to evaluate the organizational accessibility to specialized oral health care services in Brazil and to understand the factors that may be associated with accessibility from the user’s perspective. This epidemiological, cross-sectional and quantitative study was conducted by means of interviews with individuals who sought specialized public oral health services in the city of João Pessoa, Paraíba, Brazil, and consisted of a sample of 590 individuals. Users expressed a favorable view of the classification and resolutive nature of specialized services offered by Brazilian public health. The binary logistic regression analysis revealed weak points highlighting the difficulty involved in obtaining such treatments leading to unfavorable evaluations. In the resolutive nature item, difficulty in accessing the location, queues and lack of materials and equipment were highlighted as statistically significant unfavorable aspects. While many of the users considered the service to be resolutive, weaknesses were mentioned that need to be detected to promote improvements and to prevent other health models adopted worldwide from reproducing the same flaws. PMID:27775584
Sforzo, Gary A; Kaye, Miranda P; Calleri, David; Ngai, Nancy
2012-04-01
Examine effects of voluntary participation in employer-sponsored, multipoint wellness education programming on employee wellness. A randomized and controlled design was used to organize 96 participants into an education + access group; an access-only group, and control group. Outcome measures were made at start and end of a 12-week intervention period. Education + access improved wellness knowledge, which, in turn, enhanced life satisfaction, employee morale, and energy, and nearly improved stress level. Those who received facility access without educational programming did not reap health benefits. Employees voluntarily used the fitness facility and healthy meal cards only 1.3 and 1.5 times per week, respectively. Participants made limited and likely inadequate use of wellness opportunities. As a result, physical health benefits (eg, blood pressure, fitness parameters) were not seen in the present study. However, multipoint wellness education resulted in psychosocial health benefits in 12 weeks.
Distance Learning: Information Access and Services for Virtual Users.
ERIC Educational Resources Information Center
Iyer, Hemalata, Ed.
This volume centers broadly on information support services for distance education. The articles in this book can be categorized into two areas: access to information resources for distance learners, and studies of distance learning programs. Contents include: "The Challenges and Benefits of Asynchronous Learning Networks" (Daphne…
NASA Technical Reports Server (NTRS)
Whalen, Edward A.
2016-01-01
This document serves as the final report for the Flight Services and Aircraft Access task order NNL14AA57T as part of NASA Environmentally Responsible Aviation (ERA) Project ITD12A+. It includes descriptions of flight test preparations and execution for the Active Flow Control (AFC) Vertical Tail and Insect Accretion and Mitigation (IAM) experiments conducted on the 757 ecoDemonstrator. For the AFC Vertical Tail, this is the culmination of efforts under two task orders. The task order was managed by Boeing Research & Technology and executed by an enterprise-wide Boeing team that included Boeing Research & Technology, Boeing Commercial Airplanes, Boeing Defense and Space and Boeing Test and Evaluation. Boeing BR&T in St. Louis was responsible for overall Boeing project management and coordination with NASA. The 757 flight test asset was provided and managed by the BCA ecoDemonstrator Program, in partnership with Stifel Aircraft Leasing and the TUI Group. With this report, all of the required deliverables related to management of this task order have been met and delivered to NASA as summarized in Table 1. In addition, this task order is part of a broader collaboration between NASA and Boeing.
Carew, Anne Marie; Cafferty, Siobhán; Long, Jean; Bellerose, Delphine; Lyons, Suzi
2013-01-01
By accessing addiction treatment services recorded in routine national drug treatment data, the characteristics of Irish Travellers were analyzed to understand their needs and develop policies to tackle issues faced by this community. The number of Traveller cases accessing services increased by 163% between 2007 and 2010. Alcohol and opiates were the most common problem substances reported. Traveller women reported high rates of problem opiate use and risky injecting behaviors, contrary to the perception that problem substance use is a predominantly male issue. This presents a challenge to services to provide targeted, effective services to Travellers with problem substance use.
Socioeconomic disparities in home health care service access and utilization: a scoping review.
Goodridge, Donna; Hawranik, Pamela; Duncan, Vicky; Turner, Hollie
2012-10-01
Home health care services are expanding at a rapid pace in order to meet the needs of the growing population of older adults and those with chronic illnesses. Because of current restrictions on home health care as an insured service in some countries, individuals may be required to pay for some or all of their home care services out of pocket. These payments may potentially limit access to needed home care services for persons in the lowest socioeconomic strata. Previous research demonstrates a clear socioeconomic gradient in access to acute and primary care services, where those most in need of services are the most disadvantaged and under-serviced. There has been little attention paid thus far, however, to the way in which socioeconomic status may affect the receipt of home health care services. To determine what is known from existing literature about socioeconomic disparities in home health care access and utilization. A scoping review was used to map the extent and nature of the literature in this area. A search of the databases CINAHL, Medline, SocIndex and Sociological Abstracts as well as Dissertations International. A total of 206 potentially relevant articles were published between 2000 and April 2011. Two reviewers independently reviewed the articles, leaving 15 research articles to be included in the scoping review. The majority of articles reported secondary analyses of administrative datasets related to utilization of home health care. Several studies examined access and utilization using qualitative approaches. The distinction between professional and supportive home care services was not always clear in the articles. Individual and composite measures of socioeconomic status were reported, with the most frequently used indicator being income. Several studies used more complex composite ecological indicators of socieconomic status. There was general agreement that utilization of home health services favored persons with greater economic disadvantage
Zhou, Qingsheng
2016-01-01
To examine whether differences in access to specialist disability services by people from culturally and linguistically diverse (CALD) backgrounds when compared with those born in Australia represent a service gap or the healthy migrant effect. To use the latest disability statistics to measure the different rates of people with disability, and the rates of people with profound and severe disability, of people born in Australia and those born abroad; to compare the difference between those who mainly speak English with those who primarily speak a language other than English at home (LOTE); and examine the age-specific and standardised disability rates of these subgroups. The rate of access of specialist disability services by people with disability who were from CALD backgrounds is highly disproportionate to their presence in the community. As a whole, people from CALD backgrounds have a similar level of disability as Australia-born people. They have a greater rate of profound and severe disability and a higher level of need for assistance in undertaking core activities. For younger age cohorts targeted by specialist disability services, there is little difference in the level of need for assistance between people from CALD backgrounds and the rest of community. Those people who mainly speak LOTE at home have a relatively higher level of need for assistance than those who speak mainly English at home. The paper reveals a substantial gap in specialist disability services between people from CALD and the broader community. This cannot be explained by the difference in the level of need for assistance between Australia-born and overseas-born populations, therefore raises some policy questions as to the barriers to the use of such services and how to effectively narrow the service access gap and improve utilisation rates. The paper reveals a substantial accessibility gap in specialist disability services between people from culturally and linguistically diverse (CALD
Suurmond, Jeanine; Rosenmöller, Doenja L; El Mesbahi, Hakima; Lamkaddem, Majda; Essink-Bot, Marie-Louise
2016-02-01
Ethnic minority elderly have a high prevalence of functional limitations and chronic conditions compared to Dutch elderly. However, their use of home care services is low compared to Dutch elderly. Explore the barriers to access to home care services for Turkish, Moroccan Surinamese and ethnic Dutch elderly. Qualitative semi-structured group interviews and individual interviews. The Netherlands. Seven group interviews (n=50) followed by individual interviews (n=5) were conducted, in the preferred language of the participants. Results were ordered and reported according to a framework of access to health care services. This framework describes five dimensions of accessibility to generate access to health care services, from the perspective of the users: ability to perceive health needs, ability to seek health care, ability to reach, ability to pay and ability to engage. This study shows that while barriers are common among all groups, several specific barriers in access to home care services exist for ethnic minority elderly. Language and communication barriers as well as limited networks and a preference for informal care seem to mutually enforce each other, resulting in many barriers during the navigation process to home care. In order to provide equal access to home care for all who need it, the language and communication barriers should be tackled by home care services and home care nurses. Copyright © 2015 Elsevier Ltd. All rights reserved.
Polo, Gina; Acosta, C. Mera; Ferreira, Fernando; Dias, Ricardo Augusto
2015-01-01
This study integrated accessibility and location-allocation models in geographic information systems as a proposed strategy to improve the spatial planning of public health services. To estimate the spatial accessibility, we modified the two-step floating catchment area (2SFCA) model with a different impedance function, a Gaussian weight for competition among service sites, a friction coefficient, distances along a street network based on the Dijkstra’s algorithm and by performing a vectorial analysis. To check the accuracy of the strategy, we used the data from the public sterilization program for the dogs and cats of Bogot´a, Colombia. Since the proposed strategy is independent of the service, it could also be applied to any other public intervention when the capacity of the service is known. The results of the accessibility model were consistent with the sterilization program data, revealing that the western, central and northern zones are the most isolated areas under the sterilization program. Spatial accessibility improvement was sought by relocating the sterilization sites using the maximum coverage with finite demand and the p-median models. The relocation proposed by the maximum coverage model more effectively maximized the spatial accessibility to the sterilization service given the non-uniform distribution of the populations of dogs and cats throughout the city. The implementation of the proposed strategy would provide direct benefits by improving the effectiveness of different public health interventions and the use of financial and human resources. PMID:25775411
77 FR 29635 - Access to Confidential Business Information by Several Student Services Contractors
Federal Register 2010, 2011, 2012, 2013, 2014
2012-05-18
... Business Information by Several Student Services Contractors AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: EPA will be authorizing several Student Services contractors to access...? Under Order Number EP-12-H-000389, a Student Services contractor will assist the Office of Science...
Income-Related Inequalities in Access to Dental Care Services in Japan.
Nishide, Akemi; Fujita, Misuzu; Sato, Yasunori; Nagashima, Kengo; Takahashi, Sho; Hata, Akira
2017-05-12
Background : This study aimed to evaluate whether income-related inequalities in access to dental care services exist in Japan. Methods : The subjects included beneficiaries of the National Health Insurance (NHI) in Chiba City, Japan, who had been enrolled from 1 April 2014 to 31 March 2015. The presence or absence of dental visits and number of days spent on dental care services during the year were calculated using insurance claims submitted. Equivalent household income was calculated using individual income data from 1 January to 31 December 2013, declared for taxation. Results : Of the 216,211 enrolled subjects, 50.3% had dental care during the year. Among those with dental visits, the average number of days (standard deviation) spent on dental care services per year was 7.7 (7.1). Low income was associated with a decreased rate of dental care utilization regardless of age and sex. However, there was a significant inverse linear association between the number of days spent on dental care services and income levels for both sexes. Conclusions : There were income-related inequalities in access to dental care services, regardless of the age group or sex, within the Japanese universal health insurance system.
Skiles, Martha Priedeman; Cunningham, Marc; Inglis, Andrew; Wilkes, Becky; Hatch, Ben; Bock, Ariella; Barden-O'Fallon, Janine
2015-03-01
Previous studies have identified positive relationships between geographic proximity to family planning services and contraceptive use, but have not accounted for the effect of contraceptive supply reliability or the diminishing influence of facility access with increasing distance. Kernel density estimation was used to geographically link Malawi women's use of injectable contraceptives and demand for birth spacing or limiting, as drawn from the 2010 Demographic and Health Survey, with contraceptive logistics data from family planning service delivery points. Linear probability models were run to identify associations between access to injectable services-measured by distance alone and by distance combined with supply reliability-and injectable use and family planning demand among rural and urban populations. Access to services was an important predictor of injectable use. The probability of injectable use among rural women with the most access by both measures was 7‒8 percentage points higher than among rural dwellers with the least access. The probability of wanting to space or limit births among urban women who had access to the most reliable supplies was 18 percentage points higher than among their counterparts with the least access. Product availability in the local service environment plays a critical role in women's demand for and use of contraceptive methods. Use of kernel density estimation in creating facility service environments provides a refined approach to linking women with services and accounts for both distance to facilities and supply reliability. Urban and rural differences should be considered when seeking to improve contraceptive access.
Tun, Waimar; Okal, Jerry; Schenk, Katie; Esantsi, Selina; Mutale, Felix; Kyeremaa, Rita Kusi; Ngirabakunzi, Edson; Asiah, Hilary; McClain-Nhlapo, Charlotte; Moono, Grimond
2016-01-01
Knowledge about experiences in accessing HIV services among persons with disabilities who are living with HIV in sub-Saharan Africa is limited. Although HIV transmission among persons with disabilities in Africa is increasingly acknowledged, there is a need to bring to life the experiences and voices from persons with disabilities living with HIV to raise awareness of programme implementers and policy makers about their barriers in accessing HIV services. This paper explores how the barriers faced by persons with disabilities living with HIV impede their ability to access HIV-related services and manage their disease. We conducted focus group discussions with 76 persons (41 females; 35 males) with physical, visual and/or hearing impairments who were living with HIV in Ghana, Uganda and Zambia (2012-2013). We explored challenges and facilitators at different levels (individual, psychosocial and structural) of access to HIV services. Transcripts were analyzed using a framework analysis approach. Persons with disabilities living with HIV encountered a wide variety of challenges in accessing HIV services. Delays in testing for HIV were common, with most waiting until they were sick to be tested. Reasons for delayed testing included challenges in getting to the health facilities, lack of information about HIV and testing, and HIV- and disability-related stigma. Barriers to HIV-related services, including care and treatment, at health facilities included lack of disability-friendly educational materials and sign interpreters, stigmatizing treatment by providers and other patients, lack of skills to provide tailored services to persons with disabilities living with HIV and physically inaccessible infrastructure, all of which make it extremely difficult for persons with disabilities to initiate and adhere to HIV treatment. Accessibility challenges were greater for women than men due to gender-related roles. Challenges were similar across the three countries. Favourable
Tun, Waimar; Okal, Jerry; Schenk, Katie; Esantsi, Selina; Mutale, Felix; Kyeremaa, Rita Kusi; Ngirabakunzi, Edson; Asiah, Hilary; McClain-Nhlapo, Charlotte; Moono, Grimond
2016-01-01
Introduction Knowledge about experiences in accessing HIV services among persons with disabilities who are living with HIV in sub-Saharan Africa is limited. Although HIV transmission among persons with disabilities in Africa is increasingly acknowledged, there is a need to bring to life the experiences and voices from persons with disabilities living with HIV to raise awareness of programme implementers and policy makers about their barriers in accessing HIV services. This paper explores how the barriers faced by persons with disabilities living with HIV impede their ability to access HIV-related services and manage their disease. Methods We conducted focus group discussions with 76 persons (41 females; 35 males) with physical, visual and/or hearing impairments who were living with HIV in Ghana, Uganda and Zambia (2012–2013). We explored challenges and facilitators at different levels (individual, psychosocial and structural) of access to HIV services. Transcripts were analyzed using a framework analysis approach. Results Persons with disabilities living with HIV encountered a wide variety of challenges in accessing HIV services. Delays in testing for HIV were common, with most waiting until they were sick to be tested. Reasons for delayed testing included challenges in getting to the health facilities, lack of information about HIV and testing, and HIV- and disability-related stigma. Barriers to HIV-related services, including care and treatment, at health facilities included lack of disability-friendly educational materials and sign interpreters, stigmatizing treatment by providers and other patients, lack of skills to provide tailored services to persons with disabilities living with HIV and physically inaccessible infrastructure, all of which make it extremely difficult for persons with disabilities to initiate and adhere to HIV treatment. Accessibility challenges were greater for women than men due to gender-related roles. Challenges were similar across the
2012-01-01
Background Inequity of accessibility to and utilization of reproductive health (RH) services among youths is a global concern, especially in resource-limited areas. The level of inequity also varies by cultural and socio-economic contexts. To tailor RH services to the needs of youths, relevant solutions are required. This study aimed to assess baseline information on access to and utilization of RH services and unmet needs among youths living in resource-limited, suburban communities of Mandalay City, Myanmar. Methods A community-based, cross-sectional study was conducted in all resource-limited, suburban communities of Mandalay City, Myanmar. A total of 444 randomly selected youths aged between 15 and 24 years were interviewed for three main outcomes, namely accessibility to and utilization of RH services and youth's unmet needs for these services. Factors associated with these outcomes were determined using multivariate logistic regression. Results Although geographical accessibility was high (79.3%), financial accessibility was low (19.1%) resulting in a low overall accessibility (34.5%) to RH services. Two-thirds of youths used some kind of RH services at least once in the past. Levels of unmet needs for sexual RH information, family planning, maternal care and HIV testing were 62.6%, 31.9%, 38.7% and 56.2%, respectively. Youths living in the south or south-western suburbs, having a deceased parent, never being married or never exposed to mass media were less likely to access RH services. Being a young adult, current student, working as a waste recycler, having ever experienced a sexual relationship, ever being married, ever exposed to mass media, having a high knowledge of RH services and providers or a high level of accessibility to RH services significantly increased the likelihood of utilization of those services. In addition to youths’ socio-demographic characteristics, exposure to mass media, norm of peer exposure and knowledge on types of providers and
Code of Federal Regulations, 2010 CFR
2010-10-01
... priority access service by commercial mobile radio service providers. 64.402 Section 64.402... RULES RELATING TO COMMON CARRIERS Procedures for Handling Priority Services in Emergencies § 64.402 Policies and procedures for the provision of priority access service by commercial mobile radio service...
NASA Alternate Access to Station Service Concept
NASA Technical Reports Server (NTRS)
Bailey, Michelle D.; Crumbly, Chris
2001-01-01
The evolving nature of the NASA space enterprise compels the agency to develop new and innovative space systems concepts. NASA, working with increasingly strained budgets and a declining manpower base, is attempting to transform from operational activities to procurement of commercial services. NASA's current generation reusable launch vehicle, the Shuttle, is in transition from a government owned and operated entity to a commercial venture to reduce the civil servant necessities for that program. NASA foresees its second generation launch vehicles being designed and operated by industry for commercial and government services. The "service" concept is a pioneering effort by NASA. The purpose the "service" is not only to reduce the civil servant overhead but will free up government resources for further research - and enable industry to develop a space business case so that industry can sustain itself beyond government programs. In addition, NASA desires a decreased responsibility thereby decreasing liability. The Second Generation Reusable Launch Vehicle (RLV) program is implementing NASA's Space Launch Initiative (SLI) to enable industry to develop the launch vehicles of the future. The Alternate Access to Station (AAS) project office within this program is chartered with enabling industry to demonstrate an alternate access capability for the International Space Station (ISS). The project will not accomplish this by traditional government procurement methods, not by integrating the space system within the project office, or by providing the only source of business for the new capability. The project funds will ultimately be used to purchase a service to take re-supply cargo to the ISS, much the same as any business might purchase a service from FedEx to deliver a package to its customer. In the near term, the project will fund risk mitigation efforts for enabling technologies. AAS is in some ways a precursor to the 2nd Generation RLV. By accomplishing ISS resupply
NASA Alternate Access to Station Service Concept
NASA Astrophysics Data System (ADS)
Bailey, M. D.; Crumbly, C.
2002-01-01
The evolving nature of the NASA space enterprise compels the agency to develop new and innovative space systems concepts. NASA, working with increasingly strained budgets and a declining manpower base, is attempting to transform from operational activities to procurement of commercial services. NASA's current generation reusable launch vehicle, the Shuttle, is in transition from a government owned and operated entity to a commercial venture to reduce the civil servant necessities for that program. NASA foresees its second generation launch vehicles being designed and operated by industry for commercial and government services. The "service" concept is a pioneering effort by NASA. The purpose the "service" is not only to reduce the civil servant overhead but will free up government resources for further research and enable industry to develop a space business case so that industry can sustain itself beyond government programs. In addition, NASA desires a decreased responsibility thereby decreasing liability. The Second Generation Reusable Launch Vehicle (RLV) program is implementing NASA's Space Launch Initiative (SLI) to enable industry to develop the launch vehicles of the future. The Alternate Access to Station (AAS) project office within this program is chartered with enabling industry to demonstrate an alternate access capability for the International Space Station (ISS). The project will not accomplish this by traditional government procurement methods, not by integrating the space system within the project office, or by providing the only source of business for the new capability. The project funds will ultimately be used to purchase a service to take re-supply cargo to the ISS, much the same as any business might purchase a service from FedEx to deliver a package to its customer. In the near term, the project will fund risk mitigation efforts for enabling technologies. AAS is in some ways a precursor to the 2nd Generation RLV. By accomplishing ISS resupply
Eide, Arne Henning; Schür, Clare; Ranchod, Chitra; Rohleder, Poul; Swartz, Leslie; Schneider, Marguerite
2011-12-01
The main research question in this article is how access to information about HIV/AIDS and level of HIV/AIDS prevention related knowledge are distributed among disabled people, and whether level of knowledge predicts access to HIV/AIDS related services. A survey was carried out among a sample of 285 disabled people from three provinces in South Africa. Analyses of the data revealed that gender and level of education, together with geographical differences, are key predictors for access to information and knowledge about HIV/AIDS among disabled people. For male respondents number of information sources predicts access to voluntary counselling and testing services and HIV testing, while knowledge about prevention predicts access to Voluntary Counselling and Testing centres. Significant gender differences with regards to information, knowledge and access to services highlight the need for gender specific prevention strategies among disabled people.
Asfaw, Abay; Colopy, Maria
2017-01-01
Background We examined the association between parental access to paid sick leave (PPSL) and children's use of preventive care and reduced likelihood of delayed medical care and emergency room (ER) visits. Methods We used the child sample of the National Health Interview Survey data (linked to the adult and family samples) from 2011 through 2015 and logistic and negative binomial regression models. Results Controlling for covariates, the odds of children with PPSL receiving flu vaccination were 12.5% [95%CI: 1.06–1.19] higher and receiving annual medical checkups were 13.2% [95%CI: 1.04–1.23] higher than those of children without PPSL. With PPSL, the odds of children receiving delayed medical care because of time mismatch were 13.3% [95%CI: 0.76–0.98] lower, and being taken to ER were 53.6% [95%CI: 0.27–0.81] lower than those of children without PPSL. PPSL was associated with 11% [95%CI: 0.82–0.97] fewer ER visits per year. Conclusion PPSL may improve children's access and use of healthcare services and reduce the number of ER visits. PMID:28169438
Arreola, Sonya; Santos, Glenn-Milo; Beck, Jack; Sundararaj, Mohan; Wilson, Patrick A; Hebert, Pato; Makofane, Keletso; Do, Tri D; Ayala, George
2015-02-01
Globally, HIV disproportionately affects men who have sex with men (MSM). This study explored associations between access to HIV services and (1) individual-level perceived sexual stigma; (2) country-level criminalization of homosexuality; and (3) country-level investment in HIV services for MSM. 3,340 MSM completed an online survey assessing access to HIV services. MSM from over 115 countries were categorized according to criminalization of homosexuality policy and investment in HIV services targeting MSM. Lower access to condoms, lubricants, and HIV testing were each associated with greater perceived sexual stigma, existence of homosexuality criminalization policies, and less investment in HIV services. Lower access to HIV treatment was associated with greater perceived sexual stigma and criminalization. Criminalization of homosexuality and low investment in HIV services were both associated with greater perceived sexual stigma. Efforts to prevent and treat HIV among MSM should be coupled with structural interventions to reduce stigma, overturn homosexuality criminalization policies, and increase investment in MSM-specific HIV services.
ERIC Educational Resources Information Center
Young, April; Ruble, Lisa; McGrew, John
2009-01-01
Very little research has been conducted on insurance type (private vs. public funded) and costs, accessibility, and use of services of children with autism. Analysis of five parent reported outcomes: (a) out-of-pocket expenditures, (b) variety of services used, (c) access to services, (d) child and family service outcomes, and (e) satisfaction…
Ndumele, Chima D; Mor, Vincent; Allen, Susan; Burgess, James F; Trivedi, Amal N
2014-06-01
Medicaid enrollees typically report worse access to care than other insured populations. Expansions in Medicaid through less restrictive income eligibility requirements and the resulting influx of new enrollees may further erode access to care for those already enrolled in Medicaid. To assess the effect of previous Medicaid expansions on self-reported access to care and the use of emergency department services by Medicaid enrollees. Quasi-experimental difference-in-differences design among 1714 adult Medicaid enrollees in 10 states that expanded Medicaid between June 1, 2000, and October 1, 2009, and 5097 Medicaid enrollees in 14 bordering control states that did not expand Medicaid. Self-reported access to care and annualized emergency department use. Among states expanding their Medicaid program for adults, the mean income eligibility level increased from 82.6% to 144.2% of the federal poverty level. Income eligibility in matched control states remained constant at 77.1% of the federal poverty level. The proportion of adults reporting being enrolled in Medicaid increased from 7.2% to 8.8% in expansion states and from 6.1% to 6.4% in matched control states. In Medicaid program expansion states, the proportion of Medicaid enrollees reporting poor access to care declined from 8.5% before the expansion to 7.3% after the expansion. In matched control states, the proportion of Medicaid enrollees reporting poor access to care remained constant at 5.3%. The proportion of enrollees reporting any emergency department use decreased from 41.2% to 40.1% in expansion states and from 37.3% to 36.1% in matched control states. In the period following expansions, newly eligible enrollees reported poorer access to care than previously enrolled beneficiaries, although the overall difference between groups did not reach statistical significance. We found no evidence that expanding the number of individuals eligible for Medicaid coverage eroded perceived access to care or increased
ChEMBL web services: streamlining access to drug discovery data and utilities
Davies, Mark; Nowotka, Michał; Papadatos, George; Dedman, Nathan; Gaulton, Anna; Atkinson, Francis; Bellis, Louisa; Overington, John P.
2015-01-01
ChEMBL is now a well-established resource in the fields of drug discovery and medicinal chemistry research. The ChEMBL database curates and stores standardized bioactivity, molecule, target and drug data extracted from multiple sources, including the primary medicinal chemistry literature. Programmatic access to ChEMBL data has been improved by a recent update to the ChEMBL web services (version 2.0.x, https://www.ebi.ac.uk/chembl/api/data/docs), which exposes significantly more data from the underlying database and introduces new functionality. To complement the data-focused services, a utility service (version 1.0.x, https://www.ebi.ac.uk/chembl/api/utils/docs), which provides RESTful access to commonly used cheminformatics methods, has also been concurrently developed. The ChEMBL web services can be used together or independently to build applications and data processing workflows relevant to drug discovery and chemical biology. PMID:25883136
Predicting Health Care Utilization among Latinos: Health Locus of Control Beliefs or Access Factors?
ERIC Educational Resources Information Center
De Jesus, Maria; Xiao, Chenyang
2014-01-01
There are two competing research explanations to account for Latinos' underutilization of health services relative to non-Latino Whites in the United States. One hypothesis examines the impact of health locus of control (HLOC) beliefs, while the other focuses on the role of access factors on health care use. To date, the relative strength of…
Fixed Route Accessible Bus Service in Connecticut : A Case Study
DOT National Transportation Integrated Search
1981-07-01
U.S. Department of Transportation regulations implementing Section 504 of the Rehabilitation Act of 1973, require transit agencies to provide wheelchair accessibility on fixed-route bus service. The study is part of the series which included studies ...
Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Amaral, Pedro Vasconcelos; Barbosa, Allan Claudius Queiroz; Rocha, João Victor Muniz; Alvares, Viviane; de Almeida, Dante Grapiuna; Thumé, Elaine; Thomaz, Erika Bárbara Abreu Fonseca; de Sousa Queiroz, Rejane Christine; de Souza, Marta Rovery; Lein, Adriana; Lopes, Daniel Paulino; Staton, Catherine A; Vissoci, João Ricardo Nickenig; Facchini, Luiz Augusto
2017-08-22
Unequal distribution of emergency care services is a critical barrier to be overcome to assure access to emergency and surgical care. Considering this context it was objective of the present work analyze geographic access barriers to emergency care services in Brazil. A secondary aim of the study is to define possible roles to be assumed by small hospitals in the Brazilian healthcare network to overcome geographic access challenges. The present work can be classified as a cross-sectional ecological study. To carry out the present study, data of all 5843 Brazilian hospitals were categorized among high complexity centers and small hospitals. The geographical access barriers were identified through the use of two-step floating catchment area method. Once concluded the previous step an evaluation using the Getis-Ord-Gi method was performed to identify spatial clusters of municipalities with limited access to high complexity centers but well covered by well-equipped small hospitals. The analysis of accessibility index of high complexity centers highlighted large portions of the country with nearly zero hospital beds by inhabitant. In contrast, it was possible observe a group of 1595 municipalities with high accessibility to small hospitals, simultaneously with a low coverage of high complexity centers. Among the 1595 municipalities with good accessibility to small hospitals, 74% (1183) were covered by small hospitals with at least 60% of minimum emergency service requirements. The spatial clusters analysis aggregated 589 municipalities with high values related to minimum emergency service requirements. Small hospitals in these 589 cities could promote the equity in access to emergency services benefiting more than eight million people. There is a spatial disequilibrium within the country with prominent gaps in the health care network for emergency services. Taking this challenge into consideration, small hospitals could be a possible solution and foster equity in access
[Determining Factors in the Access to Mental Health Services by the Adult Colombian Population].
González, Lina María; Peñaloza, Rolando Enrique; Matallana, María Alexandra; Gil, Fabián; Gómez-Restrepo, Carlos; Landaeta, Angela Patricia Vega
2016-12-01
Access to mental health services by people with mental disorders has traditionally been limited, and is associated with attitudinal, social, and structural variables. To analyse the factors that determine access to mental health services by the adult population (18-44 years old) in Colombia, from the results obtained in the 2015 National Mental Health Survey. Analysis of variables of access to attention in mental health care for adults. The reasons for not consulting were classified as barriers of behavioural supply and demand. To analyse the factors associated with access to mental health services in the Colombian adult population, the use of health services in the last 12 months for emotional, nervous or mental health problems was taken into account, as well as associated variables such as demographic characteristics, occupational activity, affiliation to social security, and health status variables. The relationships between these variables were estimated using bivariate multinomial logistic regression models. Rural residence, being married, and having a chronic disease were associated with the decision to consult or not to consult the doctor. Further studies should be conducted to evaluate the situation as regards mental health care access, as well as to determine the potential factors associated with these limitations. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Code of Federal Regulations, 2010 CFR
2010-10-01
... transport and special access services other than channel terminations between LEC end offices and customer... services other than channel terminations between LEC end offices and customer premises, determined as... 47 Telecommunication 3 2010-10-01 2010-10-01 false Dedicated transport and special access services...
Koehlmoos, Tracey Perez; Gazi, Rukhsana; Hossain, S Shahed; Zaman, K
2009-01-21
Social franchising has developed as a possible means of improving provision of health services through engaging the non-state sector in low- and middle-income countries. To examine the evidence that social franchising has on access to and quality of health services in low- and middle-income countries. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register (up to October 2007), Cochrane Central Register of Controlled Trials (The Cochrane Library 2007, Issue 3), MEDLINE, Ovid (1950 to September Week 3 2007), EMBASE, Ovid (1980 to 2007 Week 38), CINAHL, Ovid (1982 to September Week 3 2007), EconLit, WebSPIRS (1969 to Sept 2007), LILACS, Science Citation Index Expanded and Social Sciences Citation Index (1975 to March 2008), Sociological Abstracts, CSA Illumnia (1952 September 2007), WHOLIS (1948 November 2007). Randomized controlled trials, non-randomized controlled trials, controlled before and after studies and interrupted time series comparing social franchising models with other models of health service delivery, other social franchising models or absence of health services. Two review authors independently applied the criteria for inclusion and exclusion of studies to scan titles and abstracts. The same two review authors independently screened full reports of selected citations . At each stage, results were compared and discrepancies settled through discussion. No studies were found which were eligible for inclusion in this review. There is a need to develop rigorous studies to evaluate the effects of social franchising on access to and quality of health services in low- and middle-income countries. Such studies should be informed by the wider literature to identify models of social franchising that have a sound theoretical basis and empirical research addressing their reach, acceptability, feasibility, maintenance and measurability.
Equity in access to maternal and child health services in five developing countries: what works.
Talukder, M D Noorunnabi; Rob, Ubaidur
2010-01-01
People living in rural areas are yet to have equitable access to maternal and child health services in many developing countries. This article examines selected health service delivery models that improved access to services in five developing countries. The article is based on the review of background papers on Bangladesh, Pakistan, Cambodia, Ghana, and Tanzania, prepared as part of a multi-country study on health systems and maternal and child health. Findings suggest that equity in access to health services largely depends on a system that ensures a combination of facility-based service delivery and outreach services with a functioning referral network. A key factor is the availability of health workforce at the community level. Community-based deployment of service providers or recruitment and training of community health workers is critical in enhancing service coverage and linking local populations to a health facility. Incentive is necessary to keep community health workers' interest in providing services. However, health workforce alone cannot ensure good health outcomes. They must be embedded in a functioning service delivery network to transform structural inputs into outcomes. Moreover, local-level health systems should have the ability to allocate resources in strategic ways addressing the pressing health needs of the people.
Scheffler, Elsje; Visagie, Surona; Schneider, Marguerite
2015-06-19
Health care access is complex and multi-faceted and, as a basic right, equitable access and services should be available to all user groups. The aim of this article is to explore how service delivery impacts on access to healthcare for vulnerable groups in an urban primary health care setting in South Africa. A descriptive qualitative study design was used. Data were collected through semi-structured interviews with purposively sampled participants and analysed through thematic content analysis. Service delivery factors are presented against five dimensions of access according to the ACCESS Framework. From a supplier perspective, the organisation of care in the study setting resulted in available, accessible, affordable and adequate services as measured against the DistrictHealth System policies and guidelines. However, service providers experienced significant barriers in provision of services, which impacted on the quality of care, resulting in poor client and provider satisfaction and ultimately compromising acceptability of service delivery. Although users found services to be accessible, the organisation of services presented them with challenges in the domains of availability, affordability and adequacy, resulting in unmet needs, low levels of satisfaction and loss of trust. These challenges fuelled perceptions of unacceptable services. Well developed systems and organisation of services can create accessible, affordable and available primary healthcare services, but do not automatically translate into adequate and acceptable services. Focussing attention on how services are delivered might restore the balance between supply (services) and demand (user needs) and promote universal and equitable access.
NASA Astrophysics Data System (ADS)
Dittmann, Jana; Steinebach, Martin; Wohlmacher, Petra; Ackermann, Ralf
2002-12-01
Digital watermarking is well known as enabling technology to prove ownership on copyrighted material, detect originators of illegally made copies, monitor the usage of the copyrighted multimedia data and analyze the spread spectrum of the data over networks and servers. Research has shown that data hiding techniques can be applied successfully to other application areas like manipulations recognition. In this paper, we show our innovative approach for integrating watermark and cryptography based methods within a framework of new application scenarios spanning a wide range from dedicated and user specific services, "Try&Buy" mechanisms to general means for long-term customer relationships. The tremendous recent efforts to develop and deploy ubiquitous mobile communication possibilities are changing the demands but also possibilities for establishing new business and commerce relationships. Especially we motivate annotation watermarks and aspects of M-Commerce to show important scenarios for access control. Based on a description of the challenges of the application domain and our latest work we discuss, which methods can be used for establishing services in a fast convenient and secure way for conditional access services based on digital watermarking combined with cryptographic techniques. We introduce an example scenario for digital audio and an overview of steps in order to establish these concepts practically.
