Sample records for access initiative experience

  1. Initiation of Addiction Treatment and Access to Services: Young Adults' Accounts of Their Help-Seeking Experiences.

    PubMed

    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.

  2. Lateral Transorbital Endoscopic Access to the Hippocampus, Amygdala, and Entorhinal Cortex: Initial Clinical Experience.

    PubMed

    Chen, H Isaac; Bohman, Leif-Erik; Emery, Lyndsey; Martinez-Lage, Maria; Richardson, Andrew G; Davis, Kathryn A; Pollard, John R; Litt, Brian; Gausas, Roberta E; Lucas, Timothy H

    2015-01-01

    Transorbital approaches traditionally have focused on skull base and cavernous sinus lesions medial to the globe. Lateral orbital approaches to the temporal lobe have not been widely explored despite several theoretical advantages compared to open craniotomy. Recently, we demonstrated the feasibility of the lateral transorbital technique in cadaveric specimens with endoscopic visualization. We describe our initial clinical experience with the endoscope-assisted lateral transorbital approach to lesions in the temporal lobe. Two patients with mesial temporal lobe pathology presenting with seizures underwent surgery. The use of a transpalpebral or Stallard-Wright eyebrow incision enabled access to the intraorbital compartment, and a lateral orbital wall 'keyhole' opening permitted visualization of the anterior temporal pole. This approach afforded adequate access to the surgical target and surrounding structures and was well tolerated by the patients. To the best of our knowledge, this report constitutes the first case series describing the endoscope-assisted lateral transorbital approach to the temporal lobe. We discuss the limits of exposure, the nuances of opening and closing, and comparisons to open craniotomy. Further prospective investigation of this approach is warranted for comparison to traditional approaches to the mesial temporal lobe. © 2015 S. Karger AG, Basel.

  3. Productivity Measures Associated With a Patient Access Initiative

    PubMed Central

    Gable, William H.; Pappas, Theodore N.; Jacobs, Danny O.; Cutler, Desmond A.; Kuo, Paul C.

    2006-01-01

    Objective: To assess financial performance associated with a patient 7-day access initiative. Background Data: Patient access to clinical services is frequently an obstacle at academic medical centers. Conflicting surgeon priorities among academic, clinical, educational, and leadership duties often create difficulties for patient entry into the “system.” Methods: The scope and objectives were identified to be: design of a standard, simple new patient appointment process, design of a standard process in cases where an appointment is not available in 7 days, use subspecialty team search capabilities, minimize/eliminate prescheduling requirements, centralize appointment scheduling, and creation and reporting of 7-day access metrics. Following maturation of the process, the 7-day access metrics from the period July 2004 to December 2004 and January 2005 to June 2005 were compared with corresponding time periods from calendar years 2001, 2002, and 2003. Results: Payor mix was unaltered. The median waiting time for a new patient appointment decreased from 21 days to 10 days. When compared with calendar years 2001, 2002, and 2003, respectively, the 2 periods of the 7-day access initiative in calendar years 2004 and 2005 were associated with significantly increased visits, new patients, operative procedures, hospital charges, and physician charges. Conclusions: Implementation of a 7-day access initiative can significantly increase financial productivity of general surgery groups in academic medical centers. We conclude that simplifying access to services can benefit academic surgical practices. Sustaining this level of productivity will continue to prove challenging. PMID:16632994

  4. Amplatzer vascular plug for arteriovenous hemodialysis access occlusion: initial experience.

    PubMed

    Bui, J T; Gaba, R C; Knuttinen, M G; West, D L; Owens, C A

    2009-01-01

    The Amplatzer Vascular Plug (AVP; AGA Medical, Golden Valley, MN) is a recently developed self-expanding metallic device indicated for peripheral vascular embolizations. Herein, we describe use of this device in the treatment of vascular complications related to arteriovenous hemodialysis fistulas and grafts. This HIPAA compliant retrospective study was approved by the institutional review board with informed consent waived. Six patients with problematic arteriovenous access underwent access occlusion using the AVP. Procedure indications included vascular steal syndrome in five patients, and enlarging vascular aneurysms in one patient. Contraindications for surgical correction were determined by the referring surgeon. AVP embolizations were performed using devices oversized by 50% introduced through vascular sheaths positioned within vein segments just beyond the arteriovenous anastomoses. Noninvasive evaluation of the involved extremity was performed pre- and post-embolization in addition to clinical follow-up examinations. Measured outcomes included success of angiographic occlusion, improvement in distal arterial flow, AVP number, AVP diameter, time to access occlusion, and clinical symptomatic improvement. Technical success was 100%, with complete arteriovenous access occlusion accomplished in all cases, with an average of 1.5 AVPs used per patient. Mean time to access occlusion was 19.3 minutes. Angiographic improvement in distal arterial flow was immediately evident and resolution of clinical symptoms occurred in all patients, with mean long-term follow-up of 16 months. No procedure-related complications were encountered. The Amplatzer Vascular Plug provides a minimally invasive and efficacious method for embolization of problematic arteriovenous hemodialysis access.

  5. Strategies To Improve Young People's Access to, and Their Progression within, Initial Vocational Training.

    ERIC Educational Resources Information Center

    Banks, John

    Strategies to improve disadvantaged young people's access to and progression within initial vocational training (VT) were identified through a study of relevant experiences within the European Union's member states. The study, which was based on national reports from each country, focused on the following topics: identifying the challenges and…

  6. Educators' Experiences with and Attitudes toward Accessibility Features and Accommodations

    ERIC Educational Resources Information Center

    Thurlow, Martha L.; Larson, Erik D.; Lazarus, Sheryl S.; Shyyan, Vitaliy V.; Christensen, Laurene L.

    2017-01-01

    To evaluate the experiences that teachers and other decision makers were having with accessibility features and accommodations, as well as their attitudes toward them, an online survey was conducted with educators in nine states. These states were part of an Enhanced Assessment Initiative grant project to promote optimal decision making about…

  7. [The Open Access Initiative (OAI) in the scientific literature].

    PubMed

    Sánchez-Martín, Francisco M; Millán Rodríguez, Félix; Villavicencio Mavrich, Humberto

    2009-01-01

    According to the declaration of the Budapest Open Access Initiative (OAI) is defined as a editorial model in which access to scientific journal literature and his use are free. Free flow of information allowed by Internet has been the basis of this initiative. The Bethesda and the Berlin declarations, supported by some international agencies, proposes to require researchers to deposit copies of all articles published in a self-archive or an Open Access repository, and encourage researchers to publish their research papers in journals Open Access. This paper reviews the keys of the OAI, with their strengths and controversial aspects; and it discusses the position of databases, search engines and repositories of biomedical information, as well as the attitude of the scientists, publishers and journals. So far the journal Actas Urológicas Españolas (Act Urol Esp) offer their contents on Open Access as On Line in Spanish and English.

  8. Equal Access Initiative HIV/AIDS Information Resources from NLM

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Templin-Branner W. and N. Dancy

    The Equal Access Initiative: HIV/AIDS Information Resources from the National Library of Medicine training is designed specifically for the National Minority AIDS Council 2010 Equal Access Initiative (EAI) Computer Grants Program awardees to provide valuable health information resources from the National Library of Medicine and other reliable sources to increase awareness of the wealth of treatment information and educational materials that are available on the Internet and to improve prevention and treatment education for their clients. These resources will also meet the needs of community-based

  9. Predictors of nonfunctional arteriovenous access at hemodialysis initiation and timing of access creation: A registry-based study

    PubMed Central

    Metzger, Marie; Labeeuw, Michel; Ayav, Carole; Jacquelinet, Christian; Massy, Ziad A.; Stengel, Bénédicte

    2017-01-01

    Determinants of nonfunctional arteriovenous (AV) access, including timing of AV access creation, have not been sufficiently described. We studied 29 945 patients who had predialysis AV access placement and were included in the French REIN registry from 2005 through 2013. AV access was considered nonfunctional when dialysis began with a catheter. We estimated crude and adjusted odds ratio (OR) with 95% confidence intervals (CI) of nonfunctional versus functional AV access associated with case-mix, facility characteristics, and timing of AV access creation. Analyses were stratified by dialysis start condition (planned or as an emergency) and comorbidity profile. Overall, 18% patients had nonfunctional AV access at hemodialysis initiation. In the group with planned dialysis start, female gender (OR 1.43, 95% CI 1.32–1.56), diabetes (OR 1.28, 95% CI 1.15–1.44), and a higher number of cardiovascular comorbidities (OR 1.27, 95% CI 1.09–1.49, and 1.31, 1.05–1.64, for 3 and >3 cardiovascular comorbidities versus none, respectively) were independent predictors of nonfunctional AV access. A higher percentage of AV access creation at the region level was associated with a lower rate of nonfunctional AV access (OR 0.98, 95% CI 0.98–0.99 per 1% increase). The odds of nonfunctional AV access decreased as time from creation to hemodialysis initiation increased up to 3 months in nondiabetic patients with fewer than 2 cardiovascular comorbidities and 6 months in patients with diabetes or 2 or more such comorbidities. In conclusion, both patient characteristics and clinical practices may play a role in successful AV access use at hemodialysis initiation. Adjusting the timing of AV access creation to patients’ comorbidity profiles may improve functional AV access rates. PMID:28749967

  10. Predictors of nonfunctional arteriovenous access at hemodialysis initiation and timing of access creation: A registry-based study.

    PubMed

    Alencar de Pinho, Natalia; Coscas, Raphael; Metzger, Marie; Labeeuw, Michel; Ayav, Carole; Jacquelinet, Christian; Massy, Ziad A; Stengel, Bénédicte

    2017-01-01

    Determinants of nonfunctional arteriovenous (AV) access, including timing of AV access creation, have not been sufficiently described. We studied 29 945 patients who had predialysis AV access placement and were included in the French REIN registry from 2005 through 2013. AV access was considered nonfunctional when dialysis began with a catheter. We estimated crude and adjusted odds ratio (OR) with 95% confidence intervals (CI) of nonfunctional versus functional AV access associated with case-mix, facility characteristics, and timing of AV access creation. Analyses were stratified by dialysis start condition (planned or as an emergency) and comorbidity profile. Overall, 18% patients had nonfunctional AV access at hemodialysis initiation. In the group with planned dialysis start, female gender (OR 1.43, 95% CI 1.32-1.56), diabetes (OR 1.28, 95% CI 1.15-1.44), and a higher number of cardiovascular comorbidities (OR 1.27, 95% CI 1.09-1.49, and 1.31, 1.05-1.64, for 3 and >3 cardiovascular comorbidities versus none, respectively) were independent predictors of nonfunctional AV access. A higher percentage of AV access creation at the region level was associated with a lower rate of nonfunctional AV access (OR 0.98, 95% CI 0.98-0.99 per 1% increase). The odds of nonfunctional AV access decreased as time from creation to hemodialysis initiation increased up to 3 months in nondiabetic patients with fewer than 2 cardiovascular comorbidities and 6 months in patients with diabetes or 2 or more such comorbidities. In conclusion, both patient characteristics and clinical practices may play a role in successful AV access use at hemodialysis initiation. Adjusting the timing of AV access creation to patients' comorbidity profiles may improve functional AV access rates.

  11. Administering an epoch initiated for remote memory access

    DOEpatents

    Blocksome, Michael A; Miller, Douglas R

    2014-03-18

    Methods, systems, and products are disclosed for administering an epoch initiated for remote memory access that include: initiating, by an origin application messaging module on an origin compute node, one or more data transfers to a target compute node for the epoch; initiating, by the origin application messaging module after initiating the data transfers, a closing stage for the epoch, including rejecting any new data transfers after initiating the closing stage for the epoch; determining, by the origin application messaging module, whether the data transfers have completed; and closing, by the origin application messaging module, the epoch if the data transfers have completed.

  12. Administering an epoch initiated for remote memory access

    DOEpatents

    Blocksome, Michael A; Miller, Douglas R

    2012-10-23

    Methods, systems, and products are disclosed for administering an epoch initiated for remote memory access that include: initiating, by an origin application messaging module on an origin compute node, one or more data transfers to a target compute node for the epoch; initiating, by the origin application messaging module after initiating the data transfers, a closing stage for the epoch, including rejecting any new data transfers after initiating the closing stage for the epoch; determining, by the origin application messaging module, whether the data transfers have completed; and closing, by the origin application messaging module, the epoch if the data transfers have completed.

  13. Administering an epoch initiated for remote memory access

    DOEpatents

    Blocksome, Michael A.; Miller, Douglas R.

    2013-01-01

    Methods, systems, and products are disclosed for administering an epoch initiated for remote memory access that include: initiating, by an origin application messaging module on an origin compute node, one or more data transfers to a target compute node for the epoch; initiating, by the origin application messaging module after initiating the data transfers, a closing stage for the epoch, including rejecting any new data transfers after initiating the closing stage for the epoch; determining, by the origin application messaging module, whether the data transfers have completed; and closing, by the origin application messaging module, the epoch if the data transfers have completed.

  14. Baclofen and naltrexone effects on alcohol self-administration: Comparison of treatment initiated during abstinence or ongoing alcohol access in baboons.

    PubMed

    Holtyn, August F; Kaminski, Barbara J; Weerts, Elise M

    2017-10-01

    Baclofen, a GABA B receptor agonist, is under investigation as a pharmacotherapy for alcohol use disorder. Treatment with a pharmacotherapeutic can be initiated during alcohol abstinence or active drinking, which may influence treatment outcomes. This study examined whether baclofen treatment initiated and maintained during alcohol abstinence would reduce alcohol seeking and self-administration upon return to alcohol access, and whether effects differed from treatment initiated and maintained during ongoing alcohol access. Naltrexone was tested under similar conditions for comparison. Five baboons self-administered alcohol under a three-component chained schedule of reinforcement that modeled periods of anticipation (Component 1), seeking (Component 2), and consumption (Component 3). Alcohol was only available in Component 3. In Experiment 1, baclofen (0.1-1.8mg/kg) or naltrexone (1.0-5.6mg/kg) was administered daily beginning on the first day of a 5-day abstinence period and treatment was continued for 5days of alcohol access. In Experiment 2, selected doses of both drugs were administered during ongoing alcohol access. When treatment was initiated during alcohol abstinence, baclofen and naltrexone did not significantly reduce total alcohol intake (g/kg) or alcohol seeking. In comparison, when treatment was initiated during ongoing alcohol access, both baclofen (1.8mg/kg) and naltrexone (3.2 and 5.6mg/kg) significantly reduced total alcohol intake (g/kg). Naltrexone (5.6mg/kg), but not baclofen, significantly reduced alcohol seeking. Initiation of baclofen treatment (or other alcohol use disorder treatments) during abstinence or active drinking may be an important factor in influencing efficacy and appropriate dose selection. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Nationwide citizen access to their health data: analysing and comparing experiences in Denmark, Estonia and Australia.