Demonstration of an SOA-assisted open metro-access infrastructure for heterogeneous services.
Schmuck, H; Bonk, R; Poehlmann, W; Haslach, C; Kuebart, W; Karnick, D; Meyer, J; Fritzsche, D; Weis, E; Becker, J; Freude, W; Pfeiffer, T
2014-01-13
An open converged metro-access network approach allows for sharing optical layer resources like fibers and optical spectrum among different services and operators. We demonstrated experimentally the feasibility of such a concept by the simultaneous operation of multiple services showing different modulation formats and multiplexing techniques. Flexible access nodes are implemented including semiconductor optical amplifiers to create a transparent and reconfigurable optical ring network. The impact of cascaded optical amplifiers on the signal quality is studied along the ring. In addition, the influence of high power rival signals in the same waveband and in the same fiber is analyzed.
Health service access and utilization among Syrian refugees in Jordan.
Doocy, Shannon; Lyles, Emily; Akhu-Zaheya, Laila; Burton, Ann; Burnham, Gilbert
2016-07-14
The influx of Syrian refugees into Jordan presents an immense burden to the Jordanian health system. Changing lifestyles and aging populations are shifting the global disease burden towards increased non-infectious diseases including chronic conditions, co-morbidities, and injuries which are more complicated and costly to manage. The strain placed on health systems threatens the ability to ensure the health needs of both refugees and host country populations are adequately addressed. In light of the increasing challenges facing host governments and humanitarian actors to meet health needs of Syrian refugees and affected host communities, this study was undertaken to assess utilization of health services among Syrian refugees in non-camp settings. A survey of Syrian refugees in Jordan was undertaken in June 2014 to characterize health seeking behaviors and issues related to accessing care. A cluster design with probability proportional to size sampling was used to attain a nationally representative sample of 1550 non-camp Syrian refugee households. Differences in household characteristics by geographic region, facility type, and sector utilized were examined using chi-square and t-test methods. Care-seeking was high with 86.1 % of households reporting an adult sought medical care the last time it was needed. Approximately half (51.5 %) of services were sought from public sector facilities, 38.7 % in private facilities, and 9.8 % in charity/NGO facilities. Among adult care seekers, 87.4 % were prescribed medication during the most recent visit, 89.8 % of which obtained the medication. Overall, 51.8 % of households reported out-of-pocket expenditures for the consultation or medications at the most recent visit (mean US$39.9, median US$4.2). Despite high levels of care-seeking, cost was an important barrier to health service access for Syrian refugees in Jordan. The cessation of free access to health care since the time of the survey is likely to have worsened
"On the Sidelines": Access to Autism-Related Services in the West Bank
ERIC Educational Resources Information Center
Dababnah, Sarah; Bulson, Kathleen
2015-01-01
We examined access to autism-related services among Palestinians (N = 24) raising children with autism spectrum disorder (ASD) in the West Bank. Using qualitative methods, we identified five primary interview themes. Poor screening, diagnostic, and psychoeducational practices were prevalent, as parents reported service providers minimized parental…
47 CFR 61.26 - Tariffing of competitive interstate switched exchange access services.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 47 Telecommunication 3 2010-10-01 2010-10-01 false Tariffing of competitive interstate switched exchange access services. 61.26 Section 61.26 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) TARIFFS General Rules for Nondominant Carriers § 61.26 Tariffing of competitive interstate switched...
Role-based access control permissions
Staggs, Kevin P.; Markham, Thomas R.; Hull Roskos, Julie J.; Chernoguzov, Alexander
2017-04-25
Devices, systems, and methods for role-based access control permissions are disclosed. One method includes a policy decision point that receives up-to-date security context information from one or more outside sources to determine whether to grant access for a data client to a portion of the system and creates an access vector including the determination; receiving, via a policy agent, a request by the data client for access to the portion of the computing system by the data client, wherein the policy agent checks to ensure there is a session established with communications and user/application enforcement points; receiving, via communications policy enforcement point, the request from the policy agent, wherein the communications policy enforcement point determines whether the data client is an authorized node, based upon the access vector received from the policy decision point; and receiving, via the user/application policy enforcement point, the request from the communications policy enforcement point.
ChEMBL web services: streamlining access to drug discovery data and utilities.
Davies, Mark; Nowotka, Michał; Papadatos, George; Dedman, Nathan; Gaulton, Anna; Atkinson, Francis; Bellis, Louisa; Overington, John P
2015-07-01
ChEMBL is now a well-established resource in the fields of drug discovery and medicinal chemistry research. The ChEMBL database curates and stores standardized bioactivity, molecule, target and drug data extracted from multiple sources, including the primary medicinal chemistry literature. Programmatic access to ChEMBL data has been improved by a recent update to the ChEMBL web services (version 2.0.x, https://www.ebi.ac.uk/chembl/api/data/docs), which exposes significantly more data from the underlying database and introduces new functionality. To complement the data-focused services, a utility service (version 1.0.x, https://www.ebi.ac.uk/chembl/api/utils/docs), which provides RESTful access to commonly used cheminformatics methods, has also been concurrently developed. The ChEMBL web services can be used together or independently to build applications and data processing workflows relevant to drug discovery and chemical biology. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.
Whop, Lisa J; Garvey, Gail; Lokuge, Kamalini; Mallitt, Kylie A; Valery, Patricia C
2012-01-01
In Queensland, Australia, the incidence of cancer (all cancers combined) is 21% lower for Indigenous people compared with non-Indigenous people but mortality is 36% higher. Support services play an important role in helping cancer patients through their cancer journey. Indigenous cancer patients are likely to face greater unmet supportive care needs and more barriers to accessing cancer care and support. Other barriers include the higher proportion of Indigenous people who live remotely and in regional areas, a known difficulty for access to health services. This study describes the availability of cancer support services in Queensland for Indigenous patients and relevant location. Using a set criteria 121 services were selected from a pre-existing database (n = 344) of cancer services. These services were invited to complete an online questionnaire. ArcGIS (http://www.esri.com/software/arcgis/index.html) was used to map the services' location (using postcode) against Indigenous population by local government area. Services were classified as an 'Indigenous' or 'Indigenous friendly' service using set criteria. Eighty-three services (73.6%) completed the questionnaire. Mapping revealed services are located where there are relatively low percentages of Indigenous people compared with the whole population. No 'Indigenous-specific' services were identified; however, 11 services (13%) were classed 'Indigenous-friendly'. The primary support offered by these services was 'information'. Fewer referrals were received from Indigenous liaison officers compared with other health professionals. Only 8.6% of services reported frequently having contact with an Indigenous organisation; however, 44.6% of services reported that their staff participated in cultural training. Services also identified barriers to access which may exist for Indigenous clientele, including no Indigenous staff and the costs involved in accessing the service, but were unable to address these issues due to
Sibeudu, Florence T; Uzochukwu, Benjamin S C; Onwujekwe, Obinna E
2017-02-01
Addressing existing inequities in the utilization of priority health services such as routine immunization is a current public health priority. Increasing access to routine immunization from the current low levels amongst all socio-economic status groups in Nigeria is challenging. However, little is known on the level of SES inequity in utilization of routine immunization services and such information which will inform the development of strategies for ensuring equitable provision of routine immunization services in the country. The study was a cross sectional household survey, which was undertaken in two randomly selected communities in Anambra State, southeast Nigeria. A pre-tested interviewer administered questionnaire was used to collect data on levels of access to RI by children under-2 years from randomly selected households. In each household, data was collected from the primary care givers or their representative (in their absence). The relationship between access to routine immunization and socio-economic status of households and other key variables was explored in data analysis. Households from high socio-economic status (well-off) groups utilized routine immunization services more than those that belong to low socio-economic status (poor) groups (X 2 = 9.97, p < 0.002). It was found that higher percentage of low socio-economic status households compared to the high socio-economic status households received routine immunization services at public health facilities. Households that belong to low socio-economic status groups had to travel longer distance to get to health facilities consequently incurring some transportation cost. The mean expenditures on service charge for routine immunization services (mostly informal payments) and transportation were US$1.84 and US$1.27 respectively. Logistic regression showed that access to routine immunization was positively related to socio-economic status and negatively related to distant of a household to a
Fisher, Rohan; Lassa, Jonatan
2017-04-18
Modelling travel time to services has become a common public health tool for planning service provision but the usefulness of these analyses is constrained by the availability of accurate input data and limitations inherent in the assumptions and parameterisation. This is particularly an issue in the developing world where access to basic data is limited and travel is often complex and multi-modal. Improving the accuracy and relevance in this context requires greater accessibility to, and flexibility in, travel time modelling tools to facilitate the incorporation of local knowledge and the rapid exploration of multiple travel scenarios. The aim of this work was to develop simple open source, adaptable, interactive travel time modelling tools to allow greater access to and participation in service access analysis. Described are three interconnected applications designed to reduce some of the barriers to the more wide-spread use of GIS analysis of service access and allow for complex spatial and temporal variations in service availability. These applications are an open source GIS tool-kit and two geo-simulation models. The development of these tools was guided by health service issues from a developing world context but they present a general approach to enabling greater access to and flexibility in health access modelling. The tools demonstrate a method that substantially simplifies the process for conducting travel time assessments and demonstrate a dynamic, interactive approach in an open source GIS format. In addition this paper provides examples from empirical experience where these tools have informed better policy and planning. Travel and health service access is complex and cannot be reduced to a few static modeled outputs. The approaches described in this paper use a unique set of tools to explore this complexity, promote discussion and build understanding with the goal of producing better planning outcomes. The accessible, flexible, interactive and
Evaluation of Standards for Access Control Enabling PHR-S Federation.
Mense, Alexander; Urbauer, Philipp; Sauermann, Stefan
2017-01-01
The adoption of the Internet of Things (IoT) and mobile applications in the healthcare may transform the healthcare industry by offering better disease tracking and management as well as patient empowerment. Unfortunately, almost all of these new systems set up their own ecosystem and to be really valuable for the care process they need to be integrated or federated with user managed access control services based on international standards and profiles to enable interoperability. Thus, this work presents the results of an evaluation of available specifications for federated authorization, based on a set of basic requirements.
28 CFR 115.282 - Access to emergency medical and mental health services.
Code of Federal Regulations, 2012 CFR
2012-07-01
... Mental Care § 115.282 Access to emergency medical and mental health services. (a) Resident victims of... intervention services, the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on...
28 CFR 115.282 - Access to emergency medical and mental health services.
Code of Federal Regulations, 2013 CFR
2013-07-01
... Mental Care § 115.282 Access to emergency medical and mental health services. (a) Resident victims of... intervention services, the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on...
28 CFR 115.282 - Access to emergency medical and mental health services.
Code of Federal Regulations, 2014 CFR
2014-07-01
... Mental Care § 115.282 Access to emergency medical and mental health services. (a) Resident victims of... intervention services, the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on...
Matthieu, Monica M; Gardiner, Giovanina; Ziegemeier, Ellen; Buxton, Miranda
2014-04-01
Veterans in need of social services may access many different community agencies within the public and private sectors. Each of these settings has the potential to be a pipeline for attaining needed health, mental health, and benefits services; however, many service providers lack information on how to conceptualize where Veterans go for services within their local community. This article describes a conceptual framework for outreach that uses a service sector segmented approach. This framework was developed to aid recruitment of a provider-based sample of stakeholders (N = 70) for a study on improving access to the Department of Veterans Affairs and community-based suicide prevention services. Results indicate that although there are statistically significant differences in the percent of Veterans served by the different service sectors (F(9, 55) = 2.71, p = 0.04), exposure to suicidal Veterans and providers' referral behavior is consistent across the sectors. Challenges to using this framework include isolating the appropriate sectors for targeted outreach efforts. The service sector segmented approach holds promise for identifying and referring at-risk Veterans in need of services. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.
Access to Employee Wellness Programs and Use of Preventive Care Services Among U.S. Adults.
Isehunwa, Oluwaseyi O; Carlton, Erik L; Wang, Yang; Jiang, Yu; Kedia, Satish; Chang, Cyril F; Fijabi, Daniel; Bhuyan, Soumitra S
2017-12-01
There is little research at the national level on access to employee wellness programs and the use of preventive care services. This study examined the use of seven preventive care services among U.S working adults with access to employee wellness programs. The study population comprised 17,699 working adults aged ≥18 years, obtained from the 2015 National Health Interview Survey. Multivariate logistic regression models examined the relationship between access to employee wellness programs and use of seven preventive care services: influenza vaccination, blood pressure check, diabetes check, cholesterol check, Pap smear test, mammogram, and colon cancer screening. Data analysis began in Fall 2016. Overall, 46.6% of working adults reported having access to employee wellness programs in 2015. Working adults with access to employee wellness programs had higher odds of receiving influenza vaccination (OR=1.57, 95% CI=1.43, 1.72, p<0.001), blood pressure check (OR=2.46, 95% CI=2.17, 2.78, p<0.001), diabetes check (OR=1.30, 95% CI=1.12, 1.50, p<0.001), cholesterol check (OR=1.48, 95% CI=1.33, 1.67, p<0.001), and mammogram (OR=1.57, 95% CI=1.24, 1.98, p<0.001). However, there was no significant difference between access to employee wellness programs and the use of Pap smear test and colon cancer screening services. Using a nationally representative sample of individuals, this study found a positive association between access to employee wellness programs and the use of preventive care services. The results support favorable policies to encourage implementing wellness programs in all worksites, especially those with <50 employees. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
A Model for Trust-based Access Control and Delegation in Mobile Clouds (Post Print)
2013-10-01
the access-granter knowing the identity of access requester beforehand and authenticating the requester, can no longer be applied. Mobile Wallet Cloud...TktC) for a reservation and con- tacts the user’s mobile wallet provider (MobWC) to purchase the ticket from TktC. For accessing different services...receiving regular services. For example, the human user in our scenario can be an elite member with the mobile wallet service provider that
Access control based on attribute certificates for medical intranet applications.
Mavridis, I; Georgiadis, C; Pangalos, G; Khair, M
2001-01-01
Clinical information systems frequently use intranet and Internet technologies. However these technologies have emphasized sharing and not security, despite the sensitive and private nature of much health information. Digital certificates (electronic documents which recognize an entity or its attributes) can be used to control access in clinical intranet applications. To outline the need for access control in distributed clinical database systems, to describe the use of digital certificates and security policies, and to propose the architecture for a system using digital certificates, cryptography and security policy to control access to clinical intranet applications. We have previously developed a security policy, DIMEDAC (Distributed Medical Database Access Control), which is compatible with emerging public key and privilege management infrastructure. In our implementation approach we propose the use of digital certificates, to be used in conjunction with DIMEDAC. Our proposed access control system consists of two phases: the ways users gain their security credentials; and how these credentials are used to access medical data. Three types of digital certificates are used: identity certificates for authentication; attribute certificates for authorization; and access-rule certificates for propagation of access control policy. Once a user is identified and authenticated, subsequent access decisions are based on a combination of identity and attribute certificates, with access-rule certificates providing the policy framework. Access control in clinical intranet applications can be successfully and securely managed through the use of digital certificates and the DIMEDAC security policy.
Access Control based on Attribute Certificates for Medical Intranet Applications
Georgiadis, Christos; Pangalos, George; Khair, Marie
2001-01-01
Background Clinical information systems frequently use intranet and Internet technologies. However these technologies have emphasized sharing and not security, despite the sensitive and private nature of much health information. Digital certificates (electronic documents which recognize an entity or its attributes) can be used to control access in clinical intranet applications. Objectives To outline the need for access control in distributed clinical database systems, to describe the use of digital certificates and security policies, and to propose the architecture for a system using digital certificates, cryptography and security policy to control access to clinical intranet applications. Methods We have previously developed a security policy, DIMEDAC (Distributed Medical Database Access Control), which is compatible with emerging public key and privilege management infrastructure. In our implementation approach we propose the use of digital certificates, to be used in conjunction with DIMEDAC. Results Our proposed access control system consists of two phases: the ways users gain their security credentials; and how these credentials are used to access medical data. Three types of digital certificates are used: identity certificates for authentication; attribute certificates for authorization; and access-rule certificates for propagation of access control policy. Once a user is identified and authenticated, subsequent access decisions are based on a combination of identity and attribute certificates, with access-rule certificates providing the policy framework. Conclusions Access control in clinical intranet applications can be successfully and securely managed through the use of digital certificates and the DIMEDAC security policy. PMID:11720951
Dunn, Matthew; Henshaw, Richard; McKay, Fiona H
2016-07-01
To understand health service access and needs of people who use performance and image enhancing drugs (PIED) in regional Queensland. Semi-structured interviews were conducted with 21 people (n = 19 men) who reported the use of a range of PIEDs, including anabolic-androgenic steroids, human chorionic gonadotropin, growth hormone, clenbuterol, tamoxifen, insulin and peptides. Participants reported accessing a range of services, including needle and syringe programs and pharmacies, for sterile injecting equipment. While PIEDs users attributed some stigma to needle and syringe programs, they were seen as an important service for injecting equipment. Participants reported receiving either positive care from health-care providers, such as general practitioners (GP), or having negative experiences due to the stigma attached with PIED use. Few participants reported disclosing their PIED use to their GP not only because of the concerns that their GP would no longer see them but also because they felt their GP was not knowledgeable about these substances. Participants in the study reported no difficulty in accessing health services based on living in a regional area, with their concern focused more upon how they were viewed and treated by service staff. [Dunn M, Henshaw R, Mckay F. H. Do performance and image enhancing drug users in regional Queensland experience difficulty accessing health services? Drug Alcohol Rev 2016;35:377-382]. © 2015 Australasian Professional Society on Alcohol and other Drugs.
Big Data Discovery and Access Services through NOAA OneStop
NASA Astrophysics Data System (ADS)
Casey, K. S.; Neufeld, D.; Ritchey, N. A.; Relph, J.; Fischman, D.; Baldwin, R.
2017-12-01
The NOAA OneStop Project was created as a pathfinder effort to to improve the discovery of, access to, and usability of NOAA's vast and diverse collection of big data. OneStop is led by the NOAA/NESDIS National Centers for Environmental Information (NCEI), and is seen as a key NESDIS contribution to NOAA's open data and data stewardship efforts. OneStop consists of an entire framework of services, from storage and interoperable access services at the base, through metadata and catalog services in the middle, to a modern user interface experience at the top. Importantly, it is an open framework where external tools and services can connect at whichever level is most appropriate. Since the beta release of the OneStop user interface at the 2016 Fall AGU meeting, significant progress has been made improving and modernizing many NOAA data collections to optimize their use within the framework. In addition, OneStop has made progress implementing robust metadata management and catalog systems at the collection and granule level and improving the user experience with the web interface. This progress will be summarized and the results of extensive user testing including professional usability studies will be reviewed. Key big data technologies supporting the framework will be presented and a community input sought on the future directions of the OneStop Project.
Ganle, John K; Parker, Michael; Fitzpatrick, Raymond; Otupiri, Easmon
2014-11-01
Inequities in accessibility to, and utilisation of maternal healthcare services impede progress towards attainment of the maternal health-related Millennium Development Goals. The objective of this study is to examine the extent to which maternal health services are utilised in Ghana, and whether inequities in accessibility to and utilization of services have been eliminated following the implementation of a user-fee exemption policy, that aims to reduce financial barriers to access, reduce inequities in access, and improve access to and use of birthing services. We analyzed data from the 2007 Ghana Maternal Health Survey for inequities in access to and utilization of maternal health services. In measuring the inequities, frequency tables and cross-tabulations were used to compare rates of service utilization by region, residence and selected socio-demographic variables. Findings show marginal increases in accessibility to and utilisation of skilled antenatal, delivery and postnatal care services following the policy implementation (2003-2007). However, large gradients of inequities exist between geographic regions, urban and rural areas, and different socio-demographic, religious and ethnic groupings. More urban women (40%) than rural, 53% more women in the highest wealth quintile than women in the lowest, 38% more women in the best performing region (Central Region) than the worst (Upper East Region), and 48% more women with at least secondary education than those with no formal education, accessed and used all components of skilled maternal health services in the five years preceding the survey. Our findings raise questions about the potential equity and distributional benefits of Ghana's user-fee exemption policy, and the role of non-financial barriers or considerations. Exempting user-fees for maternal health services is a promising policy option for improving access to maternal health care, but might be insufficient on its own to secure equitable access to
Fahey Babeaux, Holly P; Hall, Laura E; Seifert, Jennifer L
2015-01-01
To evaluate the impact that Charitable Pharmacy of Central Ohio (CPCO), a pharmacy providing free pharmacy services and medications, had on an indigent patient population by determining the change in patient-reported hospital use, ability to access medications, and perception of health status after receiving CPCO services. Cross-sectional study with face-to-face interviews using a convenience sample. Columbus, OH, in January to March 2013. 206 English-speaking patients 18 years or older at CPCO. Free pharmacy services and medications provided by CPCO. Number of patient-reported hospital visits before and after CPCO use. In the year before using CPCO, patients reported using the hospital a mean of 2.36 (median, 2.00) times per year versus 1.33 (median, 0.67) times per year after, a decrease of 1.03 hospital visits per year per patient. Before coming to CPCO, 41% of patients were able to have all of their prescribed medications filled; this rose to 85% after using CPCO. A total of 89% of patients reported that not only was their overall health was better, but they also had a better understanding of their medications and believed they were in more control of their own health since receiving CPCO services. A charitable pharmacy model has the potential to decrease health care costs and empower patients to be more in control of their health.
The Mawson Centre: Access for All to Education Services
ERIC Educational Resources Information Center
Trimper, Kelvin
2006-01-01
In the knowledge society of the 21st century everyone--not only children but every person, enterprise and organisation--will need ongoing access to a full range of quality education and training services. This principle, often espoused by the OECD and endorsed by the ministers of education in its member countries, has driven the planning and…
Community Consultation and Intervention: Supporting Students Who Do Not Access Counseling Services
ERIC Educational Resources Information Center
Mier, Sharon; Boone, Matthew; Shropshire, Sonya
2009-01-01
Although the severity of psychological problems among college students and the demand for campus counseling services has increased, many students who could benefit from mental health services still do not access them. This article describes Community Consultation and Intervention, a program designed to support students who are unlikely to access…
Task Delegation Based Access Control Models for Workflow Systems
NASA Astrophysics Data System (ADS)
Gaaloul, Khaled; Charoy, François
e-Government organisations are facilitated and conducted using workflow management systems. Role-based access control (RBAC) is recognised as an efficient access control model for large organisations. The application of RBAC in workflow systems cannot, however, grant permissions to users dynamically while business processes are being executed. We currently observe a move away from predefined strict workflow modelling towards approaches supporting flexibility on the organisational level. One specific approach is that of task delegation. Task delegation is a mechanism that supports organisational flexibility, and ensures delegation of authority in access control systems. In this paper, we propose a Task-oriented Access Control (TAC) model based on RBAC to address these requirements. We aim to reason about task from organisational perspectives and resources perspectives to analyse and specify authorisation constraints. Moreover, we present a fine grained access control protocol to support delegation based on the TAC model.
28 CFR 115.353 - Resident access to outside support services and legal representation.
Code of Federal Regulations, 2013 CFR
2013-07-01
... provide residents with access to outside victim advocates for emotional support services related to sexual abuse, by providing, posting, or otherwise making accessible mailing addresses and telephone numbers... reports of abuse will be forwarded to authorities in accordance with mandatory reporting laws. (c) The...
28 CFR 115.353 - Resident access to outside support services and legal representation.
Code of Federal Regulations, 2012 CFR
2012-07-01
... provide residents with access to outside victim advocates for emotional support services related to sexual abuse, by providing, posting, or otherwise making accessible mailing addresses and telephone numbers... reports of abuse will be forwarded to authorities in accordance with mandatory reporting laws. (c) The...
28 CFR 115.353 - Resident access to outside support services and legal representation.
Code of Federal Regulations, 2014 CFR
2014-07-01
... provide residents with access to outside victim advocates for emotional support services related to sexual abuse, by providing, posting, or otherwise making accessible mailing addresses and telephone numbers... reports of abuse will be forwarded to authorities in accordance with mandatory reporting laws. (c) The...
ERIC Educational Resources Information Center
Gerhardt, Lillian N.
1981-01-01
Evaluates the Prince George's County Memorial Public Library's approach to providing access to its services for children, and examines policies, regulations, practices, and conditions that affect such access. Six references are cited. (FM)
Review of SDDOT's highway access control process
DOT National Transportation Integrated Search
2000-02-01
This report presents the results and recommendations of a review of the South Dakota Department of Transportation's (SDDOT's) highway access control process. This document presents recommendations that improve South Dakota's access policy. The docume...
Jewett, Lauren; Harroud, Adil; Hill, Michael D.; Côté, Robert; Wein, Theodore; Smith, Eric E.; Gubitz, Gord; Demchuk, Andrew M.; Sahlas, Demetrios J.; Gladstone, David J.; Lindsay, M. Patrice
2018-01-01
Background: Rapid assessment and management of transient ischemic attacks and nondisabling strokes by specialized stroke prevention services reduces the risk of recurrent stroke and improves outcomes. In Canada, with its vast geography and with 16.8% of the population living in rural areas, access to these services is challenging, and considerable variation in access to care exists. The purpose of this multiphase study was to identify sites across Canada providing stroke prevention services, evaluate resource capacity and determine geographic access for Canadians. Methods: We developed a Stroke Prevention Services Resource Inventory that contained 22 questions on the organization and delivery of stroke prevention services and quality monitoring. The inventory ran from November 2015 to January 2016 and was administered online. We conducted a geospatial analysis to estimate access by drive times. Considerations were made for hours of operation and access within and across provincial borders. Results: A total of 123 stroke prevention sites were identified, of which 119 (96.7%) completed the inventory. Most (95) are designated stroke prevention or rapid assessment clinics. Of the 119 sites, 68 operate full time, and 39 operate less than 2.5 days per week. A total of 87.3% of the Canadian population has access to a stroke prevention service within a 1-hour drive; however, only 69.2% has access to a service that operates 5-7 days a week. Allowing provincial border crossing improves access (< 6-h drive) for those who are beyond a 6-hour drive within their home province (3.4%). Interpretation: Most Canadians have reasonable geographic access to stroke prevention services. Allowing patients to cross borders improves the existing access for many, particularly some remote communities along the Ontario-Quebec and British Columbia-Alberta borders. PMID:29472251
Asfaw, Abay; Colopy, Maria
2017-03-01
We examined the association between parental access to paid sick leave (PPSL) and children's use of preventive care and reduced likelihood of delayed medical care and emergency room (ER) visits. We used the child sample of the National Health Interview Survey data (linked to the adult and family samples) from 2011 through 2015 and logistic and negative binomial regression models. Controlling for covariates, the odds of children with PPSL receiving flu vaccination were 12.5% [95%CI: 1.06-1.19] higher and receiving annual medical checkups were 13.2% [95%CI: 1.04-1.23] higher than those of children without PPSL. With PPSL, the odds of children receiving delayed medical care because of time mismatch were 13.3% [95%CI: 0.76-0.98] lower, and being taken to ER were 53.6% [95%CI: 0.27-0.81] lower than those of children without PPSL. PPSL was associated with 11% [95%CI: 0.82-0.97] fewer ER visits per year. PPSL may improve children's access and use of healthcare services and reduce the number of ER visits. Am. J. Ind. Med. 60:276-284, 2017. © 2017 Wiley Periodicals, Inc. © Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
Pilot Evaluation of a Web-Based Intervention Targeting Sexual Health Service Access
ERIC Educational Resources Information Center
Brown, K. E.; Newby, K.; Caley, M.; Danahay, A.; Kehal, I.
2016-01-01
Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among…
A SOAP Web Service for accessing MODIS land product subsets
DOE Office of Scientific and Technical Information (OSTI.GOV)
SanthanaVannan, Suresh K; Cook, Robert B; Pan, Jerry Yun
2011-01-01
Remote sensing data from satellites have provided valuable information on the state of the earth for several decades. Since March 2000, the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor on board NASA s Terra and Aqua satellites have been providing estimates of several land parameters useful in understanding earth system processes at global, continental, and regional scales. However, the HDF-EOS file format, specialized software needed to process the HDF-EOS files, data volume, and the high spatial and temporal resolution of MODIS data make it difficult for users wanting to extract small but valuable amounts of information from the MODIS record. Tomore » overcome this usability issue, the NASA-funded Distributed Active Archive Center (DAAC) for Biogeochemical Dynamics at Oak Ridge National Laboratory (ORNL) developed a Web service that provides subsets of MODIS land products using Simple Object Access Protocol (SOAP). The ORNL DAAC MODIS subsetting Web service is a unique way of serving satellite data that exploits a fairly established and popular Internet protocol to allow users access to massive amounts of remote sensing data. The Web service provides MODIS land product subsets up to 201 x 201 km in a non-proprietary comma delimited text file format. Users can programmatically query the Web service to extract MODIS land parameters for real time data integration into models, decision support tools or connect to workflow software. Information regarding the MODIS SOAP subsetting Web service is available on the World Wide Web (WWW) at http://daac.ornl.gov/modiswebservice.« less
Huang, Qinlong; Yang, Yixian; Shi, Yuxiang
2018-02-24
With the growing number of vehicles and popularity of various services in vehicular cloud computing (VCC), message exchanging among vehicles under traffic conditions and in emergency situations is one of the most pressing demands, and has attracted significant attention. However, it is an important challenge to authenticate the legitimate sources of broadcast messages and achieve fine-grained message access control. In this work, we propose SmartVeh, a secure and efficient message access control and authentication scheme in VCC. A hierarchical, attribute-based encryption technique is utilized to achieve fine-grained and flexible message sharing, which ensures that vehicles whose persistent or dynamic attributes satisfy the access policies can access the broadcast message with equipped on-board units (OBUs). Message authentication is enforced by integrating an attribute-based signature, which achieves message authentication and maintains the anonymity of the vehicles. In order to reduce the computations of the OBUs in the vehicles, we outsource the heavy computations of encryption, decryption and signing to a cloud server and road-side units. The theoretical analysis and simulation results reveal that our secure and efficient scheme is suitable for VCC.
Yang, Yixian; Shi, Yuxiang
2018-01-01
With the growing number of vehicles and popularity of various services in vehicular cloud computing (VCC), message exchanging among vehicles under traffic conditions and in emergency situations is one of the most pressing demands, and has attracted significant attention. However, it is an important challenge to authenticate the legitimate sources of broadcast messages and achieve fine-grained message access control. In this work, we propose SmartVeh, a secure and efficient message access control and authentication scheme in VCC. A hierarchical, attribute-based encryption technique is utilized to achieve fine-grained and flexible message sharing, which ensures that vehicles whose persistent or dynamic attributes satisfy the access policies can access the broadcast message with equipped on-board units (OBUs). Message authentication is enforced by integrating an attribute-based signature, which achieves message authentication and maintains the anonymity of the vehicles. In order to reduce the computations of the OBUs in the vehicles, we outsource the heavy computations of encryption, decryption and signing to a cloud server and road-side units. The theoretical analysis and simulation results reveal that our secure and efficient scheme is suitable for VCC. PMID:29495269
Typing for Conflict Detection in Access Control Policies
NASA Astrophysics Data System (ADS)
Adi, Kamel; Bouzida, Yacine; Hattak, Ikhlass; Logrippo, Luigi; Mankovskii, Serge
In this paper we present an access control model that considers both abstract and concrete access control policies specifications. Permissions and prohibitions are expressed within this model with contextual conditions. This situation may lead to conflicts. We propose a type system that is applied to the different rules in order to check for inconsistencies. If a resource is well typed, it is guaranteed that access rules to the resource contain no conflicts.
Kattari, Shanna K; Walls, N Eugene; Speer, Stephanie Rachel
2017-01-01
Transgender and gender nonconforming (GNC) individuals frequently experience discrimination and potentially a lack of respect from service providers, suggesting they have decreased access to professionals with cultural competency. Similarly, people with disabilities experience higher levels of discrimination in social services than their nondisabled counterparts. From an intersectional perspective, this study examines rates of discrimination in accessing social services faced by transgender and GNC people, comparing across ability. Data indicate that although transgender and GNC individuals of all abilities experience gender-based discrimination when accessing social services, those with disabilities experience higher levels of antitransgender discrimination in mental health centers, rape crisis centers, and domestic violence shelters.
A Systematic Scheme for Multiple Access in Ethernet Passive Optical Access Networks
NASA Astrophysics Data System (ADS)
Ma, Maode; Zhu, Yongqing; Hiang Cheng, Tee
2005-11-01
While backbone networks have experienced substantial changes in the last decade, access networks have not changed much. Recently, passive optical networks (PONs) seem to be ready for commercial deployment as access networks, due to the maturity of a number of enabling technologies. Among the PON technologies, Ethernet PON (EPON) standardized by the IEEE 802.3ah Ethernet in the First Mile (EFM) Task Force is the most attractive one because of its high speed, low cost, familiarity, interoperability, and low overhead. In this paper, we consider the issue of upstream channel sharing in the EPONs. We propose a novel multiple-access control scheme to provide bandwidth-guaranteed service for high-demand customers, while providing best effort service to low-demand customers according to the service level agreement (SLA). The analytical and simulation results prove that the proposed scheme performs best in what it is designed to do compared to another well-known scheme that has not considered providing differentiated services. With business customers preferring premium services with guaranteed bandwidth and residential users preferring low-cost best effort services, our scheme could benefit both groups of subscribers, as well as the operators.
Efficient Information Access for Location-Based Services in Mobile Environments
ERIC Educational Resources Information Center
Lee, Chi Keung
2009-01-01
The demand for pervasive access of location-related information (e.g., local traffic, restaurant locations, navigation maps, weather conditions, pollution index, etc.) fosters a tremendous application base of "Location Based Services (LBSs)". Without loss of generality, we model location-related information as "spatial objects" and the accesses…
Ganle, John Kuumuori; Otupiri, Easmon; Obeng, Bernard; Edusie, Anthony Kwaku; Ankomah, Augustine; Adanu, Richard
2016-01-01
While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana. A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling's thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers' insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability. Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and patient-centred training for healthcare
Human Connectome Project Informatics: quality control, database services, and data visualization
Marcus, Daniel S.; Harms, Michael P.; Snyder, Abraham Z.; Jenkinson, Mark; Wilson, J Anthony; Glasser, Matthew F.; Barch, Deanna M.; Archie, Kevin A.; Burgess, Gregory C.; Ramaratnam, Mohana; Hodge, Michael; Horton, William; Herrick, Rick; Olsen, Timothy; McKay, Michael; House, Matthew; Hileman, Michael; Reid, Erin; Harwell, John; Coalson, Timothy; Schindler, Jon; Elam, Jennifer S.; Curtiss, Sandra W.; Van Essen, David C.
2013-01-01
The Human Connectome Project (HCP) has developed protocols, standard operating and quality control procedures, and a suite of informatics tools to enable high throughput data collection, data sharing, automated data processing and analysis, and data mining and visualization. Quality control procedures include methods to maintain data collection consistency over time, to measure head motion, and to establish quantitative modality-specific overall quality assessments. Database services developed as customizations of the XNAT imaging informatics platform support both internal daily operations and open access data sharing. The Connectome Workbench visualization environment enables user interaction with HCP data and is increasingly integrated with the HCP's database services. Here we describe the current state of these procedures and tools and their application in the ongoing HCP study. PMID:23707591
Agha, Sohail; Gage, Anastasia; Balal, Asma
2007-05-01
With declining levels of international donor funding for financing reproductive health programmes, developing country governments and international donors are looking towards private sector strategies to expand the supply of quality reproductive health services. One of the challenges of a health franchise is to improve the quality of services provided by independent private practitioners. Private providers are more likely to abide by the quality standards set by a franchiser if they see a financial benefit resulting from franchise participation. This study was conducted to measure whether (a) there were improvements in perceived quality of care and perceived access to health facilities once these facilities became part of a franchise and (b) improvements in perceived quality and perceived access were associated with increased client loyalty to franchised clinics. Franchisees were given basic reproductive health training for seven days and services marketing training for two days. Exit interviews were conducted with male and female clients at health facilities. A pre-test measurement was taken in April 2001, prior to the start of project activities. A post-test measurement was taken in February/March 2002, about 9 months after the pre-test. Multilevel regression analysis, which takes the hierarchical structure of the data into account, was used for the analysis. After taking provider-level variation into account and controlling for client characteristics, the analyses showed significant improvements in perceived quality of care and perceived access to services. Private provider participation in a franchise network helps improve client perceptions of quality of, and access to, services. Improvements in client perceptions of quality and access contribute to increased client loyalty to franchised clinics. Once increased client loyalty translates into higher client volumes, providers are likely to see the benefits of franchise participation. In turn, this should lead to
Differences in access to services in rural emergency departments of Quebec and Ontario.
Fleet, Richard; Pelletier, Christina; Marcoux, Jérémie; Maltais-Giguère, Julie; Archambault, Patrick; Audette, Louis David; Plant, Jeff; Bégin, François; Tounkara, Fatoumata Korika; Poitras, Julien
2015-01-01
Rural emergency departments (EDs) are important safety nets for the 20% of Canadians who live there. A serious problem in access to health care services in these regions has emerged. However, there are considerable geographic disparities in access to trauma center in Canada. The main objective of this project was to compare access to local 24/7 support services in rural EDs in Quebec and Ontario as well as distances to Levels 1 and 2 trauma centers. Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities. There were 26 rural EDs in Quebec and 62 in Ontario meeting these criteria. Data were collected from ministries of health, local health authorities, and ED statistics. Fisher's exact test, the t-test or Wilcoxon-Mann-Whitney test, were performed to compare rural EDs of Quebec and Ontario. All selected EDs of Quebec and Ontario agreed to participate in the study. The number of EDs visits was higher in Quebec than in Ontario (19 322 ± 6 275 vs 13 446 ± 8 056, p = 0.0013). There were no significant differences between Quebec and Ontario's local population and small town population density. Quebec's EDs have better access to advance imaging services such as CT scanner (77% vs 15%, p < .0001) and most the consultant support and ICU (92% vs 31%, p < .0001). Finally, more than 40% of rural EDs in Quebec and Ontario are more than 300 km away from Levels 1 and 2 trauma centers. Considering that Canada has a Universal health care system, the discrepancies between Quebec and Ontario in access to support services are intriguing. A nationwide study is justified to address this issue.
Differences in Access to Services in Rural Emergency Departments of Quebec and Ontario
Archambault, Patrick; Audette, Louis David; Plant, Jeff; Bégin, François; Poitras, Julien
2015-01-01
Introduction Rural emergency departments (EDs) are important safety nets for the 20% of Canadians who live there. A serious problem in access to health care services in these regions has emerged. However, there are considerable geographic disparities in access to trauma center in Canada. The main objective of this project was to compare access to local 24/7 support services in rural EDs in Quebec and Ontario as well as distances to Levels 1 and 2 trauma centers. Materials and Methods Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities. There were 26 rural EDs in Quebec and 62 in Ontario meeting these criteria. Data were collected from ministries of health, local health authorities, and ED statistics. Fisher’s exact test, the t-test or Wilcoxon-Mann-Whitney test, were performed to compare rural EDs of Quebec and Ontario. Results All selected EDs of Quebec and Ontario agreed to participate in the study. The number of EDs visits was higher in Quebec than in Ontario (19 322 ± 6 275 vs 13 446 ± 8 056, p = 0.0013). There were no significant differences between Quebec and Ontario’s local population and small town population density. Quebec’s EDs have better access to advance imaging services such as CT scanner (77% vs 15%, p < .0001) and most the consultant support and ICU (92% vs 31%, p < .0001). Finally, more than 40% of rural EDs in Quebec and Ontario are more than 300 km away from Levels 1 and 2 trauma centers. Conclusions Considering that Canada has a Universal health care system, the discrepancies between Quebec and Ontario in access to support services are intriguing. A nationwide study is justified to address this issue. PMID:25874948
Comparison of access to services in rural emergency departments in Quebec and British Columbia.
Fleet, Richard; Audette, Louis-David; Marcoux, Jérémie; Villa, Julie; Archambault, Patrick; Poitras, Julien
2014-11-01
Although emergency departments (EDs) in Canada's rural areas serve approximately 20% of the population, a serious problem in access to health care services has emerged. The objective of this project was to compare access to support services in rural EDs between British Columbia and Quebec. Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities (using the rural and small town definition from Statistics Canada). Data were collected from ministries of health, local health authorities, and ED statistics. A telephone interview was administered to collect denominative user data statistics and determine the status of services. British Columbia has more rural EDs (n = 34) than Quebec (n = 26). EDs in Quebec have higher volumes (19,310 versus 7,793 annual visits). With respect to support services, 81% of Quebec rural EDs have a 24/7 on-call general surgeon compared to 12% for British Columbia. Nearly 75% of Quebec rural EDs have 24/7 access to computed tomography versus only 3% for British Columbia. Rural EDs in Quebec are also supported by a greater proportion of intensive care units (88% versus 15%); however, British Columbia appears to have more medevac aircraft/helicopters than Quebec. The results suggest that major differences exist in access to support services in rural EDs in British Columbia and Quebec. A nationwide study is justified to address this issue of variability in rural and remote health service delivery and its impact on interfacility transfers and patient outcomes.
mORCA: ubiquitous access to life science web services.
Diaz-Del-Pino, Sergio; Trelles, Oswaldo; Falgueras, Juan
2018-01-16
Technical advances in mobile devices such as smartphones and tablets have produced an extraordinary increase in their use around the world and have become part of our daily lives. The possibility of carrying these devices in a pocket, particularly mobile phones, has enabled ubiquitous access to Internet resources. Furthermore, in the life sciences world there has been a vast proliferation of data types and services that finish as Web Services. This suggests the need for research into mobile clients to deal with life sciences applications for effective usage and exploitation. Analysing the current features in existing bioinformatics applications managing Web Services, we have devised, implemented, and deployed an easy-to-use web-based lightweight mobile client. This client is able to browse, select, compose parameters, invoke, and monitor the execution of Web Services stored in catalogues or central repositories. The client is also able to deal with huge amounts of data between external storage mounts. In addition, we also present a validation use case, which illustrates the usage of the application while executing, monitoring, and exploring the results of a registered workflow. The software its available in the Apple Store and Android Market and the source code is publicly available in Github. Mobile devices are becoming increasingly important in the scientific world due to their strong potential impact on scientific applications. Bioinformatics should not fall behind this trend. We present an original software client that deals with the intrinsic limitations of such devices and propose different guidelines to provide location-independent access to computational resources in bioinformatics and biomedicine. Its modular design makes it easily expandable with the inclusion of new repositories, tools, types of visualization, etc.
ERIC Educational Resources Information Center
Griffith, D. A.
The Griffith Service Access Frame (GSAF) is a model used for quantifying the access disadvantage to educational services of remote and rural areas in Australia. The model was specifically developed to assist policymakers and administrators in allocating resources. The problem with the current funding formula used by the Australian federal…
Thummapol, Onouma; Park, Tanya; Barton, Sylvia
2018-05-03
The aim of this scoping review was to uncover and summarize what is known in the literature about the experiences of Indigenous women in Asia regarding access to health services. The study was informed by the scoping review methodology proposed by Arksey and O'Malley [2005. "Scoping Studies: Towards a Methodological Framework." International Journal of Social Research Methodology 8 (1): 19-32. doi: 10.1080/1364557032000119616 ]. A comprehensive search of the databases for peer-reviewed studies and grey literature was conducted between January 2000 and December 2016. The data of selected papers and abstracts were analysed by three independent researchers through a protocol of data charting, descriptive numerical summary, and thematic analysis. Sixteen articles and two abstracts met the inclusion criteria for this scoping review. These 18 peer-reviewed documents consisted of eight qualitative studies, seven quantitative studies, and three mixed-method studies, which included the peer-reviewed poster and oral presentation abstracts from international conferences. The findings were sorted and grouped under the following themes: health care access for Indigenous women in Asia, facilitators to accessing healthcare services, barriers to accessing healthcare services, and cultural contexts impacting health and access. There is limited information about the experiences, facilitators, barriers, and cultural contexts faced by Indigenous women in Asia related to health services accessibility, and even less information related to improving health services accessibility and health outcomes. This scoping review in particular highlights the dearth of literature relating to Indigenous women's postpartum health and access to postnatal supports and services. Generally, it indicates that Indigenous women in Asia are more vulnerable to poor health in comparison to non-Indigenous women, and continue to face challenges and barriers in accessing quality and equitable health services. The
Analysis of Access Control Policies in Operating Systems
ERIC Educational Resources Information Center
Chen, Hong
2009-01-01
Operating systems rely heavily on access control mechanisms to achieve security goals and defend against remote and local attacks. The complexities of modern access control mechanisms and the scale of policy configurations are often overwhelming to system administrators and software developers. Therefore, mis-configurations are common, and the…
Galloway, Charlotte T.; Duffy, Jennifer L.; Dixon, Rena P.; Fuller, Taleria R.
2017-01-01
Purpose Reducing disparities in teen pregnancy and birth rates among African American and Latina teens is a central focus of a community-wide teen pregnancy prevention initiative implemented by the South Carolina Campaign to Prevent Teen Pregnancy. Disparities in teen pregnancy and birth rates are driven, in part, by differential access to contraception and reproductive health care services. The purpose of this qualitative study was to understand African American and Latino teens’ 1) preferences for finding health information, 2) perceptions of accessing reproductive health services, and 3) beliefs about contraception. Methods As a part of this community-wide initiative, eight focus groups were conducted in the Fall of 2012 with African American and Latino male and female youth from two communities in South Carolina. Among eight focus groups of youth, teens most often reported parents, other trusted relatives, and the Internet as sources of health information. Results Participants discussed the value of social media and television advertisements for reaching young people and emphasized the importance of privacy, a desire for a teen-only clinic, and the need for friendly clinical staff. Participants’ comments often reflected inaccurate beliefs about the reliability and correct usage of contraceptive methods. Female participants also reported side effects of birth control as a potential barrier to use. Conclusions Ensuring that teens’ beliefs and perceptions are taken into account when developing, marketing, and implementing culturally competent reproductive health care services is important to improve access to care for all teens in Horry and Spartanburg Counties. PMID:28235437
Galloway, Charlotte T; Duffy, Jennifer L; Dixon, Rena P; Fuller, Taleria R
2017-03-01
Reducing disparities in teen pregnancy and birth rates among African American and Latina teens is a central focus of a community-wide teen pregnancy prevention initiative implemented by the South Carolina Campaign to Prevent Teen Pregnancy. Disparities in teen pregnancy and birth rates are driven, in part, by differential access to contraception and reproductive health care services. The purpose of this qualitative study was to understand African American and Latino teens' 1) preferences for finding health information, 2) perceptions of accessing reproductive health services, and 3) beliefs about contraception. As a part of this community-wide initiative, eight focus groups were conducted in the Fall of 2012 with African American and Latino male and female youth from two communities in South Carolina. Among eight focus groups of youth, teens most often reported parents, other trusted relatives, and the Internet as sources of health information. Participants discussed the value of social media and television advertisements for reaching young people and emphasized the importance of privacy, a desire for a teen-only clinic, and the need for friendly clinical staff. Participants' comments often reflected inaccurate beliefs about the reliability and correct usage of contraceptive methods. Female participants also reported side effects of birth control as a potential barrier to use. Ensuring that teens' beliefs and perceptions are taken into account when developing, marketing, and implementing culturally competent reproductive health care services is important to improve access to care for all teens in Horry and Spartanburg Counties. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Towards an Approach of Semantic Access Control for Cloud Computing
NASA Astrophysics Data System (ADS)
Hu, Luokai; Ying, Shi; Jia, Xiangyang; Zhao, Kai
With the development of cloud computing, the mutual understandability among distributed Access Control Policies (ACPs) has become an important issue in the security field of cloud computing. Semantic Web technology provides the solution to semantic interoperability of heterogeneous applications. In this paper, we analysis existing access control methods and present a new Semantic Access Control Policy Language (SACPL) for describing ACPs in cloud computing environment. Access Control Oriented Ontology System (ACOOS) is designed as the semantic basis of SACPL. Ontology-based SACPL language can effectively solve the interoperability issue of distributed ACPs. This study enriches the research that the semantic web technology is applied in the field of security, and provides a new way of thinking of access control in cloud computing.
Bright, Tess; Felix, Lambert; Kuper, Hannah; Polack, Sarah
2018-05-01
The populations of many low- and middle-income countries (LMIC) are young. Despite progress made towards achieving Universal Health Coverage and remarkable health gains, evidence suggests that many children in LMIC are still not accessing needed healthcare services. Delayed or lack of access to health services can lead to a worsening of health and can in turn negatively impact a child's ability to attend school, and future employment opportunities. We conducted a systematic review to assess the effectiveness of interventions aimed at increasing access to health services for children over 5 years in LMIC settings. Four electronic databases were searched in March 2017. Studies were included if they evaluated interventions that aimed to increase: healthcare utilisation, immunisation uptake and compliance with medication/referral. Randomised controlled trials and non-randomised study designs were included in the review. Data extraction included study characteristics, intervention type and measures of access to health services for children above 5 years of age. Study outcomes were classified as positive, negative, mixed or null in terms of their impact on access outcomes. Ten studies met the criteria for inclusion in the review. Interventions were evaluated in Nicaragua (1), Brazil (1), Turkey (1), India (1), China (1), Uganda (1), Ghana (1), Nigeria (1), South Africa (1) and Swaziland (1). Intervention types included education (2), incentives (1), outreach (1), SMS/phone call reminders (2) and multicomponent interventions (4). All evaluations reported positive findings on measured health access outcomes; however, the quality and strength of evidence were mixed. This review provides evidence of the range of interventions that were used to increase healthcare access for children above 5 years old in LMIC. Nevertheless, further research is needed to examine each of the identified intervention types and the influence of contextual factors, with robust study designs. There
Gender Differences in Access to Extension Services and Agricultural Productivity
ERIC Educational Resources Information Center
Ragasa, Catherine; Berhane, Guush; Tadesse, Fanaye; Taffesse, Alemayehu Seyoum
2013-01-01
Purpose: This article contributes new empirical evidence and nuanced analysis on the gender difference in access to extension services and how this translates to observed differences in technology adoption and agricultural productivity. Approach: It looks at the case of Ethiopia, where substantial investments in the extension system have been…
[Access to primary healthcare services: still a way to go].
Mendes, Antônio da Cruz Gouveia; Miranda, Gabriella Morais Duarte; Figueiredo, Karla Erika Gouveia; Duarte, Petra Oliveira; Furtado, Betise Mery Alencar Sousa Macau
2012-11-01
This study seeks to evaluate accessibility to the Basic Units of the Family Health Strategy (ESF-UB) and Traditional Basic Units (BU-T) in the city of Recife in 2009. Data were collected through three instruments: a roadmap for systematic observation of the units and questionnaires for users and professional units. This is a descriptive cross-sectional study using a quantitative approach, and 1180 users, 61 doctors and 56 nurses were interviewed. The results showed good ties and recognition of users whereby primary healthcare is seen as the access portal to the health system. In the comparison between ESF-UB and UB-T, evaluations are always more favorable to the family healthcare strategy, though with relatively insignificant differences. The overall result revealed widespread dissatisfaction with the difficulty of obtaining drugs and taking tests, and also with the waiting times and access to specialized care. This showed the existence of organizational problems that may constitute barriers limiting accessibility to basic healthcare services for users.
Practical Strategies for Making Online Library Services and Instruction Accessible to All Patrons
ERIC Educational Resources Information Center
Wray, Christina C.
2013-01-01
Providing accessible library services and instruction to distance users with disabilities can seem daunting. This article, which grew out of a webinar presented by the author to the Health Science Special Interest Group of ACRL, provides practical strategies to help content creators utilize built-in accessibility features and provides a resources…
Dawson, Angela; Bateson, Deborah; Estoesta, Jane; Sullivan, Elizabeth
2016-10-22
Improving access to safe abortion is an essential strategy in the provision of universal access to reproductive health care. Australians are largely supportive of the provision of abortion and its decriminalization. However, the lack of data and the complex legal and service delivery situation impacts upon access for women seeking an early termination of pregnancy. There are no systematic reviews from a health services perspective to help direct health planners and policy makers to improve access comprehensive medical and early surgical abortion in high income countries. This review therefore aims to identify quality studies of abortion services to provide insight into how access to services can be improved in Australia. We undertook a structured search of six bibliographic databases and hand-searching to ascertain peer reviewed primary research in English between 2005 and 2015. Qualitative and quantitative study designs were deemed suitable for inclusion. A deductive content analysis methodology was employed to analyse selected manuscripts based upon a framework we developed to examine access to early abortion services. This review identified the dimensions of access to surgical and medical abortion at clinic or hospital-outpatient based abortion services, as well as new service delivery approaches utilising a remote telemedicine approach. A range of factors, mostly from studies in the United Kingdom and United States of America were found to facilitate improved access to abortion, in particular, flexible service delivery approaches that provide women with cost effective options and technology based services. Standards, recommendations and targets were also identified that provided services and providers with guidance regarding the quality of abortion care. Key insights for service delivery in Australia include the: establishment of standards, provision of choice of procedure, improved provider education and training and the expansion of telemedicine for medical
49 CFR 1542.207 - Access control systems.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY AIRPORT SECURITY Operations § 1542.207 Access control... original access medium, if the airport operator follows measures and procedures in the security program...
49 CFR 1542.207 - Access control systems.
Code of Federal Regulations, 2013 CFR
2013-10-01
... Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY AIRPORT SECURITY Operations § 1542.207 Access control... original access medium, if the airport operator follows measures and procedures in the security program...
49 CFR 1542.207 - Access control systems.
Code of Federal Regulations, 2014 CFR
2014-10-01
... Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY AIRPORT SECURITY Operations § 1542.207 Access control... original access medium, if the airport operator follows measures and procedures in the security program...
49 CFR 1542.207 - Access control systems.
Code of Federal Regulations, 2011 CFR
2011-10-01
... Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY AIRPORT SECURITY Operations § 1542.207 Access control... original access medium, if the airport operator follows measures and procedures in the security program...
49 CFR 1542.207 - Access control systems.
Code of Federal Regulations, 2012 CFR
2012-10-01
... Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION, DEPARTMENT OF HOMELAND SECURITY CIVIL AVIATION SECURITY AIRPORT SECURITY Operations § 1542.207 Access control... original access medium, if the airport operator follows measures and procedures in the security program...
Li, Alan Tai-Wai; Wales, Joshua; Wong, Josephine Pui-Hing; Owino, Maureen; Perreault, Yvette; Miao, Andrew; Maseko, Precious; Guiang, Charlie
2015-01-01
As people living with HIV/AIDS (PHAs) achieve more stable health, many have taken on active peer support and professional roles within AIDS service organizations. Although the increased engagement has been associated with many improved health outcomes, emerging program and research evidence have identified new challenges associated with such transition. This paper reports on the results of a qualitative interpretive study that explored the effect of this role transition on PHA service providers' access to mental health support and self care. A total of 27 PHA service providers of diverse ethno-racial backgrounds took part in the study. Results show that while role transition often improves access to financial and health-care benefits, it also leads to new stress from workload demands, emotional triggers from client's narratives, feeling of burnout from over-immersion in HIV at both personal and professional levels, and diminished self care. Barriers to seeking support included: concerns regarding confidentiality; self-imposed and enacted stigma associated with accessing mental health services; and boundary issues resulting from changes in relationships with peers and other service providers. Evolving support mechanisms included: new formal and informal peer support networks amongst colleagues or other PHA service providers to address both personal and professional challenges, and having access to professional support offered through the workplace. The findings suggest the need for increased organizational recognition of HIV support work as a form of emotional labor that places complex demands on PHA service providers. Increased access to employer-provided mental health services, supportive workplace policies, and adequate job-specific training will contribute to reduced work-related stress. Community level strategies that support expansion of social networks amongst PHA service providers would reduce isolation. Systemic policies to increase access to insurance
Wilson, Charlotte; Alam, Rahul; Latif, Saima; Knighting, Katherine; Williamson, Susan; Beaver, Kinta
2012-01-01
A higher risk of diabetes mellitus in South Asian and Black African populations combined with lower reported access and self-management-related health outcomes informed the aims of this study. Our aims were to synthesise and evaluate evidence relating to patient self-management and access to healthcare services for ethnic minority groups living with diabetes. A comprehensive search strategy was developed capturing a full range of study types from 1995-2010, including relevant hand-searched literature pre-dating 1995. Systematic database searches of MEDLINE, Cochrane, DARE, HTA and NHSEED, the British Nursing Index, CAB abstracts, EMBASE, Global Health, Health Management Information Consortium and PsychInfo were conducted, yielding 21,288 abstracts. Following search strategy refinement and the application of review eligibility criteria; 11 randomised controlled trials (RCTs), 18 qualitative studies and 18 quantitative studies were evaluated and principal results extracted. Results suggest that self-management practices are in need of targeted intervention in terms of patients' knowledge and understanding of their illness, inadequacy of information and language and communication difficulties arising from cultural differences. Access to health-care is similarly hindered by a lack of cultural sensitivity in service provision and under use of clinic-based interpreters and community-based services. Recommendations for practice and subsequent intervention primarily rest at the service level but key barriers at patient and provider levels are also identified. © 2011 Blackwell Publishing Ltd.
From the voices of women: facilitating survivor access to IPV services.
Simmons, Catherine A; Farrar, Melissa; Frazer, Kitty; Thompson, Mary Jane
2011-10-01
This mixed-method study investigated perceptions women domestic violence survivors/victims have about why women do not seek help from formal support structures and actions domestic helping agencies can take to facilitate survivor access to services. Congruent with previous research, quantitative analysis identified 17 reasons women do not seek help from formal support structures. Expanding current knowledge, concept mapping revealed six ways family violence programs can better reach women in abusive relationships, including (1) remove barriers to services, (2) improve comfort with services, (3) "talk about it," (4) improve community awareness, (5) victim-targeted marketing, and (6) "I honestly don't know."
Fleet, Richard; Poitras, Julien; Maltais-Giguère, Julie; Villa, Julie; Archambault, Patrick
2013-11-27
To examine 24/7 access to services and consultants in a sample of Canadian rural emergency departments (EDs). Cross-sectional study-mixed methods (structured interview, survey and government data bases) with random sampling of hospitals. Canadian rural EDs (rural small town (RST) definition-Statistics Canada). 28% (95/336) of Canadian rural EDs providing 24/7 physician coverage located in hospitals with acute care hospitalisation beds. General characteristics of the rural EDs, information about 24/7 access to consultants, equipment and services, and the proportion of rural hospitals more than 300 km from levels 1 and 2 trauma centres. Of the 336 rural EDs identified, 122 (36%) were randomly selected and contacted. Overall, 95 EDs participated in the study (participation rate, 78%). Hospitals had, on an average, 23 acute care beds, 7 ED stretchers and 13 500 annual ED visits. The proportion of rural hospitals with local access to the following 24/7 services was paediatrician, 5%; obstetrician, 10%; psychiatrist, 11%; internist, 12%; intensive care unit, 17%; CT scanner, 20%; surgeon, 26%; ultrasound, 28%; basic X-ray, 97% and laboratory services, 99%. Forty-four per cent and 54% of the RST EDs were more than 300 km from a level 1 and level 2 trauma centre, respectively. This is the first study describing the services available in Canadian rural EDs. Apart from basic laboratory and X-ray services, most rural EDs have limited access to consultants, advanced imaging and critical care services. A detailed study is needed to evaluate the impact of these limited services on patient outcomes, costs and interfacility transport demands.
2012-01-01
Background Coordinated, interdisciplinary services, supported by self-management underpin effective management for chronic low back pain (CLBP). However, a combination of system, provider and consumer-based barriers exist which limit the implementation of such models into practice, particularly in rural areas where unique access issues exist. In order to improve health service delivery for consumers with CLBP, policymakers and service providers require a more in depth understanding of these issues. The objective of this qualitative study was to explore barriers experienced by consumers in rural settings in Western Australia (WA) to accessing information and services and implementing effective self-management behaviours for CLBP. Methods Fourteen consumers with a history of CLBP from three rural sites in WA participated. Maximum variation sampling was employed to ensure a range of experiences were captured. An interviewer, blinded to quantitative pain history data, conducted semi-structured telephone interviews using a standardised schedule to explore individuals’ access to information and services for CLBP, and self-management behaviours. Interviews were digitally recorded and transcribed verbatim. Inductive analysis techniques were used to derive and refine key themes. Results Five key themes were identified that affected individuals’ experiences of managing CLBP in a rural setting, including: 1) poor access to information and services in rural settings; 2) inadequate knowledge and skills among local practitioners; 3) feelings of isolation and frustration; 4) psychological burden associated with CLBP; and 5) competing lifestyle demands hindering effective self-management for CLBP. Conclusions Consumers in rural WA experienced difficulties in knowing where to access relevant information for CLBP and expressed frustration with the lack of service delivery options to access interdisciplinary and specialist services for CLBP. Competing lifestyle demands such as
Lee, R E; Feighery, E C; Schleicher, N C; Halvorson, S
2001-12-01
These studies investigated (1) the effect of community bans of self-service tobacco displays on store environment and (2) the effect of consumer tobacco accessibility on merchants. We counted cigarette displays (self-service, clerk-assisted, clear acrylic case) in 586 California stores. Merchant interviews (N = 198) identified consumer tobacco accessibility, tobacco company incentives, and shoplifting. Stores in communities with self-service tobacco display bans had fewer self-service displays and more acrylic displays but an equal total number of displays. The merchants who limited consumer tobacco accessibility received fewer incentives and reported lower shoplifting losses. In contrast, consumer access to tobacco was unrelated to the amount of monetary incentives. Community bans decreased self-service tobacco displays; however, exposure to tobacco advertising in acrylic displays remained high. Reducing consumer tobacco accessibility may reduce shoplifting.
Morton, Cory M.; Simmel, Cassandra; Peterson, N. Andrew
2014-01-01
This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed. PMID:24529493
Being Single as a Social Barrier to Access Reproductive Healthcare Services by Iranian Girls.
Kohan, Shahnaz; Mohammadi, Fatemeh; Mostafavi, Firoozeh; Gholami, Ali
2016-08-17
Iranian single women are deprived of reproductive healthcare services, though the provision of such services to the public has increased. This study aimed to explore the experiences of Iranian single women on their access to reproductive health services. A qualitative design using a conventional content analysis method was used. Semi-structured interviews were held with 17 single women and nine health providers chosen using the purposive sampling method. Data analysis resulted in the development of three categories: 'family's attitudes and performance about single women's reproductive healthcare,' 'socio-cultural factors influencing reproductive healthcare,' and 'cultural factors influencing being a single woman.' Cultural and contextual factors affect being a single woman in every society. Therefore, healthcare providers need to identify such factors during the designing of strategies for improving the facilitation of access to reproductive healthcare services. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
McCann, Terence V; Lubman, Dan I
2012-08-01
Despite the emergence of mental health problems during adolescence and early adulthood, many young people encounter difficulties accessing appropriate services. In response to this gap, the Australian Government recently established new enhanced primary care services (headspace) that target young people with emerging mental health problems. In this study, we examine the experience of young people with depression accessing one of these services, with a focus on understanding how they access the service and the difficulties they encounter in the process. Individual, in-depth, audio-recorded interviews were used to collect data. Twenty-six young people with depression were recruited from a headspace site in Melbourne, Australia. Interpretative phenomenological analysis was used to analyse the data. Four overlapping themes were identified in the data. First, school counsellors as access mediators, highlights the prominent role school counsellors have in facilitating student access to the service. Second, location as an access facilitator and inhibitor. Although the service is accessible by public transport, it is less so to those who do not live near public transport. Third, encountering barriers accessing the service initially. Two main service access barriers were experienced: unfamiliarity with the service, and delays in obtaining initial appointments for ongoing therapy. Finally, the service's funding model acts as an access facilitator and barrier. While the model provides a low or no cost services initially, it limits the number of funded sessions, and this can be problematic. Young people have contrasting experiences accessing the service. School counsellors have an influential role in facilitating access, and its close proximity to public transport enhances access. The service needs to become more prominent in young people's consciousness, while the appointment system would benefit from providing more timely appointments with therapists. The service's funding
Howard, Larry L
2014-09-01
As the demand for publicly funded health care continues to rise in the U.S., there is increasing pressure on state governments to ensure patient access through adjustments in provider compensation policies. This paper longitudinally examines the fees that states paid physicians for services covered by the Medicaid program over the period 1998-2004. Controlling for an extensive set of economic and health care industry characteristics, the elasticity of states' Medicaid fees, with respect to Medicare fees, is estimated to be in the range of 0.2-0.7 depending on the type of physician service examined. The findings indicate a significant degree of price competition between the Medicaid and Medicare programs for physician services that is more pronounced for cardiology and critical care, but not hospital care. The results also suggest several policy levers that work to either increase patient access or reduce total program costs through changes in fees.
Duda, Catherine; Rajaram, Kumar; Barz, Christiane; Rosenthal, J Thomas
2013-01-01
There has been an increasing emphasis on health care efficiency and costs and on improving quality in health care settings such as hospitals or clinics. However, there has not been sufficient work on methods of improving access and customer service times in health care settings. The study develops a framework for improving access and customer service time for health care settings. In the framework, the operational concept of the bottleneck is synthesized with queuing theory to improve access and reduce customer service times without reduction in clinical quality. The framework is applied at the Ronald Reagan UCLA Medical Center to determine the drivers for access and customer service times and then provides guidelines on how to improve these drivers. Validation using simulation techniques shows significant potential for reducing customer service times and increasing access at this institution. Finally, the study provides several practice implications that could be used to improve access and customer service times without reduction in clinical quality across a range of health care settings from large hospitals to small community clinics.
Evaluating the effectiveness of biometric access control systems
NASA Astrophysics Data System (ADS)
Lively, Valerie M.
2005-05-01
This paper describes the contribution by the National Safe Skies Alliance (Safe Skies) in operational testing of biometric access control systems under the guidance of the Transportation Security Administration (TSA). Safe Skies has been conducting operational tests of biometric access control systems on behalf of the TSA for approximately four years. The majority of this testing has occurred at the McGhee Tyson Airport (TYS) in Knoxville, Tennessee. Twelve separate biometric devices - eight fingerprint, facial, iris, hand geometry, and fingerprint and iris, have been tested to date. Tests were conducted at a TYS administrative door and different airports to evaluate the access control device under normal, abnormal, and attempt-to-defeat conditions.
Applying human rights to improve access to reproductive health services.
Shaw, Dorothy; Cook, Rebecca J
2012-10-01
Universal access to reproductive health is a target of Millennium Development Goal (MDG) 5B, and along with MDG 5A to reduce maternal mortality by three-quarters, progress is currently too slow for most countries to achieve these targets by 2015. Critical to success are increased and sustainable numbers of skilled healthcare workers and financing of essential medicines by governments, who have made political commitments in United Nations forums to renew their efforts to reduce maternal mortality. National essential medicine lists are not reflective of medicines available free or at cost in facilities or in the community. The WHO Essential Medicines List indicates medicines required for maternal and newborn health including the full range of contraceptives and emergency contraception, but there is no consistent monitoring of implementation of national lists through procurement and supply even for basic essential drugs. Health advocates are using human rights mechanisms to ensure governments honor their legal commitments to ensure access to services essential for reproductive health. Maternal mortality is recognized as a human rights violation by the United Nations and constitutional and human rights are being used, and could be used more effectively, to improve maternity services and to ensure access to drugs essential for reproductive health. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Access to and use of infertility services in the United States: framing the challenges.
Adashi, Eli Y; Dean, Laura A
2016-05-01
An overview of access to and use of general infertility and assisted reproductive technology (ART) services in the United States (U.S.) shows a declining trend for the ever-use of infertility services. Moreover, the use of ART services lags relative to other member nations of the Organization for Economic Co-operation and Development (OECD). Access to and use of general infertility and ART services is primarily undermined by a severely constrained underwriting universe dominated by self-insured employers and by a finite number of state infertility insurance mandates. The contribution of traditional public and private payers to the underwriting of ART is limited. As compared with OECD member nations wherein the access to and underwriting of general infertility and ART services is universal, the current status quo in the U.S. can only be characterized as dismal. Further, the current state of affairs is socially unjust in that the right to build a family in the face of infertility appears to have become a function of economic prowess. Given the dominance of the self-insured employers as underwriters of general infertility and ART services, advocacy directed at this interest group is likely to prove most productive. Improving the state of underwriting of general infertility and ART services in the U.S. must be embraced as a central moral imperative and as an unwavering strategic goal of the professional societies entrusted with the reproductive health of women and men. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Distributed clinical data sharing via dynamic access-control policy transformation.