    PubMed

    Nøhr, Christian; Parv, Liisa; Kink, Pille; Cummings, Elizabeth; Almond, Helen; Nørgaard, Jens Rahbek; Turner, Paul

    2017-08-07

    Most countries face an ageing population, increasing chronic diseased, and constrictions on budget for providing health services. Involving patients in their own care by allowing them access to their patient data is a trend seen in many places. Data on the type and level of access citizens have to their own health data in three countries was gathered from public sources. Data from each individual country is presented and the experiences of Denmark, Estonia and Australia are examined whilst similarities and differences explored. The discussion adopts a citizen-centred perspective to consider how the different e-portal systems support, protect and structure citizen interactions with their own health data in three key areas: Security, privacy and data protection; User support; and Citizen adoption and use. The paper highlights the impact of opt-in/opt-out approaches on citizen access and the lack of a structured approach to addressing differences in citizen health and e-health literacy. This research also confirms while current data provides detail on the availability and use of personal health data by citizens, questions still remain over the ultimate impact on patient outcomes of these initiatives. It is anticipated the insights generated from the three countries experiences, supporting citizen access to their health data will be useful to improve these initiatives and guide other countries aspiring to support similar initiatives.

  16. Patients' experiences of an open access follow up arrangement in managing inflammatory bowel disease

    PubMed Central

    Rogers, A; Kennedy, A; Nelson, E; Robinson, A

    2004-01-01

    Background: Improving access is a key policy issue in improving quality of care and extending patient choice and participation. People's experience of changing from fixed outpatient appointments to more flexible direct access arrangements for chronic disease has been underexplored. Objectives: To examine patients' views on using an open system of access compared with fixed outpatient appointments as part of a guided self-management intervention for inflammatory bowel disease (IBD). Design: Embedded qualitative study undertaken alongside a randomised controlled trial. Semi-structured interviews were undertaken to obtain an in depth understanding of patients' experience of the change in access arrangements. Participants: A purposive sample (n = 30) was drawn from the intervention group (n = 700) according to a range of responses to the trial baseline and follow up quantitative measures. Results: 28 interviews were included in the analysis. Compared with the previous system of fixed appointments, preference for the new open access system was based on enhanced personal control in contacting services and the view that it fitted better with everyday routine management and the requirement for urgent medical contact when symptoms fail to respond to medication. Preference for retaining fixed appointments was based on a sense of security from gaining access which did not require the individual to initiate the request for medical help. Conclusions: Open access may fit better with patients' self-management of their condition and everyday routines, roles and responsibilities. Ensuring that outpatient organisational arrangements and personnel are responsive to patient initiated requests for appointments is likely to impact on the acceptability of this type of access arrangement. Some people may continue to prefer the fixed appointment system which should be retained if patient choice is to be respected. PMID:15465941

  17. Veterans' experiences initiating VA-based mental health care.

    PubMed

    Bovin, Michelle J; Miller, Christopher J; Koenig, Christopher J; Lipschitz, Jessica M; Zamora, Kara A; Wright, Patricia B; Pyne, Jeffrey M; Burgess, James F

    2018-05-21

    Military veterans who could benefit from mental health services often do not access them. Research has revealed a range of barriers associated with initiating United States Department of Veterans Affairs (VA) care, including those specific to accessing mental health care (e.g., fear of stigmatization). More work is needed to streamline access to VA mental health-care services for veterans. In the current study, we interviewed 80 veterans from 9 clinics across the United States about initiation of VA mental health care to identify barriers to access. Results suggested that five predominant factors influenced veterans' decisions to initiate care: (a) awareness of VA mental health services; (b) fear of negative consequences of seeking care; (c) personal beliefs about mental health treatment; (d) input from family and friends; and (e) motivation for treatment. Veterans also spoke about the pathways they used to access this care. The four most commonly reported pathways included (a) physical health-care appointments; (b) the service connection disability system; (c) non-VA care; and (d) being mandated to care. Taken together, these data lend themselves to a model that describes both modifiers of, and pathways to, VA mental health care. The model suggests that interventions aimed at the identified pathways, in concert with efforts designed to reduce barriers, may increase initiation of VA mental health-care services by veterans. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  18. Advanced Cosmic-Ray Composition Experiment for Space Station (ACCESS): ACCESS Accommodation Study Report

    NASA Technical Reports Server (NTRS)

    Wilson, Thomas L. (Editor); Wefel, John P. (Editor)

    1999-01-01

    In 1994 NASA Administrator selected the first high-energy particle physics experiment for the Space Station, the Alpha Magnetic Spectrometer (AMS), to place a magnetic spectrometer in Earth orbit and search for cosmic antimatter. A natural consequence of this decision was that NASA would begin to explore cost-effective ways through which the design and implementation of AMS might benefit other promising payload experiments. The first such experiment to come forward was Advanced Cosmic-Ray Composition Experiment for Space Station (ACCESS) in 1996. It was proposed as a new mission concept in space physics to attach a cosmic-ray experiment of weight, volume, and geometry similar to the AMS on the International Space Station (ISS), and replace the latter as its successor when the AMS is returned to Earth. This was to be an extension of NASA's suborbital balloon program, with balloon payloads serving as the precursor flights and heritage for ACCESS. The balloon programs have always been a cost-effective NASA resource since the particle physics instrumentation for balloon and space applications are directly related. The next step was to expand the process, pooling together expertise from various NASA centers and universities while opening up definition of the ACCESS science goals to the international community through the standard practice of peer review. This process is still ongoing, and the accommodation study presented here will discuss the baseline definition of ACCESS as we understand it today.

  19. Local initiatives to access emergency obstetric and neonatal care in Burkina Faso.

    PubMed

    Yaméogo, Wambi M E; Ouédraogo, Talatou M; Kouanda, Seni

    2016-11-01

    To describe the various local initiatives to access emergency obstetric and neonatal care in Burkina Faso. An existing framework was used to review the three processes for local initiatives: emergence, formulation, and implementation. Multiple case studies were conducted, followed by literature review and semi-structured interviews with key informants. Sixteen districts had implemented local initiatives, including cost sharing, free care for women and children, and free care for delivery and cesareans. Most districts (n=10) had implemented the cost-sharing intervention. These initiatives were initiated by local actors as well as nongovernmental organizations. The profile of those involved led to different ways of handling the emergence and formulation processes. At implementation, these initiatives faced many issues including late payment of contributions, low involvement of local governments, and equity in participation. There are some issues in the implementation and sustainability of the local initiatives. Although many initiatives exist, these are unable to fully address the financial barriers to care. However, these initiatives highlight context-based financial barriers that must be taken into account to accelerate universal access to health care. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  20. Accessible Transportation Technologies Research Initiative (ATTRI) : User Needs Assessment: Stakeholder Engagement Report.

    DOT National Transportation Integrated Search

    2016-05-01

    The Accessible Transportation Technologies Research Initiative (ATTRI) is a joint U.S. Department of Transportation (U.S. DOT) initiative that is co-led by the Federal Highway Administration (FHWA) and the Federal Transit Administration (FTA). ATTRI ...

  1. Access with evidence development: the US experience.

    PubMed

    Mohr, Penny E; Tunis, Sean R

    2010-01-01

    The concept of access with evidence development (AED), also known as 'coverage with evidence development' in the Medicare programme, has long been discussed as a policy option for ensuring more appropriate use of new technologies in the US. This article provides a comprehensive overview of more than 10 years of US experience with AED, both in the public and private healthcare sectors. Beginning with a discussion of the successes of private plans' conditional coverage for high-density chemotherapy for autologous bone marrow transplants for metastatic breast cancer and Medicare's conditional coverage of lung-volume-reduction surgery in the 1990s, the article moves on to describe how Medicare worked to codify AED as one of its coverage policy options in the early part of this decade. More recent private and public sector initiatives are also discussed, including an overview of barriers to implementing AED. Despite the complexity of political, financial and ethical issues faced in implementation, AED is now a permanent fixture of US coverage policy. Future initiatives within the Medicare programme and with private payers in the US are much more likely to succeed by relying upon the simple but consequential principles laid out at a Summit convened in Banff, Alberta, Canada in 2009 and presented in another article in this issue.

  2. Open Access Initiatives in Africa--Structure, Incentives and Disincentives

    ERIC Educational Resources Information Center

    Nwagwu, Williams E.

    2013-01-01

    Building open access in Africa is imperative not only for African scholars and researchers doing scientific research but also for the expansion of the global science and technology knowledgebase. This paper examines the structure of homegrown initiatives, and observes very low level of awareness prevailing in the higher educational institutions…

  3. Expanding Educational Access in Eastern Turkey: A New Initiative

    ERIC Educational Resources Information Center

    O'Dwyer, John; Aksit, Necmi; Sands, Margaret

    2010-01-01

    The Eastern Anatolian project extends opportunity and access to quality education. The study examines the selection and learning systems adopted within the framework of gender equity, family background and higher order skills. Performance data on a range of selection measures and the initial programme are analysed. Results show that selection was…

  4. Vascular Access Creation before Hemodialysis Initiation and Use: A Population-Based Cohort Study

    PubMed Central

    Al-Jaishi, Ahmed A.; Lok, Charmaine E.; Garg, Amit X.; Zhang, Joyce C.

    2015-01-01

    Background and objectives In Canada, approximately 17% of patients use an arteriovenous access (fistula or arteriovenous graft) at commencement of hemodialysis, despite guideline recommendations promoting its timely creation and use. It is unclear if this low pattern of use is attributable to the lack of surgical creation or a high nonuse rate. Design, setting, participants, & measurements Using large health care databases in Ontario, Canada, a population-based cohort of adult patients (≥18 years old) who initiated hemodialysis as their first form of RRT between 2001 and 2010 was studied. The aims were to (1) estimate the proportion of patients who had an arteriovenous access created before starting hemodialysis and the proportion who successfully used it at hemodialysis start, (2) test for secular trends in arteriovenous access creation, and (3) estimate the effect of late nephrology referral and patient characteristics on arteriovenous access creation. Results There were 17,183 patients on incident hemodialysis. The mean age was 65.8 years, 60% were men, and 40% were referred late to a nephrologist; 27% of patients (4556 of 17,183) had one or more arteriovenous accesses created, and the median time between arteriovenous access creation and hemodialysis start was 184 days. When late referrals were excluded, 39% of patients (4007 of 10,291) had one or more arteriovenous accesses created, and 27% of patients (2724 of 10,291) used the arteriovenous access. Since 2001, there has been a decline in arteriovenous access creation before hemodialysis initiation. Women, higher numbers of comorbidities, and rural residence were consistently associated with lower rates of arteriovenous access creation. These results persisted even after removing patients with <6 months nephrology care or who had AKI 6 months before starting hemodialysis. Conclusions In Canada, arteriovenous access creation before hemodialysis initiation is low, even among patients followed by a nephrologist

  5. Vascular access creation before hemodialysis initiation and use: a population-based cohort study.

    PubMed

    Al-Jaishi, Ahmed A; Lok, Charmaine E; Garg, Amit X; Zhang, Joyce C; Moist, Louise M

    2015-03-06

    In Canada, approximately 17% of patients use an arteriovenous access (fistula or arteriovenous graft) at commencement of hemodialysis, despite guideline recommendations promoting its timely creation and use. It is unclear if this low pattern of use is attributable to the lack of surgical creation or a high nonuse rate. Using large health care databases in Ontario, Canada, a population-based cohort of adult patients (≥18 years old) who initiated hemodialysis as their first form of RRT between 2001 and 2010 was studied. The aims were to (1) estimate the proportion of patients who had an arteriovenous access created before starting hemodialysis and the proportion who successfully used it at hemodialysis start, (2) test for secular trends in arteriovenous access creation, and (3) estimate the effect of late nephrology referral and patient characteristics on arteriovenous access creation. There were 17,183 patients on incident hemodialysis. The mean age was 65.8 years, 60% were men, and 40% were referred late to a nephrologist; 27% of patients (4556 of 17,183) had one or more arteriovenous accesses created, and the median time between arteriovenous access creation and hemodialysis start was 184 days. When late referrals were excluded, 39% of patients (4007 of 10,291) had one or more arteriovenous accesses created, and 27% of patients (2724 of 10,291) used the arteriovenous access. Since 2001, there has been a decline in arteriovenous access creation before hemodialysis initiation. Women, higher numbers of comorbidities, and rural residence were consistently associated with lower rates of arteriovenous access creation. These results persisted even after removing patients with <6 months nephrology care or who had AKI 6 months before starting hemodialysis. In Canada, arteriovenous access creation before hemodialysis initiation is low, even among patients followed by a nephrologist. Better understanding of the barriers and influencers of arteriovenous access creation is

  6. The National Aerospace Initiative (NAI): Technologies For Responsive Space Access

    NASA Technical Reports Server (NTRS)

    Culbertson, Andrew; Bhat, Biliyar N.

    2003-01-01

    The Secretary of Defense has set new goals for the Department of Defense (DOD) to transform our nation's military forces. The Director for Defense Research and Engineering (DDR&E) has responded to this challenge by defining and sponsoring a transformational initiative in Science and Technology (S&T) - the National Aerospace Initiative (NAI) - which will have a fundamental impact on our nation's military capabilities and on the aerospace industry in general. The NAI is planned as a joint effort among the tri-services, DOD agencies and National Aeronautics and Space Administration (NASA). It is comprised of three major focus areas or pillars: 1) High Speed Hypersonics (HSH), 2) Space Access (SA), and 3) Space Technology (ST). This paper addresses the Space Access pillar. The NAI-SA team has employed a unique approach to identifying critical technologies and demonstrations for satisfying both military and civilian space access capabilities needed in the future. For planning and implementation purposes the NAI-SA is divided into five technology subsystem areas: Airframe, Propulsion, Flight Subsystems, Operations and Payloads. Detailed technology roadmaps were developed under each subsystem area using a time-phased, goal oriented approach that provides critical space access capabilities in a timely manner and involves subsystem ground and flight demonstrations. This S&T plan addresses near-term (2009), mid-term (2016), and long-term (2025) goals and objectives for space access. In addition, system engineering and integration approach was used to make sure that the plan addresses the requirements of the end users. This paper describes in some detail the technologies in NAI-Space Access pillar. Some areas of emphasis are: high temperature materials, thermal protection systems, long life, lightweight, highly efficient airframes, metallic and composite cryotanks, advanced liquid rocket engines, integrated vehicle health monitoring and management, highly operable systems and

  7. Young people with depression and their experience accessing an enhanced primary care service for youth with emerging mental health problems: a qualitative study.

    PubMed

    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

  8. Young people with depression and their experience accessing an enhanced primary care service for youth with emerging mental health problems: a qualitative study

    PubMed Central

    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

  9. [The subject repositories of strategy of the Open Access initiative].

    PubMed

    Soares Guimarães, M C; da Silva, C H; Horsth Noronha, I

    2012-11-01

    The subject repositories are defined as a set of digital objects resulting from the research related to a specific disciplinary field and occupy a still restricted space in the discussion agenda of the Free Access Movement when compared to amplitude reached in the discussion of Institutional Repositories. Although the Subject Repository comes to prominence in the field, especially for the success of initiatives such as the arXiv, PubMed and E-prints, the literature on the subject is recognized as very limited. Despite its roots in the Library and Information Science, and focus on the management of disciplinary collections (subject area literature), there is little information available about the development and management of subject repositories. The following text seeks to make a brief summary on the topic as a way to present the potential to develop subject repositories in order to strengthen the initiative of open access.