Rezaeibagha, Fatemeh; Mu, Yi
2016-05-01
Data sharing in electronic health record (EHR) systems is important for improving the quality of healthcare delivery. Data sharing, however, has raised some security and privacy concerns because healthcare data could be potentially accessible by a variety of users, which could lead to privacy exposure of patients. Without addressing this issue, large-scale adoption and sharing of EHR data are impractical. The traditional solution to the problem is via encryption. Although encryption can be applied to access control, it is not applicable for complex EHR systems that require multiple domains (e.g. public and private clouds) with various access requirements. This study was carried out to address the security and privacy issues of EHR data sharing with our novel access-control mechanism, which captures the scenario of the hybrid clouds and need of access-control policy transformation, to provide secure and privacy-preserving data sharing among different healthcare enterprises. We introduce an access-control mechanism with some cryptographic building blocks and present a novel approach for secure EHR data sharing and access-control policy transformation in EHR systems for hybrid clouds. We propose a useful data sharing system for healthcare providers to handle various EHR users who have various access privileges in different cloud environments. A systematic study has been conducted on data sharing in EHR systems to provide a solution to the security and privacy issues. In conclusion, we introduce an access-control method for privacy protection of EHRs and EHR policy transformation that allows an EHR access-control policy to be transformed from a private cloud to a public cloud. This method has never been studied previously in the literature. Furthermore, we provide a protocol to demonstrate policy transformation as an application scenario. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Hyndman, J C; Holman, C D
2001-12-01
The accessibility and spatial distribution of health services provided by the main source of primary medical care in Australia--the general practice surgery--was investigated by level of social disadvantage of local catchment areas. All 459 general practice surgeries in Perth, an Australian city of 1.2 million residents, were surveyed with a 94% response. Amount of service provision was measured using weekly doctor-hours, available from consulting rooms during opening hours, and associated nurse-hours of service. Access factors were defined as the distance to the nearest surgery, provision of Sunday and evening services, ease of making a same day appointment, bulk-billing, and whether the surgery offered a choice of gender of doctor. There were relatively more surgeries in disadvantaged areas and doctor-hours of service provision were also greater (41.0 h/1,000 most disadvantaged vs. 37.9 h/1000 least disadvantaged). Bulk-billing care, at no direct cost to the patient, was more likely to be provided in most disadvantaged areas compared with least disadvantaged areas (61 vs. 38%). However, populations living in the most disadvantaged areas were less likely to be able to see the local GP at short notice (91 vs. 95%), to have access to a local female GP (56 vs. 62%) or a local service in the evenings (42 vs. 51%). While the overall picture of accessibility was favourable, there was considerable variation in the type of services provided to different socioeconomic groups. Health care planners should investigate the reasons for these differences and advise Government to ensure that access factors affecting publicly funded services are equitably distributed.
A survey of access to medical services in nursing and residential homes in England.
Glendinning, Caroline; Jacobs, Sally; Alborz, Alison; Hann, Mark
2002-07-01
Residential and nursing homes make major demands on NHS services. To investigate patterns of access to medical services for residents in homes for older people. Telephone survey. All nursing and dual registered homes and one in four residential homes located in a stratified random sample of 72 English primary care group/trust (PCG/T) areas. A structured questionnaire investigating home characteristics, numbers of general practitioners (GPs) or practices per home, homes' policies for registering new residents with GPs, existence of payments to GPs, GP services provided to homes, and access to specialist medical care. There were wide variations in the numbers of GPs providing services to individual homes; this was not entirely dependent on home size. Eight percent of homes paid local GPs for their services to residents; these were more likely to be nursing homes (33%) than residential homes (odds ratio [OR] = 10.82, [95% CI = 4.48 to 26.13], P<0.001) and larger homes (OR for a ten-bed increase = 1.51 [95% CI = 1.28 to 1.79], P<0.001). Larger homes were more likely to encourage residents to register with a 'home' GP (OR for a ten-bed increase = 1.16 [95% CI = 1.04 to 1.31], P = 0.009). Homes paying local GPs were more likely to receive one or more additional services, over and above GPs' core contractual obligations. Few homes had direct access to specialist clinicians. Extensive variations in homes' policies and local GP services raise serious questions about patient choice, levels of GP services and, above all, about equity between residents within homes, between homes and between those in homes and in the community.
Human rights and access to healthcare services for indigenous peoples in Africa.
Durojaye, Ebenezer
2017-09-20
In September 2015, the United Nations adopted the sustainable development goals (SDGs) to address among others poverty and inequality within and among countries of the world. In particular, the SDGs aim at ameliorating the position of disadvantaged and vulnerable groups in societies. One of the over-arching goals of the SDGs is to ensure that no one is left behind in the realisation of their access to health care. African governments are obligated under international and regional human rights law to ensure access to healthcare services for everyone, including indigenous populations, on a non-discriminatory basis. This requires the governments to adopt appropriate measures that will remove barriers to healthcare services for disadvantaged and marginalised groups such as indigenous peoples.
Ability to pay and equity in access to Italian and British National Health Services.
Domenighetti, Gianfranco; Vineis, Paolo; De Pietro, Carlo; Tomada, Angelo
2010-10-01
Equity in delivery and distribution of health care is an important determinant of health and a cornerstone in the long way to social justice. We performed a comparative analysis of the prevalence of Italian and British residents who have fully paid out-of-pocket for health services which they could have obtained free of charge or at a lower cost from their respective National Health Services. Cross-sectional study based on a standardized questionnaire survey carried out in autumn 2006 among two representative samples (n = 1000) of the general population aged 20-74 years in each of the two countries. 78% (OR 19.9; 95% CI 15.5-25.6) of Italian residents have fully paid out-of-pocket for at least one access to health services in their lives, and 45% (OR 18.1; 95% CI 12.9-25.5) for more than five accesses. Considering only the last 2 years, 61% (OR 16.5; 95% CI 12.6-21.5) of Italians have fully paid out-of-pocket for at least one access. The corresponding pattern for British residents is 20 and 4% for lifelong prevalence, and 10% for the last 2 years. Opening the public health facilities to a privileged private access to all hospital physicians based on patient's ability to pay, as Italy does, could be a source of social inequality in access to care and could probably represent a major obstacle to decreasing waiting times for patients in the standard formal 'free of charge' way of access.
Ganle, John Kuumuori; Otupiri, Easmon; Obeng, Bernard; Edusie, Anthony Kwaku; Ankomah, Augustine; Adanu, Richard
2016-01-01
Background While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana. Methods and Findings A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling’s thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers’ insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability. Conclusions Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and
Kawuma, Herman Joseph S
2007-03-01
General Health Services that pay due attention to the management of skin conditions are opportune for suspecting and diagnosing early leprosy. In many developing countries, patients with dermatological conditions can only access specialist services in the larger cities and university hospitals; unaffordable costs make the services even less accessible if they can only be provided in the private sector. The high profile of dermatologists in the health services, gives them the opportunity to facilitate the development and implementation of a referral system that includes leprosy. This potential benefit for leprosy control must be initiated by current National Leprosy Programme Managers through establishing formal relationships with the dermatologists and involving them and other partners in the re-designing of leprosy control strategies to keep them in tandem with changing epidemiological patterns, national policies and on -going health sector reforms. The same health service managers should avail of the opportunities from the dermatologists (both in public and private sectors) about the current knowledge on the management and control of leprosy.
Managed Care for Children: Effect on Access to Care and Utilization of Health Services.
ERIC Educational Resources Information Center
Szilagyi, Peter G.
1998-01-01
Reviews what is known about the effect of managed care on access to health services, as well as utilization of hospital care, emergency department visits, primary care services, and specialty pediatric services. The effect of managed care appears dependent on several factors and, thus, is likely to vary according to the population served. (SLD)
Access Patterns of ADHD Students Utilizing Campus Disability Services Supports
ERIC Educational Resources Information Center
Jackson, Meribeth L.
2013-01-01
Source of initial access to disability services, accommodations received as supports on campus, and the rate of continuous enrollment data was measured and compared for students diagnosed with ADHD prior to age eighteen and those diagnosed with ADHD after age eighteen. These two groups were compared to analyze the assumption that students who were…
Tugli, Augustine K.; Mpofu, Molyn
2017-01-01
Background Maternal and infant mortality remains a huge public health problem in developing countries. One of the strategies to minimise the risks of both maternal and infant mortality is access to and utilisation of antenatal care (ANC) services. Aim This study aimed to investigate the accessibility factors that influence the use of ANC services in Mangwe district. Methods A qualitative approach using explorative design was adopted to target women who have babies under 1 year of age. The study was conducted in Mangwe district, Matabeleland South province, Zimbabwe. Data were collected through semi-structured interviews and observations. Data saturation was reached after 15 women who were conveniently sampled were interviewed. Field notes were analysed thematically using Tech’s steps. Lincoln and Guba’s criteria ensured trustworthiness of the study findings. Results Accessibility factors such as lack of transport, high transport costs and long distances to health care facilities, health care workers’ attitudes, type and quality of services as well as delays in receiving care influence women’s utilisation of ANC services in Mangwe district, Zimbabwe. Conclusion The study concluded that women were still facing problems of unavailability of nearby clinics; therefore, it was recommended that the government should avail resources for women to use. Recommendations Mangwe District Health Department should provide mobile clinics rendering ANC services in distant rural areas. PMID:28697619
Amaral, Fabienne Louise Juvêncio dos Santos; Motta, Márcia Heloyse Alves; da Silva, Laíla Pereira Gomes; Alves, Simone Bezerra
2012-11-01
This study seeks to analyze which are the variables associated with the difficulty of elderly people with disabilities gaining access to the health services. This is an observational study of an analytical cross-sectional nature, with a sample of 244 elderly people with disabilities. Data relating to socio-economic profile, the nature of the disability, and the conditions of access to health services were gathered. Version 11.0 of the Statistical Package for the Social Sciences software was used for descriptive, statistical and analytical assessment of the data. The protection variables for difficulties in being treated in the health services were: the lack of drains, culverts, trash, bags of refuse, or irregular floor surfaces; the absence of ramps on sidewalks and pavements; the availability of transport; ease in scheduling appointments; and the length of the waiting period to be attended. The number of factors listed shows that the architectonic barriers and the current situation of healthcare need to be adequate in order to ensure full access and use by the elderly with disabilities to the health services.
A descriptive study of access to services in a random sample of Canadian rural emergency departments
Fleet, Richard; Poitras, Julien; Maltais-Giguère, Julie; Villa, Julie; Archambault, Patrick
2013-01-01
Objective To examine 24/7 access to services and consultants in a sample of Canadian rural emergency departments (EDs). Design Cross-sectional study—mixed methods (structured interview, survey and government data bases) with random sampling of hospitals. Setting Canadian rural EDs (rural small town (RST) definition—Statistics Canada). Participants 28% (95/336) of Canadian rural EDs providing 24/7 physician coverage located in hospitals with acute care hospitalisation beds. Main outcome measures General characteristics of the rural EDs, information about 24/7 access to consultants, equipment and services, and the proportion of rural hospitals more than 300 km from levels 1 and 2 trauma centres. Results Of the 336 rural EDs identified, 122 (36%) were randomly selected and contacted. Overall, 95 EDs participated in the study (participation rate, 78%). Hospitals had, on an average, 23 acute care beds, 7 ED stretchers and 13 500 annual ED visits. The proportion of rural hospitals with local access to the following 24/7 services was paediatrician, 5%; obstetrician, 10%; psychiatrist, 11%; internist, 12%; intensive care unit, 17%; CT scanner, 20%; surgeon, 26%; ultrasound, 28%; basic X-ray, 97% and laboratory services, 99%. Forty-four per cent and 54% of the RST EDs were more than 300 km from a level 1 and level 2 trauma centre, respectively. Conclusions This is the first study describing the services available in Canadian rural EDs. Apart from basic laboratory and X-ray services, most rural EDs have limited access to consultants, advanced imaging and critical care services. A detailed study is needed to evaluate the impact of these limited services on patient outcomes, costs and interfacility transport demands. PMID:24285633
2012-01-01
Background Despite the emergence of mental health problems during adolescence and early adulthood, many young people encounter difficulties accessing appropriate services. In response to this gap, the Australian Government recently established new enhanced primary care services (headspace) that target young people with emerging mental health problems. In this study, we examine the experience of young people with depression accessing one of these services, with a focus on understanding how they access the service and the difficulties they encounter in the process. Method Individual, in-depth, audio-recorded interviews were used to collect data. Twenty-six young people with depression were recruited from a headspace site in Melbourne, Australia. Interpretative phenomenological analysis was used to analyse the data. Results Four overlapping themes were identified in the data. First, school counsellors as access mediators, highlights the prominent role school counsellors have in facilitating student access to the service. Second, location as an access facilitator and inhibitor. Although the service is accessible by public transport, it is less so to those who do not live near public transport. Third, encountering barriers accessing the service initially. Two main service access barriers were experienced: unfamiliarity with the service, and delays in obtaining initial appointments for ongoing therapy. Finally, the service’s funding model acts as an access facilitator and barrier. While the model provides a low or no cost services initially, it limits the number of funded sessions, and this can be problematic. Conclusions Young people have contrasting experiences accessing the service. School counsellors have an influential role in facilitating access, and its close proximity to public transport enhances access. The service needs to become more prominent in young people’s consciousness, while the appointment system would benefit from providing more timely
Secure Dynamic access control scheme of PHR in cloud computing.
Chen, Tzer-Shyong; Liu, Chia-Hui; Chen, Tzer-Long; Chen, Chin-Sheng; Bau, Jian-Guo; Lin, Tzu-Ching
2012-12-01
With the development of information technology and medical technology, medical information has been developed from traditional paper records into electronic medical records, which have now been widely applied. The new-style medical information exchange system "personal health records (PHR)" is gradually developed. PHR is a kind of health records maintained and recorded by individuals. An ideal personal health record could integrate personal medical information from different sources and provide complete and correct personal health and medical summary through the Internet or portable media under the requirements of security and privacy. A lot of personal health records are being utilized. The patient-centered PHR information exchange system allows the public autonomously maintain and manage personal health records. Such management is convenient for storing, accessing, and sharing personal medical records. With the emergence of Cloud computing, PHR service has been transferred to storing data into Cloud servers that the resources could be flexibly utilized and the operation cost can be reduced. Nevertheless, patients would face privacy problem when storing PHR data into Cloud. Besides, it requires a secure protection scheme to encrypt the medical records of each patient for storing PHR into Cloud server. In the encryption process, it would be a challenge to achieve accurately accessing to medical records and corresponding to flexibility and efficiency. A new PHR access control scheme under Cloud computing environments is proposed in this study. With Lagrange interpolation polynomial to establish a secure and effective PHR information access scheme, it allows to accurately access to PHR with security and is suitable for enormous multi-users. Moreover, this scheme also dynamically supports multi-users in Cloud computing environments with personal privacy and offers legal authorities to access to PHR. From security and effectiveness analyses, the proposed PHR access
2012-01-01
Background Immigration is not a new phenomenon but, rather, has deep roots in human history. Documents from every era detail individuals who left their homelands and struggled to reestablish their lives in other countries. The aim of this study was to explore and understand the experience of Iranian immigrants who accessed Canadian health care services. Research with immigrants is useful for learning about strategies that newcomers develop to access health care services. Methods The research question guiding this study was, “What are the processes by which Iranian immigrants learn to access health care services in Canada?” To answer the question, a constructivist grounded theory approach was applied. Initially, unstructured interviews were conducted with 17 participants (11 women and six men) who were adults (at least 18 years old) and had immigrated to Canada within the past 15 years. Eight participants took part in a second interview, and four participants took part in a third interview. Results Using a constructivist grounded theory approach, “tackling the stumbling blocks of access” emerged as the core category. The basic social process (BSP), becoming self-sufficient, was a transitional process and had five stages: becoming a stranger; feeling helpless; navigating/seeking information; employing strategies; and becoming integrated and self-sufficient. We found that “tackling the stumbling blocks of access” was the main struggle throughout this journey. Some of the immigrants were able to overcome these challenges and became proficient in accessing health care services, but others were unable to make the necessary changes and thus stayed in earlier stages/phases of transition, and sometimes returned to their country of origin. Conclusion During the course of this journey a substantive grounded theory was developed that revealed the challenges and issues confronted by this particular group of immigrants. This process explains why some Iranian
A CoAP-Based Network Access Authentication Service for Low-Power Wide Area Networks: LO-CoAP-EAP.
Garcia-Carrillo, Dan; Marin-Lopez, Rafael; Kandasamy, Arunprabhu; Pelov, Alexander
2017-11-17
The Internet-of-Things (IoT) landscape is expanding with new radio technologies. In addition to the Low-Rate Wireless Personal Area Network (LR-WPAN), the recent set of technologies conforming the so-called Low-Power Wide Area Networks (LP-WAN) offers long-range communications, allowing one to send small pieces of information at a reduced energy cost, which promotes the creation of new IoT applications and services. However, LP-WAN technologies pose new challenges since they have strong limitations in the available bandwidth. In general, a first step prior to a smart object being able to gain access to the network is the process of network access authentication. It involves authentication, authorization and key management operations. This process is of vital importance for operators to control network resources. However, proposals for managing network access authentication in LP-WAN are tailored to the specifics of each technology, which could introduce interoperability problems in the future. In this sense, little effort has been put so far into providing a wireless-independent solution for network access authentication in the area of LP-WAN. To fill this gap, we propose a service named Low-Overhead CoAP-EAP (LO-CoAP-EAP), which is based on previous work designed for LR-WPAN. LO-CoAP-EAP integrates the use of Authentication, Authorization and Accounting (AAA) infrastructures and the Extensible Authentication Protocol (EAP) protocol. For this integration, we use the Constrained Application Protocol (CoAP) to design a network authentication service independent of the type of LP-WAN technology. LO-CoAP-EAP represents a trade-off between flexibility, wireless technology independence, scalability and performance in LP-WAN.
A CoAP-Based Network Access Authentication Service for Low-Power Wide Area Networks: LO-CoAP-EAP
Garcia-Carrillo, Dan; Marin-Lopez, Rafael; Kandasamy, Arunprabhu; Pelov, Alexander
2017-01-01
The Internet-of-Things (IoT) landscape is expanding with new radio technologies. In addition to the Low-Rate Wireless Personal Area Network (LR-WPAN), the recent set of technologies conforming the so-called Low-Power Wide Area Networks (LP-WAN) offers long-range communications, allowing one to send small pieces of information at a reduced energy cost, which promotes the creation of new IoT applications and services. However, LP-WAN technologies pose new challenges since they have strong limitations in the available bandwidth. In general, a first step prior to a smart object being able to gain access to the network is the process of network access authentication. It involves authentication, authorization and key management operations. This process is of vital importance for operators to control network resources. However, proposals for managing network access authentication in LP-WAN are tailored to the specifics of each technology, which could introduce interoperability problems in the future. In this sense, little effort has been put so far into providing a wireless-independent solution for network access authentication in the area of LP-WAN. To fill this gap, we propose a service named Low-Overhead CoAP-EAP (LO-CoAP-EAP), which is based on previous work designed for LR-WPAN. LO-CoAP-EAP integrates the use of Authentication, Authorization and Accounting (AAA) infrastructures and the Extensible Authentication Protocol (EAP) protocol. For this integration, we use the Constrained Application Protocol (CoAP) to design a network authentication service independent of the type of LP-WAN technology. LO-CoAP-EAP represents a trade-off between flexibility, wireless technology independence, scalability and performance in LP-WAN. PMID:29149040
Soltani, Shahin; Takian, Amirhossein; Akbari Sari, Ali; Majdzadeh, Reza; Kamali, Mohammad
2017-01-01
Background: People with disability experience various problems to access to healthcare services. This study aimed to identify cultural barriers in access to healthcare services for people with disability in Iran. Methods: We conducted a qualitative study using content analysis to identify the cultural barriers. We used semi-structured interviews to collect data. Participants were selected through purposeful sampling with maximum variation. 50 individual interviews were conducted with three groups of people with disability, healthcare services providers and policy makers, September to May 2015, at different locations in Tehran, Iran. Results: We identified a number of different cultural barriers in access to health services for people with disability in Iran. These related to health service providers, namely reluctance to provide health services and disrespect; related to People with disability, namely denial of disability, disproportionate expectation, shame and insufficient sociocultural supports; and related to policy makers, namely lack of concern, little attention to the culture of disability and discrimination. We categorized misconception as a barrier that was observed at all levels of the society. Conclusion: Disability is a reality that some human being may experience and live with it. The negative attitude towards people with disability has a close relationship with the cultural norms of a society. The culture of disability in different dimensions should be a priority for all policy makers. Removing cultural barriers in access to healthcare for people with a disability needs collective efforts and collaborations among all stakeholders.
How Drug Control Policy and Practice Undermine Access to Controlled Medicines
Csete, Joanne; Wilson, Duncan; Fox, Edward; Wolfe, Daniel; Rasanathan, Jennifer J. K.
2017-01-01
Abstract Drug conventions serve as the cornerstone for domestic drug laws and impose a dual obligation upon states to prevent the misuse of controlled substances while ensuring their adequate availability for medical and scientific purposes. Despite the mandate that these obligations be enforced equally, the dominant paradigm enshrined in the drug conventions is an enforcement-heavy criminal justice response to controlled substances that prohibits and penalizes their misuse. Prioritizing restrictive control is to the detriment of ensuring adequate availability of and access to controlled medicines, thereby violating the rights of people who need them. This paper argues that the drug conventions’ prioritization of criminal justice measures—including efforts to prevent non-medical use of controlled substances—undermines access to medicines and infringes upon the right to health and the right to enjoy the benefits of scientific progress. While the effects of criminalization under drug policy limit the right to health in multiple ways, we draw on research and documented examples to highlight the impact of drug control and criminalization on access to medicines. The prioritization and protection of human rights—specifically the right to health and the right to enjoy the benefits of scientific progress—are critical to rebalancing drug policy. PMID:28630556
How Drug Control Policy and Practice Undermine Access to Controlled Medicines.
Burke-Shyne, Naomi; Csete, Joanne; Wilson, Duncan; Fox, Edward; Wolfe, Daniel; Rasanathan, Jennifer J K
2017-06-01
Drug conventions serve as the cornerstone for domestic drug laws and impose a dual obligation upon states to prevent the misuse of controlled substances while ensuring their adequate availability for medical and scientific purposes. Despite the mandate that these obligations be enforced equally, the dominant paradigm enshrined in the drug conventions is an enforcement-heavy criminal justice response to controlled substances that prohibits and penalizes their misuse. Prioritizing restrictive control is to the detriment of ensuring adequate availability of and access to controlled medicines, thereby violating the rights of people who need them. This paper argues that the drug conventions' prioritization of criminal justice measures-including efforts to prevent non-medical use of controlled substances-undermines access to medicines and infringes upon the right to health and the right to enjoy the benefits of scientific progress. While the effects of criminalization under drug policy limit the right to health in multiple ways, we draw on research and documented examples to highlight the impact of drug control and criminalization on access to medicines. The prioritization and protection of human rights-specifically the right to health and the right to enjoy the benefits of scientific progress-are critical to rebalancing drug policy.
Programmable Direct-Memory-Access Controller
NASA Technical Reports Server (NTRS)
Hendry, David F.
1990-01-01
Proposed programmable direct-memory-access controller (DMAC) operates with computer systems of 32000 series, which have 32-bit data buses and use addresses of 24 (or potentially 32) bits. Controller functions with or without help of central processing unit (CPU) and starts itself. Includes such advanced features as ability to compare two blocks of memory for equality and to search block of memory for specific value. Made as single very-large-scale integrated-circuit chip.
Admission and Preventive Load Control for Delivery of Multicast and Broadcast Services via S-UMTS
NASA Astrophysics Data System (ADS)
Angelou, E.; Koutsokeras, N.; Andrikopoulos, I.; Mertzanis, I.; Karaliopoulos, M.; Henrio, P.
2003-07-01
An Admission Control strategy is proposed for unidirectional satellite systems delivering multicast and broadcast services to mobile users. In such systems, both the radio interface and the targeted services impose particular requirements on the RRM task. We briefly discuss the RRM requirements that stem from the services point of view and from the features of the SATIN access scheme that differentiate it from the conventional T-UMTS radio interface. The main functional entities of RRM and the alternative modes of operation are outlined and the proposed Admission Control algorithm is described in detail. The results from the simulation study that demonstrate its performance for a number of different scenarios are finally presented and conclusions derived.
Being Single as a Social Barrier to Access Reproductive Healthcare Services by Iranian Girls
Kohan, Shahnaz; Mohammadi, Fatemeh; Mostafavi, Firoozeh; Gholami, Ali
2017-01-01
Background: Iranian single women are deprived of reproductive healthcare services, though the provision of such services to the public has increased. This study aimed to explore the experiences of Iranian single women on their access to reproductive health services. Methods: A qualitative design using a conventional content analysis method was used. Semi-structured interviews were held with 17 single women and nine health providers chosen using the purposive sampling method. Results: Data analysis resulted in the development of three categories: ‘family’s attitudes and performance about single women’s reproductive healthcare,’ ‘socio-cultural factors influencing reproductive healthcare,’ and ‘cultural factors influencing being a single woman.’ Conclusion: Cultural and contextual factors affect being a single woman in every society. Therefore, healthcare providers need to identify such factors during the designing of strategies for improving the facilitation of access to reproductive healthcare services. PMID:28812794
A survey of access to medical services in nursing and residential homes in England.
Glendinning, Caroline; Jacobs, Sally; Alborz, Alison; Hann, Mark
2002-01-01
BACKGROUND: Residential and nursing homes make major demands on NHS services. AIM: To investigate patterns of access to medical services for residents in homes for older people. DESIGN OF STUDY: Telephone survey. SETTING: All nursing and dual registered homes and one in four residential homes located in a stratified random sample of 72 English primary care group/trust (PCG/T) areas. METHOD: A structured questionnaire investigating home characteristics, numbers of general practitioners (GPs) or practices per home, homes' policies for registering new residents with GPs, existence of payments to GPs, GP services provided to homes, and access to specialist medical care. RESULTS: There were wide variations in the numbers of GPs providing services to individual homes; this was not entirely dependent on home size. Eight percent of homes paid local GPs for their services to residents; these were more likely to be nursing homes (33%) than residential homes (odds ratio [OR] = 10.82, [95% CI = 4.48 to 26.13], P<0.001) and larger homes (OR for a ten-bed increase = 1.51 [95% CI = 1.28 to 1.79], P<0.001). Larger homes were more likely to encourage residents to register with a 'home' GP (OR for a ten-bed increase = 1.16 [95% CI = 1.04 to 1.31], P = 0.009). Homes paying local GPs were more likely to receive one or more additional services, over and above GPs' core contractual obligations. Few homes had direct access to specialist clinicians. CONCLUSION: Extensive variations in homes' policies and local GP services raise serious questions about patient choice, levels of GP services and, above all, about equity between residents within homes, between homes and between those in homes and in the community. PMID:12120725
Web Services Provide Access to SCEC Scientific Research Application Software
NASA Astrophysics Data System (ADS)
Gupta, N.; Gupta, V.; Okaya, D.; Kamb, L.; Maechling, P.
2003-12-01
Web services offer scientific communities a new paradigm for sharing research codes and communicating results. While there are formal technical definitions of what constitutes a web service, for a user community such as the Southern California Earthquake Center (SCEC), we may conceptually consider a web service to be functionality provided on-demand by an application which is run on a remote computer located elsewhere on the Internet. The value of a web service is that it can (1) run a scientific code without the user needing to install and learn the intricacies of running the code; (2) provide the technical framework which allows a user's computer to talk to the remote computer which performs the service; (3) provide the computational resources to run the code; and (4) bundle several analysis steps and provide the end results in digital or (post-processed) graphical form. Within an NSF-sponsored ITR project coordinated by SCEC, we are constructing web services using architectural protocols and programming languages (e.g., Java). However, because the SCEC community has a rich pool of scientific research software (written in traditional languages such as C and FORTRAN), we also emphasize making existing scientific codes available by constructing web service frameworks which wrap around and directly run these codes. In doing so we attempt to broaden community usage of these codes. Web service wrapping of a scientific code can be done using a "web servlet" construction or by using a SOAP/WSDL-based framework. This latter approach is widely adopted in IT circles although it is subject to rapid evolution. Our wrapping framework attempts to "honor" the original codes with as little modification as is possible. For versatility we identify three methods of user access: (A) a web-based GUI (written in HTML and/or Java applets); (B) a Linux/OSX/UNIX command line "initiator" utility (shell-scriptable); and (C) direct access from within any Java application (and with the
Access to oral health care services among adults with learning disabilities: a scoping review.
Naseem, Mustafa; Shah, Altaf H; Khiyani, Muhammad Faheem; Khurshid, Zohaib; Zafar, Muhammad Sohail; Gulzar, Shabnam; AlJameel, AlBandary H; Khalil, Hesham S
2016-01-01
The prevalence of oral diseases including dental caries and periodontal conditions is remarkably higher in people with disabilities. The provision of accessible oral health services for people with learning disabilities may be challenging. The objectives of the review were to identify barriers in accessing oral health care that persists within society, enabling or disabling people with learning disabilities. Using the Arksey O'Malley framework, a scoping review was conducted on PubMed/Medline, OVIDSP, and EMBASE. Studies were evaluated and short-listed based on the inclusion criteria, which consisted of: (1) study participants or population with learning disabilities, (2) aged 16 years or over, (3) reporting on access to oral health services, (4) published in the English language. Those that justified the inclusion criteria were carefully chosen after a blind peer-reviewed process when relevance and quality were debated. Nine studies were eventually included from searches. Tabulation of data was done under the heading of study type, outcomes, the year of publication and patient selection. The majority of studies provided a biomedical overview of access for adults with learning disabilities. The concept of access for people with disability is still ill-defined and obscure. Access to oral health care and needs of people with learning disabilities are complex and multi-facet.
Morton, Cory M; Simmel, Cassandra; Peterson, N Andrew
2014-05-01
This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.
Schuurman, Nadine; Bell, Nathaniel; Hameed, Morad S; Simons, Richard
2008-07-01
Timely access to definitive trauma care has been shown to improve survival rates after severe injury. Unfortunately, despite development of sophisticated trauma systems, prompt, definitive trauma care remains unavailable to over 50 million North Americans, particularly in rural areas. Measures to quantify social and geographic isolation may provide important insights for the development of health policy aimed at reducing the burden of injury and improving access to trauma care in presently under serviced populations. Indices of social deprivation based on census data, and spatial analyses of access to trauma centers based on street network files were combined into a single index, the Population Isolation Vulnerability Amplifier (PIVA) to characterize vulnerability to trauma in socioeconomically and geographically diverse rural and urban communities across British Columbia. Regions with a sufficient core population that are more than one hour travel time from existing services were ranked based on their level of socioeconomic vulnerability. Ten regions throughout the province were identified as most in need of trauma services based on population, isolation and vulnerability. Likewise, 10 communities were classified as some of the least isolated areas and were simultaneously classified as least vulnerable populations in province. The model was verified using trauma services utilization data from the British Columbia Trauma Registry. These data indicate that including vulnerability in the model provided superior results to running the model based only on population and road travel time. Using the PIVA model we have shown that across Census Urban Areas there are wide variations in population dependence on and distances to accredited tertiary/district trauma centers throughout British Columbia. Many of the factors that influence access to definitive trauma care can be combined into a single quantifiable model that researchers in the health sector can use to predict
Hurley, Catherine; Panagiotopoulos, Georgia; Tsianikas, Michael; Newman, Lareen; Walker, Ruth
2013-03-01
In most developed nations, ageing migrants represent a growing proportion of the older population. Policies that emphasise care in the community depend on older migrants having access to formal services along with informal support, yet little is known about how older migrants experience community-based formal services. By examining the views of both Greek elders in Australia and those of formal service providers, this research fills an important gap in the literature around access to and acceptability of formal community-based services for older migrants. A research team including two Greek background researchers used existing social groups and a snowball sampling method to conduct face-to-face interviews and focus groups with seventy older Greeks in Adelaide, Australia. In addition, 22 community-based service providers were interviewed over the telephone. Results from users and providers showed that while many older Greeks experience service access issues, they also relied heavily on family for support and assistance at home. Reliance on family was both in preference to formal services or where formal services were used, to locate, negotiate and monitor such services. Common barriers identified by both groups included cost, transport and availability, but additional challenges were posed by language, literacy and cultural attitudes. Demographic changes including greater employment mobility and female workforce participation among adult children will have implications for both formal and informal care providers. Formal service providers need to ensure that services are promoted and delivered to take account of the important role of family in informal support while also addressing the access challenges posed by language and literacy. Research conducted by researchers from the same cultural background in the respondent's native language can further advance knowledge in this area. © 2012 Blackwell Publishing Ltd.
Rural access to clinical pharmacy services.
Patterson, Brandon J; Kaboli, Peter J; Tubbs, Traviss; Alexander, Bruce; Lund, Brian C
2014-01-01
To examine the impact of rural residence and primary care site on use of clinical pharmacy services (CPS) and to describe the use of clinical telepharmacy within the Veterans Health Administration (VHA) health care system. Using 2011 national VHA data, the frequency of patients with CPS encounters was compared across patient residence (urban or rural) and principal site of primary care (medical center, urban clinic, or rural clinic). The likelihood of CPS utilization was estimated with random effects logistic regression. Individual service types (e.g., anticoagulation clinics) and delivery modes (e.g., telehealth) were also examined. Of 3,040,635 patients, 711,348 (23.4%) received CPS. Service use varied by patient residence (urban: 24.9%; rural: 19.7%) and principal site of primary care (medical center: 25.9%; urban clinic: 22.5%; rural clinic: 17.6%). However, in adjusted analyses, urban-rural differences were explained primarily by primary care site and less so by patient residence. Similar findings were observed for individual CPS types. Telehealth encounters were common, accounting for nearly one-half of patients receiving CPS. Video telehealth was infrequent (<0.2%), but more common among patients of rural clinics than those receiving CPS at medical centers (odds ratio [OR] = 9.7; 95% CI 9.0-10.5). We identified a potential disparity between rural and urban patients' access to CPS, which was largely explained by greater reliance on community clinics for primary care than on medical centers. Future research is needed to determine if this disparity will be alleviated by emerging organizational changes, including expanding telehealth capacity and integrating pharmacists into primary care teams, and whether lessons learned at VHA translate to other settings.
Sundari Ravindran, T K; Fonn, Sharon
2011-11-01
A social franchise in health is a network of for-profit private health practitioners linked through contracts to provide socially beneficial services under a common brand. The early 21st century has seen considerable donor enthusiasm for promoting social franchises for the provision of reproductive health services. Based on a compendium of descriptive information on 45 clinical social franchises, located in 27 countries of Africa, Asia and Latin America, this paper examines their contribution to universal access to comprehensive reproductive health services. It finds that these franchises have not widened the range of reproductive health services, but have mainly focused on contraceptive services, and to a lesser extent, maternal health care and abortion. In many instances, coverage had not been extended to new areas. Measures taken to ensure sustainability ran counter to the objective of access for low-income groups. In almost two-thirds of the franchises, the full cost of all services had to be paid out of pocket and was unaffordable for low-income women. While standards and protocols for quality assurance were in place in all franchises, evidence on adherence to these was limited. Informal interviews with patients indicated satisfaction with services. However, factors such as difficulties in recruiting franchisees and significant attrition, franchisees' inability to attend training programmes, use of lay health workers to deliver services without support or supervision, and logistical problems with applying quality assurance tools, all raise concerns. The contribution of social franchises to universal access to reproductive health services appears to be uncertain. Continued investment in them for the provision of reproductive health services does not appear to be justified until and unless further evidence of their value is forthcoming. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
Handa, Kozue; Dairoku, Hitoshi; Toriyama, Yoshiko
2010-01-01
This study investigates the priority needs of museum service accessibility for visually impaired visitors. For this purpose, conjoint analysis was utilized. Four conjoint attributes of museum services were selected: A--facilities for wayfinding; B--exhibitions and collections including objects for touching, hearing, smelling, etc.; C--information…
Allen, Sean; Ruiz, Monica; O'Rourke, Allison
2015-03-01
Prior research has explored spatial access to syringe exchange programs (SEPs) among people who inject drugs (PWID), but little is known about service utilization by former PWID who continue to access services (e.g., HIV screenings and referrals for social services) at harm reduction providers. The purpose of this research is to examine differences in access to SEPs between current and former PWID seeking services at a mobile SEP in Washington, DC. A geometric point distance estimation technique was applied to data collected as part of a PWID population estimation study that took place in Washington, DC, in March and April 2014. We calculated the walking distance from the centroid point of home residence zip code to the mobile exchange site where PWID presented for services. An independent samples t-test was used to examine differences in walking distance measures between current and former PWID. Differences in mean walking distance were statistically significant with current and former PWID having mean walking distances of 2.75 and 1.80 miles, respectively. The results of this study suggest that former PWID who are engaging with SEPs primarily for non-needle exchange services (e.g., medical or social services) may have decreased access to SEPs than their counterparts who are active injectors. This research provides support for expanding SEP operations such that both active and former PWID have increased access to harm reduction providers and associated health and social services. Increasing service accessibility may help resolve unmet needs among current and former PWID.
Experiences Accessing Abortion Care in Alabama among Women Traveling for Services.
White, Kari; deMartelly, Victoria; Grossman, Daniel; Turan, Janet M
2016-01-01
In Alabama, more than one-half of reproductive-aged women live in counties without an abortion provider. State regulations require in-person counseling (or confirmed receipt of materials sent by certified mail) followed by a 48-hour waiting period. We explored the impact of this service and policy environment on experiences accessing abortion care for women traveling long distances to clinics. We conducted in-depth interviews with 25 women who traveled more than 30 miles to an Alabama clinic providing abortion care between July and September 2014. Women were interviewed by telephone at least 1 day after their consultation, procedure, or follow-up visit. We used content analysis methods to code and analyze interview transcripts. Almost all women found a clinic by searching online or talking to others in their social networks who had abortions. These strategies did not always direct women to the closest clinic, and some described searches that yielded inaccurate information. The majority of women did not believe an in-person consultation visit was necessary and found it to be burdensome because of the extra travel required and long waits at the clinic. Two-thirds of the women were unable to schedule their abortion 48 hours later owing to work schedules or because appointments were offered only once a week, and four women were delayed until their second trimester even though they sought services earlier in pregnancy. It is often difficult for women in communities without an abortion provider to find and access timely abortion care. Efforts are needed to make abortion more accessible and prevent further restrictions on services. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Navy Commercial Access Control System Did Not Effectively Mitigate Access Control Risks
2013-09-16
fOR OFFICL’tb HSE OtuN Contents Introduction Objective 1 Background 1 Review of Internal Controls 4 Finding A. NCACS Did Not Effectively...8fHh’ DODIC.-20 13·134 I v FOR OFFICL’tb HSE ONI-X Introduction Objective The objective of the audit was to determine whether the Navy... HSE ONb\\’ authorized a Common Access Card. In order to avoid the appearance of endorsing Rapidgate, Eid Passport’s trademarked product, in May 2011
NASA Technical Reports Server (NTRS)
Aleman, Alicia; Olsen, Lola; Ritz, Scott; Morahan, Michael; Cepero, Laurel; Stevens, Tyler
2011-01-01
NASA's Global Change Master Directory provides the scientific community with the ability to discover, access, and use Earth science data, data-related services, and climate diagnostics worldwide. The GCMD offers descriptions of Earth science data sets using the Directory Interchange Format (DIF) metadata standard; Earth science related data services are described using the Service Entry Resource Format (SERF); and climate visualizations are described using the Climate Diagnostic (CD) standard. The DIF, SERF and CD standards each capture data attributes used to determine whether a data set, service, or climate visualization is relevant to a user's needs. Metadata fields include: title, summary, science keywords, service keywords, data center, data set citation, personnel, instrument, platform, quality, related URL, temporal and spatial coverage, data resolution and distribution information. In addition, nine valuable sets of controlled vocabularies have been developed to assist users in normalizing the search for data descriptions. An update to the GCMD's search functionality is planned to further capitalize on the controlled vocabularies during database queries. By implementing a dynamic keyword "tree", users will have the ability to search for data sets by combining keywords in new ways. This will allow users to conduct more relevant and efficient database searches to support the free exchange and re-use of Earth science data. http://gcmd.nasa.gov/
NASA Astrophysics Data System (ADS)
Aleman, A.; Olsen, L. M.; Ritz, S.; Stevens, T.; Morahan, M.; Grebas, S. K.
2011-12-01
NASA's Global Change Master Directory provides the scientific community with the ability to discover, access, and use Earth science data, data-related services, and climate diagnostics worldwide.The GCMD offers descriptions of Earth science data sets using the Directory Interchange Format (DIF) metadata standard; Earth science related data services are described using the Service Entry Resource Format (SERF); and climate visualizations are described using the Climate Diagnostic (CD) standard. The DIF, SERF and CD standards each capture data attributes used to determine whether a data set, service, or climate visualization is relevant to a user's needs.Metadata fields include: title, summary, science keywords, service keywords, data center, data set citation, personnel, instrument, platform, quality, related URL, temporal and spatial coverage, data resolution and distribution information.In addition, nine valuable sets of controlled vocabularies have been developed to assist users in normalizing the search for data descriptions. An update to the GCMD's search functionality is planned to further capitalize on the controlled vocabularies during database queries.By implementing a dynamic keyword "tree", users will have the ability to search for data sets by combining keywords in new ways.This will allow users to conduct more relevant and efficient database searches to support the free exchange and re-use of Earth science data.
Onsite provision of specialized contraceptive services: does Title X funding enhance access?
Thiel de Bocanegra, Heike; Cross Riedel, Julie; Menz, Mary; Darney, Philip D; Brindis, Claire D
2014-05-01
This article presents the extent to which providers enrolled in California's Family Planning, Access, Care, and Treatment (Family PACT) program offer contraceptive methods onsite, thus eliminating one important access barrier. Family PACT has a diverse provider network, including public-sector providers receiving Title X funding, public-sector providers not receiving Title X funding, and private-sector providers. We explored whether Title X funding enhances providers' ability to offer contraceptive methods that require specialized skills onsite. Data were derived from 1,072 survey responses to a 2010 provider-capacity survey matched by unique identifier to administrative claims data. A significantly greater proportion of Title X-funded providers compared to non-Title X public and private providers offered onsite services for the following studied methods: intrauterine contraceptives (90% Title X, 51% public non-Title X, 38% private); contraceptive implants (58% Title X, 19% public non-Title X, 7% private); vasectomy (8% Title X, 4% public non-Title X, 1% private); and fertility-awareness methods (69% Title X, 55% public non-Title X, 49% private) (all p<0.0001). The association between onsite provision and Title X funding remained after stratifying individually by clinic specialty, facility capacity to provide reproductive health services (based on staffing), and rural/urban location. Extra funding for publicly funded family-planning programs, through mechanisms such as Title X, appears to be associated with increased onsite access to a wide range of contraceptive services, including those that require special skills and training.
McKay, Naomi D; Langworthy, Jennifer
2011-09-13
People with physical disabilities experience barriers to healthcare across all services despite a legal and moral obligation to the contrary. Complementary medicine is considered as supplementary to conventional care and integration of these approaches is essential to achieve optimal care. This paper explores the utilisation of chiropractic services and practitioner experiences of treating wheelchair-users which appears under-reported. A 20 item questionnaire was posted to 250 randomly selected chiropractors registered with the General Chiropractic Council. Follow-up questionnaires were sent 7 days after the initial return date. Quantitative data were subjected to frequency analysis. The response rate was 64% (n = 161). The majority (66%) of chiropractors had been in practice less than 10 years and were practice owners (50%). Fifty-two percent of chiropractors sampled had treated a patient in a wheelchair in the previous 5 years. The majority (87%) had treated between 1 and 5 such patients. Patients with multiple sclerosis, stroke and cerebral palsy most commonly presented for treatment. The majority of patients' presenting complaint was musculoskeletal in origin, primarily for pain control. Only 13% of respondents worked in a fully accessible clinic. Impracticality of alterations was the most common reason for inaccessibility. Wheelchair-users seem to be an underserved patient group in relation to chiropractic services. Chiropractic management is primarily utilised for pain control in patients with physical disabilities in which mobility may be improved or maintained. Co-management of wheelchair-users with GPs appears to be desirable in order to achieve optimal patient care however more research is required regarding the efficacy of chiropractic treatment for a range of disabling conditions. Physical access was identified as a key barrier to accessing care.
Limited access to special education services for school-aged children with developmental delay.
Twardzik, Erica; Smit, Ellen; Hatfield, Bridget; Odden, Michelle C; Dixon-Ibarra, Alicia; MacDonald, Megan
2018-01-01
Current policy in Oregon limits eligibility of children diagnosed with developmental delay for school-based services. Due to eligibility definitions, children with developmental delay may face additional barriers transitioning from early intervention/early childhood special education into school-based special education services. Examine the relationship between enrollment in school-based special education programs given a change in primary disability diagnosis. Logistic regression models were fit for children who enrolled in early intervention/early childhood special education services with a primary disability diagnosis of developmental delay and changed primary disability diagnosis before third grade (n=5076). Odds of enrollment in future special education were greater in children with a change in primary disability diagnosis after the age of five in comparison to children that had a change in primary disability diagnosis before the age of five, while adjusting for demographic characteristics (adjusted odds ratio: 2.37, 95% CI 1.92, 2.92). Results suggest that children who are diagnosed with a developmental delay and exit early childhood special education due to maximum age of eligibility are more likely to enroll in special education compared to children without a gap in service access. Gaps in service access during early development are associated with the need for supportive services later on in life. Copyright © 2017 Elsevier Ltd. All rights reserved.
MacFarlane, Katrina A; O'Neil, Mary Lou; Tekdemir, Deniz; Çetin, Elvin; Bilgen, Barış; Foster, Angel M
2016-11-01
Turkey has maintained liberal contraception and abortion policies since the 1980s. In 2012, the government proposed to restrict abortion; a bill limiting abortion was later drafted but never passed into law. Since the proposed restriction, women have reported difficulty accessing abortion services across Turkey. We aimed to better understand the current availability of abortion and reproductive health services in Istanbul and explore whether access to services has changed since 2012. In 2015, we completed 14 in-depth interviews with women and 11 semi-structured interviews with key informants. We transcribed all interviews and completed content and thematic analyses of the data. Key informants had good knowledge about the political discourse and the current abortion law. In contrast, women were familiar with the political discourse but had mixed information about the current status of abortion and were unsure about the legality of their own abortions. There was consensus that access to services has become more limited in the last five years due to the political climate, thus advocacy to prioritize reproductive health services, and abortion care in particular, in the public health system are needed. Copyright © 2016 Elsevier Inc. All rights reserved.
Increasing Access to Tuberculosis Services in Ethiopia: Findings From a Patient-Pathway Analysis.
Fekadu, Lelisa; Hanson, Christy; Osberg, Mike; Makayova, Julia; Mingkwan, Pia; Chin, Daniel
2017-11-06
In Ethiopia, extensive scale-up of the availability of health extension workers (HEWs) at the community level has been credited with increased identification and referral of patients with presumptive tuberculosis, which has contributed to increased tuberculosis case notification and better treatment outcomes. However, nearly 30% of Ethiopia's estimated 191000 patients with tuberculosis remained unnotified in 2015. A better understanding of patient care-seeking practices may inform future government action to reach all patients with tuberculosis. A patient-pathway analysis was completed to assess the alignment between patient care initiation and the availability of diagnostic and treatment services at the national level. More than one third of patients initiated care with HEWs, who refer patients to health centers for diagnosis. An additional one third of patients initiated care at health centers. Of those health centers, >80% had microscopy services, but few had access to Xpert. Despite an extensive microscopy and radiography network at middle levels of the health system, a quarter of all notified patients with tuberculosis had no bacteriological confirmation of disease. While 30% of patients reported receiving some form of care from the private sector, private-sector facilities, especially pharmacies, were not widely accessed for tuberculosis diagnosis. The availability of HEWs can increase access to tuberculosis diagnostic and treatment support services, particularly for rural populations. Continued strengthening of referral systems from HEWs and health posts are needed to enable consistent and timely access to Xpert as an initial diagnostic test and to drug resistance screening. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.
Cost-effectiveness of an improving access to psychological therapies service.
Mukuria, Clara; Brazier, John; Barkham, Michael; Connell, Janice; Hardy, Gillian; Hutten, Rebecca; Saxon, Dave; Dent-Brown, Kim; Parry, Glenys
2013-03-01
Effective psychological therapies have been recommended for common mental health problems, such as depression and anxiety, but provision has been poor. Improving Access to Psychological Therapies (IAPT) may provide a cost-effective solution to this problem. To determine the cost-effectiveness of IAPT at the Doncaster demonstration site (2007-2009). An economic evaluation comparing costs and health outcomes for patients at the IAPT demonstration site with those for comparator sites, including a separate assessment of lost productivity. Sensitivity analyses were undertaken. The IAPT site had higher service costs and was associated with small additional gains in quality-adjusted life-years (QALYs) compared with its comparator sites, resulting in a cost per QALY gained of £29 500 using the Short Form (SF-6D). Sensitivity analysis using predicted EQ-5D scores lowered this to £16 857. Costs per reliable and clinically significant (RCS) improvement were £9440 per participant. Improving Access to Psychological Therapies provided a service that was probably cost-effective within the usual National Institute for Health and Clinical Excellence (NICE) threshold range of £20 000-30 000, but there was considerable uncertainty surrounding the costs and outcome differences.
Report #2006-P-00005, December 14, 2005. Controls needed to be improved in areas such as visitor access to facilities, use of contractor access badges, and general physical access to the NCC, computer rooms outside the NCC, and media storage rooms.
Domestic Violence Survivors' Access of Career Counseling Services: A Qualitative Investigation
ERIC Educational Resources Information Center
Chronister, Krista M.; Linville, Deanna; Kaag, Kristi Palmer
2008-01-01
The present study was a qualitative investigation of the impact of domestic violence on women's career development and the contextual barriers and supports that affect women's ability to access career counseling services. Our sample included 11 women who completed various stages of a community-based career counseling intervention program. The…
[Gender, equality, and health services access: an empirical approximation].
Gómez Gómez, Elsa
2002-01-01
This piece describes the conceptual framework and the objectives that guided a research initiative in the Region of the Americas that was called "Gender, Equity, and Access to Health Services" and that was sponsored in 2001 by the Pan American Health Organization. The piece does not summarize the results of the six projects that were carried under the initiative, whose analyses have not all been completed. Instead, the piece discusses some of the foundations of the initiative and provides a general introduction to the country studies that were done. The six studies were done in Barbados/Jamaica, Brazil, Chile, Colombia, Ecuador, and Peru. The primary objective of the initiative was to stimulate the use of existing quantitative information in the countries, with the goal of starting a process of systematically documenting two things: 1) the unfair, unnecessary, and avoidable inequalities between men and women in their access to health care and 2) the linkages between those inequalities and other socioeconomic factors. The concept of gender equity that guided this examination of health care was not the usual one calling for the equal distribution of resources. Rather, it was the notion that resources should be allocated differentially, according to the particular needs of men and of women, and that persons should pay for health services according to their economic ability rather than their risk level. The starting point for the initiative was the premise that gender inequities in utilizing and paying for health care result from gender differences in the macroeconomic and microeconomic distribution of resources. The piece concludes that achieving equity in health care access will require a better understanding of the gender needs and gender barriers that are linked to social structures and health systems.
A study of HIV positive undocumented African migrants' access to health services in the UK.
Whyte, James; Whyte, Maria D; Hires, Kimberly
2015-01-01
Newly immigrated persons, whatever their origin, tend to fall in the lower socioeconomic levels. In fact, failure of an asylum application renders one destitute in a large proportion of cases, often resulting in a profound lack of access to basic necessities. With over a third of HIV positive failed asylum seekers reporting no income, and the remainder reporting highly limited resources, poverty is a reality for the vast majority. The purpose of the study was to determine the basic social processes that guide HIV positive undocumented migrant's efforts to gain health services in the UK. The study used the Grounded Theory Approach. Theoretical saturation occurred after 16 participants were included in the study. The data included reflections of the prominent factors related to the establishment of a safe and productive life and the ability of individuals to remain within the UK. The data reflected heavily upon the ability of migrants to enter the medical care system during their asylum period, and on an emerging pattern of service denial after loss on immigration appeal. The findings of this study are notable in that they have demonstrated sequence of events along a timeline related to the interaction between the asylum process and access to health-related services. The results reflect that African migrants maintain a degree of formal access to health services during the period that they possess legal access to services and informal access after the failure of their asylum claim. The purpose of this paper is to examine the basic social processes that characterize efforts to gain access to health services among HIV positive undocumented African migrants to the UK. The most recent estimates indicate that there are a total of 618,000 migrants who lack legal status within the UK. Other studies have placed the number of undocumented migrants within the UK in the range of 525,000-950,000. More than 442,000 are thought to dwell in the London metropolitan area. Even in
Experience with ActiveX control for simple channel access
DOE Office of Scientific and Technical Information (OSTI.GOV)
Timossi, C.; Nishimura, H.; McDonald, J.
2003-05-15
Accelerator control system applications at Berkeley Lab's Advanced Light Source (ALS) are typically deployed on operator consoles running Microsoft Windows 2000 and utilize EPICS[2]channel access for data access. In an effort to accommodate the wide variety of Windows based development tools and developers with little experience in network programming, ActiveX controls have been deployed on the operator stations. Use of ActiveX controls for use in the accelerator control environment has been presented previously[1]. Here we report on some of our experiences with the use and development of these controls.
Health literacy of mothers accessing child development services: a model of information use.
Cheung, Winnie; Davey, Jeanette; St John, Winsome; Bydeveldt, Carmen; Forsingdal, Shareen
2016-02-01
This study aimed to explore how mothers use information in home therapy programs within child development services. A grounded theory study using semistructured interviews was conducted with 14 mothers of children aged 3-6 years accessing occupational therapy, physiotherapy and speech pathology services for developmental needs. A conceptual model of mothers' information use was developed. Findings showed that the mothers went through a cyclical process of information use and decision making: acquisition (collaboration, learning preferences), appraisal (understanding, relevance), application (capacity, resourcefulness) and review (evaluation, modification), with contextual factors including information characteristics, environment, personal characteristics and relationships. Mothers who used information effectively had a sense of confidence, control and mastery, and were empowered to apply information to make decisions and adapt their child's home therapy. This study adds to knowledge about health literacy, specifically how mothers interpret and use health-related information at home. Findings will enable health professionals to address families' unique health literacy needs and empower them to support their child's optimal development, functioning and participation at their stage of life.
Accessing Suomi NPP OMPS Products Through the GES DISC Online Data Services
NASA Astrophysics Data System (ADS)
Johnson, J. E.; Wei, J. C.; Garasimov, I.; Vollmer, B.
2017-12-01
The NASA Goddard Earth Sciences Data and Information Services Center (GES DISC) is the primary archive of the latest versions of atmospheric composition data from the Suomi National Polar-orbiting Partnership (NPP) Ozone Mapping Profiler Suite (OMPS) mission. OMPS consists of three spectrometers: a Nadir Mapper (300-420 nm) with 50×50 km2 resolution and 2600 km wide swath, a Nadir Profiler (250-310 nm) with 250×250 km2 footprint, and a three-slit Limb Profiler (290-1000 nm) making 3 vertical profiles spaced about 250 km apart with 1-2 km vertical resolution up to 65 km altitude. OMPS measures primarily ozone, both total column and vertical profiles, but also includes measurements of NO2 and SO2 total and tropospheric columns, aerosol extinction profiles. Also available from OMPS are the Level-1B calibrated and geolocated radiances. All data products are generated at the OMPS Science Investigator Processing System (SIPS) at NASA/GSFC. This presentation will provide an overview of the OMPS products available at the GES DISC archive, as well as demonstrate the various data services provided by the GES DISC. Traditionally users have accessed data by downloading data files using anonymous FTP. Although one may still download the full OMPS data products from the archive (using HTTPS instead), the GES DISC now also offers online data services that allow users to not have to physically download the full data files to their desktop computer. Users can access the data through a desktop client tool (such as IDL, Matlab or Panoply) using OPeNDAP. Other data services include file subsetters (spatially, temporally, and/or by variable), as well as data visualization and exploration services for users to preview or quickly analyze the data. Since TOMS and EOS Aura data products are also available from the GES DISC archive, these can be easily accessed and compared with the OMPS data.
Speed control system for an access gate
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bzorgi, Fariborz M
2012-03-20
An access control apparatus for an access gate. The access gate typically has a rotator that is configured to rotate around a rotator axis at a first variable speed in a forward direction. The access control apparatus may include a transmission that typically has an input element that is operatively connected to the rotator. The input element is generally configured to rotate at an input speed that is proportional to the first variable speed. The transmission typically also has an output element that has an output speed that is higher than the input speed. The input element and the outputmore » element may rotate around a common transmission axis. A retardation mechanism may be employed. The retardation mechanism is typically configured to rotate around a retardation mechanism axis. Generally the retardation mechanism is operatively connected to the output element of the transmission and is configured to retard motion of the access gate in the forward direction when the first variable speed is above a control-limit speed. In many embodiments the transmission axis and the retardation mechanism axis are substantially co-axial. Some embodiments include a freewheel/catch mechanism that has an input connection that is operatively connected to the rotator. The input connection may be configured to engage an output connection when the rotator is rotated at the first variable speed in a forward direction and configured for substantially unrestricted rotation when the rotator is rotated in a reverse direction opposite the forward direction. The input element of the transmission is typically operatively connected to the output connection of the freewheel/catch mechanism.« less
Access to primary healthcare services for the Roma population in Serbia: a secondary data analysis
2011-01-01
Background Serbia has proclaimed access to healthcare as a human right. In a context wherein the Roma population are disadvantaged, the aim of this study was to assess whether the Roma population are able to effectively access primary care services, and if not, what barriers prevent them from doing so. The history of the Roma in Serbia is described in detail so as to provide a context for their current vulnerable position. Methods Disaggregated data were analyzed from three population groups in Serbia; the general population, the Roma population, and the poorest quintile of the general population not including the Roma. The effective coverage framework, which incorporates availability, affordability, accessibility, acceptability, and effectiveness of health services, was used to structure the secondary data analysis. Acute respiratory infection (ARI) in children less than five years of age was used as an example as this is the leading cause of death in children under 5 years old in Serbia. Results Roma children were significantly more likely to experience an ARI than either the general population or the poorest quintile of the general population, not including the Roma. All three population groups were equally likely to not receive the correct treatment regime of antibiotics. An analysis of the factors that affect quality of access to health services reveal that personal documentation is a statistically significant problem; availability of health services is not an issue that disproportionately affects the Roma; however the geographical accessibility and affordability are substantive issues that disproportionately affect the Roma population. Affordability of services affected the Roma and the poorest quintile and affordability of medications significantly affected all three population groups. With regards to acceptability, mothers from all three population groups are equally likely to recognize the importance of seeking treatment. Conclusions The Roma should be
Accessibility, stabilizability, and feedback control of continuous orbital transfer.
Gurfil, Pini
2004-05-01
This paper investigates the problem of low-thrust orbital transfer using orbital element feedback from a control-theoretic standpoint, concepts of controllability, feedback stabilizability, and their interaction. The Gauss variational equations (GVEs) are used to model the state-space dynamics. First, the notion of accessibility, a weaker form of controllability, is presented. It is then shown that the GVEs are globally accessible. Based on the accessibility result, a nonlinear feedback controller is derived that asymptotically steers a vehicle from an initial elliptic Keplerian orbit to any given elliptic Keplerian orbit. The performance of the new controller is illustrated by simulating an orbital transfer between two geosynchronous Earth orbits. It is shown that the low-thrust controller requires less fuel than an impulsive maneuver for the same transfer time. Closed-form, analytic expressions for the new orbital transfer controller are given. Finally, it is proved, based on a topological nonlinear stabilizability test, that there does not exist a continuous closed-loop controller that can transfer a spacecraft to a parabolic escape trajectory.
Doumouras, Aristithes G; Gomez, David; Haas, Barbara; Boyes, Donald M; Nathens, Avery B
2012-09-01
The regionalization of medical services has resulted in improved outcomes and greater compliance with existing guidelines. For certain "time-critical" conditions intimately associated with emergency medicine, early intervention has demonstrated mortality benefits. For these conditions, then, appropriate triage within a regionalized system at first diagnosis is paramount, ideally occurring in the field by emergency medical services (EMS) personnel. Therefore, EMS ground transport access is an important metric in the ongoing evaluation of a regionalized care system for time-critical emergency services. To our knowledge, no studies have demonstrated how methodologies for calculating EMS ground transport access differ in their estimates of access over the same study area for the same resource. This study uses two methodologies to calculate EMS ground transport access to trauma center care in a single study area to explore their manifestations and critically evaluate the differences between the methodologies. Two methodologies were compared in their estimations of EMS ground transport access to trauma center care: a routing methodology (RM) and an as-the-crow-flies methodology (ACFM). These methodologies were adaptations of the only two methodologies that had been previously used in the literature to calculate EMS ground transport access to time-critical emergency services across the United States. The RM and ACFM were applied to the nine Level I and Level II trauma centers within the province of Ontario by creating trauma center catchment areas at 30, 45, 60, and 120 minutes and calculating the population and area encompassed by the catchments. Because the methodologies were identical for measuring air access, this study looks specifically at EMS ground transport access. Catchments for the province were created for each methodology at each time interval, and their populations and areas were significantly different at all time periods. Specifically, the RM calculated
Access to oral health care services among adults with learning disabilities: a scoping review
Naseem, Mustafa; Shah, Altaf H; Khiyani, Muhammad Faheem; Khurshid, Zohaib; Zafar, Muhammad Sohail; Gulzar, Shabnam; AlJameel, AlBandary H.; Khalil, Hesham S.
2016-01-01
Summary Background The prevalence of oral diseases including dental caries and periodontal conditions is remarkably higher in people with disabilities. The provision of accessible oral health services for people with learning disabilities may be challenging. Objectives The objectives of the review were to identify barriers in accessing oral health care that persists within society, enabling or disabling people with learning disabilities. Methods Using the Arksey O’Malley framework, a scoping review was conducted on PubMed/Medline, OVIDSP, and EMBASE. Studies were evaluated and short-listed based on the inclusion criteria, which consisted of: (1) study participants or population with learning disabilities, (2) aged 16 years or over, (3) reporting on access to oral health services, (4) published in the English language. Those that justified the inclusion criteria were carefully chosen after a blind peer-reviewed process when relevance and quality were debated. Results Nine studies were eventually included from searches. Tabulation of data was done under the heading of study type, outcomes, the year of publication and patient selection. The majority of studies provided a biomedical overview of access for adults with learning disabilities. Conclusions The concept of access for people with disability is still ill-defined and obscure. Access to oral health care and needs of people with learning disabilities are complex and multi-facet. PMID:28149451
28 CFR 16.99 - Exemption of the Immigration and Naturalization Service Systems-limited access.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Exemption of the Immigration and....99 Exemption of the Immigration and Naturalization Service Systems-limited access. (a) The following systems of records of the Immigration and Naturalization Service are exempt from 5 U.S.C. 552a (c) (3) and...
Sakai, Christina; Mackie, Thomas I; Shetgiri, Rashmi; Franzen, Sara; Partap, Anu; Flores, Glenn; Leslie, Laurel K
2014-01-01
To examine the perspectives of youth on factors that influence mental health service use after aging out of foster care. Focus groups were conducted with youth with a history of mental health needs and previous service use who had aged out of foster care. Questions were informed by the Health Belief Model and addressed 4 domains: youth perceptions of the "threat of mental health problems," treatment benefits versus barriers to accessing mental health services, self-efficacy, and "cues to action." Data were analyzed using a modified grounded-theory approach. Youth (N = 28) reported ongoing mental health problems affecting their functioning; however, they articulated variable levels of reliance on formal mental health treatment versus their own ability to resolve these problems without treatment. Past mental health service experiences influenced whether youth viewed treatment options as beneficial. Youth identified limited self-efficacy and insufficient psychosocial supports "cueing action" during their transition out of foster care. Barriers to accessing mental health services included difficulties obtaining health insurance, finding a mental health provider, scheduling appointments, and transportation. Youths' perceptions of their mental health needs, self-efficacy, psychosocial supports during transition, and access barriers influence mental health service use after aging out of foster care. Results suggest that strategies are needed to 1) help youth and clinicians negotiate shared understanding of mental health treatment needs and options, 2) incorporate mental health into transition planning, and 3) address insurance and other systemic barriers to accessing mental health services after aging out of foster care. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Internet tool box for rural GPs to access mental health services information.
Ollerenshaw, Alison
2009-01-01
Rural GPs play a significant role in the mental health care of their patients. It is therefore crucial that they have access to reputable support and advice that enhances their existing knowledge. This article outlines a recent project initiated by the Australian rural Ballarat and District Division of General Practice (BDDGP) to develop and implement an online resource to facilitate local implementation and delivery of the 'Better Access to Mental Health Care' (BAMHC) program. This 12 month project was initiated in response to a request from local GPs for additional information about and support in using the BAMHC program. The project is the culmination of significant collaboration among key stakeholders that includes local GPs, GP advisors from BDDGP, BDDGP staff, and two University of Ballarat research centres (the Centre for Health Research and Practice, and the Centre for Electronic Commerce and Communication). This article documents the key stages involved in the project from initiation to implementation, and reports on the use of this resource 12 months after its launch. The BDDGP represents 107 GPs and six GP registrars and covers a large rural/semi-rural area of 7300 km2 and a catchment population of more than 120,000. The format and design of the project entailed four distinct but interrelated stages of development: (1) developing the program specifications and localising it to the BDDGP catchment; (2) constructing a decision-making support tool with 7 sequential steps comprising key questions and links to detailed answers; (3) developing and populating an online service directory of local allied health professionals; and (4) constructing the website for easy access and navigation for GPs and other service providers. The website was publicly launched in December 2007 and is hosted by BDDGP. Since then it has received strong support. In the 12 months since its launch the website received regular and continuous visits (2847 visits/11,500 pages accessed). In
Matrix Management in Practice in Access Services at the NCSU Libraries
ERIC Educational Resources Information Center
Harris, Colleen S.
2010-01-01
The former Associate Head of Access and Delivery Services of the North Carolina State University Libraries reports on successful use of matrix management techniques for the Circulation and Reserves unit of the department. Despite their having fallen out of favor in much of the management literature, matrix management principles are useful for…
Mandatory and Location-Aware Access Control for Relational Databases
NASA Astrophysics Data System (ADS)
Decker, Michael
Access control is concerned with determining which operations a particular user is allowed to perform on a particular electronic resource. For example, an access control decision could say that user Alice is allowed to perform the operation read (but not write) on the resource research report. With conventional access control this decision is based on the user's identity whereas the basic idea of Location-Aware Access Control (LAAC) is to evaluate also a user's current location when making the decision if a particular request should be granted or denied. LAAC is an interesting approach for mobile information systems because these systems are exposed to specific security threads like the loss of a device. Some data models for LAAC can be found in literature, but almost all of them are based on RBAC and none of them is designed especially for Database Management Systems (DBMS). In this paper we therefore propose a LAAC-approach for DMBS and describe a prototypical implementation of that approach that is based on database triggers.
NASA Astrophysics Data System (ADS)
Ferrini, V. L.; Grange, B.; Morton, J. J.; Soule, S. A.; Carbotte, S. M.; Lehnert, K.
2016-12-01
The National Deep Submergence Facility (NDSF) operates the Human Occupied Vehicle (HOV) Alvin, the Remotely Operated Vehicle (ROV) Jason, and the Autonomous Underwater Vehicle (AUV) Sentry. These vehicles are deployed throughout the global oceans to acquire sensor data and physical samples for a variety of interdisciplinary science programs. As part of the EarthCube Integrative Activity Alliance Testbed Project (ATP), new web services were developed to improve access to existing online NDSF data and metadata resources. These services make use of tools and infrastructure developed by the Interdisciplinary Earth Data Alliance (IEDA) and enable programmatic access to metadata and data resources as well as the development of new service-driven user interfaces. The Alvin Frame Grabber and Jason Virtual Van enable the exploration of frame-grabbed images derived from video cameras on NDSF dives. Metadata available for each image includes time and vehicle position, data from environmental sensors, and scientist-generated annotations, and data are organized and accessible by cruise and/or dive. A new FrameGrabber web service and service-driven user interface were deployed to offer integrated access to these data resources through a single API and allows users to search across content curated in both systems. In addition, a new NDSF Dive Metadata web service and service-driven user interface was deployed to provide consolidated access to basic information about each NDSF dive (e.g. vehicle name, dive ID, location, etc), which is important for linking distributed data resources curated in different data systems.
Factors determining access to oral health services among children aged less than 12 years in Peru
Azañedo, Diego; Hernández-Vásquez, Akram; Casas-Bendezú, Mixsi; Gutiérrez, César; Agudelo-Suárez, Andrés A.; Cortés, Sandra
2017-01-01
Background: Understanding problems of access to oral health services requires knowledge of factors that determine access. This study aimed to evaluate factors that determine access to oral health services among children aged <12 years in Peru between 2014 and 2015. Methods: We performed a secondary data analysis of 71,614 Peruvian children aged <12 years and their caregivers. Data were obtained from the Survey on Demography and Family Health 2014-2015 (Encuesta Demográfica y de Salud Familiar - ENDES). Children’s access to oral health services within the previous 6 months was used as the dependent variable (i.e. Yes/No), and the Andersen and col model was used to select independent variables. Predisposing (e.g., language spoken by tutor or guardian, wealth level, caregivers’ educational level, area of residence, natural region of residence, age, and sex) and enabling factors (e.g. type of health insurance) were considered. Descriptive statistics were calculated, and multivariate analysis was performed using generalized linear models (Poisson family). Results: Of all the children, 51% were males, 56% were aged <5 years, and 62.6% lived in urban areas. The most common type of health insurance was Integral Health Insurance (57.8%), and most respondents were in the first quintile of wealth (31.6%). Regarding caregivers, the most common educational level was high school (43.02%) and the most frequently spoken language was Spanish (88.4%). Univariate analysis revealed that all variables, except sex and primary educational level, were statistically significant. After adjustment, sex, area of residence, and language were insignificant, whereas the remaining variables were statistically significant. Conclusions: Wealth index, caregivers’ education level, natural region of residence, age, and type of health insurance are factors that determine access to oral health services among children aged <12 years in Peru. These factors should be considered when devising
Factors determining access to oral health services among children aged less than 12 years in Peru.