  10. Access to Fluoridated Water and Adult Dental Caries: A Natural Experiment.

    PubMed

    Peres, M A; Peres, K G; Barbato, P R; Höfelmann, D A

    2016-07-01

    Systematic reviews have found no evidence to support a benefit of water fluoridation (WF) to prevent dental caries in adult populations. The aim of this natural experiment was to investigate whether lifetime access to fluoridated water is associated with dental caries experience among adults from Florianópolis, Brazil. The data originated from a population-based cohort study (EpiFloripa Adult) initiated in 2009 (n = 1,720) when participants were aged 20 to 59 years. The second wave was carried out in 2012 (n = 1,140) and included a dental examination and a face-to-face questionnaire. Participants residing at the same address since the age of 7 y or before were included in the primary analyses. Sensitivity analyses were also performed. WF was implemented in the city in 2 different periods of time: 1982 (60% of the population) and 1996. Dental caries was assessed by the decayed, missing, and filled teeth (DMFT) index. A combination of residential status, participant's age, and year of implementation of WF permitted the creation of participants' lifetime access to fluoridated water: >75%, 50% to 75%, and <50% of a participant's lifetime. Covariates included sex, age, socioeconomic mobility, educational attainment, income, pattern of dental attendance, and smoking. Participants who accessed fluoridate water <50% of their lifetime presented a higher mean rate ratio of DMFT (1.39; 95% CI, 1.05-1.84) compared with those living >75% of their lifetime with residential access to fluoridated water. Participants living between 50% and 75% and <50% of their lives in fluoridated areas presented a decayed and filled teeth mean ratio of 1.34 (95% CI, 1.02-1.75) and 1.47 (95% CI, 1.05-2.04) higher than those with residential access to fluoridated water >75% of their lifetime, respectively. Longer residential lifetime access to fluoridated water was associated with less dental caries even in a context of multiple exposures to fluoride. © International & American Associations for

  11. 36 CFR 903.6 - Appeal of initial denial of access.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Appeal of initial denial of access. 903.6 Section 903.6 Parks, Forests, and Public Property PENNSYLVANIA AVENUE DEVELOPMENT... the Executive Director, Pennsylvania Avenue Development Corporation, 1331 Pennsylvania Avenue, NW...

  12. Survey Instruments to Assess Patient Experiences With Access and Coordination Across Health Care Settings: Available and Needed Measures.

    PubMed

    Quinn, Martha; Robinson, Claire; Forman, Jane; Krein, Sarah L; Rosland, Ann-Marie

    2017-07-01

    Improving access can increase the providers a patient sees, and cause coordination challenges. For initiatives that increase care across health care settings, measuring patient experiences with access and care coordination will be crucial. Map existing survey measures of patient experiences with access and care coordination expected to be relevant to patients accessing care across settings. Preliminarily examine whether aspects of access and care coordination important to patients are represented by existing measures. Structured literature review of domains and existing survey measures related to access and care coordination across settings. Survey measures, and preliminary themes from semistructured interviews of 10 patients offered VA-purchased Community Care, were mapped to identified domains. We identified 31 existing survey instruments with 279 items representing 6 access and 5 care coordination domains relevant to cross-system care. Domains frequently assessed by existing measures included follow-up coordination, primary care access, cross-setting coordination, and continuity. Preliminary issues identified in interviews, but not commonly assessed by existing measures included: (1) acceptability of distance to care site given patient's clinical situation; (2) burden on patients to access and coordinate care and billing; (3) provider familiarity with Veteran culture and VA processes. Existing survey instruments assess many aspects of patient experiences with access and care coordination in cross-system care. Systems assessing cross-system care should consider whether patient surveys accurately reflect the level of patients' concerns with burden to access and coordinate care, and adequately reflect the impact of clinical severity and cultural familiarity on patient preferences.

  13. Inability to access addiction treatment predicts injection initiation among street-involved youth in a Canadian setting.

    PubMed

    DeBeck, Kora; Kerr, Thomas; Nolan, Seonaid; Dong, Huiru; Montaner, Julio; Wood, Evan

    2016-01-06

    Preventing injection drug use among vulnerable youth is critical for reducing serious drug-related harms. Addiction treatment is one evidence-based intervention to decrease problematic substance use; however, youth frequently report being unable to access treatment services and the impact of this on drug use trajectories remains largely unexplored. This study examines the relationship between being unable to access addiction treatment and injection initiation among street-involved youth. Data were derived from the At-Risk Youth Study (ARYS), a prospective cohort of street-involved youth aged 14-26 who use illicit drugs, from September 2005 to May 2014. An extended Cox model with time-dependent variables was used to identify factors independently associated with injection initiation. Among 462 participants who were injection naïve at baseline, 97 (21 %) initiated injection drug use over study follow-up and 129 (28 %) reported trying but being unable to access addiction treatment in the previous 6 months at some point during the study period. The most frequently reported reason for being unable to access treatment was being put on a wait list. In a multivariable Cox regression analysis, being unable to access addiction treatment remained independently associated with a more rapid rate of injection initiation (Adjusted Hazard Ratio =2.02; 95 % Confidence Interval: 1.12-3.62), after adjusting for potential confounders. Inability to access addiction treatment was common among our sample and associated with injection initiation. Findings highlight the need for easily accessible, evidence-based addiction treatment for high-risk youth as a means to prevent injection initiation and subsequent serious drug-related harms.

  14. NLM Emergency Access Initiative: FAQs

    Science.gov Websites

    provide temporary free access to full-text articles from over 650 biomedical serial titles and over 4,000 specified on the EAI welcome page can access the free full text resources during the period indicated to will I have access to this site? The dates of the free access period are listed on the home page along

  15. 5 CFR 2606.204 - Request for review of an initial denial of access.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Request for review of an initial denial of access. 2606.204 Section 2606.204 Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES PRIVACY ACT RULES Access to Records and Accounting of Disclosures § 2606.204...

  16. Complication with Intraosseous Access: Scandinavian Users’ Experience

    PubMed Central

    Hallas, Peter; Brabrand, Mikkel; Folkestad, Lars

    2013-01-01

    Introduction: Intraosseous access (IO) is indicated if vascular access cannot be quickly established during resuscitation. Complication rates are estimated to be low, based on small patient series, model or cadaver studies, and case reports. However, user experience with IO use in real-life emergency situations might differ from the results in the controlled environment of model studies and small patient series. We performed a survey of IO use in real-life emergency situations to assess users’ experiences of complications. Methods: An online questionnaire was sent to Scandinavian emergency physicians, anesthesiologists and pediatricians. Results: 1,802 clinical cases of IO use was reported by n=386 responders. Commonly reported complications with establishing IO access were patient discomfort/pain (7.1%), difficulties with penetration of periosteum with IO needle (10.3%), difficulties with aspiration of bone marrow (12.3%), and bended/broken needle (4.0%). When using an established IO access the reported complications were difficulties with injection fluid and drugs after IO insertion (7.4%), slow infusion (despite use of pressure bag) (8.8%), displacement after insertion (8.5%), and extravasation (3.7%). Compartment syndrome and osteomyelitis occurred in 0.6% and 0.4% of cases respectively. Conclusion: In users’ recollection of real-life IO use, perceived complications were more frequent than usually reported from model studies. The perceived difficulties with using IO could affect the willingness of medical staff to use IO. Therefore, user experience should be addressed both in education of how to use, and research and development of IOs. PMID:24106537

  17. 5 CFR 2606.204 - Request for review of an initial denial of access.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ORGANIZATION AND PROCEDURES PRIVACY ACT RULES Access to Records and Accounting of Disclosures § 2606.204 Request for review of an initial denial of access. (a)(1) A data subject may submit a written appeal of... (including the Federal Election Commission) other than OGE, the appeal must be submitted to the Privacy Act...

  18. 5 CFR 2606.204 - Request for review of an initial denial of access.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ORGANIZATION AND PROCEDURES PRIVACY ACT RULES Access to Records and Accounting of Disclosures § 2606.204 Request for review of an initial denial of access. (a)(1) A data subject may submit a written appeal of... (including the Federal Election Commission) other than OGE, the appeal must be submitted to the Privacy Act...

  19. Accessible transportation technologies research initiative : advancing mobility solutions for travelers with disabilities.

    DOT National Transportation Integrated Search

    2016-01-01

    The Accessible Transportation Technologies Research Initiative (ATTRI) improves the mobility of travelers with disabilities through research, development, and implementation of transformative technologies, applications, or systems for people of all a...

  20. Open Access Publishing in High-Energy Physics: the SCOAP3 Initiative

    NASA Astrophysics Data System (ADS)

    Mele, S.

    2010-10-01

    Scholarly communication in High-Energy Physics (HEP) shows traits very similar to Astronomy and Astrophysics: pervasiveness of Open Access to preprints through community-based services; a culture of openness and sharing among its researchers; a compact number of yearly articles published by a relatively small number of journals which are dear to the community. These aspects have led HEP to spearhead an innovative model for the transition of its scholarly publishing to Open Access. The Sponsoring Consortium for Open Access Publishing in Particle Physics (SCOAP) aims to be a central body to finance peer-review service rather than the purchase of access to information as in the traditional subscription model, with all articles in the discipline eventually available in Open Access. Sustainable funding to SCOAP would come from libraries, library consortia and HEP funding agencies, through a re-direction of funds currently spent for subscriptions to HEP journals. This paper presents the cultural and bibliometric factors at the roots of SCOAP and the current status of this worldwide initiative.

  1. Initial blood storage experiment

    NASA Technical Reports Server (NTRS)

    Surgenor, Douglas MACN.

    1988-01-01

    The design of the Initial Blood Storage Experiment (IBSE) was based upon a carefully controlled comparison between identical sets of human blood cell suspensions - red cells, white cell, and platelets - one set of which was transported aboard the Columbia on a 6 day 11 hour mission, and the other held on the ground. Both sets were carried inside stainless steel dewars within specially fabricated flight hardware. Individual bags of cell suspensions were randomly assigned with respect to ground vs orbit status, dewar chamber, and specific location within the dewar. To foster optimal preservation, each cell type was held under specific optimal conditions of pH, ionic strength, solute concentration, gas tension, and temperature. An added variable in this initial experiment was provided by the use of three different polymer/plasticizer formulations for the sealed bags which held the blood cells. At termination of the experiment, aliquots of the suspensions, identified only by code, were distributed to be assayed. Assays were selected to constitute a broad survey of cellular properties and thereby maximize the chances of detection of gravitational effects. A total of 74 different outcome measurements were reported for statistical analysis. When the measurements were completed, the results were entered into the IBSE data base, at which time the data were matched with the original blood bag numbers to determine their status with respect to polymer/plasticizer type, orbit status (orbit or ground), and storage position within the experimental hardware. The data were studied by analysis of variance. Initially, type of bag and orbital status were main factors; later more detailed analyses were made on specific issues such as position in the hardware and specific plastic. If the analysis of variance indicated a statistical significance at the 5 percent level the corresponding p-value was reported.

  2. 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.

  3. Addressing Earth Science Data Access Challenges through User Experience Research

    NASA Astrophysics Data System (ADS)

    Hemmings, S. N.; Banks, B.; Kendall, J.; Lee, C. M.; Irwin, D.; Toll, D. L.; Searby, N. D.

    2013-12-01

    help users find, interpret, and obtain appropriate content quickly. The data access challenge for both SERVIR and USWP consisted of organizing a wide range of content for their respective user bases, which are diverse, international, and in some cases loosely characterized. The UX/UI design approach generated profiles of prototypical users and corresponding task flows and organizational schemes for their preferred types of content. Wireframe acceptance testing by SERVIR helped elicit and optimize how users interact with the information online. These approaches produced customized UIs and knowledge management strategies to address the data access challenges faced by each user type. Both studies revealed critical considerations for user experiences in developing nations (e.g., low-bandwidth internet connections, rolling power outages at data storage or network centers). For SERVIR, these findings influenced not only the portal infrastructure; they also informed the transition of the platform to a Cloud-based model, as well as the development of custom data delivery tools such as SMS and other mobile solutions. While SERVIR's data access solutions are customized for the network's community of users, they are also standardized and interoperable according to GEO and ISO standards, providing a model for other initiatives such as the ongoing USWP Portal development effort.

  4. Students' Experiences with Community in an Open Access Course

    ERIC Educational Resources Information Center

    Blackmon, Stephanie J.; Cullen, Theresa A.

    2016-01-01

    Online open access courses have become regular offerings of many universities. Building community and connectedness is an important part of branding and success of such offerings. Our goal was to investigate students' experiences with community in an open access course. Therefore, in this study, we explored the sense of community of 342…

  5. Deaf women: experiences and perceptions of healthcare system access.

    PubMed

    Steinberg, Annie G; Wiggins, Erin A; Barmada, Carlin Henry; Sullivan, Vicki Joy

    2002-10-01

    The authors investigated the knowledge, attitudes, and healthcare experiences of Deaf women. Interviews with 45 deaf women who participated in focus groups in American Sign Language were translated, transcribed, and analyzed. Deaf women's understanding of women's health issues, knowledge of health vocabulary in both English and American Sign Language, common health concerns among Deaf women, and issues of access to information, including pathways and barriers, were examined. As a qualitative study, the results of this investigation are limited and should be viewed as exploratory. A lack of health knowledge was evident, including little understanding of the meaning or value of cancer screening, mammography, or Pap smears; purposes of prescribed medications, such as hormone replacement therapy (HRT); or necessity for other medical or surgical interventions. Negative experiences and avoidance or nonuse of health services were reported, largely due to the lack of a common language with healthcare providers. Insensitive behaviors were also described. Positive experiences and increased access to health information were reported with practitioners who used qualified interpreters. Providers who demonstrated minimal signing skills, a willingness to use paper and pen, and sensitivity to improving communication were appreciated. Deaf women have unique cultural and linguistic issues that affect healthcare experiences. Improved access to health information may be achieved with specialized resource materials, improved prevention and targeted intervention strategies, and self-advocacy skills development. Healthcare providers must be trained to become more effective communicators with Deaf patients and to use qualified interpreters to assure access to healthcare for Deaf women.

  6. Advanced Cosmic Ray Composition Experiment for Space Station (ACCESS)

    NASA Technical Reports Server (NTRS)

    Wilson, Thomas L.; Wefel, John P.

    1999-01-01

    In 1994 the first high-energy particle physics experiment for the Space Station, the Alpha Magnetic Spectrometer (AMS), was selected by NASA's Administrator as a joint collaboration with the U.S. Department of Energy (DOE). The AMS program was chartered to place a magnetic spectrometer in Earth orbit and search for cosmic antimatter. A natural consequence of this decision was that NASA would begin to explore cost-effective ways through which the design and implementation of AMS might benefit other promising payload experiments which were evolving from the Office of Space Science. The first such experiment to come forward was ACCESS in 1996. It was proposed as a new mission concept in space physics to place a cosmic-ray experiment of weight, volume, and geometry similar to the AMS on the ISS, and replace the latter as its successor when the AMS is returned to Earth. This was to be an extension of NASA's sub-orbital balloon program, with balloon payloads serving as the precursor flights and heritage for ACCESS. The balloon programs have always been a cost-effective NASA resource since the particle physics instrumentation for balloon and space applications are directly related. The next step was to expand the process, pooling together expertise from various NASA centers and universities while opening up definition of the ACCESS science goals to the international community through the standard practice of peer-review. This process is still on-going and the Accommodation Study presented here will discuss the baseline definition of ACCESS as we understand it today. Further detail on the history, scope, and background of the study is provided in Appendix A.

  7. Experience of initiating collaboration of traditional healers in managing HIV and AIDS in Tanzania

    PubMed Central

    Kayombo, Edmund J; Uiso, Febronia C; Mbwambo, Zakaria H; Mahunnah, Rogasian L; Moshi, Mainen J; Mgonda, Yasin H

    2007-01-01

    Collaboration between traditional healers and biomedical practitioners is now being accepted by many African countries south of the Sahara because of the increasing problem of HIV/AIDS. The key problem, however, is how to initiate collaboration between two health systems which differ in theory of disease causation and management. This paper presents findings on experience learned by initiation of collaboration between traditional healers and the Institute of Traditional Medicine in Arusha and Dar-es-Salaam Municipalities, Tanzania where 132 and 60 traditional healers respectively were interviewed. Of these 110 traditional healers claimed to be treating HIV/AIDS. The objective of the study was to initiate sustainable collaboration with traditional healers in managing HIV/AIDS. Consultative meetings with leaders of traditional healers' associations and government officials were held, followed by surveys at respective traditional healers' "vilinge" (traditional clinics). The findings were analysed using both qualitative and quantitative methods. The findings showed that influential people and leaders of traditional healers' association appeared to be gatekeepers to access potential good healers in the two study areas. After consultative meetings these leaders showed to be willing to collaborate; and opened doors to other traditional healers, who too were willing to collaborate with the Institute of Traditional Medicine in managing HIV/AIDS patients. Seventy five percent of traditional healers who claimed to be treating HIV/AIDS knew some HIV/AIDS symptoms; and some traditional healers attempted to manage these symptoms. Even though, they were willing to collaborate with the Institute of Traditional Medicine there were nevertheless some reservations based on questions surrounding sharing from collaboration. The reality of past experiences of mistreatment of traditional healers in the colonial period informed these reservations. General findings suggest that initiating

  8. A Comparison of Web Resource Access Experiments: Planning for the New Millennium.

    ERIC Educational Resources Information Center

    Greenberg, Jane

    This paper reports on research that compared five leading experiments that aim to improve access to the growing number of information resources on the World Wide Web. The objective was to identify characteristics of success and considerations for improvement in experiments providing access to Web resources via bibliographic control methods. The…

  9. The National Perinatal Depression Initiative: An evaluation of access to general practitioners, psychologists and psychiatrists through the Medicare Benefits Schedule.

    PubMed

    Chambers, Georgina M; Randall, Sean; Hoang, Van Phuong; Sullivan, Elizabeth A; Highet, Nicole; Croft, Maxine; Mihalopoulos, Cathrine; Morgan, Vera A; Reilly, Nicole; Austin, Marie-Paule

    2016-03-01

    To evaluate the impact of the National Perinatal Depression Initiative on access to Medicare services for women at risk of perinatal mental illness. Retrospective cohort study using difference-in-difference analytical methods to quantify the impact of the National Perinatal Depression Initiative policies on Medicare Benefits Schedule mental health usage by Australian women giving birth between 2006 and 2010. A random sample of women of reproductive age enrolled in Medicare who had not given birth where used as controls. The main outcome measures were the proportions of women giving birth each month who accessed a Medicare Benefits Schedule mental health items during the perinatal period (pregnancy through to the end of the first postnatal year) before and after the introduction of the National Perinatal Depression Initiative. The proportion of women giving birth who accessed at least one mental health item during the perinatal period increased from 88 to 141 per 1000 between 2007 and 2010. The difference-in-difference analysis showed that while there was an overall increase in Medicare Benefits Schedule mental health item access as a result of the National Perinatal Depression Initiative, this did not reach statistical significance. However, the National Perinatal Depression Initiative was found to significantly increase access in subpopulations of women, particularly those aged under 25 and over 34 years living in major cities. In the 2 years following its introduction, the National Perinatal Depression Initiative was found to have increased access to Medicare funded mental health services in particular groups of women. However, an overall increase across all groups did not reach statistical significance. Further studies are needed to assess the impact of the National Perinatal Depression Initiative on women during childbearing years, including access to tertiary care, the cost-effectiveness of the initiative, and mental health outcomes. It is recommended that new

  10. Development of Accessible Laboratory Experiments for Students with Visual Impairments

    ERIC Educational Resources Information Center

    Kroes, KC; Lefler, Daniel; Schmitt, Aaron; Supalo, Cary A.

    2016-01-01

    The hands-on laboratory experiments are frequently what spark students' interest in science. Students who are blind or have low vision (BLV) typically do not get the same experience while participating in hands-on activities due to accessibility. Over the course of approximately nine months, common chemistry laboratory experiments were adapted and…

  11. VA OpenNotes: exploring the experiences of early patient adopters with access to clinical notes.

    PubMed

    Nazi, Kim M; Turvey, Carolyn L; Klein, Dawn M; Hogan, Timothy P; Woods, Susan S

    2015-03-01

    To explore the experience of early patient adopters who accessed their clinical notes online using the Blue Button feature of the My HealtheVet portal. A web-based survey of VA patient portal users from June 22 to September 15, 2013. 33.5% of respondents knew that clinical notes could be viewed, and nearly one in four (23.5%) said that they had viewed their notes at least once. The majority of VA Notes users agreed that accessing their notes will help them to do a better job of taking medications as prescribed (80.1%) and be better prepared for clinic visits (88.6%). Nine out of 10 users agreed that use of visit notes will help them understand their conditions better (91.8%), and better remember the plan for their care (91.9%). In contrast, 87% disagreed that VA Notes will make them worry more, and 88.4% disagreed that access to VA Notes will be more confusing than helpful. Users who had either contacted their provider or healthcare team (11.9%) or planned to (13.5%) primarily wanted to learn more about a health issue, medication, or test results (53.7%). Initial assessment of the patient experience within the first 9 months of availability provides evidence that patients both value and benefit from online access to clinical notes. These findings are congruent with OpenNotes study findings on a broader scale. Additional outreach and education is needed to enhance patient awareness. Healthcare professionals should author notes keeping in mind the opportunity patient access presents for enhanced communication. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. How was the UNAIDS drug access initiative implemented in Chile?

    PubMed Central

    Brousselle, Astrid; Champagne, François

    2012-01-01

    In 1997, UNAIDS decided to implement Drug Access Initiatives (DAI) in four different pilot-countries. We studied the implementation of the DAI in Chile as part of the evaluation program conducted by the ‘Agence Nationale de Recherche sur le SIDA’ (ANRS/France). The objective was to understand how the politico-organizational dynamic influenced the implementation process of the DAI. Approximately 50 semi-directed interviews and observation activities were conducted with the actors who participated in the implementation of the DAI or who played a role in the HIV/AIDS context. The program theory models were established and their evolution analyzed. This article offers an original analysis of an international HIV/AIDS drug access program that was put in place at a time when such programs were seen as a priority by international and governmental institutions. It also offers some insights for the creation of international projects that will be locally implemented. PMID:23230344

  13. The Genesis, Implementation and Impact of the Better Access Mental Health Initiative Introducing Medicare-Funded Psychology Services

    ERIC Educational Resources Information Center

    Littlefield, Lyn; Giese, Jill

    2008-01-01

    The Australian Government's Better Access to Mental Health Care initiative introduced mental health reforms that included the availability of Medicare-funded psychology services. The mental health initiative has resulted in a huge uptake of these services, demonstrating the strong community demand for psychological treatment. The initiative has…

  14. 5 CFR 2606.205 - Response to a request for review of an initial denial of access.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Response to a request for review of an initial denial of access. 2606.205 Section 2606.205 Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES PRIVACY ACT RULES Access to Records and Accounting of Disclosures § 2606.205...

  15. A Scoping Review of Immigrant Experience of Health Care Access Barriers in Canada.

    PubMed

    Kalich, Angela; Heinemann, Lyn; Ghahari, Setareh

    2016-06-01

    Canadian population-based surveys report comparable access to health care services between immigrant and non-immigrant populations, yet other research reports immigrant-specific access barriers. A scoping review was conducted to explore research regarding Canadian immigrants' unique experiences in accessing health care, and was guided by the research question: "What is currently known about the barriers that adult immigrants face when accessing Canadian health care services?" The findings of this study suggest that there are unmet health care access needs specific to immigrants to Canada. In reviewing research of immigrants' health care experiences, the most common access barriers were found to be language barriers, barriers to information, and cultural differences. These findings, in addition to low cultural competency reported by interviewed health care workers in the reviewed articles, indicate inequities in access to Canadian health care services for immigrant populations. Suggestions for future research and programming are discussed.

  16. Helpful advice and hidden expertize: pharmacy users' experiences of community pharmacy accessibility.

    PubMed

    Lindsey, Laura; Husband, Andy; Steed, Liz; Walton, Robert; Todd, Adam

    2017-09-01

    In recent years community pharmacies have emerged as strategically important settings to deliver services aimed at promoting public health. In order to develop evidence-based approaches to public health interventions that exploit the unique accessibility of community pharmacies, it is important to determine how people experience care in this context. This study, therefore, aimed to describe how care is perceived and experienced in community pharmacies with particular focus on community pharmacy access. In-depth semi-structured interviews were used to explore the perceptions and experiences' of people using community pharmacies. A total of 30 participants were interviewed. Themes specifically emerged in relation to community pharmacy access; these fell into four main categories: relationships; time; lack of awareness; and empowerment. The experience of developing a trusting relationship with the pharmacist is an important consideration in the context of community pharmacy accessibility. This could be an important consideration when a person uses a community pharmacy to access a public health service. There is also a perceived lack of awareness among the general public about the extended role of community pharmacy; this is a potential barrier toward people using them. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  17. Accessible Transportation Technologies Research Initiative (ATTRI) Institutional and Policy Issues Assessment : Task 6: Summary Report

    DOT National Transportation Integrated Search

    2017-02-16

    This report summarizes the research and findings of the Accessible Transportation Technologies Research Initiative (ATTRI) Institutional and Policy Assessment. The objective of this project is to identify and analyze the policy, institutional, and le...

  18. Accessible Transportation Technologies Research Initiative (ATTRI) Institutional and Policy Issues Assessment : Task 6 : Summary Report

    DOT National Transportation Integrated Search

    2017-02-16

    This report summarizes the research and findings of the Accessible Transportation Technologies Research Initiative (ATTRI) Institutional and Policy Assessment. The objective of this project is to identify and analyze the policy, institutional, and le...

  19. Benefits Access for College Completion: Lessons Learned from a Community College Initiative to Help Low-Income Students

    ERIC Educational Resources Information Center

    Duke-Benfield, Amy Ellen; Saunders, Katherine

    2016-01-01

    This report analyzes how students were served by Benefits Access for College Completion (BACC), a 2.5-year initiative designed to increase access to public benefits (such as SNAP or Medicaid) for eligible low-income students. These crucial supports reduce students' unmet financial needs and help them finish school. Launched in 2011, BACC funded…

  20. A study of Iranian immigrants’ experiences of accessing Canadian health care services: a grounded theory

    PubMed Central

    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

  1. Area disparity in children's perceptions of access to tobacco and cigarette purchasing experiences in Taiwan.

    PubMed

    Lee, Heng; Hsu, Chih-Cheng; Chen, Fu-Li; Yen, Yea-Yin; Lin, Pi-Li; Chiu, Yu-Wen; Lee, Chien-Hung; Peng, Wu-Der; Chen, Ted; Lu, Di-Lin; Huang, Hsiao-Ling

    2014-08-01

    Adolescents who perceive easy access to tobacco are more likely to acquire cigarettes and experience smoking. This study assesses area disparities in perceptions of access to tobacco and cigarette purchasing experiences among schoolchildren. Data on children's tobacco-related variables were obtained from the Control of School-Aged Children Smoking Study Survey in Taiwan. A stratified random sample of 65 primary schools was included. Polytomous logistic regression analyzed factors associated with tobacco accessibility and purchasing experiences. More than half of the children reported that tobacco retailers often or always sold cigarettes to them. Rural and mountainous children were more likely to have access to cigarettes (adjusted odds ratio [AOR] = 2.01 and 3.01, respectively) and have cigarette purchasing experiences (AOR = 3.06 and 13.76, respectively). Cigarette purchasing from retailers (AOR = 1.84) was significantly associated with children's perceptions of access to tobacco. The factors associated with cigarette purchasing experiences were families smoking (AOR = 8.90), peers smoking (AOR = 2.22), frequent exposure to entertainer smoking on TV and in films (AOR = 2.15), and perceived access to tobacco (AOR = 1.51). The health department should strictly enforce laws regarding retailers selling tobacco to underage, particularly in remote areas. Schools can reinforce tobacco-use prevention messages. © 2014, American School Health Association.

  2. Multinational Experiment 7. Protecting Access to Space: Presentation to Senior Leaders

    DTIC Science & Technology

    2013-07-08

    Multinational Experiment 7: Outcome 3: Space Access Briefing to SLS 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...operations Consequence management Ship status during search & rescue Tele-medicine Broadband internet TV signal distribution Satellite radio Rural...military-usage • Significant economic & societal consequences Access to space at risk • Current approach unsustainable • Broad range of threats

  3. Simulations of initial MHD experiments on the Madison Dynamo Experiment

    NASA Astrophysics Data System (ADS)

    O'Connell, R.; Forest, C. B.; Goldwin, J. M.; Kendrick, R. D.; Canary, H. W.; Nornberg, M. D.; Jaun, A.

    1999-11-01

    Initial experiments for a liquid metal MHD device have been modelled using measurements from geometrically similar water experiments. In the low B limit the water flows are the same as sodium flows. Two codes have been written to predict 1) linear stability of the system and 2) the response of the system to an externally applied vertical magnetic field, using measured velocity profiles. Predictions are made for a first set of MHD experiments, including: a) demonstration of the distortion and amplification of externally applied magnetic fields by sheared flows, b) demonstration of the β-effect by measurement of the turbulent conductivity, c) demonstration of a turbulent α effect and d) characterization of magnetic eigenmodes.

  4. Patient experience of access to primary care: identification of predictors in a national patient survey.

    PubMed

    Kontopantelis, Evangelos; Roland, Martin; Reeves, David

    2010-08-28

    The 2007/8 GP Access Survey in England measured experience with five dimensions of access: getting through on the phone to a practice, getting an early appointment, getting an advance appointment, making an appointment with a particular doctor, and surgery opening hours. Our aim was to identify predictors of patient satisfaction and experience with access to English primary care. 8,307 English general practices were included in the survey (of 8,403 identified). 4,922,080 patients were randomly selected and contacted by post and 1,999,523 usable questionnaires were returned, a response rate of 40.6%. We used multi-level logistic regressions to identify patient, practice and regional predictors of patient satisfaction and experience. After controlling for all other factors, younger people, and people of Asian ethnicity, working full time, or with long commuting times to work, reported the lowest levels of satisfaction and experience of access. For people in work, the ability to take time off work to visit the GP effectively eliminated the disadvantage in access. The ethnic mix of the local area had an impact on a patient's reported satisfaction and experience over and above the patient's own ethnic identity. However, area deprivation had only low associations with patient ratings. Responses from patients in small practices were more positive for all aspects of access with the exception of satisfaction with practice opening hours. Positive reports of access to care were associated with higher scores on the Quality and Outcomes Framework and with slightly lower rates of emergency admission. Respondents in London were the least satisfied and had the worst experiences on almost all dimensions of access. This study identifies a number of patient groups with lower satisfaction, and poorer experience, of gaining access to primary care. The finding that access is better in small practices is important given the increasing tendency for small practices to combine into larger

  5. Experiments with Image Theatre: Accessing and Giving Meaning to Sensory Experiences in Social Anthropology

    ERIC Educational Resources Information Center

    Strauss, Annika

    2017-01-01

    This article puts forward an experiential teaching method for becoming aware of, getting access to, and giving meaning to the sensory experiences that constitute and shape learning processes during social anthropological fieldwork. While social anthropologists use all their senses in the field, the preparation and processing of fieldwork are…

  6. Area Disparity in Children's Perceptions of Access to Tobacco and Cigarette Purchasing Experiences in Taiwan

    ERIC Educational Resources Information Center

    Lee, Heng; Hsu, Chih-Cheng; Chen, Fu-Li; Yen, Yea-Yin; Lin, Pi-Li; Chiu, Yu-Wen; Lee, Chien-Hung; Peng, Wu-Der; Chen, Ted; Lu, Di-Lin; Huang, Hsiao-Ling

    2014-01-01

    Background: Adolescents who perceive easy access to tobacco are more likely to acquire cigarettes and experience smoking. This study assesses area disparities in perceptions of access to tobacco and cigarette purchasing experiences among schoolchildren. Methods: Data on children's tobacco-related variables were obtained from the Control of…

  7. 32 CFR 319.10 - Appeal of initial adverse Agency determination for access, correction or amendment.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Appeal of initial adverse Agency determination for access, correction or amendment. 319.10 Section 319.10 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM DEFENSE INTELLIGENCE AGENCY...