Azañedo, Diego; Hernández-Vásquez, Akram; Casas-Bendezú, Mixsi; Gutiérrez, César; Agudelo-Suárez, Andrés A; Cortés, Sandra
2017-01-01
Background: Understanding problems of access to oral health services requires knowledge of factors that determine access. This study aimed to evaluate factors that determine access to oral health services among children aged <12 years in Peru between 2014 and 2015. Methods: We performed a secondary data analysis of 71,614 Peruvian children aged <12 years and their caregivers. Data were obtained from the Survey on Demography and Family Health 2014-2015 (Encuesta Demográfica y de Salud Familiar - ENDES). Children's access to oral health services within the previous 6 months was used as the dependent variable (i.e. Yes/No), and the Andersen and col model was used to select independent variables. Predisposing (e.g., language spoken by tutor or guardian, wealth level, caregivers' educational level, area of residence, natural region of residence, age, and sex) and enabling factors (e.g. type of health insurance) were considered. Descriptive statistics were calculated, and multivariate analysis was performed using generalized linear models (Poisson family). Results: Of all the children, 51% were males, 56% were aged <5 years, and 62.6% lived in urban areas. The most common type of health insurance was Integral Health Insurance (57.8%), and most respondents were in the first quintile of wealth (31.6%). Regarding caregivers, the most common educational level was high school (43.02%) and the most frequently spoken language was Spanish (88.4%). Univariate analysis revealed that all variables, except sex and primary educational level, were statistically significant. After adjustment, sex, area of residence, and language were insignificant, whereas the remaining variables were statistically significant. Conclusions: Wealth index, caregivers' education level, natural region of residence, age, and type of health insurance are factors that determine access to oral health services among children aged <12 years in Peru. These factors should be considered when devising strategies
Emergency intraosseous access in a helicopter emergency medical service: a retrospective study.
Sunde, Geir A; Heradstveit, Bård E; Vikenes, Bjarne H; Heltne, Jon K
2010-10-07
Intraosseous access (IO) is a method for providing vascular access in out-of-hospital resuscitation of critically ill and injured patients when traditional intravenous access is difficult or impossible. Different intraosseous techniques have been used by our Helicopter Emergency Medical Services (HEMS) since 2003. Few articles document IO use by HEMS physicians. The aim of this study was to evaluate the use of intraosseous access in pre-hospital emergency situations handled by our HEMS. We reviewed all medical records from the period May 2003 to April 2010, and compared three different techniques: Bone Injection Gun (B.I.G® - Waismed), manual bone marrow aspiration needle (Inter V - Medical Device Technologies) and EZ-IO® (Vidacare), used on both adults and paediatric patients. During this seven-year period, 78 insertion attempts were made on 70 patients. Overall success rates were 50% using the manual needle, 55% using the Bone Injection Gun, and 96% using the EZ-IO®. Rates of success on first attempt were significantly higher using the EZ-IO® compared to the manual needle/Bone Injection Gun (p < 0.01/p < 0.001). Fifteen failures were due to insertion-related problems (19.2%), with four technical problems (5.1%) and three extravasations (3.8%) being the most frequent causes. Intraosseous access was primarily used in connection with 53 patients in cardiac arrest (75.7%), including traumatic arrest, drowning and SIDS. Other diagnoses were seven patients with multi-trauma (10.0%), five with seizures/epilepsy (7.1%), three with respiratory failure (4.3%) and two others (2.9%). Nearly one third of all insertions (n = 22) were made in patients younger than two years. No cases of osteomyelitis or other serious complications were documented on the follow-up. Newer intraosseous techniques may enable faster and more reliable vascular access, and this can lower the threshold for intraosseous access on both adult and paediatric patients in critical situations. We believe
Emergency intraosseous access in a helicopter emergency medical service: a retrospective study
2010-01-01
Background Intraosseous access (IO) is a method for providing vascular access in out-of-hospital resuscitation of critically ill and injured patients when traditional intravenous access is difficult or impossible. Different intraosseous techniques have been used by our Helicopter Emergency Medical Services (HEMS) since 2003. Few articles document IO use by HEMS physicians. The aim of this study was to evaluate the use of intraosseous access in pre-hospital emergency situations handled by our HEMS. Methods We reviewed all medical records from the period May 2003 to April 2010, and compared three different techniques: Bone Injection Gun (B.I.G® - Waismed), manual bone marrow aspiration needle (Inter V - Medical Device Technologies) and EZ-IO® (Vidacare), used on both adults and paediatric patients. Results During this seven-year period, 78 insertion attempts were made on 70 patients. Overall success rates were 50% using the manual needle, 55% using the Bone Injection Gun, and 96% using the EZ-IO®. Rates of success on first attempt were significantly higher using the EZ-IO® compared to the manual needle/Bone Injection Gun (p < 0.01/p < 0.001). Fifteen failures were due to insertion-related problems (19.2%), with four technical problems (5.1%) and three extravasations (3.8%) being the most frequent causes. Intraosseous access was primarily used in connection with 53 patients in cardiac arrest (75.7%), including traumatic arrest, drowning and SIDS. Other diagnoses were seven patients with multi-trauma (10.0%), five with seizures/epilepsy (7.1%), three with respiratory failure (4.3%) and two others (2.9%). Nearly one third of all insertions (n = 22) were made in patients younger than two years. No cases of osteomyelitis or other serious complications were documented on the follow-up. Conclusions Newer intraosseous techniques may enable faster and more reliable vascular access, and this can lower the threshold for intraosseous access on both adult and paediatric
NASA Astrophysics Data System (ADS)
Tamkin, G.; Schnase, J. L.; Duffy, D.; Li, J.; Strong, S.; Thompson, J. H.
2017-12-01
NASA's efforts to advance climate analytics-as-a-service are making new capabilities available to the research community: (1) A full-featured Reanalysis Ensemble Service (RES) comprising monthly means data from multiple reanalysis data sets, accessible through an enhanced set of extraction, analytic, arithmetic, and intercomparison operations. The operations are made accessible through NASA's climate data analytics Web services and our client-side Climate Data Services Python library, CDSlib; (2) A cloud-based, high-performance Virtual Real-Time Analytics Testbed supporting a select set of climate variables. This near real-time capability enables advanced technologies like Spark and Hadoop-based MapReduce analytics over native NetCDF files; and (3) A WPS-compliant Web service interface to our climate data analytics service that will enable greater interoperability with next-generation systems such as ESGF. The Reanalysis Ensemble Service includes the following: - New API that supports full temporal, spatial, and grid-based resolution services with sample queries - A Docker-ready RES application to deploy across platforms - Extended capabilities that enable single- and multiple reanalysis area average, vertical average, re-gridding, standard deviation, and ensemble averages - Convenient, one-stop shopping for commonly used data products from multiple reanalyses including basic sub-setting and arithmetic operations (e.g., avg, sum, max, min, var, count, anomaly) - Full support for the MERRA-2 reanalysis dataset in addition to, ECMWF ERA-Interim, NCEP CFSR, JMA JRA-55 and NOAA/ESRL 20CR… - A Jupyter notebook-based distribution mechanism designed for client use cases that combines CDSlib documentation with interactive scenarios and personalized project management - Supporting analytic services for NASA GMAO Forward Processing datasets - Basic uncertainty quantification services that combine heterogeneous ensemble products with comparative observational products (e
Eide, Arne H; Dyrstad, Karin; Munthali, Alister; Van Rooy, Gert; Braathen, Stine H; Halvorsen, Thomas; Persendt, Frans; Mvula, Peter; Rød, Jan Ketil
2018-06-26
Equitable access to health services is a key ingredient in reaching health for persons with disabilities and other vulnerable groups. So far, research on access to health services in low- and middle-income countries has largely relied on self-reported survey data. Realizing that there may be substantial discrepancies between perceived and actual access, other methods are needed for more precise knowledge to guide health policy and planning. The objective of this article is to describe and discuss an innovative methodological triangulation where statistical and spatial analysis of perceived distance and objective measures of access is combined with qualitative evidence. The data for the study was drawn from a large household and individual questionnaire based survey carried out in Namibia and Malawi. The survey data was combined with spatial data of respondents and health facilities, key informant interviews and focus group discussions. To analyse access and barriers to access, a model is developed that takes into account both measured and perceived access. The geo-referenced survey data is used to establish four outcome categories of perceived and measured access as either good or poor. Combined with analyses of the terrain and the actual distance from where the respondents live to the health facility they go to, the data allows for categorising areas and respondents according to the four outcome categories. The four groups are subsequently analysed with respect to variation in individual characteristics and vulnerability factors. The qualitative component includes participatory map drawing and is used to gain further insight into the mechanisms behind the different combinations of perceived and actual access. Preliminary results show that there are substantial discrepancies between perceived and actual access to health services and the qualitative study provides insight into mechanisms behind such divergences. The novel combination of survey data, geographical
Pérez-Urdiales, Iratxe; Goicolea, Isabel
2017-09-12
To determine the perception of health professionals working in alternative health centres on the barriers and facilitators in the access by immigrant women to general public health services and sexual and reproductive health in the Basque Country. Basque Country. Analysis of qualitative content based on 11 individual interviews. Health professionals working in alternative health centres of Primary Care and sexual and reproductive health. Data collection was performed between September and December 2015 in four alternative health centres. After transcription, the units of meaning, codes and categories were identified. Four categories emerged from the analysis, which represented how the characteristics of immigrant women (Tell me how you are and I will tell you how to access), the attitude of the administrative and health staff ("When they are already taken care of"), the functioning of the health system (Inflexible, passive and needs-responsive health system), and health policies ("If you do not meet the requirements, you do not go in. The law is the law") influence access to health services of immigrant women. This study shows that there are a considerable number of barriers and few facilitators to the access by immigrant women to public health and sexual and reproductive health services in the Basque Country. The alternative health centres were presented as favouring the improvement of the health of the immigrant population and in their access. Copyright © 2017. Publicado por Elsevier España, S.L.U.
Improving Access to Behavioral Health Care for Remote Service Members and Their Families
2015-01-01
that drive times exceeding 30 minutes are associated with marked decrements in utilization of care.6 The researchers find that remote service members...location, the location of behavioral health services, and information on insurance coverage and regulations surrounding access. A drive time of 30...geographic and health insurance data; how- ever, the data are somewhat limited due to their sensitive nature and availability. Third, the team considered
Equity in Access to Health Promotion and Risk Reduction Services: Implications for Elder Health.
ERIC Educational Resources Information Center
Smith, Nancy H.; Howze, Elizabeth Harper
Although there is a national emphasis on health promotion and preventive practices, questions remain regarding the equity of access to these services by low income and minority groups, and the implications of inequities for elder health. Data from a systematic survey of 500 public and private providers of health promotion services in northern…
Open versus Controlled-Access Data | Office of Cancer Genomics
OCG employs stringent human subjects’ protection and data access policies to protect the privacy and confidentiality of the research participants. Depending on the risk of patient identification, OCG programs data are available to the scientific community in two tiers: open or controlled access. Both types of data can be accessed through its corresponding OCG program-specific data matrix or portal. Open-access Data
McQuoid, Julia; Jowsey, Tanisha; Talaulikar, Girish
2017-06-01
Stable routines are key to successful illness self-management for the growing number of people living with chronic illness around the world. Yet, the influence of chronically ill individuals' everyday contexts in supporting routines is poorly understood. This paper takes a space-time geographical approach to explore the everyday space-time contexts and routines of individuals with chronic kidney disease (CKD). We ask: what is the relationship between renal patients' space-time contexts and their ability to establish and maintain stable routines, and, what role does health service access play in this regard? We draw from a qualitative case study of 26 individuals with CKD in Australia. Data comprised self-reported two day participant diaries and semi-structured interviews. Thematic analysis of interview transcripts was guided by an inductive-deductive approach. We examined the embeddedness of routines within the space-time contexts of participants' everyday lives. We found that participants' everyday space-time contexts were highly complex, especially for those receiving dialysis and/or employed, making routines difficult to establish and vulnerable to disruption. Health service access helped shape participants' everyday space-time contexts, meaning that incidences of unpredictability in accessing health services set-off 'ripple effects' within participants' space-time contexts, disrupting routines and making everyday life negotiation more difficult. The ability to absorb ripple effects from unpredictable health services without disrupting routines varied by space-time context. Implications of these findings for the deployment of the concept of routine in health research, the framing of patient success in self-managing illness, and health services design are discussed. In conclusion, efforts to understand and support individuals in establishing and maintaining routines that support health and wellbeing can benefit from approaches that contextualise and de
McQuoid, Julia; Jowsey, Tanisha; Talaulikar, Girish
2017-01-01
Stable routines are key to successful illness self-management for the growing number of people living with chronic illness around the world. Yet, the influence of chronically ill individuals’ everyday contexts in supporting routines is poorly understood. This paper takes a space-time geographical approach to explore the everyday space-time contexts and routines of individuals with chronic kidney disease (CKD). We ask: what is the relationship between renal patients’ space-time contexts and their ability to establish and maintain stable routines, and, what role does health service access play in this regard? We draw from a qualitative case study of 26 individuals with CKD in Australia. Data comprised self-reported two day participant diaries and semi-structured interviews. Thematic analysis of interview transcripts was guided by an inductive-deductive approach. We examined the embeddedness of routines within the space-time contexts of participants’ everyday lives. We found that participants’ everyday space-time contexts were highly complex, especially for those receiving dialysis and/or employed, making routines difficult to establish and vulnerable to disruption. Health service access helped shape participants’ everyday space-time contexts, meaning that incidences of unpredictability in accessing health services set-off ‘ripple effects’ within participants’ space-time contexts, disrupting routines and making everyday life negotiation more difficult. The ability to absorb ripple effects from unpredictable health services without disrupting routines varied by space-time context. Implications of these findings for the deployment of the concept of routine in health research, the framing of patient success in self-managing illness, and health services design are discussed. In conclusion, efforts to understand and support individuals in establishing and maintaining routines that support health and wellbeing can benefit from approaches that contextualise
The Ins and Outs of Access Control.
ERIC Educational Resources Information Center
Longworth, David
1999-01-01
Presents basic considerations when school districts plan to acquire an access-control system for their education facilities. Topics cover cards and readers, controllers, software, automation, card technology, expandability, price, specification of needs beyond the canned specifications already supplied, and proper usage training to cardholders.…
Access of Hispanics to health care and cuts in services: a state-of-the-art overview.
Andersen, R M; Giachello, A L; Aday, L A
1986-01-01
The most current research literature on the access of Hispanics to medical care is reviewed, and data from a 1982 national survey by Louis Harris and Associates on access to health care are presented to document current levels of access to health care of the Hispanic population. Through telephone interviews, 4,800 families were contacted, yielding a total sample of 6,610 persons. According to the survey's data, the ability of Hispanics to obtain health services is hampered by relatively low incomes, lack of health insurance coverage, and ties to a particular physician. However, Hispanics do not differ significantly from whites in their use of hospitals, physicians, or outpatient departments and emergency rooms. Hispanics are less satisfied than whites on a host of measures describing the most recent medical visit. These levels of dissatisfaction with the visit are similar to those of blacks. The recession and public care service cutbacks did not appear to result in a substantial reduction in the volume of medical care received by Hispanics and blacks. Still, the services available to minorities are viewed by them as less effective in meeting their needs in comparison with how whites view the services they receive. Further, the 1982 survey reveals particular difficulties and barriers for Hispanics in obtaining needed medical services. More than one-fifth of the Hispanic families had one or more significant problems in obtaining needed services.
Research on Rural Residence and Access to Drug Abuse Services: Where Are We and where Do We Go?
ERIC Educational Resources Information Center
Borders, Tyrone F.; Booth, Brenda M.
2007-01-01
Context: Illicit drug use is common in rural areas, but very little research has investigated rural populations' access to drug abuse services. Purpose: To describe the current state of the scientific literature on access to drug abuse services in rural areas and suggest directions for future research. Methods: We performed a literature review of…
Access control and confidentiality in radiology
NASA Astrophysics Data System (ADS)
Noumeir, Rita; Chafik, Adil
2005-04-01
A medical record contains a large amount of data about the patient such as height, weight and blood pressure. It also contains sensitive information such as fertility, abortion, psychiatric data, sexually transmitted diseases and diagnostic results. Access to this information must be carefully controlled. Information technology has greatly improved patient care. The recent extensive deployment of digital medical images made diagnostic images promptly available to healthcare decision makers, regardless of their geographic location. Medical images are digitally archived, transferred on telecommunication networks, and visualized on computer screens. However, with the widespread use of computing and communication technologies in healthcare, the issue of data security has become increasingly important. Most of the work until now has focused on the security of data communication to ensure its integrity, authentication, confidentiality and user accountability. The mechanisms that have been proposed to achieve the security of data communication are not specific to healthcare. Data integrity can be achieved with data signature. Data authentication can be achieved with certificate exchange. Data confidentiality can be achieved with encryption. User accountability can be achieved with audits. Although these mechanisms are essential to ensure data security during its transfer on the network, access control is needed in order to ensure data confidentiality and privacy within the information system application. In this paper, we present and discuss an access control mechanism that takes into account the notion of a care process. Radiology information is categorized and a model to enforce data privacy is proposed.
Silveira, Cássio; Carneiro Junior, Nivaldo; Ribeiro, Manoel Carlos Sampaio de Almeida; Barata, Rita de Cássia Barradas
2013-10-01
Bolivian immigrants in Brazil experience serious social problems: precarious work conditions, lack of documents and insufficient access to health services. The study aimed to investigate inequalities in living conditions and access to health services among Bolivian immigrants living in the central area of São Paulo, Brazil, using a cross-sectional design and semi-structured interviews with 183 adults. According to the data, the immigrants tend to remain in Brazil, thus resulting in an aging process in the group. Per capita income increases the longer the immigrants stay in the country. The majority have secondary schooling. Work status does not vary according to time since arrival in Brazil. The immigrants work and live in garment sweatshops and speak their original languages. Social networks are based on ties with family and friends. Access to health services shows increasing inclusion in primary care. The authors conclude that the immigrants' social exclusion is decreasing due to greater access to documentation, work (although precarious), and the supply of health services from the public primary care system.
Walker, Mary Ellen; Anonson, June; Szafron, Michael
2015-01-01
The relationship between political environment and health services accessibility (HSA) has not been the focus of any specific studies. The purpose of this study was to address this gap in the literature by examining the relationship between political environment and HSA. This relationship that HSA indicators (physicians, nurses and hospital beds per 10 000 people) has with political environment was analyzed with multiple least-squares regression using the components of democracy (electoral processes and pluralism, functioning of government, political participation, political culture, and civil liberties). The components of democracy were represented by the 2011 Economist Intelligence Unit Democracy Index (EIUDI) sub-scores. The EIUDI sub-scores and the HSA indicators were evaluated for significant relationships with multiple least-squares regression. While controlling for a country's geographic location and level of democracy, we found that two components of a nation's political environment: functioning of government and political participation, and their interaction had significant relationships with the three HSA indicators. These study findings are of significance to health professionals because they examine the political contexts in which citizens access health services, they come from research that is the first of its kind, and they help explain the effect political environment has on health. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Onsite Provision of Specialized Contraceptive Services: Does Title X Funding Enhance Access?
Riedel, Julie Cross; Menz, Mary; Darney, Philip D.; Brindis, Claire D.
2014-01-01
Abstract Background: This article presents the extent to which providers enrolled in California's Family Planning, Access, Care, and Treatment (Family PACT) program offer contraceptive methods onsite, thus eliminating one important access barrier. Family PACT has a diverse provider network, including public-sector providers receiving Title X funding, public-sector providers not receiving Title X funding, and private-sector providers. We explored whether Title X funding enhances providers' ability to offer contraceptive methods that require specialized skills onsite. Methods: Data were derived from 1,072 survey responses to a 2010 provider-capacity survey matched by unique identifier to administrative claims data. Results: A significantly greater proportion of Title X–funded providers compared to non–Title X public and private providers offered onsite services for the following studied methods: intrauterine contraceptives (90% Title X, 51% public non–Title X, 38% private); contraceptive implants (58% Title X, 19% public non–Title X, 7% private); vasectomy (8% Title X, 4% public non–Title X, 1% private); and fertility-awareness methods (69% Title X, 55% public non–Title X, 49% private) (all p<0.0001). The association between onsite provision and Title X funding remained after stratifying individually by clinic specialty, facility capacity to provide reproductive health services (based on staffing), and rural/urban location. Conclusions: Extra funding for publicly funded family-planning programs, through mechanisms such as Title X, appears to be associated with increased onsite access to a wide range of contraceptive services, including those that require special skills and training. PMID:24405313
de Lusignan, Simon; Mold, Freda; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Gronlund, Toto Anne; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Barker, Fiona; Ellis, Beverley; Koczan, Phil; Arvanitis, Theodoros N; McCarthy, Mary; Jones, Simon; Rafi, Imran
2014-01-01
Objectives To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Setting Primary care. Participants A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Primary and secondary outcome measures Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. Results No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Conclusions Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of
NASA Astrophysics Data System (ADS)
Bai, Wei; Yang, Hui; Xiao, Hongyun; Yu, Ao; He, Linkuan; Zhang, Jie; Li, Zhen; Du, Yi
2017-11-01
With the increase in varieties of services in network, time-sensitive services (TSSs) appear and bring forward an impending need for delay performance. Ultralow-latency communication has become one of the important development goals for many scenarios in the coming 5G era (e.g., robotics and driverless cars). However, the conventional methods, which decrease delay by promoting the available resources and the network transmission speed, have limited effect; a new breakthrough for ultralow-latency communication is necessary. We propose a de-optical-line-terminal (De-OLT) hybrid access-aggregation optical network (DAON) for TSS based on software-defined networking (SDN) orchestration. In this network, low-latency all-optical communication based on optical burst switching can be achieved by removing OLT. For supporting this network and guaranteeing the quality of service for TSSs, we design SDN-driven control method and service provision method. Numerical results demonstrate the proposed DAON promotes network service efficiency and avoids traffic congestion.
Tippett, Vivienne C; Toloo, Ghasem Sam; Eeles, David; Ting, Joseph Y S; Aitken, Peter J; Fitzgerald, Gerard J
2013-02-01
To determine the impact of the introduction of universal access to ambulance services via the implementation of the Community Ambulance Cover (CAC) program in Queensland in 2003-04. The study involved a 10-year (2000-01 to 2009-10) retrospective analysis of routinely collected data reported by the Queensland Ambulance Service (QAS) and by the Council of Ambulance Authorities. The data were analysed for the impact of policy changes that resulted in universal access to ambulance services in Queensland. QAS is a statewide, publically funded ambulance service. In Queensland, ambulance utilisation rate (AUR) per 1000 persons grew by 41% over the decade or 3.9% per annum (10-year mean=149.8, 95% CI: 137.3-162.3). The AUR mean after CAC was significantly higher for urgent incidents than for non-urgent ones. However projection modelling demonstrates that URs after the introduction of CAC were significantly lower than the projected utilisation for the same period. The introduction of universal access under the Community Ambulance Cover program in Queensland has not had any significant independent long-term impact on demand overall. There has been a reduction in the long-term growth rate, which may have been contributed to by an 'appropriate use' public awareness program.
Bellamy, Kim; Ostini, Remo; Martini, Nataly; Kairuz, Therese
2017-10-01
The aim of this study was to explore the barriers to accessing medicines and pharmacy services among refugees in Queensland, Australia, from the perspectives of resettled African refugees. A generic qualitative approach was used in this study. Resettled African refugees were recruited via a purposive snowball sampling method. The researcher collected data from different African refugee communities, specifically those from Sudanese, Congolese and Somalian communities. Participants were invited by a community health leader to participate in the study; a community health leader is a trained member of the refugee community who acts as a 'health information conduit' between refugees and the health system. Invitations were done either face-to-face, telephonically or by email. The focus groups were digitally recorded in English and transcribed verbatim by the researcher. Transcripts were entered into NVIVO© 11 and the data were analysed using inductive thematic analysis. Four focus groups were conducted between October and November 2014 in the city of Brisbane with African refugees, one with five Somali refugees, one with five Congolese refugees, one with three refugee community health leaders from South Sudan, Liberia and Eritrea and one with three refugee community health leaders from Uganda, Burundi and South Sudan. Eleven sub-themes emerged through the coding process, which resulted in four overarching themes: health system differences, navigating the Australian health system, communication barriers and health care-seeking behaviour. With regard to accessing medicines and pharmacy services, this study has shown that there is a gap between resettled refugees' expectations of health services and the reality of the Australian health system. Access barriers identified included language barriers, issues with the Translating and Interpreter Service, a lack of professional communication and cultural beliefs affecting health care-seeking behaviour. This exploratory study has
Spatial analysis of elderly access to primary care services.
Mobley, Lee R; Root, Elisabeth; Anselin, Luc; Lozano-Gracia, Nancy; Koschinsky, Julia
2006-05-15
Admissions for Ambulatory Care Sensitive Conditions (ACSCs) are considered preventable admissions, because they are unlikely to occur when good preventive health care is received. Thus, high rates of admissions for ACSCs among the elderly (persons aged 65 or above who qualify for Medicare health insurance) are signals of poor preventive care utilization. The relevant geographic market to use in studying these admission rates is the primary care physician market. Our conceptual model assumes that local market conditions serving as interventions along the pathways to preventive care services utilization can impact ACSC admission rates. We examine the relationships between market-level supply and demand factors on market-level rates of ACSC admissions among the elderly residing in the U.S. in the late 1990s. Using 6,475 natural markets in the mainland U.S. defined by The Health Resources and Services Administration's Primary Care Service Area Project, spatial regression is used to estimate the model, controlling for disease severity using detailed information from Medicare claims files. Our evidence suggests that elderly living in impoverished rural areas or in sprawling suburban places are about equally more likely to be admitted for ACSCs. Greater availability of physicians does not seem to matter, but greater prevalence of non-physician clinicians and international medical graduates, relative to U.S. medical graduates, does seem to reduce ACSC admissions, especially in poor rural areas. The relative importance of non-physician clinicians and international medical graduates in providing primary care to the elderly in geographic areas of greatest need can inform the ongoing debate regarding whether there is an impending shortage of physicians in the United States. These findings support other authors who claim that the existing supply of physicians is perhaps adequate, however the distribution of them across the landscape may not be optimal. The finding that elderly
Access to healthcare for disabled persons. How are blind people reached by HIV services?
Saulo, Bryson; Walakira, Eddy; Darj, Elisabeth
2012-03-01
Disabled people are overlooked and marginalised globally. There is a lack of information on blind people and HIV-related services and it is unclear how HIV-services target blind people in a sub-Saharan urban setting. To explore how blind people are reached by HIV-services in Kampala, Uganda. A purposeful sample of blind people and seeing healthcare workers were interviewed, and data on their opinions and experiences were collected. The data were analysed by qualitative content analysis, with a focus on manifest content. Three categories emerged from the study, reaching for HIV information and knowledge, lack of services, and experiences of discrimination. General knowledge on HIV prevention/transmission methods was good; however, there was scepticism about condom use. Blind people mainly relied on others for accessing HIV information, and a lack of special services for blind people to be able to test for HIV was expressed. The health service for blind people was considered inadequate, unequal and discriminatory, and harassment by healthcare staff was expressed, but not sexual abuse. Concerns about disclosure of personal medical information were revealed. Access to HIV services and other healthcare related services for blind people is limited and the objectives of the National Strategic Plan for HIV/AIDS 2007-2012 have not been achieved. There is a need for alternative methods for sensitisation and voluntary counselling and testing (VCT) for blind people. Copyright © 2011 Elsevier B.V. All rights reserved.
Access and Use of FIA Data Through FIA Spatial Data Services
Elizabeth LaPoint
2005-01-01
Forest Inventory and Analysis (FIA) Spatial Data Services (SDS) was established in May 2002 to facilitate outside access to FIA data and allow use of georeferenced plot data while protecting the confidentiality of plot locations. Modification of the Food Security Act of 1985 legislated the protection of information on plot location and ownership. Penalties were put in...
Partisan Activism and Access to Welfare in Lebanon
2014-01-01
How do welfare regimes function when state institutions are weak and ethnic or sectarian groups control access to basic services? This paper explores how people gain access to basic services in Lebanon, where sectarian political parties from all major religious communities are key providers of social assistance and services. Based on analyses of an original national survey (n= 1,911) as well as in-depth interviews with providers and other elites (n= 175) and beneficiaries of social programs (n= 135), I make two main empirical claims in the paper. First, political activism and a demonstrated commitment to a party are associated with access to social assistance; and second, higher levels of political activism may facilitate access to higher levels or quantities of aid, including food baskets and financial assistance for medical and educational costs. These arguments highlight how politics can mediate access to social assistance in direct ways and add new dimensions to scholarly debates about clientelism by focusing on contexts with politicized religious identities and by problematizing the actual goods and services exchanged. PMID:24904187
Fine-Grained Access Control for Electronic Health Record Systems
NASA Astrophysics Data System (ADS)
Hue, Pham Thi Bach; Wohlgemuth, Sven; Echizen, Isao; Thuy, Dong Thi Bich; Thuc, Nguyen Dinh
There needs to be a strategy for securing the privacy of patients when exchanging health records between various entities over the Internet. Despite the fact that health care providers such as Google Health and Microsoft Corp.'s Health Vault comply with the U.S Health Insurance Portability and Accountability Act (HIPAA), the privacy of patients is still at risk. Several encryption schemes and access control mechanisms have been suggested to protect the disclosure of a patient's health record especially from unauthorized entities. However, by implementing these approaches, data owners are not capable of controlling and protecting the disclosure of the individual sensitive attributes of their health records. This raises the need to adopt a secure mechanism to protect personal information against unauthorized disclosure. Therefore, we propose a new Fine-grained Access Control (FGAC) mechanism that is based on subkeys, which would allow a data owner to further control the access to his data at the column-level. We also propose a new mechanism to efficiently reduce the number of keys maintained by a data owner in cases when the users have different access privileges to different columns of the data being shared.
Arulogun, Oyedunni S; Titiloye, Musibau A; Afolabi, Nathanael B; Oyewole, Oyediran E; Nwaorgu, Onyekwere G B
2013-03-01
Delivery of health services to people with hearing impairment is poorly understood in Nigeria and limited research has been done to throw more light on the process involved. This study described experiences of 167 girls with hearing impairment in accessing reproductive health services in Ibadan using a validated questionnaire. Descriptive statistics and binary logistic regression were used to analyze the data. Almost 95.0% of respondents had ever visited health facility for reproductive health issues. Of these 6.2% and 4.6% went for treatment of STIs and pregnancy termination respectively; 36.7% were embarrassed to ask questions in the presence of an interpreter, communication (40.5%) and cost (10.8%) were key barriers to access and 85.6% would use facility if hearing impairment-friendly services are provided. Respondents who were currently working were 20 times more likely to receive services they wanted (OR = 20.29, CI = 1.05-392.16). Availability of certified interpreters and ensuring confidentiality are key to effective service delivery for the hearing impaired.
NASA Astrophysics Data System (ADS)
Archibong, Belinda
While previous literature has emphasized the importance of energy and public infrastructure services for economic development, questions surrounding the implications of unequal spatial distribution in access to these resources remain, particularly in the developing country context. This dissertation provides evidence on the nature, origins and implications of this distribution uniting three strands of research from the development and political economy, regional science and energy economics fields. The dissertation unites three papers on the nature of spatial inequality of access to energy and infrastructure with further implications for conflict risk , the historical institutional and biogeographical determinants of current distribution of access to energy and public infrastructure services and the response of households to fuel price changes over time. Chapter 2 uses a novel survey dataset to provide evidence for spatial clustering of public infrastructure non-functionality at schools by geopolitical zone in Nigeria with further implications for armed conflict risk in the region. Chapter 3 investigates the drivers of the results in chapter 2, exploiting variation in the spatial distribution of precolonial institutions and geography in the region, to provide evidence for the long-term impacts of these factors on current heterogeneity of access to public services. Chapter 4 addresses the policy implications of energy access, providing the first multi-year evidence on firewood demand elasticities in India, using the spatial variation in prices for estimation.
Doi, Shunsuke; Ide, Hiroo; Takeuchi, Koichi; Fujita, Shinsuke; Takabayashi, Katsuhiko
2017-01-01
Accessibility to healthcare service providers, the quantity, and the quality of them are important for national health. In this study, we focused on geographic accessibility to estimate and evaluate future demand and supply of healthcare services. We constructed a simulation model called the patient access area model (PAAM), which simulates patients’ access time to healthcare service institutions using a geographic information system (GIS). Using this model, to evaluate the balance of future healthcare services demand and supply in small areas, we estimated the number of inpatients every five years in each area and compared it with the number of hospital beds within a one-hour drive from each area. In an experiment with the Tokyo metropolitan area as a target area, when we assumed hospital bed availability to be 80%, it was predicted that over 78,000 inpatients would not receive inpatient care in 2030. However, this number would decrease if we lowered the rate of inpatient care by 10% and the average length of the hospital stay. Using this model, recommendations can be made regarding what action should be undertaken and by when to prevent a dramatic increase in healthcare demand. This method can help plan the geographical resource allocation in healthcare services for healthcare policy. PMID:29125585
Butler, Danielle C; Petterson, Stephen; Phillips, Robert L; Bazemore, Andrew W
2013-01-01
Objective To develop a measure of social deprivation that is associated with health care access and health outcomes at a novel geographic level, primary care service area. Data Sources/Study Setting Secondary analysis of data from the Dartmouth Atlas, AMA Masterfile, National Provider Identifier data, Small Area Health Insurance Estimates, American Community Survey, Area Resource File, and Behavioural Risk Factor Surveillance System. Data were aggregated to primary care service areas (PCSAs). Study Design Social deprivation variables were selected from literature review and international examples. Factor analysis was used. Correlation and multivariate analyses were conducted between index, health outcomes, and measures of health care access. The derived index was compared with poverty as a predictor of health outcomes. Data Collection/Extraction Methods Variables not available at the PCSA level were estimated at block level, then aggregated to PCSA level. Principal Findings Our social deprivation index is positively associated with poor access and poor health outcomes. This pattern holds in multivariate analyses controlling for other measures of access. A multidimensional measure of deprivation is more strongly associated with health outcomes than a measure of poverty alone. Conclusions This geographic index has utility for identifying areas in need of assistance and is timely for revision of 35-year-old provider shortage and geographic underservice designation criteria used to allocate federal resources. PMID:22816561
Oosterhoff, Pauline; Anh, Nguyen Thu; Yen, Pham Ngoc; Wright, Pamela; Hardon, Anita
2008-11-01
Various support and self-help groups for people living with HIV and their families have developed in Viet Nam in recent years. This paper reports on a case study of Sunflowers, the first support group for HIV positive mothers in Hanoi, begun in 2004, and a sister group begun in 2005 in Thai Nguyen province. From April 2004 to early 2007, we carried out semi-structured interviews with 275 health care workers and 153 HIV-positive women and members of their families, as well as participant observation of group meetings and activities. Sunflowers have successfully organised themselves to access vital social, medical and economic support and services for themselves, their children and partners. They gained self-confidence, and learned to communicate with their peers and voice their needs to service providers. Based on personal development plans, they have accessed other state services, such as loans, job counselling and legal advice. They have also gained access to school and treatment for their children, who had previously been excluded. Although the women were vulnerable to HIV as wives and mothers, motherhood also provided them with social status and an identity they used to help build organisations and develop strategies to access the essential services that they and their families need.