  8. 32 CFR 319.10 - Appeal of initial adverse Agency determination for access, correction or amendment.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 2 2014-07-01 2014-07-01 false Appeal of initial adverse Agency determination for access, correction or amendment. 319.10 Section 319.10 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM DEFENSE INTELLIGENCE AGENCY...

  9. 32 CFR 319.10 - Appeal of initial adverse Agency determination for access, correction or amendment.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 2 2012-07-01 2012-07-01 false Appeal of initial adverse Agency determination for access, correction or amendment. 319.10 Section 319.10 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM DEFENSE INTELLIGENCE AGENCY...

  10. 77 FR 5027 - Food and Drug Administration Transparency Initiative: Exploratory Program To Increase Access to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2009-N-0247] Food and Drug Administration Transparency Initiative: Exploratory Program To Increase Access to the... responsible for a broad range of compliance and enforcement activities. Increasing the transparency of these...

  11. A mixed-methods impact evaluation of the feasibility of an initiative in small rural stores to improve access to fruit and vegetables.

    PubMed

    Palermo, Claire; Gardiner, Breeana; Gee, Carena; Charaktis, Stella; Blake, Miranda

    2016-02-01

    Retail stores are a promising setting for improving access to nutritious food. This study opportunistically evaluated an initiative that supported stores in small rural Victorian towns to sell fresh fruit and vegetables. It aimed to measure whether the initiative showed a trend towards improved access to fruit and vegetables in these rural communities. A mixed-methods, pre-post evaluation was employed to measure the range and price of 39 fruits and 45 vegetables, together with 15 interviews with stakeholders 2.5 years after the commencement of the initiative. Twenty-one of 35 eligible stores took up the initiative. Analysis of qualitative and quantitative data showed that the initiative improved the availability of and access to fruit and vegetables, and that stores have a role in improving access to fruit and vegetables. The overall range of fruit and vegetables increased over 18 months from a median of 10 varieties (n=10) to 17 varieties (n=15) (P=0.028) and the prices decreased over 12 months in five out of seven stores where data was available. The capacity to influence availability of fruit and vegetables was affected by time, human resources and community support. Sustaining change to fruit and vegetables access is challenging. Using stores for health promotion may be an effective strategy for improving rural populations' fruit and vegetable intake.

  12. Training for percutaneous renal access on a virtual reality simulator.

    PubMed

    Zhang, Yi; Yu, Cheng-fan; Liu, Jin-shun; Wang, Gang; Zhu, He; Na, Yan-qun

    2013-01-01

    The need to develop new methods of surgical training combined with advances in computing has led to the development of virtual reality surgical simulators. The PERC Mentor(TM) is designed to train the user in percutaneous renal collecting system access puncture. This study aimed to validate the use of this kind of simulator, in percutaneous renal access training. Twenty-one urologists were enrolled as trainees to learn a fluoroscopy-guided percutaneous renal accessing technique. An assigned percutaneous renal access procedure was immediately performed on the PERC Mentor(TM) after watching instruction video and an analog operation. Objective parameters were recorded by the simulator and subjective global rating scale (GRS) score were determined. Simulation training followed and consisted of 2 hours daily training sessions for 2 consecutive days. Twenty-four hours after the training session, trainees were evaluated performing the same procedure. The post-training evaluation was compared to the evaluation of the initial attempt. During the initial attempt, none of the trainees could complete the appointed procedure due to the lack of experience in fluoroscopy-guided percutaneous renal access. After the short-term training, all trainees were able to independently complete the procedure. Of the 21 trainees, 10 had primitive experience in ultrasound-guided percutaneous nephrolithotomy. Trainees were thus categorized into the group of primitive experience and inexperience. The total operating time and amount of contrast material used were significantly lower in the group of primitive experience versus the inexperience group (P = 0.03 and 0.02, respectively). The training on the virtual reality simulator, PERC Mentor(TM), can help trainees with no previous experience of fluoroscopy-guided percutaneous renal access to complete the virtual manipulation of the procedure independently. This virtual reality simulator may become an important training and evaluation tool in

  13. Smile Alabama! Initiative: Interim Results from a Program To Increase Children's Access to Dental Care.

    ERIC Educational Resources Information Center

    Greene-McIntyre, Mary; Finch, Mary Hayes; Searcy, John

    2003-01-01

    An Alabama initiative aimed to improve access to oral health care for Medicaid-eligible children through four components: improved Medicaid claims processing, increased reimbursement for providers, outreach and educational activities to support providers, and parent and patient education about children's oral health. In the first 3 program years,…

  14. America's College Promise: Situating President Obama's Initiative in the History of Federal Higher Education Aid and Access Policy

    ERIC Educational Resources Information Center

    Palmadessa, Allison L.

    2017-01-01

    Purpose: America's College Promise (ACP) is a legislative initiative introduced by President Obama to increase access to higher education, to build the economy, and to support his earlier American Graduation Initiative. This legislation has the potential to settle among the ranks of the most influential federal higher education aid and access…

  15. Supporting open access to clinical trial data for researchers: The Duke Clinical Research Institute-Bristol-Myers Squibb Supporting Open Access to Researchers Initiative.

    PubMed

    Pencina, Michael J; Louzao, Darcy M; McCourt, Brian J; Adams, Monique R; Tayyabkhan, Rehbar H; Ronco, Peter; Peterson, Eric D

    2016-02-01

    There are growing calls for sponsors to increase transparency by providing access to clinical trial data. In response, Bristol-Myers Squibb and the Duke Clinical Research Institute have collaborated on a new initiative, Supporting Open Access to Researchers. The aim is to facilitate open sharing of Bristol-Myers Squibb trial data with interested researchers. Key features of the Supporting Open Access to Researchers data sharing model include an independent review committee that ensures expert consideration of each proposal, stringent data deidentification/anonymization and protection of patient privacy, requirement of prespecified statistical analysis plans, and independent review of manuscripts before submission for publication. We believe that these approaches will promote open science by allowing investigators to verify trial results as well as to pursue interesting secondary uses of trial data without compromising scientific integrity. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Revisiting an open access monograph experiment: measuring citations and tweets 5 years later.

    PubMed

    Snijder, Ronald

    An experiment run in 2009 could not assess whether making monographs available in open access enhanced scholarly impact. This paper revisits the experiment, drawing on additional citation data and tweets. It attempts to answer the following research question: does open access have a positive influence on the number of citations and tweets a monograph receives, taking into account the influence of scholarly field and language? The correlation between monograph citations and tweets is also investigated. The number of citations and tweets measured in 2014 reveal a slight open access advantage, but the influence of language or subject should also be taken into account. However, Twitter usage and citation behaviour hardly overlap.

  17. Challenges in Obtaining Property Access: The FUSRAP Maywood Site Experience - 13433

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kollar, William

    2013-07-01

    The Formerly Utilized Sites Remedial Action Program (FUSRAP) is the US government program started in 1974 to identify, investigate and clean up or control sites that became contaminated as a result of the nation's early atomic programs. Many of these sites are not owned by the federal government and therefore require owner permission to enter. The experience in pursuing such access at the FUSRAP Maywood Superfund Site (the Maywood Site or the Site) in Bergen County, New Jersey, is extensive. Since the US Army Corps of Engineers (the Corps) assumed responsibility for the Maywood Site from the US Department ofmore » Energy in 1997, at least 186 separate property access agreements (known in FUSRAP as a Real Estate Right-of- Entry or ROE) have been executed between the Corps and approximately 55 different land owners and tenant occupants at the Maywood Site (agreement renewals with the same owners over time account for the difference). Maywood's experience during the Corps' tenure, reflected here in three case studies of representative property access efforts, offers some lessons and best practices that may apply to other remedial programs. While the Site Community Relations Manager (the author of this paper) managed the property access task, multi-disciplinary support from across the project was also critical to success in this endeavor. (authors)« less

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

    PubMed

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

    2010-01-01

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

  19. Mobile access to virtual randomization for investigator-initiated trials.

    PubMed

    Deserno, Thomas M; Keszei, András P

    2017-08-01

    Background/aims Randomization is indispensable in clinical trials in order to provide unbiased treatment allocation and a valid statistical inference. Improper handling of allocation lists can be avoided using central systems, for example, human-based services. However, central systems are unaffordable for investigator-initiated trials and might be inaccessible from some places, where study subjects need allocations. We propose mobile access to virtual randomization, where the randomization lists are non-existent and the appropriate allocation is computed on demand. Methods The core of the system architecture is an electronic data capture system or a clinical trial management system, which is extended by an R interface connecting the R server using the Java R Interface. Mobile devices communicate via the representational state transfer web services. Furthermore, a simple web-based setup allows configuring the appropriate statistics by non-statisticians. Our comprehensive R script supports simple randomization, restricted randomization using a random allocation rule, block randomization, and stratified randomization for un-blinded, single-blinded, and double-blinded trials. For each trial, the electronic data capture system or the clinical trial management system stores the randomization parameters and the subject assignments. Results Apps are provided for iOS and Android and subjects are randomized using smartphones. After logging onto the system, the user selects the trial and the subject, and the allocation number and treatment arm are displayed instantaneously and stored in the core system. So far, 156 subjects have been allocated from mobile devices serving five investigator-initiated trials. Conclusion Transforming pre-printed allocation lists into virtual ones ensures the correct conduct of trials and guarantees a strictly sequential processing in all trial sites. Covering 88% of all randomization models that are used in recent trials, virtual randomization

  20. Preservice Teachers' Experiences on Accessing Course Materials Using Mobile Devices

    ERIC Educational Resources Information Center

    Unal, Zafer; Unal, Aslihan

    2014-01-01

    This study investigates and reports the first time experiences of mobile device users accessing the course materials on both the web and mobile version of course management system (Web Moodle & Mobile Moodle) during an online course offered at the University of South Florida, St. Petersburg College of Education.

  1. Using the Internet to access information inflates future use of the Internet to access other information.

    PubMed

    Storm, Benjamin C; Stone, Sean M; Benjamin, Aaron S

    2017-07-01

    The ways in which people learn, remember, and solve problems have all been impacted by the Internet. The present research explored how people become primed to use the Internet as a form of cognitive offloading. In three experiments, we show that using the Internet to retrieve information alters a person's propensity to use the Internet to retrieve other information. Specifically, participants who used Google to answer an initial set of difficult trivia questions were more likely to decide to use Google when answering a new set of relatively easy trivia questions than were participants who answered the initial questions from memory. These results suggest that relying on the Internet to access information makes one more likely to rely on the Internet to access other information.

  2. Access to Specialized Care Through Telemedicine in Limited-Resource Country: Initial 1,065 Teleconsultations in Albania.

    PubMed

    Latifi, Rifat; Gunn, Jayleen K L; Bakiu, Evis; Boci, Arian; Dasho, Erion; Olldashi, Fatos; Pipero, Pellumb; Stroster, John A; Qesteri, Orland; Kucani, Julian; Sulo, Ardi; Oshafi, Manjola; Osmani, Kalterina L; Dogjani, Agron; Doarn, Charles R; Shatri, Zhaneta; Kociraj, Agim; Merrell, Ronald C

    2016-12-01

    To analyze the initial experience of the nationwide clinical telemedicine program of Albania, as a model of implementation of telemedicine using "Initiate-Build-Operate-Transfer" strategy. This was a retrospective study of prospectively collected data from teleconsultations in Albania between January 1, 2014 and August 26, 2015, delivered synchronously, asynchronously, or a combination of both methods. Patient's demographics, mode of consultation, clinical specialty, hospitals providing referral and consultation, time from initial call to completion of consultation, and patient disposition following teleconsultation were analyzed. Challenges of the newly created program have been identified and analyzed as well. There were 1,065 teleconsultations performed altogether during the study period. Ninety-one patients with autism managed via telemedicine were not included in this analysis and will be reported separately. Of 974 teleconsults, the majority were for radiology, neurotrauma, and stroke (55%, 16%, and 10% respectively). Asynchronous technology accounted for nearly two-thirds of all teleconsultations (63.7%), followed by combined (24.3%), and then synchronous (12.0%). Of 974 cases, only 20.0% of patients in 2014 and 22.72% of patients in 2015 were transferred to a tertiary hospital. A majority (98.5%) of all teleconsultations were conducted within the country itself. The Integrated Telemedicine and e-Health program of Albania has become a useful tool to improve access to high-quality healthcare, particularly in high demanding specialty disciplines. A number of challenges were identified and these should serve as lessons for other countries in their quest to establish nationwide telemedicine programs.

  3. Improving access to important recovery information for heart patients with low health literacy: reflections on practice-based initiatives.

    PubMed

    Naccarella, Lucio; Biuso, Catuscia; Jennings, Amanda; Patsamanis, Harry

    2018-05-29

    Evidence exists for the association between health literacy and heart health outcomes. Cardiac rehabilitation is critical for recovery from heart attack and reducing hospital readmissions. Despite this, <30% of people participate in a program. Significant patient, hospital and health system challenges exist to improve recovery through increased heart health literacy. This brief case study reflects and documents practice-based initiatives by Heart Foundation Victoria to improve access to recovery information for patients with low literacy levels. Three key initiatives, namely the Six Steps To Cardiac Recovery resource, the Love Your Heart book and the nurse ambassador program, were implemented informed by mixed methods that assessed need and capacity at the individual, organisational and systems levels. Key outcomes included increased access to recovery information for patients with low health literacy, nurse knowledge and confidence to engage with patients on recovery information, improved education of patients and improved availability and accessibility of information for patients in diverse formats. Given the challenges involved in addressing heart health literacy, multifaceted practice-based approaches are essential to improve access to recovery information for patients with low literacy levels. What is known about the topic? Significant challenges exist for patients with lower health literacy receiving recovery information after a heart attack in hospitals. What does this paper add? This case study provides insights into a practice-based initiative by Heart Foundation Victoria to improve access to recovery information for patients with low literacy levels. What are the implications for practitioners? Strategies to improve recovery through increased heart health literacy must address the needs of patients, nursing staff and the health system within hospitals. Such strategies need to be multifaceted and designed to build the capacity of nurses, heart patients and

  4. Differences in Experiences of Discrimination in Accessing Social Services Among Transgender/Gender Nonconforming Individuals by (Dis)Ability.

    PubMed

    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.

  5. The Nimbus 5 user's guide. [for experiments, instrumentation, and data access

    NASA Technical Reports Server (NTRS)

    Sabatini, R. R.

    1972-01-01

    Background information on the Nimbus 5 spacecraft and experiments is presented as a basis for selecting, obtaining, and utilizing the data in research studies. The basic spacecraft system operation and the objectives of the Nimbus 5 flight are outlined, followed by a detailed discussion of each of the experiments. The format, archiving, and access to the data, and the contents and format of the Nimbus 5 Data Catalogs are described.

  6. Initial Experience Performing In-office Ultrasound-guided Transperineal Prostate Biopsy Under Local Anesthesia Using the PrecisionPoint Transperineal Access System.

    PubMed

    Meyer, Alexa R; Joice, Gregory A; Schwen, Zeyad R; Partin, Alan W; Allaf, Mohamad E; Gorin, Michael A

    2018-05-01

    To describe our procedural technique and initial outcomes performing in-office transperineal prostate biopsies using the PrecisionPoint Transperineal Access System (Perineologic, Cumberland, MD). Following institutional review board approval, we retrospectively reviewed the records of men who underwent an in-office transperineal prostate biopsy using the PrecisionPoint device. Records were reviewed for baseline characteristics, biopsy results, and postbiopsy complications. Between January 4, 2017 and August 23, 2017, 43 men underwent an in-office transperineal prostate biopsy using the PrecisionPoint Transperineal Access System. Patients had a median serum prostate specific antigen level of 6.1 ng/mL (range 0.8-32.9). Of the 43 biopsies, 12 (27.9%) were performed for active surveillance of low-risk prostate cancer and 31 (72.1%) were performed for cancer screening. Overall, 21 (48.8%) men were found to have prostate cancer. Among those on active surveillance, cancer was detected in 8 of 12 (66.7%) patients, with 2 of 12 (16.7%) found to have Gleason ≥3 + 4 = 7 prostate cancer. Additionally, cancer was detected in 13 of 31 (41.9%) patients undergoing a biopsy for prostate cancer screening, with 5 (16.1%) found to have Gleason ≥3 + 4 = 7 disease. In total, 3 (7.0%) patients experienced a postbiopsy complication: 2 (4.7%) with urinary retention and 1 (2.3%) with gross hematuria requiring catheterization. No patient experienced an infectious complication despite omission of periprocedural antibiotics in all cases. The PrecisionPoint device allowed for the successful performance of in-office transperineal prostate biopsies under local anesthesia without the need for periprocedural antibiotics. We observed an acceptable cancer detection rate with no infectious complications. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. 'Hello, you're not supposed to be here': homeless emerging adults' experiences negotiating food access.

    PubMed

    Bowen, Elizabeth A; Irish, Andrew

    2018-07-01

    We aimed to examine the food-seeking experiences of homeless emerging adults (age 18-24 years) in a US urban context. The study used a qualitative descriptive design, combining semi-structured interviews with a standardized quantitative measure of food insecurity. Interview data were coded using constant comparative methods to identify patterns across and within interviews. Emerging themes were confirmed and refined through member checking. Buffalo, a mid-sized city in the Northeastern USA. A sample of thirty participants was recruited through community-based methods. Eligibility criteria specified that participants were aged 18-24 years and did not have a stable place to live. The sample was demographically diverse and included participants who were couch-surfing, staying on the streets and/or using shelters. Participants' food access strategies varied across their living circumstances. Common strategies included purchasing food with cash or benefits (reported by 77 %), using free meal programmes (70 %) and eating at friends' or relatives' homes (47 %). Although 70 % of participants received Supplemental Nutrition Assistance Program benefits, several reported access barriers, including initial denials of eligibility due to being listed on a parent's application even when the participant no longer resided in the household. Participants described a stigma associated with using food pantries and free meal programmes and expressed preference for less institutionalized programmes such as Food Not Bombs. Given endemic levels of food insecurity among homeless youth and young adults, policy modifications and service interventions are needed to improve food access for this population.

  8. Ultrasound Vein and Artery Mapping by General Surgery Residents During Initial Consult Can Decrease Time to Dialysis Access Creation.

    PubMed

    Gray, Kelsey; Korn, Abraham; Zane, Joshua; Gonzalez, Gabriel; Kaji, Amy; Bowens, Nina; de Virgilio, Christian

    2018-05-01

    Formal preoperative ultrasound (US) mapping of vascular anatomy by radiology is recommended before hemodialysis access surgery. We hypothesized that US performed by general surgery residents in place of formal US would decrease the time from initial consult to creation of dialysis access without affecting patient outcomes. This is a retrospective review of all patients who underwent dialysis access surgery from November 2014 to July 2016 and received preoperative upper extremity US vein and artery evaluation by either radiology or general surgery residents. The primary endpoints were days from initial consult to dialysis access creation, rate of arteriovenous fistula (AVF) creation, fistula maturation, and 1-year primary assisted patency. Of 242 patients, 167 (69%) had formal US, and 75 (31%) had only a resident US. The resident US group had 100% AVF creation compared with the formal US group with 92.2% AVF creation (P = 0.01). There was no difference between the groups in rate of fistula maturation (P = 0.1) and 1-year assisted patency (P = 0.9). Of the resident US 90.7% occurred in the outpatient setting. On multivariable analysis controlling for outpatient consult, the average time to the operating room was 13.7 days longer for the formal US group in the outpatient setting (P = 0.0006). Ultrasound vein and artery evaluation at the time of the initial consult by general surgery residents can decrease the time to dialysis access creation by bypassing the need for formal US with a higher rate of AVF creation and no difference in fistula maturation or 1-year primary assisted patency. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Semantic Mediation via Access Broker: the OWS-9 experiment

    NASA Astrophysics Data System (ADS)

    Santoro, Mattia; Papeschi, Fabrizio; Craglia, Massimo; Nativi, Stefano

    2013-04-01

    Even with the use of common data models standards to publish and share geospatial data, users may still face semantic inconsistencies when they use Spatial Data Infrastructures - especially in multidisciplinary contexts. Several semantic mediation solutions exist to address this issue; they span from simple XSLT documents to transform from one data model schema to another, to more complex services based on the use of ontologies. This work presents the activity done in the context of the OGC Web Services Phase 9 (OWS-9) Cross Community Interoperability to develop a semantic mediation solution by enhancing the GEOSS Discovery and Access Broker (DAB). This is a middleware component that provides harmonized access to geospatial datasets according to client applications preferred service interface (Nativi et al. 2012, Vaccari et al. 2012). Given a set of remote feature data encoded in different feature schemas, the objective of the activity was to use the DAB to enable client applications to transparently access the feature data according to one single schema. Due to the flexible architecture of the Access Broker, it was possible to introduce a new transformation type in the configured chain of transformations. In fact, the Access Broker already provided the following transformations: Coordinate Reference System (CRS), spatial resolution, spatial extent (e.g., a subset of a data set), and data encoding format. A new software module was developed to invoke the needed external semantic mediation service and harmonize the accessed features. In OWS-9 the Access Broker invokes a SPARQL WPS to retrieve mapping rules for the OWS-9 schemas: USGS, and NGA schema. The solution implemented to address this problem shows the flexibility and extensibility of the brokering framework underpinning the GEO DAB: new services can be added to augment the number of supported schemas without the need to modify other components and/or software modules. Moreover, all other transformations (CRS

  10. Experiments and simulations of Richtmyer-Meshkov Instability with measured,volumetric initial conditions

    NASA Astrophysics Data System (ADS)

    Sewell, Everest; Ferguson, Kevin; Jacobs, Jeffrey; Greenough, Jeff; Krivets, Vitaliy

    2016-11-01

    We describe experiments of single-shock Richtmyer-Meskhov Instability (RMI) performed on the shock tube apparatus at the University of Arizona in which the initial conditions are volumetrically imaged prior to shock wave arrival. Initial perturbations play a major role in the evolution of RMI, and previous experimental efforts only capture a single plane of the initial condition. The method presented uses a rastered laser sheet to capture additional images throughout the depth of the initial condition immediately before the shock arrival time. These images are then used to reconstruct a volumetric approximation of the experimental perturbation. Analysis of the initial perturbations is performed, and then used as initial conditions in simulations using the hydrodynamics code ARES, developed at Lawrence Livermore National Laboratory (LLNL). Experiments are presented and comparisons are made with simulation results.

  11. African American Women Coping with the Lived Experiences of Limited Mental Healthcare Access in Rural North Carolina

    ERIC Educational Resources Information Center

    Lesane, Everick S.

    2013-01-01

    This study examined the impact of lived experiences among African American women with limited mental healthcare access in rural North Carolina. The research examined how those lived experiences-due to limited transportation, low socioeconomic status, and limited healthcare access-further exacerbate emotional challenges among African American…

  12. Measuring health systems strength and its impact: experiences from the African Health Initiative.

    PubMed

    Sherr, Kenneth; Fernandes, Quinhas; Kanté, Almamy M; Bawah, Ayaga; Condo, Jeanine; Mutale, Wilbroad

    2017-12-21

    Health systems are essential platforms for accessible, quality health services, and population health improvements. Global health initiatives have dramatically increased health resources; however, funding to strengthen health systems has not increased commensurately, partially due to concerns about health system complexity and evidence gaps demonstrating health outcome improvements. In 2009, the African Health Initiative of the Doris Duke Charitable Foundation began supporting Population Health Implementation and Training Partnership projects in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze significant advances in strengthening health systems. This manuscript reflects on the experience of establishing an evaluation framework to measure health systems strength, and associate measures with health outcomes, as part of this Initiative. Using the World Health Organization's health systems building block framework, the Partnerships present novel approaches to measure health systems building blocks and summarize data across and within building blocks to facilitate analytic procedures. Three Partnerships developed summary measures spanning the building blocks using principal component analysis (Ghana and Tanzania) or the balanced scorecard (Zambia). Other Partnerships developed summary measures to simplify multiple indicators within individual building blocks, including health information systems (Mozambique), and service delivery (Rwanda). At the end of the project intervention period, one to two key informants from each Partnership's leadership team were asked to list - in rank order - the importance of the six building blocks in relation to their intervention. Though there were differences across Partnerships, service delivery and information systems were reported to be the most common focus of interventions, followed by health workforce and leadership and governance. Medical products, vaccines and technologies, and

  13. A Conceptual Framework of Mapping Access to Health Care across EU Countries: The Patient Access Initiative.

    PubMed

    Souliotis, Kyriakos; Hasardzhiev, Stanimir; Agapidaki, Eirini

    Research evidence suggests that access to health care is the key influential factor for improved population health outcomes and health care system sustainability. Although the importance of addressing barriers in access to health care across European countries is well documented, little has been done to improve the situation. This is due to different definitions, approaches and policies, and partly due to persisting disparities in access within and between European countries. To bridge this gap, the Patient Access Partnership (PACT) developed (a) the '5As' definition of access, which details the five critical elements (adequacy, accessibility, affordability, appropriateness, and availability) of access to health care, (b) a multi-stakeholders' approach for mapping access, and (c) a 13-item questionnaire based on the 5As definition in an effort to address these obstacles and to identify best practices. These tools are expected to contribute effectively to addressing access barriers in practice, by suggesting a common framework and facilitating the exchange of knowledge and expertise, in order to improve access to health care between and within European countries. © 2016 S. Karger AG, Basel.

  14. Thermal control surfaces experiment: Initial flight data analysis

    NASA Technical Reports Server (NTRS)

    Wilkes, Donald R.; Hummer, Leigh L.

    1991-01-01

    The behavior of materials in the space environment continues to be a limiting technology for spacecraft and experiments. The thermal control surfaces experiment (TCSE) aboard the Long Duration Exposure Facility (LDEF) is the most comprehensive experiment flown to study the effects of the space environment on thermal control surfaces. Selected thermal control surfaces were exposed to the LDEF orbital environment and the effects of this exposure were measured. The TCSE combined in-space orbital measurements with pre and post-flight analyses of flight materials to determine the effects of long term space exposure. The TCSE experiment objective, method, and measurements are described along with the results of the initial materials analysis. The TCSE flight system and its excellent performance on the LDEF mission is described. A few operational anomalies were encountered and are discussed.

  15. Empowering Learners with Mobile Open-Access Learning Initiatives

    ERIC Educational Resources Information Center

    Mills, Michael, Ed.; Wake, Donna, Ed.

    2017-01-01

    Education has been progressing at a rapid pace ever since educators have been able to harness the power of mobile technology. Open-access learning techniques provide more students with the opportunity to engage in educational opportunities that may have been previously restricted. "Empowering Learners with Mobile Open-Access Learning…

  16. Assured Access/Mobile Computing Initiatives on Five University Campuses.

    ERIC Educational Resources Information Center

    Blurton, Craig; Chee, Yam San; Long, Phillip D.; Resmer, Mark; Runde, Craig

    Mobile computing and assured access are becoming popular terms to describe a growing number of university programs which take advantage of ubiquitous network access points and the portability of notebook computers to ensure all students have access to digital tools and resources. However, the implementation of such programs varies widely from…

  17. Flight initiation by Ferruginous Hawks depends on disturbance type, experience, and the anthropogenic landscape

    PubMed Central

    Wellicome, Troy I.; Bayne, Erin M.

    2017-01-01

    The expansion of humans and their related infrastructure is increasing the likelihood that wildlife will interact with humans. When disturbed by humans, animals often change their behaviour, which can result in time and energetic costs to that animal. An animal's decision to change behaviour is likely related to the type of disturbance, the individual's past experience with disturbance, and the landscape in which the disturbance occurs. In southern Alberta and Saskatchewan, we quantified probability of flight initiation from the nest by Ferruginous Hawks (Buteo regalis) during approaches to nests by investigators. We tested if probability of flight was related to different disturbance types, previous experience, and the anthropogenic landscape in which individual Ferruginous Hawks nested. Probability of flight was related to the type of approach by the investigator, the number of previous visits by investigators, and the vehicular traffic around the nest. Approaches by humans on foot resulted in a greater probability of flight than those in a vehicle. Approaches in a vehicle via low traffic volume access roads were related to increased probability of flight relative to other road types. The number of previous investigator approaches to the nest increased the probability of flight. Overall, we found support that Ferruginous Hawks show habituation to vehicles and the positive reinforcement hypotheses as probability of flight was negatively related to an index of traffic activity near the nest. Our work emphasizes that complex, dynamic processes drive the decision to initiate flight from the nest, and contributes to the growing body of work explaining how responses to humans vary within species. PMID:28542334

  18. Flight initiation by Ferruginous Hawks depends on disturbance type, experience, and the anthropogenic landscape.

    PubMed

    Nordell, Cameron J; Wellicome, Troy I; Bayne, Erin M

    2017-01-01

    The expansion of humans and their related infrastructure is increasing the likelihood that wildlife will interact with humans. When disturbed by humans, animals often change their behaviour, which can result in time and energetic costs to that animal. An animal's decision to change behaviour is likely related to the type of disturbance, the individual's past experience with disturbance, and the landscape in which the disturbance occurs. In southern Alberta and Saskatchewan, we quantified probability of flight initiation from the nest by Ferruginous Hawks (Buteo regalis) during approaches to nests by investigators. We tested if probability of flight was related to different disturbance types, previous experience, and the anthropogenic landscape in which individual Ferruginous Hawks nested. Probability of flight was related to the type of approach by the investigator, the number of previous visits by investigators, and the vehicular traffic around the nest. Approaches by humans on foot resulted in a greater probability of flight than those in a vehicle. Approaches in a vehicle via low traffic volume access roads were related to increased probability of flight relative to other road types. The number of previous investigator approaches to the nest increased the probability of flight. Overall, we found support that Ferruginous Hawks show habituation to vehicles and the positive reinforcement hypotheses as probability of flight was negatively related to an index of traffic activity near the nest. Our work emphasizes that complex, dynamic processes drive the decision to initiate flight from the nest, and contributes to the growing body of work explaining how responses to humans vary within species.