34 CFR 370.7 - What shall the designated agency do to make its services accessible?
Code of Federal Regulations, 2010 CFR
2010-07-01
... 34 Education 2 2010-07-01 2010-07-01 false What shall the designated agency do to make its services accessible? 370.7 Section 370.7 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION...
Valencia-Garcia, Dellanira; Simoni, Jane M.; Alegría, Margarita; Takeuchi, David T.
2012-01-01
Objective We examined whether individual-level social capital--the intangible resources in a community available through membership in social networks or other social structures and perceived trust in the community—was associated with acculturation; depression and anxiety symptoms; and perceived access to services among women of Mexican ancestry. Method Recruited through venue-based targeted sampling in King County, WA, 205 women of Mexican descent age 18 to 64 years who differed in socioeconomic status and nativity completed a cross-sectional survey. Half completed the survey in Spanish and half in English. Structural equation modeling was used for model testing. Results Social capital increased with level of acculturation and was negatively related to depression and anxiety; it had no direct association with perceived access to services. Social capital mediated the relation between acculturation and both depression and anxiety symptoms. Acculturation had no direct association with psychological distress but was directly associated with perceived access to services. This community sample of women reported high levels of psychological distress, with 20–26% of women meeting diagnostic criteria for depression or anxiety. Conclusions Social capital can be assessed at the individual level, increases with acculturation, and may be a potential target for interventions to improve mental health among Mexican American women residing in the U.S. PMID:22329824
Access control and privilege management in electronic health record: a systematic literature review.
Jayabalan, Manoj; O'Daniel, Thomas
2016-12-01
This study presents a systematic literature review of access control for electronic health record systems to protect patient's privacy. Articles from 2006 to 2016 were extracted from the ACM Digital Library, IEEE Xplore Digital Library, Science Direct, MEDLINE, and MetaPress using broad eligibility criteria, and chosen for inclusion based on analysis of ISO22600. Cryptographic standards and methods were left outside the scope of this review. Three broad classes of models are being actively investigated and developed: access control for electronic health records, access control for interoperability, and access control for risk analysis. Traditional role-based access control models are extended with spatial, temporal, probabilistic, dynamic, and semantic aspects to capture contextual information and provide granular access control. Maintenance of audit trails and facilities for overriding normal roles to allow full access in emergency cases are common features. Access privilege frameworks utilizing ontology-based knowledge representation for defining the rules have attracted considerable interest, due to the higher level of abstraction that makes it possible to model domain knowledge and validate access requests efficiently.
Research on a dynamic workflow access control model
NASA Astrophysics Data System (ADS)
Liu, Yiliang; Deng, Jinxia
2007-12-01
In recent years, the access control technology has been researched widely in workflow system, two typical technologies of that are RBAC (Role-Based Access Control) and TBAC (Task-Based Access Control) model, which has been successfully used in the role authorizing and assigning in a certain extent. However, during the process of complicating a system's structure, these two types of technology can not be used in minimizing privileges and separating duties, and they are inapplicable when users have a request of frequently changing on the workflow's process. In order to avoid having these weakness during the applying, a variable flow dynamic role_task_view (briefly as DRTVBAC) of fine-grained access control model is constructed on the basis existed model. During the process of this model applying, an algorithm is constructed to solve users' requirements of application and security needs on fine-grained principle of privileges minimum and principle of dynamic separation of duties. The DRTVBAC model is implemented in the actual system, the figure shows that the task associated with the dynamic management of role and the role assignment is more flexible on authority and recovery, it can be met the principle of least privilege on the role implement of a specific task permission activated; separated the authority from the process of the duties completing in the workflow; prevented sensitive information discovering from concise and dynamic view interface; satisfied with the requirement of the variable task-flow frequently.
Martinez-Harms, Maria Jose; Bryan, Brett A; Wood, Spencer A; Fisher, David M; Law, Elizabeth; Rhodes, Jonathan R; Dobbs, Cynnamon; Biggs, Duan; Wilson, Kerrie A
2018-09-15
Experiences with nature through visits to protected areas provide important cultural ecosystem services that have the potential to strengthen pro-environmental attitudes and behavior. Understanding accessibility to protected areas and likely preferences for enjoying the benefits of nature visits are key factors in identifying ways to reduce inequality in access and inform the planning and management for future protected areas. We develop, at a regional scale, a novel social media database of visits to public protected areas in part of the Chilean biodiversity hotspot using geotagged photographs and assess the inequality of access using the home locations of the visitors and socio-economic data. We find that 20% of the population of the region make 87% of the visits to protected areas. The larger, more biodiverse protected areas were the most visited and provided most cultural ecosystem services. Wealthier people tend to travel further to visit protected areas while people with lower incomes tend to visit protected areas that are closer to home. By providing information on the current spatial flows of people to protected areas, we demonstrate the need to expand the protected area network, especially in lower income areas, to reduce inequality in access to the benefits from cultural ecosystem services provided by nature to people. Copyright © 2018 Elsevier B.V. All rights reserved.
Bishop, Malachy; Pionke, J.J.; Strauser, David; Santens, Ryan L.
2017-01-01
Background: Individuals with multiple sclerosis (MS) face a range of barriers to accessing and using health-care services. The aim of this review was to identify specific barriers to accessing and using health-care services based on a continuum of the health-care delivery system. Methods: Literature searches were conducted in the PubMed, PsycINFO, CINAHL, and Web of Science databases. The following terms were searched as subject headings, key words, or abstracts: health care, access, barriers, physical disability, and multiple sclerosis. The literature search produced 361 potentially relevant citations. After screening titles, abstracts, and citations, eight citations were selected for full-text review. Results: Health-care barriers were divided into three continuous phases of receiving health care. In the before-visit phase, the most commonly identified barrier was transportation. In the during-visit phase, communication quality was the major concern. In the after-visit phase, discontinued referral was the major barrier encountered. Conclusions: There are multiple interrelated barriers to accessing and using health-care services along the health-care delivery continuum for people with MS and its associated physical disabilities, ranging from complex and long-recognized barriers that will likely require extended advocacy to create policy changes to issues that can and should be addressed through relatively minor changes in health-care delivery practices, improved care coordination, and increased provider awareness, education, and responsiveness to patients' needs. PMID:29270089
Greenwood, Nan; Habibi, Ruth; Smith, Raymond; Manthorpe, Jill
2015-01-01
As populations age, the numbers of carers overall and numbers of carers from minority ethnic groups in particular are rising. Evidence suggests that carers from all sections of the community and particularly carers from minority groups often fail to access care services. This may relate to barriers in accessing services and service dissatisfaction. The aim of this systematic review was to identify and summarise minority ethnic carers' perceptions of barriers to accessing community social care services and their satisfaction with these services if accessed. The following databases were searched from their start until July 2013: Social Care Online, Social Policy and Research, Scopus, PsychINFO, HMIC, ASSIA, MEDLINE, Embase, CINAHL Plus and AMED. Thirteen studies met the inclusion criteria. Most investigated either barriers to access or satisfaction levels, although three explored both. Only 4 studies investigated minority ethnic carers' satisfaction with social care, although 12 studies reported perceived barriers to accessing services. Few studies compared minority ethnic carers' perceptions with majority ethnic groups, making it difficult to identify issues specific to minority groups. Most barriers described were potentially relevant to all carers, irrespective of ethnic group. They included attitudinal barriers such as not wanting to involve outsiders or not seeing the need for services and practical barriers such as low awareness of services and service availability. Issues specific to minority ethnic groups included language barriers and concerns about services' cultural or religious appropriateness. Studies investigating satisfaction with services reported a mixture of satisfaction and dissatisfaction. Barriers common to all groups should not be underestimated and a better understanding of the relationship between perceived barriers to accessing services and dissatisfaction with services is needed before the experiences of all carers can be improved. © 2014
Greenwood, Nan; Habibi, Ruth; Smith, Raymond; Manthorpe, Jill
2015-01-01
As populations age, the numbers of carers overall and numbers of carers from minority ethnic groups in particular are rising. Evidence suggests that carers from all sections of the community and particularly carers from minority groups often fail to access care services. This may relate to barriers in accessing services and service dissatisfaction. The aim of this systematic review was to identify and summarise minority ethnic carers' perceptions of barriers to accessing community social care services and their satisfaction with these services if accessed. The following databases were searched from their start until July 2013: Social Care Online, Social Policy and Research, Scopus, PsychINFO, HMIC, ASSIA, MEDLINE, Embase, CINAHL Plus and AMED. Thirteen studies met the inclusion criteria. Most investigated either barriers to access or satisfaction levels, although three explored both. Only 4 studies investigated minority ethnic carers' satisfaction with social care, although 12 studies reported perceived barriers to accessing services. Few studies compared minority ethnic carers' perceptions with majority ethnic groups, making it difficult to identify issues specific to minority groups. Most barriers described were potentially relevant to all carers, irrespective of ethnic group. They included attitudinal barriers such as not wanting to involve outsiders or not seeing the need for services and practical barriers such as low awareness of services and service availability. Issues specific to minority ethnic groups included language barriers and concerns about services' cultural or religious appropriateness. Studies investigating satisfaction with services reported a mixture of satisfaction and dissatisfaction. Barriers common to all groups should not be underestimated and a better understanding of the relationship between perceived barriers to accessing services and dissatisfaction with services is needed before the experiences of all carers can be improved. PMID
A Framework for Context Sensitive Risk-Based Access Control in Medical Information Systems
Choi, Donghee; Kim, Dohoon; Park, Seog
2015-01-01
Since the access control environment has changed and the threat of insider information leakage has come to the fore, studies on risk-based access control models that decide access permissions dynamically have been conducted vigorously. Medical information systems should protect sensitive data such as medical information from insider threat and enable dynamic access control depending on the context such as life-threatening emergencies. In this paper, we suggest an approach and framework for context sensitive risk-based access control suitable for medical information systems. This approach categorizes context information, estimating and applying risk through context- and treatment-based permission profiling and specifications by expanding the eXtensible Access Control Markup Language (XACML) to apply risk. The proposed framework supports quick responses to medical situations and prevents unnecessary insider data access through dynamic access authorization decisions in accordance with the severity of the context and treatment. PMID:26075013
28 CFR 115.82 - Access to emergency medical and mental health services.
Code of Federal Regulations, 2014 CFR
2014-07-01
... § 115.82 Access to emergency medical and mental health services. (a) Inmate victims of sexual abuse..., the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at...
28 CFR 115.82 - Access to emergency medical and mental health services.
Code of Federal Regulations, 2013 CFR
2013-07-01
... § 115.82 Access to emergency medical and mental health services. (a) Inmate victims of sexual abuse..., the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at...
28 CFR 115.82 - Access to emergency medical and mental health services.
Code of Federal Regulations, 2012 CFR
2012-07-01
... § 115.82 Access to emergency medical and mental health services. (a) Inmate victims of sexual abuse..., the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at...
Access control and privacy in large distributed systems
NASA Technical Reports Server (NTRS)
Leiner, B. M.; Bishop, M.
1986-01-01
Large scale distributed systems consists of workstations, mainframe computers, supercomputers and other types of servers, all connected by a computer network. These systems are being used in a variety of applications including the support of collaborative scientific research. In such an environment, issues of access control and privacy arise. Access control is required for several reasons, including the protection of sensitive resources and cost control. Privacy is also required for similar reasons, including the protection of a researcher's proprietary results. A possible architecture for integrating available computer and communications security technologies into a system that meet these requirements is described. This architecture is meant as a starting point for discussion, rather that the final answer.
Network Access Control List Situation Awareness
ERIC Educational Resources Information Center
Reifers, Andrew
2010-01-01
Network security is a large and complex problem being addressed by multiple communities. Nevertheless, current theories in networking security appear to overestimate network administrators' ability to understand network access control lists (NACLs), providing few context specific user analyses. Consequently, the current research generally seems to…
ERIC Educational Resources Information Center
Poljski, Carolyn; Quiazon, Regina; Tran, Chau
2014-01-01
Drawing on the research and advocacy work being conducted by the Multicultural Centre for Women's Health (MCWH), a national community-based organization in Victoria, Australia, the paper analyzes female international students' experiences with accessing sexual and reproductive health information and services. Accessibility of sexual and…
Adolescent health care: improving access by school-based service.
Gonzales, C; Mulligan, D; Kaufman, A; Davis, S; Hunt, K; Kalishman, N; Wallerstein, N
1985-10-01
Participants in this discussion of the potential of school-based health care services for adolescents included family medicine physicians, school health coordinators, a school nurse, and a community worker. It was noted that health care for adolescents tends to be either inaccessible or underutilized, largely because of a lack of sensitivity to adolescent culture and values. An ideal service for adolescents would offer immediate services for crises, strict confidentiality, ready access to prescribed medications, a sliding-scale scheme, and a staff that is tolerant of divergent values and life-styles. School-based pilot adolescent clinics have been established by the University of New Mexico's Department of Family, Community, and Emergency Medicine to test the community-oriented health care model. On-site clinics provide urgent medical care, family planning, pregnancy testing, psychological counseling, alcohol and drug counseling, and classroom health education. Experience with these programs has demonstrated the necessity for an alliance among the health team and the school administration, parents, and students. Financial, ethical, and political factors can serve as constraints to school-based programs. In some cases, school administrators have been resistant to the provision of contraception to students on school grounds and parents have been unwilling to accept the adolescent's right to confidentiality. These problems in part stem from having 2 separate systems, each with its own values, orientation, and responsibilities, housed in 1 facility. In addition, there have been problems generating awareness of the school-based clinic among students. Health education theater groups, peer counseling, and student-run community services have been effective, however, in increasing student participation. It has been helpful to mold clinic services to meet the needs identified by teenagers themselves. There is an interest not only in curative services, but in services focused
Oakley, Lisa P; Harvey, S Marie; López-Cevallos, Daniel F
2018-05-02
Racial/ethnic discrimination and medical mistrust contribute to disparities in use of and satisfaction with health care services. Previous work examining the influence of discrimination and medical mistrust on health care experiences has focused primarily on African Americans. Despite the finding that Latinas report lower rates of contraceptive use than White women, little is known about the influence of these factors on health care satisfaction, specifically satisfaction with contraceptive services, among Latina women. We conducted computer-assisted interviews with 254 Latina women aged 18 to 25 living in rural communities in Oregon. Only the 211 women who reported ever receiving birth control services answered the question regarding satisfaction with birth control services and were included in the analytic sample. Using multivariable logistic regression models, we explored the relationship between medical mistrust and everyday discrimination on satisfaction with birth control services, accounting for relevant factors. More than 80% of the total sample reported ever seeing a health care provider for birth control services and of these women, 75% reported being very or extremely satisfied with their birth control services. Latinas who reported higher levels of medical mistrust and racial/ethnic discrimination reported being less satisfied with birth control services. After adjusting for perceived barriers to accessing contraceptive services and other relevant factors, only perceived barriers and racial/ethnic discrimination remained significantly associated with satisfaction. This study contributes to the growing understanding of the pervasive effects that racial/ethnic discrimination and medical mistrust have on satisfaction with health services among Latinas in the United States. Copyright © 2018 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Meehan, Sue-Ann; Leon, Natalie; Naidoo, Pren; Jennings, Karen; Burger, Ronelle; Beyers, Nulda
2015-09-02
The South African government is striving for universal access to HIV counselling and testing (HCT), a fundamental component of HIV care and prevention. In the Cape Town district, Western Cape Province of South Africa, HCT is provided free of charge at publically funded primary health care (PHC) facilities and through non-governmental organizations (NGOs). This study investigated the availability and accessibility of HCT services; comparing health seeking behaviour and client experiences of HCT across public PHC facilities (fixed sites) and NGO mobile services. This qualitative study used semi-structured interviews. Systematic sampling was used to select 16 participants who accessed HCT in either a PHC facility (8) or a NGO mobile service (8). Interviews, conducted between March and June 2011, were digitally recorded, transcribed and where required, translated into English. Constant comparative and thematic analysis was used to identify common and divergent responses and themes in relation to the key questions (reasons for testing, choice of service provider and experience of HCT). The sample consisted of 12 females and 4 males with an age range of 19-60 years (median age 28 years). Motivations for accessing health facilities and NGO services were similar; opportunity to test, being affected by HIV and a perceived personal risk for contracting HIV. Participants chose a particular service provider based on accessibility, familiarity with and acceptability of that service. Experiences of both services were largely positive, though instances of poor staff attitude and long waiting times were reported at PHC facilities. Those attending NGO services reported shorter waiting times and overall positive testing experiences. Concerns about lack of adequate privacy and associated stigma were expressed about both services. Realised access to HCT is dependent on availability and acceptability of HCT services. Those who utilised either a NGO mobile service or a public PHC
NASA Astrophysics Data System (ADS)
Archibong, B.
2014-12-01
Do precolonial institutions, geography and ecological diversity affect population access to public infrastructure services over a century later? Can local leaders from historically centralized or 'conqueror' groups still influence access to public goods today? Do precolonial states located in ecologically diverse environments have better access to water, power and sanitation resources today? A growing body of literature examining the sources of the current state of African economic development has cited the enduring impacts of precolonial institutions and geography on contemporary African economic development using large sample cross-sectional analysis. In this paper, I focus on within country effects of local ethnic and political state institutions on access to public infrastructure services in present day Nigeria. Specifically, I combine information on the spatial distribution of ethnic states and ecological diversity in Nigeria circa mid 19th century and political states in Nigeria circa 1785 and 1850 with information, from a novel geocoded survey dataset, on access to public infrastructure at the local government level in present day Nigeria to examine the impact of precolonial state centralization on the current unequal access to public infrastructure services in Nigeria, accounting for the effects of ecological diversity and other geographic covariates. Some preliminary results show evidence for the long-term impacts of institutions, geography and ecological diversity on access to public infrastructure in Nigeria.
Lyons, Tara; Krüsi, Andrea; Pierre, Leslie; Smith, Adrienne; Small, Will; Shannon, Kate
2016-10-01
Little is known about trans womens' experiences accessing gender-segregated health and housing services, particularly services for marginalized individuals living in poverty. As such, we conducted a qualitative investigation into experiences of accessing women-specific health and housing services among trans women and two-spirit persons in a downtown neighborhood of Vancouver, Canada. Between June 2012 and May 2013 interviews were conducted with 32 trans women and two-spirit individuals who had accessed women-specific health and/or housing services. Participants were recruited from four open prospective cohorts of sex workers and individuals who use drugs. Interview data were analyzed using a participatory analysis approach with two participants who were hired as research assistants. Participants were generally able to access women-specific services in the neighborhood. However, there were reports of discrimination related to gender identity, discrimination based on gender expression (e.g., requirement of a feminine gender expression), and lack of staff intervention in harassment from other service users. Trans women and two-spirit persons in our study relied upon services for their health and safety and, therefore, exclusion from women-specific services had potentially severe adverse consequences such as homelessness and sexual violence. Recommendations to improve accessibility, including policy development and procedural recommendations, are put forth.
Krüsi, Andrea; Pierre, Leslie; Smith, Adrienne; Small, Will; Shannon, Kate
2016-01-01
Abstract Purpose: Little is known about trans womens' experiences accessing gender-segregated health and housing services, particularly services for marginalized individuals living in poverty. As such, we conducted a qualitative investigation into experiences of accessing women-specific health and housing services among trans women and two-spirit persons in a downtown neighborhood of Vancouver, Canada. Methods: Between June 2012 and May 2013 interviews were conducted with 32 trans women and two-spirit individuals who had accessed women-specific health and/or housing services. Participants were recruited from four open prospective cohorts of sex workers and individuals who use drugs. Interview data were analyzed using a participatory analysis approach with two participants who were hired as research assistants. Results: Participants were generally able to access women-specific services in the neighborhood. However, there were reports of discrimination related to gender identity, discrimination based on gender expression (e.g., requirement of a feminine gender expression), and lack of staff intervention in harassment from other service users. Conclusion: Trans women and two-spirit persons in our study relied upon services for their health and safety and, therefore, exclusion from women-specific services had potentially severe adverse consequences such as homelessness and sexual violence. Recommendations to improve accessibility, including policy development and procedural recommendations, are put forth. PMID:27575593
Wamala, Sarah; Merlo, Juan; Boström, Gunnel
2006-12-01
To analyse the effects of socioeconomic disadvantage on access to dental care services and on oral health. Design, setting and outcomes: Cross-sectional data from the Swedish National Surveys of Public Health 2004 and 2005. Outcomes were poor oral health (self-rated oral health and symptoms of periodontal disease) and lack of access to dental care services. A socioeconomic disadvantage index (SDI) was developed, consisting of social welfare beneficiary, being unemployed, financial crisis and lack of cash reserves. Swedish population-based sample of 17 362 men and 20 037 women. Every instance of increasing levels of socioeconomic disadvantage was associated with worsened oral health but, simultaneously, with decreased utilisation of dental care services. After adjusting for age, men with a mild SDI compared with those with no SDI had 2.7 (95% confidence interval (CI) 2.5 to 3.0) times the odds for self-rated poor oral health, whereas odds related to severe SDI were 6.8 (95% CI 6.2 to 7.5). The corresponding values among women were 2.3 (95% CI 2.1 to 2.5) and 6.8 (95% CI 6.3 to 7.5). Nevertheless, people with severe socioeconomic disparities were 7-9 times as likely to refrain from seeking the required dental treatment. These associations persisted even after controlling for living alone, education, occupational status and lifestyle factors. Lifestyle factors explained only 29% of the socioeconomic differences in poor oral health among men and women, whereas lack of access to dental care services explained about 60%. The results of the multilevel regression analysis indicated no additional effect of the administrative boundaries of counties or of municipalities in Sweden. Results call for urgent public health interventions to increase equitable access to dental care services.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-09-22
... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Part D Grant for Coordinated HIV Services and Access to Research for Women, Infants, Children, and Youth Part D Funds Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA...
Dynamic access control model for privacy preserving personalized healthcare in cloud environment.
Son, Jiseong; Kim, Jeong-Dong; Na, Hong-Seok; Baik, Doo-Kwon
2015-01-01
When sharing and storing healthcare data in a cloud environment, access control is a central issue for preserving data privacy as a patient's personal health data may be accessed without permission from many stakeholders. Specifically, dynamic authorization for the access of data is required because personal health data is stored in cloud storage via wearable devices. Therefore, we propose a dynamic access control model for preserving the privacy of personal healthcare data in a cloud environment. The proposed model considers context information for dynamic access. According to the proposed model, access control can be dynamically determined by changing the context information; this means that even for a subject with the same role in the cloud, access permission is defined differently depending on the context information and access condition. Furthermore, we experiment the ability of the proposed model to provide correct responses by representing a dynamic access decision with real-life personalized healthcare system scenarios.
Ray, Nicolas; Ebener, Steeve
2008-01-01
Background Access to health care can be described along four dimensions: geographic accessibility, availability, financial accessibility and acceptability. Geographic accessibility measures how physically accessible resources are for the population, while availability reflects what resources are available and in what amount. Combining these two types of measure into a single index provides a measure of geographic (or spatial) coverage, which is an important measure for assessing the degree of accessibility of a health care network. Results This paper describes the latest version of AccessMod, an extension to the Geographical Information System ArcView 3.×, and provides an example of application of this tool. AccessMod 3 allows one to compute geographic coverage to health care using terrain information and population distribution. Four major types of analysis are available in AccessMod: (1) modeling the coverage of catchment areas linked to an existing health facility network based on travel time, to provide a measure of physical accessibility to health care; (2) modeling geographic coverage according to the availability of services; (3) projecting the coverage of a scaling-up of an existing network; (4) providing information for cost effectiveness analysis when little information about the existing network is available. In addition to integrating travelling time, population distribution and the population coverage capacity specific to each health facility in the network, AccessMod can incorporate the influence of landscape components (e.g. topography, river and road networks, vegetation) that impact travelling time to and from facilities. Topographical constraints can be taken into account through an anisotropic analysis that considers the direction of movement. We provide an example of the application of AccessMod in the southern part of Malawi that shows the influences of the landscape constraints and of the modes of transportation on geographic coverage
28 CFR 115.382 - Access to emergency medical and mental health services.
Code of Federal Regulations, 2012 CFR
2012-07-01
....382 Access to emergency medical and mental health services. (a) Resident victims of sexual abuse shall... nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at the time a...
28 CFR 115.382 - Access to emergency medical and mental health services.
Code of Federal Regulations, 2014 CFR
2014-07-01
....382 Access to emergency medical and mental health services. (a) Resident victims of sexual abuse shall... nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at the time a...
28 CFR 115.382 - Access to emergency medical and mental health services.
Code of Federal Regulations, 2013 CFR
2013-07-01
....382 Access to emergency medical and mental health services. (a) Resident victims of sexual abuse shall... nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at the time a...
Hormone-dependent control of developmental timing through regulation of chromatin accessibility
Uyehara, Christopher M.; Nystrom, Spencer L.; Niederhuber, Matthew J.; Leatham-Jensen, Mary; Ma, Yiqin; Buttitta, Laura A.
2017-01-01
Specification of tissue identity during development requires precise coordination of gene expression in both space and time. Spatially, master regulatory transcription factors are required to control tissue-specific gene expression programs. However, the mechanisms controlling how tissue-specific gene expression changes over time are less well understood. Here, we show that hormone-induced transcription factors control temporal gene expression by regulating the accessibility of DNA regulatory elements. Using the Drosophila wing, we demonstrate that temporal changes in gene expression are accompanied by genome-wide changes in chromatin accessibility at temporal-specific enhancers. We also uncover a temporal cascade of transcription factors following a pulse of the steroid hormone ecdysone such that different times in wing development can be defined by distinct combinations of hormone-induced transcription factors. Finally, we show that the ecdysone-induced transcription factor E93 controls temporal identity by directly regulating chromatin accessibility across the genome. Notably, we found that E93 controls enhancer activity through three different modalities, including promoting accessibility of late-acting enhancers and decreasing accessibility of early-acting enhancers. Together, this work supports a model in which an extrinsic signal triggers an intrinsic transcription factor cascade that drives development forward in time through regulation of chromatin accessibility. PMID:28536147
Ethical conflicts over access to services: patient effects and worker influence in home health.
Egan, Marcia; Kadushin, Goldie
2002-01-01
A survey of home health social workers (N = 51) explored the effects on patients of ethical conflicts over access to services. The findings suggest that patients were as likely to be discharged or not receive services as they were to receive the services without paying a fee. Social workers rated themselves as moderately influential in the resolution of the conflict. Their influence was significantly correlated with patients more often receiving services and less often being discharged. Social work influence was enhanced by recognition of professional expertise and/or through informal networking within the agency. Implications for practice and education are discussed.
Abraham, Amanda J; Bagwell-Adams, Grace; Jayawardhana, Jayani
2017-08-01
Given the high prevalence of smoking among substance use disorder (SUD) patients, the specialty SUD treatment system is an important target for adoption and implementation of tobacco cessation (TC) services. While research has addressed the impact of tobacco control on individual tobacco consumption, largely overlooked in the literature is the potential impact of state tobacco control policies on availability of services for tobacco cessation. This paper examines the association between state tobacco control policy and availability of TC services in SUD treatment programs in the United States. State tobacco control and state demographic data (n=51) were merged with treatment program data from the 2012 National Survey of Substance Abuse Treatment Services (n=10.413) to examine availability of TC screening, counseling and pharmacotherapy services in SUD treatment programs using multivariate logistic regression models clustered at the state-level. Approximately 60% of SUD treatment programs offered TC screening services, 41% offered TC counseling services and 26% offered TC pharmacotherapy services. Results of multivariate logistic regression showed the odds of offering TC services were greater for SUD treatment programs located in states with higher cigarette excise taxes and greater spending on tobacco prevention and control. Findings indicate cigarette excise taxes and recommended funding levels may be effective policy tools for increasing access to TC services in SUD treatment programs. Coupled with changes to insurance coverage for TC under the Affordable Care Act, state tobacco control policy tools may further reduce tobacco use in the United States. Published by Elsevier Ltd.
Wagner, Vincent; Bertrand, Karine; Flores-Aranda, Jorge; Acier, Didier; Brunelle, Natacha; Landry, Michel; Brochu, Serge
2017-09-01
Substance addiction in young adults is particularly problematic. Yet, much remain at stake in understanding the specifics of this population's access to services. The objective of this study is to explore young adults' initiation of substance misuse treatment. Our study sample was composed of 35 individuals aged 18 to 30 with problematic psychoactive substance use who have been identified in criminal courts, hospital emergency departments, and Health and Social Services Centers in Québec (Canada). A thematic analysis was performed on the 62 semi-structured interviews conducted with participants. Three components emerged. First, personal elements-expectations, individual motivations, perceptions of use, and capacity to control it-influence initiation of substance misuse treatment. Second, family and peers have noticeable influences. Finally, system characteristics and prior care experiences also shape the process. Consideration should be given to tailor interventions that can reach young adults and encourage them to initiate appropriate care.
Meehan, Sue-Ann; Naidoo, Pren; Claassens, Mareli M; Lombard, Carl; Beyers, Nulda
2014-12-20
Studies within sub-Saharan African countries have shown that mobile services increase uptake of HIV counselling and testing (HCT) services when compared to clinics and are able to access different populations, but these have included provider-initiated HCT in clinics. This study aimed to compare the characteristics of clients who self-initiated HCT at either a mobile or a clinic service in terms of demographic and socio-economic variables, also comparing reasons for accessing a particular health service provider. This study took place in eight areas around Cape Town. A matched design was used with one mobile HCT service matched with one or more clinics (offering routine HCT services) within each of the eight areas. Adult clients who self-referred for an HIV test within a specified time period at either a mobile or clinic service were invited to participate in the study. Data were collected between February and April 2011 using a questionnaire. Summary statistics were calculated for each service type within a matched pair and differences of outcomes from pairs were used to calculate effect sizes and 95% confidence intervals. 1063 participants enrolled in the study with 511 from mobile and 552 from clinic HCT services. The proportion of males accessing mobile HCT significantly exceeded that of clinic HCT (p < 0.001). The mean age of participants attending mobile HCT was higher than clinic participants (p = 0.023). No significant difference was found for socio-economic variables between participants, with the exception of access to own piped water (p = 0.029). Participants who accessed mobile HCT were significantly more likely to report that they were just passing, deemed an "opportunistic" visit (p = 0.014). Participants who accessed clinics were significantly more likely to report the service being close to home or work (p = 0.035). An HCT strategy incorporating a mobile HCT service, has a definite role to play in reaching those population groups who do
de Lusignan, Simon; Mold, Freda; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Gronlund, Toto Anne; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Barker, Fiona; Ellis, Beverley; Koczan, Phil; Arvanitis, Theodoros N; McCarthy, Mary; Jones, Simon; Rafi, Imran
2014-09-08
To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Primary care. A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of access to a wider group of patients. A1 SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO
ERIC Educational Resources Information Center
Colgan, Siobhan Eileen
2012-01-01
This study investigated the relationship between maternal depression and children's access to early intervention services among a sample of children with developmental delay at age two who were determined to be eligible for early intervention services, were full term and of normal birth weight, and were not previously identified with any special…
SAFE: SPARQL Federation over RDF Data Cubes with Access Control.
Khan, Yasar; Saleem, Muhammad; Mehdi, Muntazir; Hogan, Aidan; Mehmood, Qaiser; Rebholz-Schuhmann, Dietrich; Sahay, Ratnesh
2017-02-01
Several query federation engines have been proposed for accessing public Linked Open Data sources. However, in many domains, resources are sensitive and access to these resources is tightly controlled by stakeholders; consequently, privacy is a major concern when federating queries over such datasets. In the Healthcare and Life Sciences (HCLS) domain real-world datasets contain sensitive statistical information: strict ownership is granted to individuals working in hospitals, research labs, clinical trial organisers, etc. Therefore, the legal and ethical concerns on (i) preserving the anonymity of patients (or clinical subjects); and (ii) respecting data ownership through access control; are key challenges faced by the data analytics community working within the HCLS domain. Likewise statistical data play a key role in the domain, where the RDF Data Cube Vocabulary has been proposed as a standard format to enable the exchange of such data. However, to the best of our knowledge, no existing approach has looked to optimise federated queries over such statistical data. We present SAFE: a query federation engine that enables policy-aware access to sensitive statistical datasets represented as RDF data cubes. SAFE is designed specifically to query statistical RDF data cubes in a distributed setting, where access control is coupled with source selection, user profiles and their access rights. SAFE proposes a join-aware source selection method that avoids wasteful requests to irrelevant and unauthorised data sources. In order to preserve anonymity and enforce stricter access control, SAFE's indexing system does not hold any data instances-it stores only predicates and endpoints. The resulting data summary has a significantly lower index generation time and size compared to existing engines, which allows for faster updates when sources change. We validate the performance of the system with experiments over real-world datasets provided by three clinical organisations as
NASA Astrophysics Data System (ADS)
Cornaglia, Bruno; Young, Gavin; Marchetta, Antonio
2015-12-01
Fixed broadband network deployments are moving inexorably to the use of Next Generation Access (NGA) technologies and architectures. These NGA deployments involve building fiber infrastructure increasingly closer to the customer in order to increase the proportion of fiber on the customer's access connection (Fibre-To-The-Home/Building/Door/Cabinet… i.e. FTTx). This increases the speed of services that can be sold and will be increasingly required to meet the demands of new generations of video services as we evolve from HDTV to "Ultra-HD TV" with 4k and 8k lines of video resolution. However, building fiber access networks is a costly endeavor. It requires significant capital in order to cover any significant geographic coverage. Hence many companies are forming partnerships and joint-ventures in order to share the NGA network construction costs. One form of such a partnership involves two companies agreeing to each build to cover a certain geographic area and then "cross-selling" NGA products to each other in order to access customers within their partner's footprint (NGA coverage area). This is tantamount to a bi-lateral wholesale partnership. The concept of Fixed Access Network Sharing (FANS) is to address the possibility of sharing infrastructure with a high degree of flexibility for all network operators involved. By providing greater configuration control over the NGA network infrastructure, the service provider has a greater ability to define the network and hence to define their product capabilities at the active layer. This gives the service provider partners greater product development autonomy plus the ability to differentiate from each other at the active network layer.
10 CFR 20.1601 - Control of access to high radiation areas.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 10 Energy 1 2010-01-01 2010-01-01 false Control of access to high radiation areas. 20.1601 Section 20.1601 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Control of Exposure From External Sources in Restricted Areas § 20.1601 Control of access to high radiation areas. (a...
10 CFR 20.1601 - Control of access to high radiation areas.
Code of Federal Regulations, 2014 CFR
2014-01-01
... 10 Energy 1 2014-01-01 2014-01-01 false Control of access to high radiation areas. 20.1601 Section 20.1601 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Control of Exposure From External Sources in Restricted Areas § 20.1601 Control of access to high radiation areas. (a...
10 CFR 20.1601 - Control of access to high radiation areas.
Code of Federal Regulations, 2013 CFR
2013-01-01
... 10 Energy 1 2013-01-01 2013-01-01 false Control of access to high radiation areas. 20.1601 Section 20.1601 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Control of Exposure From External Sources in Restricted Areas § 20.1601 Control of access to high radiation areas. (a...