  19. Principles of chronic venous access: recommendations based on the Roswell Park experience.

    PubMed

    Sabel, M S; Smith, J L

    1997-11-01

    At Roswell Park Cancer Institute, we have seen a dramatic increase in the need for long-term venous access. Chronic venous catheters are an indispensible part of the treatment provided to oncology patients. Cancer patients are often at higher risk for complications secondary to their underlying disease and treatments. These risks may be minimized by paying close attention to several important aspects of central line placement. These include matching individual patient needs with the access device most suited to those needs, a thorough preoperative assessment, and the safest and most appropriate operative approach for placement. Likewise, the prompt recognition and treatment of complications when they do occur is crucial to the care of these patients. In order to optimize the care of patients with long-term venous access devices, we have reviewed our experience of over 700 vascular access consultations and offer the following recommendations.

  20. International surgical telementoring: our initial experience.

    PubMed

    Lee, B R; Caddedu, J A; Janetschek, G; Schulam, P; Docimo, S G; Moore, R G; Partin, A W; Kavoussi, L R

    1998-01-01

    Telesurgical laparoscopic telementoring has successfully been implemented between the Johns Hopkins Bayview Medical Center and the Johns Hopkins Hospital in 27 prior operations. In this previously reported series, telerobotic mentoring was achieved between two institutions 3.5 miles away. We report our experience in performing two international surgical telementoring operations. To determine the clinical utility of international surgical telementoring during laparoscopic surgical procedures. A laparoscopic adrenalectomy was telementored between Innsbruck, Austria (5,083 miles) and Baltimore, MD. As well, a laparoscopic varicocelectomy was telementored between Bangkok, Thailand and Baltimore, MD (10,880 miles) both over three ISDN lines (384 kbps) with an approximate 1 sec delay. Both procedures were successfully accomplished with an uneventful postoperative course. International telementoring is a viable method of instructing less experienced laparoscopic surgeons through potentially complex laparoscopic procedures, as well as potentially improving patient access to specialty care.

  1. Mental health leadership and patient access to care: a public-private initiative in South Africa.

    PubMed

    Szabo, Christopher Paul; Fine, Jennifer; Mayers, Pat; Naidoo, Shan; Zabow, Tuviah

    2017-01-01

    Mental health leadership is a critical component of patient access to care. More specifically, the ability of mental health professionals to articulate the needs of patients, formulate strategies and engage meaningfully at the appropriate level in pursuit of resources. This is not a skill set routinely taught to mental health professionals. A public-private mental health leadership initiative, emanating from a patient access to care programme, was developed with the aim of building leadership capacity within the South African public mental health sector. The express aim was to equip health care professionals with the requisite skills to more effectively advocate for their patients. The initiative involved participants from various sites within South Africa. Inclusion was based on the proposal of an ongoing "project", i.e. a clinician-initiated service development with a multidisciplinary focus. The projects were varied in nature but all involved identification of and a plan for addressing an aspect of the participants' daily professional work which negatively impacted on patient care due to unmet needs. Six such projects were included and involved 15 participants, comprising personnel from psychiatry, psychology, occupational therapy and nursing. Each project group was formally mentored as part of the initiative, with mentors being senior professionals with expertise in psychiatry, public health and nursing. The programme design thus provided a unique practical dimension in which skills and learnings were applied to the projects with numerous and diverse outcomes. Benefits were noted by participants but extended beyond the individuals to the health institutions in which they worked and the patients that they served. Participants acquired both the skills and the confidence which enabled them to sustain the changes that they themselves had initiated in their institutions. The initiative gave impetus to the inclusion of public mental health as part of the curriculum

  2. Expanding Notions of Digital Access: Parents' Negotiation of School-Based Technology Initiatives in New Immigrant Communities

    ERIC Educational Resources Information Center

    Noguerón-Liu, Silvia

    2017-01-01

    Initiatives to integrate technology in schools are continuously increasing, with efforts to bridge the "homework gap" and provide technology access in low-income households. However, it is critical to include nondominant parents in technology adoption decisions in order to avoid mirroring past patterns of inequality in home-school…

  3. In Their Own Words: Young Adults' Menthol Cigarette Initiation, Perceptions, Experiences and Regulation Perspectives.

    PubMed

    Wackowski, Olivia A; Evans, Kiameesha R; Harrell, Melissa B; Loukas, Alexandra; Lewis, M Jane; Delnevo, Cristine D; Perry, Cheryl L

    2017-02-17

    Menthol cigarettes are disproportionately used by young people and have been called smoking starter products. However, limited qualitative research exists on young adults' perceptions of and experiences with these products, with much of it based on document reviews of the tobacco industry's research. We conducted six focus groups with young adult (ages 18-24) menthol smokers in New Jersey (half with black smokers) between December 2014 and March 2015. Participants were asked open-ended questions about their menthol smoking initiation, preference reasons, substitution behaviors, and perceptions of menthol cigarette risks and regulation. Participants' menthol cigarette initiation and preference were influenced by their perceived popularity, brand recognition, taste, smoothness, satisfaction and access (including as "loosies," typically available for Newport). Some believed menthol cigarettes were less harmful than non-menthol cigarettes when initiating smoking. Many currently believed menthol cigarettes were more harmful because they contained extra "additives," were stronger (ie, requiring fewer cigarettes to feel satisfied), and/or based on hearsay. Many had tried new brand Camel Crush, which was perceived to be especially minty, fun, and attractive for newer smokers. While some used non-menthol cigarettes when menthols were unavailable, many said they would never or almost never substitute. Many acknowledged a menthol cigarettes ban would likely help them quit smoking, even though they did not support the idea. Menthol cigarette initiation is influenced by an interplay of multiple factors including their sensory properties, marketing, perceived popularity and availability. The FDA should continue to pursue closing this flavored cigarette loophole. In this first qualitative study of menthol cigarette use among young adults, we found further evidence that menthol cigarettes can act as starter products because they are perceived as easier to smoke and taste and smell

  4. Rural patients’ experiences accessing surgery in British Columbia

    PubMed Central

    Humber, Nancy; Dickinson, Paul

    2010-01-01

    Background More than 33% of Canadians live in rural areas. The vulnerability of rural surgical patients makes them particularly sensitive to barriers to accessing health care. This study aims to describe rural patients’ experiences accessing local non-specialist, family physician–surgeon care and regional specialist surgical care when no local surgical care was available. Methods We conducted a qualitative pilot study of self-selected patients. Interviews were analyzed using a modified Delphi technique and NVivo qualitative software. Results The needs of rural surgical patients were reflective of Maslow’s hierarchy of needs: physiologic, safety and security, community belonging and self-esteem/self-actualization. Rural patients expressed a strong desire for individualized care in a familiar environment. When such care was not available, patients found it difficult to meet even basic physiologic needs. Maternity patients and marginalized populations were particularly vulnerable. Conclusion Rural patients seem to prefer individualized care in a familiar environment to address more of their qualitative emotional, psychological and cultural needs rather than only the physiologic needs of surgery. Larger studies are needed to delineate more clearly the qualitative aspects of surgical care. PMID:21092429

  5. Despite Increased Insurance Coverage, Nonwhite Sexual Minorities Still Experience Disparities In Access To Care.

    PubMed

    Hsieh, Ning; Ruther, Matt

    2017-10-01

    Previous studies suggest that members of sexual minority groups have poorer access to health services than heterosexuals. However, few studies have examined how sexual orientation interacts with gender and race to affect health care experience. Moreover, little is known about the role in health care disparities played by economic strains such as unemployment and poverty, which may result from prejudice and discrimination based on sexual orientation. Using data for 2013-15 from the National Health Interview Survey, we found that most members of sexual minority groups no longer have higher uninsurance rates than heterosexuals, but many continue to experience poorer access to high-quality care. Gay nonwhite men, bisexual white women, and bisexual and lesbian nonwhite women are disadvantaged in multiple aspects of access, compared to straight white men. Only some of these disparities are attributable to economic factors, which implies that noneconomic barriers to care are substantial. Our results suggest that the intersection of multiple social identities can reveal important gaps in health care experience. Making culturally sensitive services available may be key to closing the gaps. Project HOPE—The People-to-People Health Foundation, Inc.

  6. Building and Sustaining Citywide Afterschool Initiatives: Experiences of the Cross-Cities Network Citywide Afterschool Initiatives.

    ERIC Educational Resources Information Center

    Hall, Georgia; Harvey, Brooke

    This paper highlights the experiences of several citywide after school initiatives from the Cross-Cities Network, describing activities and strategies that contributed to building operational and sustainable citywide delivery of out-of-school time programs. The paper presents evidence of success and notes lessons learned, identifying key elements…

  7. ENVRI PLUS: European initiative towards technical and research cultural solutions for across-disciplines accessible Research Infrastructure products

    NASA Astrophysics Data System (ADS)

    Asmi, A.; Kutsch, W. L.

    2015-12-01

    Environmental Research Infrastructures are often built as bottom-up initiatives to provide products for specific target group, which often is very discipline specific. However, the societal or environmental challenges are typically not concentrated on specific disciplines, and require usage of data sets from many RIs. ENVRI PLUS is an initiative where the European environmental RIs work together to provide common technical background (in physical observation technologies and in data products and descriptions) to make the RI products more usable to user groups outside of the original RI target groups. ENVRI PLUS also includes many policy and dissemination concentrated actions to make the RI operations coherent and understandable to both scientists and other potential users. The actions include building common technological capital of the RIs (physical and data-oriented), creating common access procedures (especially for cross-diciplinary access), developing ethical guidelines and related policies, distributing know-how between RIs and building common communication and collaboration system for European environmental RIs. All ENVRI PLUS products are free to use, e.g. for use of new or existing environmental RIs worldwide.

  8. Experiences with http/WebDAV protocols for data access in high throughput computing

    NASA Astrophysics Data System (ADS)

    Bernabeu, Gerard; Martinez, Francisco; Acción, Esther; Bria, Arnau; Caubet, Marc; Delfino, Manuel; Espinal, Xavier

    2011-12-01

    In the past, access to remote storage was considered to be at least one order of magnitude slower than local disk access. Improvement on network technologies provide the alternative of using remote disk. For those accesses one can today reach levels of throughput similar or exceeding those of local disks. Common choices as access protocols in the WLCG collaboration are RFIO, [GSI]DCAP, GRIDFTP, XROOTD and NFS. HTTP protocol shows a promising alternative as it is a simple, lightweight protocol. It also enables the use of standard technologies such as http caching or load balancing which can be used to improve service resilience and scalability or to boost performance for some use cases seen in HEP such as the "hot files". WebDAV extensions allow writing data, giving it enough functionality to work as a remote access protocol. This paper will show our experiences with the WebDAV door for dCache, in terms of functionality and performance, applied to some of the HEP work flows in the LHC Tier1 at PIC.

  9. Patient and professional views of open access hysterosalpingography for the initial management of infertility in primary care

    PubMed Central

    Wilkes, Scott; Rubin, Greg; Crosland, Ann; Hall, Nicola; Murdoch, Alison

    2009-01-01

    Background Hysterosalpingography (HSG) is recommended as a first-line investigation for tubal assessment of infertile women. This investigation is not routinely available to GPs. Aim To explore the perceptions and attitudes of patients and health professionals to open access HSG for the initial management of infertile couples in general practice. Design of study A nested qualitative study using in-depth interviews with GPs, fertility specialists, and infertile couples. Setting Northumberland, Newcastle upon Tyne, North Tyneside, South Tyneside, and Gateshead. Method Participants were 39 interviewees: 12 GPs, five fertility specialists, and 13 infertile couples (nine interviewed with their partner). Results Four themes emerged: personal factors; will it benefit patients, GPs, and fertility specialists?; professional factors; does it fit the role of a GP?; local context; do the skills exist in general practice?; and wider context; will it benefit the NHS? GPs who had used open access HSG, felt it was appropriate for general practice and would continue to use the service. All GPs, fertility specialists, and infertile couples who had experienced open access HSG wished the service to remain in place. The main barriers to its uptake were: infrequency with which infertility presents; lack of clarity on perceived responsibilities; difficulty keeping up to date, including assimilating guidelines; low clinical priority; and lack of support in authoritative guidance. Conclusion Providing GPs with open access to HSG would allow a full initial assessment of the infertile couple and refer women with blocked tubes directly to tertiary care. While there is general support for the provision of such a facility, the majority of GPs perceive its use as being by a limited number of GPs who have a special interest in infertility. The study findings can inform future development of infertility services at the interface between primary and secondary/tertiary care. PMID:19401016

  10. Access to cancer screening for women with mobility disabilities.

    PubMed

    Angus, Jan; Seto, Lisa; Barry, Nancy; Cechetto, Naomi; Chandani, Samira; Devaney, Julie; Fernando, Sharmini; Muraca, Linda; Odette, Fran

    2012-03-01

    Women with mobility disabilities are less likely to access cancer screening, even when they have a primary care provider. The Gateways to Cancer Screening project was initiated to document the challenges for women with disabilities in their access and experiences of screening for breast, cervical and colorectal cancer. The study followed the tenets of participatory action research. Five peer-led focus groups were held with 24 women with mobility disabilities. Study participants identified multiple and interacting institutional barriers to cancer screening. Their discussions highlighted the complex work of (1) arranging and attending health-related appointments, (2) confronting normative assumptions about women's bodies and (3) securing reliable health care and information. These overlapping, mutually reinforcing issues interact to shape how women with disabilities access and experience cancer screening. We explore implications for redesign of cancer screening services and education of health providers, providing specific recommendations suggested by our participants and the findings.

  11. British Isles Field Experience: An Initiative in International Education.

    ERIC Educational Resources Information Center

    Martin, William J.

    The British Isles Field Experience (BIFE) program was initiated at Williamsport Area Community College (WACC) to provide a group of WACC faculty and staff members with individual and group activities of a personal, professional, and cultural nature in order to promote an international perspective that can be infused into student, collegiate, and…

  12. The Ocean Observatories Initiative: Data Access and Visualization via the Graphical User Interface

    NASA Astrophysics Data System (ADS)

    Garzio, L. M.; Belabbassi, L.; Knuth, F.; Smith, M. J.; Crowley, M. F.; Vardaro, M.; Kerfoot, J.