10 CFR 20.1601 - Control of access to high radiation areas.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 10 Energy 1 2011-01-01 2011-01-01 false Control of access to high radiation areas. 20.1601 Section 20.1601 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Control of Exposure From External Sources in Restricted Areas § 20.1601 Control of access to high radiation areas. (a...
10 CFR 20.1601 - Control of access to high radiation areas.
Code of Federal Regulations, 2012 CFR
2012-01-01
... 10 Energy 1 2012-01-01 2012-01-01 false Control of access to high radiation areas. 20.1601 Section 20.1601 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Control of Exposure From External Sources in Restricted Areas § 20.1601 Control of access to high radiation areas. (a...
Information-Flow-Based Access Control for Web Browsers
NASA Astrophysics Data System (ADS)
Yoshihama, Sachiko; Tateishi, Takaaki; Tabuchi, Naoshi; Matsumoto, Tsutomu
The emergence of Web 2.0 technologies such as Ajax and Mashup has revealed the weakness of the same-origin policy[1], the current de facto standard for the Web browser security model. We propose a new browser security model to allow fine-grained access control in the client-side Web applications for secure mashup and user-generated contents. We propose a browser security model that is based on information-flow-based access control (IBAC) to overcome the dynamic nature of the client-side Web applications and to accurately determine the privilege of scripts in the event-driven programming model.
Fox, Karen C; Somes, Grant W; Waters, Teresa M
2007-08-01
The aim of this study was to examine the effectiveness of a telemedicine program in improving timeliness of and access to healthcare services in adolescent correctional facilities. This study is a pre/post quasi-experimental design comparing time to treatment and healthcare use in the year preceding and the 2 years after the implementation of a telemedicine program in four facilities housing adolescents from 12 to 19. Timeliness of care is measured by time from referral to date of service (for behavioral healthcare only). Access to care is measured by use of outpatient care, emergency department (ED) visits, and inpatient visits. Two of the four state correctional facilities had a significant decrease (24%) in time from referral to treatment after the implementation of the telemedicine intervention. The facilities not showing significant improvements in timeliness experienced difficulty implementing the telemedicine program. The telemedicine program was also associated with significant improvements in access to care. Outpatient visits increased by 40% in the 2 years after implementation of telemedicine. For each 1% increase in telemedicine usage, outpatient visits increased by 1%, whereas emergency room visits decreased by 7%. Telemedicine can have a positive impact on timeliness of and access to care for youth in correctional facilities.
ERIC Educational Resources Information Center
McGrew, Lee
A part of the Adult College Career Employment Support Services (ACCESS), the minicourse entitled Emeritus Career and Vocational Exploration has been designed to facilitate the entry or reentry of older persons into the work force as paid or volunteer workers. Organized into two four-week modules, the course offers participants assistance in…
Schoo, Adrian; Lawn, Sharon; Carson, Dean
2016-04-02
Access to rural health services is compromised in many countries including Australia due to workforce shortages. The issues that consequently impact on equity of access and sustainability of rural and remote health services are complex. The purpose of this paper is to describe a number of approaches from the literature that could form the basis of a more integrated approach to health workforce and rural health service enhancement that can be supported by policy. A case study is used to demonstrate how such an approach could work. Disjointed health services are common in rural areas due to the 'tyranny of distance.' Recruitment and retention of health professionals in rural areas and access to and sustainability of rural health services is therefore compromised. Strategies to address these issues tend to have a narrow focus. An integrated approach is needed to enhance rural workforce and health services; one that develops, acknowledges and accounts for social capital and social relations within the rural community.
Web Accessibility and Accessibility Instruction
ERIC Educational Resources Information Center
Green, Ravonne A.; Huprich, Julia
2009-01-01
Section 508 of the Americans with Disabilities Act (ADA) mandates that programs and services be accessible to people with disabilities. While schools of library and information science (SLIS*) and university libraries should model accessible Web sites, this may not be the case. This article examines previous studies about the Web accessibility of…
Valencia-Garcia, Dellanira; Simoni, Jane M; Alegría, Margarita; Takeuchi, David T
2012-04-01
We examined whether individual-level social capital-the intangible resources in a community available through membership in social networks or other social structures and perceived trust in the community-was associated with acculturation, depression and anxiety symptoms, and perceived access to services among women of Mexican ancestry. Recruited through venue-based targeted sampling in King County, Washington, 205 women of Mexican descent ages 18 to 64 years who differed in socioeconomic status and nativity completed a cross-sectional survey. Half completed the survey in Spanish and half in English. Structural equation modeling was used for model testing. Social capital increased with level of acculturation and was negatively related to depression and anxiety; it had no direct association with perceived access to services. Social capital mediated the relation between acculturation and both depression and anxiety symptoms. Acculturation had no direct association with psychological distress but was directly associated with perceived access to services. This community sample of women reported high levels of psychological distress, with 20% to 26% of women meeting diagnostic criteria for depression or anxiety. Social capital can be assessed at the individual level, increases with acculturation, and may be a potential target for interventions to improve mental health among Mexican American women residing in the United States. PsycINFO Database Record (c) 2012 APA, all rights reserved.
OASIS: A Data Fusion System Optimized for Access to Distributed Archives
NASA Astrophysics Data System (ADS)
Berriman, G. B.; Kong, M.; Good, J. C.
2002-05-01
The On-Line Archive Science Information Services (OASIS) is accessible as a java applet through the NASA/IPAC Infrared Science Archive home page. It uses Geographical Information System (GIS) technology to provide data fusion and interaction services for astronomers. These services include the ability to process and display arbitrarily large image files, and user-controlled contouring, overlay regeneration and multi-table/image interactions. OASIS has been optimized for access to distributed archives and data sets. Its second release (June 2002) provides a mechanism that enables access to OASIS from "third-party" services and data providers. That is, any data provider who creates a query form to an archive containing a collection of data (images, catalogs, spectra) can direct the result files from the query into OASIS. Similarly, data providers who serve links to datasets or remote services on a web page can access all of these data with one instance of OASIS. In this was any data or service provider is given access to the full suite of capabilites of OASIS. We illustrate the "third-party" access feature with two examples: queries to the high-energy image datasets accessible from GSFC SkyView, and links to data that are returned from a target-based query to the NASA Extragalactic Database (NED). The second release of OASIS also includes a file-transfer manager that reports the status of multiple data downloads from remote sources to the client machine. It is a prototype for a request management system that will ultimately control and manage compute-intensive jobs submitted through OASIS to computing grids, such as request for large scale image mosaics and bulk statistical analysis.
Sandahl, Hinuga; Norredam, Marie; Hjern, Anders; Asher, Henry; Nielsen, Signe Smith
2013-08-01
Asylum-seeking children constitute a vulnerable group with high prevalence and risk for mental health problems. The aim of this study was to compare policies of access to healthcare services, including physical examination and screening for mental health problems on arrival, for accompanied asylum-seeking children in the Nordic countries. This study was based on the national reports "Reception of refugee children in the Nordic countries" written by independent national experts for the Nordic Network for Research on Refugee Children, supplemented by information from relevant authorities. In Sweden, Norway and Iceland, asylum-seeking children had access to healthcare services equal to children in the general population. On a policy level, Denmark imposed restrictions on non-acute hospitalisations and prolonged specialist treatments. Regarding health examinations, Sweden deviated from the Nordic pattern by not performing these systematically. In Denmark, Iceland, and some counties in Sweden, but not in Norway, screening for mental health problems was offered to asylum-seeking children. Access to healthcare services for asylum-seeking children differs in the Nordic countries; the consequences of these systematic differences for the individual asylum-seeking child are unknown. For asylum-seeking children, access to healthcare has to be considered in a wider context that includes the core conditions of being an asylum-seeker. A comparative study at policy level needs to be supplemented with empirical follow-up studies of the well-being of the study population to document potential consequences of policies in practice.
42 CFR 475.103 - Eligibility of physician-access organizations.
Code of Federal Regulations, 2010 CFR
2010-10-01
....103 Section 475.103 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS QUALITY IMPROVEMENT ORGANIZATIONS Utilization and Quality Control Quality Improvement Organizations § 475.103 Eligibility of physician-access...
Access Control to Information in Pervasive Computing Environments
2005-08-01
for foo’s public key. (Digital signatures are omitted.) indicate a set of location and time intervals. A service will return location information only...stands for foo’s public key. (Digital signatures are omitted.) it describes the resource to which access is granted. Currently, we allow only resources...information relationship. Alice’s location information is bun- dled in her personal information. (The digital signature is omitted.) We use extended
Remote Internet access to advanced analytical facilities: a new approach with Web-based services.
Sherry, N; Qin, J; Fuller, M Suominen; Xie, Y; Mola, O; Bauer, M; McIntyre, N S; Maxwell, D; Liu, D; Matias, E; Armstrong, C
2012-09-04
Over the past decade, the increasing availability of the World Wide Web has held out the possibility that the efficiency of scientific measurements could be enhanced in cases where experiments were being conducted at distant facilities. Examples of early successes have included X-ray diffraction (XRD) experimental measurements of protein crystal structures at synchrotrons and access to scanning electron microscopy (SEM) and NMR facilities by users from institutions that do not possess such advanced capabilities. Experimental control, visual contact, and receipt of results has used some form of X forwarding and/or VNC (virtual network computing) software that transfers the screen image of a server at the experimental site to that of the users' home site. A more recent development is a web services platform called Science Studio that provides teams of scientists with secure links to experiments at one or more advanced research facilities. The software provides a widely distributed team with a set of controls and screens to operate, observe, and record essential parts of the experiment. As well, Science Studio provides high speed network access to computing resources to process the large data sets that are often involved in complex experiments. The simple web browser and the rapid transfer of experimental data to a processing site allow efficient use of the facility and assist decision making during the acquisition of the experimental results. The software provides users with a comprehensive overview and record of all parts of the experimental process. A prototype network is described involving X-ray beamlines at two different synchrotrons and an SEM facility. An online parallel processing facility has been developed that analyzes the data in near-real time using stream processing. Science Studio and can be expanded to include many other analytical applications, providing teams of users with rapid access to processed results along with the means for detailed
75 FR 4007 - Risk Management Controls for Brokers or Dealers With Market Access
Federal Register 2010, 2011, 2012, 2013, 2014
2010-01-26
... 3235-AK53 Risk Management Controls for Brokers or Dealers With Market Access AGENCY: Securities and... or other persons, to implement risk management controls and supervisory procedures reasonably... access may not utilize any pre-trade risk management controls (i.e., ``unfiltered'' or ``naked'' access...
Access Control for Mobile Assessment Systems Using ID.
Nakayama, Masaharu; Ishii, Tadashi; Morino, Kazuma
2015-01-01
The assessment of shelters during disaster is critical to ensure the health of evacuees and prevent pandemic. In the Ishinomaki area, one of the areas most damaged by the Great East Japan Earthquake, the highly organized assessment helped to successfully manage a total of 328 shelters with a total of 46,480 evacuees. The input and analysis of vast amounts of data was tedious work for staff members. However, a web-based assessment system that utilized mobile devices was thought to decrease workload and standardize the evaluation form. The necessary access of information should be controlled in order to maintain individuals' privacy. We successfully developed an access control system using IDs. By utilizing a unique numerical ID, users can access the input form or assessment table. This avoids unnecessary queries to the server, resulting in a quick response and easy availability, even with poor internet connection.
Frequency and Correlates of Service Access among Youth with Autism Transitioning to Adulthood
Taylor, Julie Lounds; Henninger, Natalie A.
2014-01-01
This study examined service receipt and unmet service needs among youth with autism spectrum disorders (ASD) in their last year of high school, as well as the youth (intellectual disability, race/ethnicity, autism severity, comorbid psychiatric diagnoses, behavior problems, adaptive behavior) and family (income, parental health, parental depressive symptoms, parental anxiety) correlates of service access. Thirty-nine families of youth with ASD participated. Data were collected via parental interview/questionnaire and youth psychological evaluation. Results suggested that this sample was underserved relative to a nationally-representative cohort. Those with a comorbid psychiatric diagnosis and lower levels of adaptive behavior received more services. Greater unmet needs were reported for youth who were racial/ethnic minorities, who had more behavior problems, and whose parents had greater anxiety. PMID:25081594
Mheta, Doreen; Mashamba-Thompson, Tivani P
2017-05-16
The Sustainable Development Goals (SDGs) emphasises the increasing equitable coverage of quality health care and provision of integrated services as means of reducing maternal mortality. Despite so much effort being placed on improved access to maternity health care, studies show that women with disabilities are being systemically excluded from the mainstream maternal health services. The proposed scoping review aims to map literature on the barriers and facilitators of access to maternal services for women with disabilities. The search strategy for this scoping review study will involve electronic databases including Pubmed, MEDLINE via EBSCOhost, CINAHL Plus with full text via EBSCOhost, Africa-Wide Info via EBSCOhost, JSTOR and Proquest Health and Medical Complete. Articles will also be searched through the "Cited by" search as well as citations included in the reference lists of included articles. A two-stage mapping strategy would be conducted. Stage 1 would be to screen studies through examining their titles. Furthermore, we will screen abstracts of the identified studies descriptively and by focus and method as stipulated by the inclusion and exclusion criteria. In stage 2, we will extract data from the included studies. A parallel screening and data extraction will be undertaken by two reviewers. We will access the quality of the included studies using the mixed methods appraisal tool (MMAT). We will use NVIVO version 10 to extract the relevant outcomes and thematic analysis of the studies. We anticipate to find relevant studies reporting evidence on the barriers and facilitators of access to maternal health services in Sub-Saharan Africa. The evidence obtained from the included studies when summarised will help guide future research. The study findings will be disseminated electronically and in print. In addition, it will be presented at conferences related to sexual reproductive health, maternal health care and reproductive health.
Mbonye, A K; Hansen, K S; Wamono, F; Magnussen, P
2009-12-01
To explore whether private midwives can perform HIV counselling and testing, provide antiretroviral treatment and contraceptives, and how this affects access to services especially among young and HIV-positive women. A formative study was conducted between January and April 2009 to assess care-seeking practices and perceptions on the prevention of mother-to-child transmission (PMTCT) and family planning services in Wakiso district, central Uganda. A household survey supplemented by 12 focus group discussions and 66 key informant interviews was carried out between January and April 2009. 10,706 women, mean age 25.8 years (14-49 years) were interviewed. The majority of women, 4786 (57%) were in the lowest wealth quintile; 62.0% were not using family planning (p<0.000); 56.2% did not access HIV counselling and testing because they feared knowing their HIV status (p<0.013), while 66.5% feared spouses knowing their HIV status (p<0.013). Access to these services among the young women and those with no education was also poor. Private midwives provide HIV testing to 7.8% of their clients; 5.9% received antiretroviral drugs and 8.6% received contraceptives. Client satisfaction with services at private midwifery practices was high. Private midwives are trusted and many clients confide in them. An intervention through private midwives was perceived to improve access because of short distances and no transport costs. Adolescents prioritized confidentiality, while subsidizing costs, community sensitisation and focusing on male spouses were overwhelmingly recommended. Private midwives clinics are potential delivery outlets for PMTCT in Uganda. A well-designed intervention linking them to the public sector and the community could increase access to services.
NASA Technical Reports Server (NTRS)
Kempler, Steve; Leptoukh, Greg; Lynnes, Chris
2010-01-01
The presentation purpose is to describe multi-instrument tools and services that facilitate access and usability of NASA Earth science data at Goddard Space Flight Center (GSFC). NASA's Earth observing system includes 14 satellites. Topics include EOSDIS facilities and system architecture, and overview of GSFC Earth Science Data and Information Services Center (GES DISC) mission, Mirador data search, Giovanni, multi-instrument data exploration, Google Earth[TM], data merging, and applications.
NASA Astrophysics Data System (ADS)
Impemba, Ernesto; Inzerilli, Tiziano
2003-07-01
Integration of satellite access networks with the Internet is seen as a strategic goal to achieve in order to provide ubiquitous broadband access to Internet services in Next Generation Networks (NGNs). One of the main interworking aspects which has been most studied is an efficient management of satellite resources, i.e. bandwidth and buffer space, in order to satisfy most demanding application requirements as to delay control and bandwidth assurance. In this context, resource management in DVB-S/DVB-RCS satellite technologies, emerging technologies for broadband satellite access and transport of IP applications, is a research issue largely investigated as a means to provide efficient bi-directional communications across satellites. This is in particular one of the principal goals of the SATIP6 project, sponsored within the 5th EU Research Programme Framework, i.e. IST. In this paper we present a possible approach to efficiently exploit bandwidth, the most critical resource in a broadband satellite access network, while pursuing satisfaction of delay and bandwidth requirements for applications with guaranteed QoS through a traffic control architecture to be implemented in ground terminals. Performance of this approach is assessed in terms of efficient exploitation of the uplink bandwidth and differentiation and minimization of queuing delays for most demanding applications over a time-varying capacity. Opnet simulations is used as analysis tool.
Accessing Electronic Journals.
ERIC Educational Resources Information Center
McKay, Sharon Cline
1999-01-01
Discusses issues librarians need to consider when providing access to electronic journals. Topics include gateways; index and abstract services; validation and pay-per-view; title selection; integration with OPACs (online public access catalogs)or Web sites; paper availability; ownership versus access; usage restrictions; and services offered…
PANATIKI: A Network Access Control Implementation Based on PANA for IoT Devices
Sanchez, Pedro Moreno; Lopez, Rafa Marin; Gomez Skarmeta, Antonio F.
2013-01-01
Internet of Things (IoT) networks are the pillar of recent novel scenarios, such as smart cities or e-healthcare applications. Among other challenges, these networks cover the deployment and interaction of small devices with constrained capabilities and Internet protocol (IP)-based networking connectivity. These constrained devices usually require connection to the Internet to exchange information (e.g., management or sensing data) or access network services. However, only authenticated and authorized devices can, in general, establish this connection. The so-called authentication, authorization and accounting (AAA) services are in charge of performing these tasks on the Internet. Thus, it is necessary to deploy protocols that allow constrained devices to verify their credentials against AAA infrastructures. The Protocol for Carrying Authentication for Network Access (PANA) has been standardized by the Internet engineering task force (IETF) to carry the Extensible Authentication Protocol (EAP), which provides flexible authentication upon the presence of AAA. To the best of our knowledge, this paper is the first deep study of the feasibility of EAP/PANA for network access control in constrained devices. We provide light-weight versions and implementations of these protocols to fit them into constrained devices. These versions have been designed to reduce the impact in standard specifications. The goal of this work is two-fold: (1) to demonstrate the feasibility of EAP/PANA in IoT devices; (2) to provide the scientific community with the first light-weight interoperable implementation of EAP/PANA for constrained devices in the Contiki operating system (Contiki OS), called PANATIKI. The paper also shows a testbed, simulations and experimental results obtained from real and simulated constrained devices. PMID:24189332
PANATIKI: a network access control implementation based on PANA for IoT devices.
Moreno Sanchez, Pedro; Marin Lopez, Rafa; Gomez Skarmeta, Antonio F
2013-11-01
Internet of Things (IoT) networks are the pillar of recent novel scenarios, such as smart cities or e-healthcare applications. Among other challenges, these networks cover the deployment and interaction of small devices with constrained capabilities and Internet protocol (IP)-based networking connectivity. These constrained devices usually require connection to the Internet to exchange information (e.g., management or sensing data) or access network services. However, only authenticated and authorized devices can, in general, establish this connection. The so-called authentication, authorization and accounting (AAA) services are in charge of performing these tasks on the Internet. Thus, it is necessary to deploy protocols that allow constrained devices to verify their credentials against AAA infrastructures. The Protocol for Carrying Authentication for Network Access (PANA) has been standardized by the Internet engineering task force (IETF) to carry the Extensible Authentication Protocol (EAP), which provides flexible authentication upon the presence of AAA. To the best of our knowledge, this paper is the first deep study of the feasibility of EAP/PANA for network access control in constrained devices. We provide light-weight versions and implementations of these protocols to fit them into constrained devices. These versions have been designed to reduce the impact in standard specifications. The goal of this work is two-fold: (1) to demonstrate the feasibility of EAP/PANA in IoT devices; (2) to provide the scientific community with the first light-weight interoperable implementation of EAP/PANA for constrained devices in the Contiki operating system (Contiki OS), called PANATIKI. The paper also shows a testbed, simulations and experimental results obtained from real and simulated constrained devices.
Aung, Nyein Chan; Rechel, Bernd; Odermatt, Peter
2010-10-12
An estimated 10,000 Burmese migrants are currently living in London. No studies have been conducted on their access to health services. Furthermore, most studies on migrants in the United Kingdom (UK) have been conducted at the point of service provision, carrying the risk of selection bias. Our cross-sectional study explored access to and utilisation of General Practice (GP) services by Burmese migrants residing in London. We used a mixed-method approach: a quantitative survey using self-administered questionnaires was complemented by qualitative in-depth interviews for developing the questionnaire and triangulating the findings of the survey. Overall, 137 questionnaires were received (a response rate of 57%) and 11 in-depth interviews conducted. The main outcome variables of the study included GP registration, barriers towards registration, GP consultations, barriers towards consultations, and knowledge on entitlements to health care. Quantitative data were analysed using descriptive statistics, association tests, and a multivariate analysis using logistic regression. The qualitative information was analysed using content analysis. The respondents were young, of roughly equal gender (51.5% female), well educated, and had a fair level of knowledge on health services in the UK. Although the GP registration rate was relatively high (80%, 109 out of 136), GP service utilisation during the last episode of illness, at 56.8% (54 out of 95), was low. The statistical analysis showed that age being younger than 35 years, lacking prior overseas experience, having an unstable immigration status, having a shorter duration of stay, and resorting to self-medication were the main barriers hindering Burmese migrants from accessing primary health care services. These findings were corroborated by the in-depth interviews. Our study found that having formal access to primary health care was not sufficient to ensure GP registration and health care utilisation. Some respondents faced
Urban Studies: A Study of Bibliographic Access and Control.
ERIC Educational Resources Information Center
Anderson, Barbara E.
This paper analyzes: (1) the bibliographic access to publications in urban studies via printed secondary sources; (2) development and scope of classification systems and of vocabulary control for urban studies; and (3) currently accessible automated collections of bibliographic citations. Urban studies is defined as "an agglomeration of…
Open access publishing, article downloads, and citations: randomised controlled trial
Lewenstein, Bruce V; Simon, Daniel H; Booth, James G; Connolly, Mathew J L
2008-01-01
Objective To measure the effect of free access to the scientific literature on article downloads and citations. Design Randomised controlled trial. Setting 11 journals published by the American Physiological Society. Participants 1619 research articles and reviews. Main outcome measures Article readership (measured as downloads of full text, PDFs, and abstracts) and number of unique visitors (internet protocol addresses). Citations to articles were gathered from the Institute for Scientific Information after one year. Interventions Random assignment on online publication of articles published in 11 scientific journals to open access (treatment) or subscription access (control). Results Articles assigned to open access were associated with 89% more full text downloads (95% confidence interval 76% to 103%), 42% more PDF downloads (32% to 52%), and 23% more unique visitors (16% to 30%), but 24% fewer abstract downloads (−29% to −19%) than subscription access articles in the first six months after publication. Open access articles were no more likely to be cited than subscription access articles in the first year after publication. Fifty nine per cent of open access articles (146 of 247) were cited nine to 12 months after publication compared with 63% (859 of 1372) of subscription access articles. Logistic and negative binomial regression analysis of article citation counts confirmed no citation advantage for open access articles. Conclusions Open access publishing may reach more readers than subscription access publishing. No evidence was found of a citation advantage for open access articles in the first year after publication. The citation advantage from open access reported widely in the literature may be an artefact of other causes. PMID:18669565
Dual-mode ultraflow access networks: a hybrid solution for the access bottleneck
NASA Astrophysics Data System (ADS)
Kazovsky, Leonid G.; Shen, Thomas Shunrong; Dhaini, Ahmad R.; Yin, Shuang; De Leenheer, Marc; Detwiler, Benjamin A.
2013-12-01
Optical Flow Switching (OFS) is a promising solution for large Internet data transfers. In this paper, we introduce UltraFlow Access, a novel optical access network architecture that offers dual-mode service to its end-users: IP and OFS. With UltraFlow Access, we design and implement a new dual-mode control plane and a new dual-mode network stack to ensure efficient connection setup and reliable and optimal data transmission. We study the impact of the UltraFlow system's design on the network throughput. Our experimental results show that with an optimized system design, near optimal (around 10 Gb/s) OFS data throughput can be attained when the line rate is 10Gb/s.
Wagner, Michael M.; Levander, John D.; Brown, Shawn; Hogan, William R.; Millett, Nicholas; Hanna, Josh
2013-01-01
This paper describes the Apollo Web Services and Apollo-SV, its related ontology. The Apollo Web Services give an end-user application a single point of access to multiple epidemic simulators. An end user can specify an analytic problem—which we define as a configuration and a query of results—exactly once and submit it to multiple epidemic simulators. The end user represents the analytic problem using a standard syntax and vocabulary, not the native languages of the simulators. We have demonstrated the feasibility of this design by implementing a set of Apollo services that provide access to two epidemic simulators and two visualizer services. PMID:24551417
Wagner, Michael M; Levander, John D; Brown, Shawn; Hogan, William R; Millett, Nicholas; Hanna, Josh
2013-01-01
This paper describes the Apollo Web Services and Apollo-SV, its related ontology. The Apollo Web Services give an end-user application a single point of access to multiple epidemic simulators. An end user can specify an analytic problem-which we define as a configuration and a query of results-exactly once and submit it to multiple epidemic simulators. The end user represents the analytic problem using a standard syntax and vocabulary, not the native languages of the simulators. We have demonstrated the feasibility of this design by implementing a set of Apollo services that provide access to two epidemic simulators and two visualizer services.
ERIC Educational Resources Information Center
Huff-Eibl, Robyn; Miller-Wells, John; Begay, Wendy
2014-01-01
This article describes the process and role frontline access and public service staff play in needs assessment and evaluation of user services, specifically in understanding the voice of the customer. Information includes how the University of Arizona Libraries have incorporated daily data collection into the strategic planning process, resources…
Jennings, Larissa; Omoni, Adetayo; Akerele, Akunle; Ibrahim, Yisa; Ekanem, Ekpenyong
2015-05-01
Mobile communication technologies may reduce maternal health disparities related to cost, distance, and infrastructure. However, the ability of mHealth initiatives to accelerate maternal health goals requires in part that women with the greatest health needs have access to mobile phones. This study examined if women with limited mobile phone access have differential odds of maternal knowledge and health service utilization as compared to female mobile phone users who are currently eligible to participate in maternal mHealth programs. Using household survey data from Nigeria, multivariable logistic regressions were used to examine the odds of maternal knowledge and service utilization by mobile phone strata. Findings showed that in settings with unequal access to mobile phones, mHealth interventions may not reach women who have the poorest maternal knowledge and care-seeking as these women often lacked mobile connectivity. As compared to mobile users, women without mobile phone access had significantly lower odds of antenatal care utilization (OR=0.48, 95%CI: 0.36-0.64), skilled delivery (OR=0.56, 95%CI: 0.45-0.70), and modern contraceptive use (OR=0.50, 95%CI: 0.33-0.76) after adjusting for demographic characteristics. They also had significantly lower knowledge of maternal danger signs (OR=0.69, 95%CI: 0.53-0.90) and knowledge of antenatal (OR=0.46, 95%CI: 0.36-0.59) and skilled delivery care benefits (OR=0.62, 95%CI: 0.47-0.82). No differences were observed by mobile phone strata in uptake of emergency obstetric care, postnatal services, or breastfeeding. As maternal mHealth strategies are increasingly utilized, more efforts are needed to improve women's access to mobile phones and minimize potential health inequities brought on by health systems and technological barriers in access to care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Sekabaraga, Claude; Diop, Francois; Soucat, Agnes
2011-11-01
Ensuring financial access to health services is a critical challenge for poor countries if they are to reach the health Millennium Development Goals (MDGs). This article examines the case of Rwanda, a country which has championed innovative health care financing policies. Between 2000 and 2007, Rwanda has improved financial access for the poor, increased utilization of health services and reduced out-of-pocket payments for health care. Poor groups' utilization has increased for all health services, sometimes dramatically. Use of assisted deliveries, for example, increased from 12.1% to 42.7% among the poorest quintile; payments at the point of delivery have also been reduced; and catastrophic expenditures have declined. Part of these achievements is likely linked to innovative health financing policies, particularly the expansion of micro-insurance ('mutuelles') and performance-based financing. The paper concludes that the Rwanda experience provides a useful example of effective implementation of policies that reduce the financial barrier to health services, hereby contributing to the health MDGs. Today's main challenge is to build the sustainability of this system. Finally, the paper proposes a simple set of rigorous metrics to assess the impact of health financing policies and calls for implementing rigorous impact evaluation of health care financing policies in low-income countries.
Fertility Effects of Abortion and Birth Control Pill Access for Minors
GULDI, MELANIE
2008-01-01
This article empirically assesses whether age-restricted access to abortion and the birth control pill influence minors’ fertility in the United States. There is not a strong consensus in previous literature regarding the relationship between laws restricting minors’ access to abortion and minors’ birthrates. This is the first study to recognize that state laws in place prior to the 1973 Roe v. Wade decision enabled minors to legally consent to surgical treatment—including abortion—in some states but not in others, and to construct abortion access variables reflecting this. In this article, age-specific policy variables measure either a minor’s legal ability to obtain an abortion or to obtain the birth control pill without parental involvement. I find fairly strong evidence that young women’s birthrates dropped as a result of abortion access as well as evidence that birth control pill access led to a drop in birthrates among whites. PMID:19110899
Fertility effects of abortion and birth control pill access for minors.
Guldi, Melanie
2008-11-01
This article empirically assesses whether age-restricted access to abortion and the birth control pill influence minors' fertility in the United States. There is not a strong consensus in previous literature regarding the relationship between laws restricting minors' access to abortion and minors' birth rates. This is the first study to recognize that state laws in place prior to the 1973 Roe v. Wade decision enabled minors to legally consent to surgical treatment-including abortion-in some states but not in others, and to construct abortion access variables reflecting this. In this article, age-specific policy variables measure either a minor's legal ability to obtain an abortion or to obtain the birth control pill without parental involvement. I find fairly strong evidence that young women's birth rates dropped as a result of abortion access as well as evidence that birth control pill access led to a drop in birth rates among whites.
NASA Astrophysics Data System (ADS)
Kirsch, Peter; Breen, Paul
2013-04-01
We wish to highlight outputs of a project conceived from a science requirement to improve discovery and access to Antarctic meteorological data in near real-time. Given that the data was distributed in both spatial and temporal domains and is to be accessed across several science disciplines, the creation of an interoperable, OGC compliant web service was deemed the most appropriate approach. We will demonstrate an implementation of the OGC SOS Interface Standard to discover, browse, and access Antarctic meteorological data-sets. A selection of programmatic (R, Perl) and web client interfaces utilizing open technologies ( e.g. jQuery, Flot, openLayers ) will be demonstrated. In addition we will show how high level abstractions can be constructed to allow the users flexible and straightforward access to SOS retrieved data.
A SOA broker solution for standard discovery and access services: the GI-cat framework
NASA Astrophysics Data System (ADS)
Boldrini, Enrico
2010-05-01
GI-cat ideal users are data providers or service providers within the geoscience community. The former have their data already available through an access service (e.g. an OGC Web Service) and would have it published through a standard catalog service, in a seamless way. The latter would develop a catalog broker and let users query and access different geospatial resources through one or more standard interfaces and Application Profiles (AP) (e.g. OGC CSW ISO AP, CSW ebRIM/EO AP, etc.). GI-cat actually implements a broker components (i.e. a middleware service) which carries out distribution and mediation functionalities among "well-adopted" catalog interfaces and data access protocols. GI-cat also publishes different discovery interfaces: the OGC CSW ISO and ebRIM Application Profiles (the latter coming with support for the EO and CIM extension packages) and two different OpenSearch interfaces developed in order to explore Web 2.0 possibilities. An extended interface is also available to exploit all available GI-cat features, such as interruptible incremental queries and queries feedback. Interoperability tests performed in the context of different projects have also pointed out the importance to enforce compatibility with existing and wide-spread tools of the open source community (e.g. GeoNetwork and Deegree catalogs), which was then achieved. Based on a service-oriented framework of modular components, GI-cat can effectively be customized and tailored to support different deployment scenarios. In addition to the distribution functionality an harvesting approach has been lately experimented, allowing the user to switch between a distributed and a local search giving thus more possibilities to support different deployment scenarios. A configurator tool is available in order to enable an effective high level configuration of the broker service. A specific geobrowser was also naturally developed, for demonstrating the advanced GI-cat functionalities. This client
Tomnay, Jane E; Coelli, Lauren; Davidson, Ange; Hulme-Chambers, Alana; Orr, Catherine; Hocking, Jane S
2018-06-01
To describe how a nurse led, MToP service is run in primary care in regional Victoria and investigate the characteristics and contraceptive choices of the women who have attended. Descriptive study of the development and implementation of a rural MToP service and a retrospective chart audit of patients attending between January 2015 and September 2016. Characteristics and clinical outcomes for women attending an MToP service in a primary care setting in rural Victoria. Contraceptive usage pre and post attending a rural service for MToP. There were 229 presentations, representing 223 women, of which 172 women (75.1%; 95%CI: 69.0%, 80.6%) had a successful MToP and for two further women, MToP failed, requiring a surgical termination (0.9%; 95%CI: 0.1%, 3.1%). At the time of presentation, the mean age of women was 25 years, the median length of gestation was 49 days and 171 (75%) had not had a previous termination. Data about contraceptive use was available for 195 women, 143 (73.3%) reported no contraception, 2 reported emergency contraceptive pill (1.0%), 10 used condoms (2.1%) and 39 (20.0%) reported hormonal contraception. Among the 156 women using no contraception, condoms or emergency contraception at the time of pregnancy, 113 (72.4%) initiated a reliable form of contraception post presentation to the MToP service. Provision of accessible, affordable MToP through an integrated primary health service is one strategy to address access inequity in regional areas. Copyright © 2018 Elsevier B.V. All rights reserved.
Sundari Ravindran, T K
2014-05-01
Universal access to sexual and reproductive health services is one of the goals of the International Conference on Population and Development of 1994. The Millennium Development Goals were intended above all to end poverty. Universal access to health and health services are among the goals being considered for the post-2015 agenda, replacing or augmenting the MDGs. Yet we are not only far from reaching any of these goals but also appear to have lost our way somewhere along the line. Poverty and lack of food security have, through their multiple linkages to health and access to health care, deterred progress towards universal access to health services, including for sexual and reproductive health needs. A more insidious influence is neoliberal globalisation. This paper describes neoliberal globalisation and the economic policies it has engendered, the ways in which it influences poverty and food security, and the often unequal impact it has had on women as compared to men. It explores the effects of neoliberal economic policies on health, health systems, and universal access to health care services, and the implications for access to sexual and reproductive health. To be an advocate for universal access to health and health care is to become an advocate against neoliberal globalisation. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.