    2016-02-01

    The Ocean Observatories Initiative (OOI), funded by the National Science Foundation, is a broad-scale, multidisciplinary effort to transform oceanographic research by providing users with real-time access to long-term datasets from a variety of deployed physical, chemical, biological, and geological sensors. The global array component of the OOI includes four high latitude sites: Irminger Sea off Greenland, Station Papa in the Gulf of Alaska, Argentine Basin off the coast of Argentina, and Southern Ocean near coordinates 55°S and 90°W. Each site is composed of fixed moorings, hybrid profiler moorings and mobile assets, with a total of approximately 110 instruments at each site. Near real-time (telemetered) and recovered data from these instruments can be visualized and downloaded via the OOI Graphical User Interface. In this Interface, the user can visualize scientific parameters via six different plotting functions with options to specify time ranges and apply various QA/QC tests. Data streams from all instruments can also be downloaded in different formats (CSV, JSON, and NetCDF) for further data processing, visualization, and comparison to supplementary datasets. In addition, users can view alerts and alarms in the system, access relevant metadata and deployment information for specific instruments, and find infrastructure specifics for each array including location, sampling strategies, deployment schedules, and technical drawings. These datasets from the OOI provide an unprecedented opportunity to transform oceanographic research and education, and will be readily accessible to the general public via the OOI's Graphical User Interface.

  13. Initial evaluation of fruit of accessions of Persea schiedeana Nees for nutritional value, quality and oil extraction.

    PubMed

    López-Yerena, A; Guerra-Ramírez, D; Jácome-Rincón, J; Espinosa-Solares, T; Reyes-Trejo, B; Famiani, F; Cruz-Castillo, J G

    2018-04-15

    Persea schiedeana Nees is an underutilized and very little known species whose fruit is consumed in Mesoamerica where it grows wild. This study was carried out to evaluate: 1) the variability of fruit characteristics of different accessions; 2) the effects of centrifugation and microwave treatment on extracting oil from the fruit and on its qualitative characteristics; 3) the nutraceutical characteristics of the fruit and seeds of different accessions. The results showed a large variability in fruit size and oil/dry matter contents among the different accessions. There was a significant relationship between the dry matter and oil contents in the pulp. The combined use of centrifugation and microwave treatments gave high oil extraction yields (67-68%). The oils had good fatty acid composition and antioxidant capacity. The results gave an initial picture about the total phenol contents and antioxidant capacities in the seeds and in the different parts of the fruit. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. The Transformative Potential of Teacher Care as Described by Students in a Higher Education Access Initiative

    ERIC Educational Resources Information Center

    Foster, Karen C.

    2008-01-01

    The "attitude-achievement gap" characterizing economically disadvantaged students of color is reexamined in a study of student perceptions of a higher education access program. Their descriptions of past and present experiences of teachers are contextualized in research citing the impact of stress, social stigma, and teacher misperceptions on…

  15. Open access to high-level data and analysis tools in the CMS experiment at the LHC

    DOE PAGES

    Calderon, A.; Colling, D.; Huffman, A.; ...

    2015-12-23

    The CMS experiment, in recognition of its commitment to data preservation and open access as well as to education and outreach, has made its first public release of high-level data under the CC0 waiver: up to half of the proton-proton collision data (by volume) at 7 TeV from 2010 in CMS Analysis Object Data format. CMS has prepared, in collaboration with CERN and the other LHC experiments, an open-data web portal based on Invenio. The portal provides access to CMS public data as well as to analysis tools and documentation for the public. The tools include an event display andmore » histogram application that run in the browser. In addition a virtual machine containing a CMS software environment along with XRootD access to the data is available. Within the virtual machine the public can analyse CMS data, example code is provided. As a result, we describe the accompanying tools and documentation and discuss the first experiences of data use.« less

  16. A Qualitative Exploration of Low-Income Women's Experiences Accessing Abortion in Massachusetts.

    PubMed

    Dennis, Amanda; Manski, Ruth; Blanchard, Kelly

    2015-01-01

    At a time when most states are working to restrict abortion, Massachusetts stands out as one of the few states with multiple state-level policies in place that support abortion access for low-income women. In 2006, Massachusetts passed health care reform, which resulted in almost all residents having insurance. Also, almost all state-level public and subsidized insurance programs cover abortion and there are fewer restrictions on abortion in Massachusetts compared with other states. We explored low-income women's experiences accessing abortion in Massachusetts through 27 in-depth telephone interviews with a racially diverse sample of low-income women who obtained abortions. Interviews were digitally recorded, transcribed, coded, and analyzed thematically. Most women described having access to timely, conveniently located, affordable, and highly acceptable abortion care. However, a sizable minority of women had difficulty enrolling in or staying on insurance, making abortion expensive. A small minority of women said their abortion care could be improved by increasing emotional support and privacy, and decreasing appointment times. Some limited data also suggest that young women and immigrant women face specific barriers to care. This study provides important, novel information about the need for state-level policies that support access to health insurance and comprehensive abortion coverage. Such policies, along with a well-functioning health care environment, help to ensure that low-income women have access to abortion. However, not all abortion access challenges have been resolved in Massachusetts. More work is needed to ensure that all women can access affordable, confidential care that is responsive to their specific needs and preferences. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  17. Constraints on Access: Costs and Benefits (Spontaneous Memory for Relevant Experiences)

    DTIC Science & Technology

    1989-05-01

    F. I. M. Craik (Eds.), Levels of processing and human memory. Hillsdale, NJ: Erlbaum. Dewey, J. (1963). How we think. Portions published in R. M...transfer. Pictures (vs. words) and levels of processing and elaborative encoding manipulations are shown to affect directed access but are found to have...includes most 5 6 list-learning experiments, research on schema/script abstraction, and studies of remembering which might manipulate levels of processing

  18. 77 FR 40628 - HUD's Fiscal Year (FY) 2012 Transformation Initiative: Natural Experiments Research Grant Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-10

    ... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5600-N-18-C-1] HUD's Fiscal Year (FY) 2012 Transformation Initiative: Natural Experiments Research Grant Program, Cancellation AGENCY: Office... Availability (NOFA) ``Transformation Initiative: Natural Experiments Grant Program'' on Grants.gov . The close...

  19. Retroperitoneoscopic living donor nephrectomy: initial experience with a unique hand-assisted approach.

    PubMed

    Capolicchio, J-P; Feifer, A; Plante, M K; Tchervenkov, J

    2011-01-01

    The retroperitoneoscopic (RP) approach to live donor nephrectomy (LDN) may be advantageous for the donor because it avoids mobilization of peritoneal organs and provides direct access to the renal vessels. Notwithstanding, this approach is not popular, likely because of the steeper learning curve. We feel that hand-assistance (HA) can reduce the learning curve and in this study, we present our experience with a novel hand-assist approach to retroperitoneoscopic live donor nephrectomy (HARP-LDN). Over a one-yr period, 10 consecutive patients underwent left HARP-LDN with a mean body mass index of 29 and three with prior left abdomen surgery. The surgical technique utilizes a 7 cm, muscle-sparing incision for the hand-port with two endoscopic ports. Operative time was an average of 155 min., with no open conversions. Mean blood loss was 68 mL, and warm ischemia time was 2.5 min. Hospital stay averaged 2.7 d with postoperative complications limited to one urinary retention. Our modified HARP approach to left LDN is safe, effective and can be performed expeditiously. Our promising initial results require a larger patient cohort to confirm the advantages of the hand-assisted retroperitoneal technique. © 2010 John Wiley & Sons A/S.

  20. An Initial Approach for Learning Objects from Experience

    DTIC Science & Technology

    2018-05-02

    The US Army Research Laboratorys Vehicle Technology Directorate (VTD) and the Human Research and Engineering Directorate , as part of VTDs 6.1 refresh...experience in an open-set framework. We have shown preliminary results from initial tests using a motion detection algorithm to delineate objects which are... performance and our topology can be defined using our nonparametric model. ARL will continue research to determine the best algorithms to use in the pipeline for the APPLE program.

  1. Security of social network credentials for accessing course portal: Users' experience

    NASA Astrophysics Data System (ADS)

    Katuk, Norliza; Fong, Choo Sok; Chun, Koo Lee

    2015-12-01

    Social login (SL) has recently emerged as a solution for single sign-on (SSO) within the web and mobile environments. It allows users to use their existing social network credentials (SNC) to login to third party web applications without the need to create a new identity in the intended applications' database. Although it has been used by many web application providers, its' applicability in accessing learning materials is not yet fully investigated. Hence, this research aims to explore users' (i.e., instructors' and students') perception and experience on the security of SL for accessing learning contents. A course portal was developed for students at a higher learning institution and it provides two types of user authentications (i) traditional user authentication, and (ii) SL facility. Users comprised instructors and students evaluated the login facility of the course portal through a controlled lab experimental study following the within-subject design. The participants provided their feedback in terms of the security of SL for accessing learning contents. The study revealed that users preferred to use SL over the traditional authentication, however, they concerned on the security of SL and their privacy.

  2. Physical Science Informatics: Providing Open Science Access to Microheater Array Boiling Experiment Data

    NASA Technical Reports Server (NTRS)

    McQuillen, John; Green, Robert D.; Henrie, Ben; Miller, Teresa; Chiaramonte, Fran

    2014-01-01

    The Physical Science Informatics (PSI) system is the next step in this an effort to make NASA sponsored flight data available to the scientific and engineering community, along with the general public. The experimental data, from six overall disciplines, Combustion Science, Fluid Physics, Complex Fluids, Fundamental Physics, and Materials Science, will present some unique challenges. Besides data in textual or numerical format, large portions of both the raw and analyzed data for many of these experiments are digital images and video, requiring large data storage requirements. In addition, the accessible data will include experiment design and engineering data (including applicable drawings), any analytical or numerical models, publications, reports, and patents, and any commercial products developed as a result of the research. This objective of paper includes the following: Present the preliminary layout (Figure 2) of MABE data within the PSI database. Obtain feedback on the layout. Present the procedure to obtain access to this database.

  3. Patients' perspectives and experiences concerning barriers to accessing information about bilateral prophylactic mastectomy.

    PubMed

    Glassey, Rachael; O'Connor, Moira; Ives, Angela; Saunders, Christobel; kConFab Investigators; O'Sullivan, Sarah; Hardcastle, Sarah J

    2018-05-11

    To explore the barriers and experiences of accessing information for women who have received genetic risk assessment/testing results for breast cancer (BC) and are considering a bilateral prophylactic mastectomy (BPM) and, exploring participants' preferences concerning information and support needs. A qualitative retrospective study guided by interpretative phenomenological analysis was utilised. Semi-structured interviews were conducted with forty-six women who were either considering BPM or had already undergone the surgery. Three themes identified barriers to accessing information; difficulties accessing information, inconsistent information and clinical focus/medicalized information. A fourth theme - preferences of information and support needs, identified three subthemes; these were, psychological support, clearly defined processes and photos of mastectomies/reconstruction surgeries. Barriers to accessing information appeared to be widespread. A lack of integrated services contributed to inconsistent information, and medicalized terminology/clinical focus of consultations further complicated understanding. Preferences for information include clearly defined processes, so women know the pathways after confirmation of familial BC risk. Clinical implications include a multidisciplinary team approach, and a protocol that reflects current practice. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Distributed observing facility for remote access to multiple telescopes

    NASA Astrophysics Data System (ADS)

    Callegari, Massimo; Panciatici, Antonio; Pasian, Fabio; Pucillo, Mauro; Santin, Paolo; Aro, Simo; Linde, Peter; Duran, Maria A.; Rodriguez, Jose A.; Genova, Francoise; Ochsenbein, Francois; Ponz, J. D.; Talavera, Antonio

    2000-06-01

    The REMOT (Remote Experiment Monitoring and conTrol) project was financed by 1996 by the European Community in order to investigate the possibility of generalizing the remote access to scientific instruments. After the feasibility of this idea was demonstrated, the DYNACORE (DYNAmically, COnfigurable Remote Experiment monitoring and control) project was initiated as a REMOT follow-up. Its purpose is to develop software technology to support scientists in two different domains, astronomy and plasma physics. The resulting system allows (1) simultaneous multiple user access to different experimental facilities, (2) dynamic adaptability to different kinds of real instruments, (3) exploitation of the communication infrastructures features, (4) ease of use through intuitive graphical interfaces, and (5) additional inter-user communication using off-the-shelf projects such as video-conference tools, chat programs and shared blackboards.

  5. "Elite" Career-Changers and Their Experience of Initial Teacher Education

    ERIC Educational Resources Information Center

    Wilkins, Chris

    2017-01-01

    This study explores the motivation of "high-status" professionals to change career and enter teaching, and their experience of undertaking initial teacher education (ITE) programmes in England. The study builds on previous research which found that career-changers are disproportionately more likely to fail to complete their ITE studies,…

  6. The Virtual Ramp to the Equivalent Experience in the Virtual Museum: Accessibility to Museums on the Web.

    ERIC Educational Resources Information Center

    Nevile, Liddy; McCathieNevile, Charles

    This paper argues that a range of forms and modalities of resources should be provided to ensure accessibility and richness on the World Wide Web for all users. Based on experiences in developing virtual exhibitions of Quinkan Aboriginal Rock Art, the authors present a brief overview of the technology available for accessibility. Then they explore…

  7. Do performance and image enhancing drug users in regional Queensland experience difficulty accessing health services?

    PubMed

    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.

  8. More than a feeling: Emotional cues impact the access and experience of autobiographical memories.

    PubMed

    Sheldon, Signy; Donahue, Julia

    2017-07-01

    Remembering is impacted by several factors of retrieval, including the emotional content of a memory cue. Here we tested how musical retrieval cues that differed on two dimensions of emotion-valence (positive and negative) and arousal (high and low)-impacted the following aspects of autobiographical memory recall: the response time to access a past personal event, the experience of remembering (ratings of memory vividness), the emotional content of a cued memory (ratings of event arousal and valence), and the type of event recalled (ratings of event energy, socialness, and uniqueness). We further explored how cue presentation affected autobiographical memory retrieval by administering cues of similar arousal and valence levels in a blocked fashion to one half of the tested participants, and randomly to the other half. We report three main findings. First, memories were accessed most quickly in response to musical cues that were highly arousing and positive in emotion. Second, we observed a relation between a cue and the elicited memory's emotional valence but not arousal; however, both the cue valence and arousal related to the nature of the recalled event. Specifically, high cue arousal led to lower memory vividness and uniqueness ratings, but cues with both high arousal and positive valence were associated with memories rated as more social and energetic. Finally, cue presentation impacted both how quickly and specifically memories were accessed and how cue valence affected the memory vividness ratings. The implications of these findings for views of how emotion directs the access to memories and the experience of remembering are discussed.

  9. Use of a Patient-Accessible Electronic Medical Record in a Practice for Congestive Heart Failure: Patient and Physician Experiences

    PubMed Central

    Earnest, Mark A.; Ross, Stephen E.; Wittevrongel, Loretta; Moore, Laurie A.; Lin, Chen-Tan

    2004-01-01

    Objective: The aim of this study was to evaluate the experiences of patients and physicians in a clinical trial of an online electronic medical record (SPPARO, System Providing Patients Access to Records Online). Design: Quantitative data were obtained from questionnaires. Qualitative data were obtained from individual interviews and focus groups. Measurements: Questionnaire items were based on issues identified by patients and physicians in previous studies. Individual interviews and focus groups were performed using a semistructured format developed through an iterative process. Results: Of the eight physicians who participated in the trial, seven completed questionnaires and interviews. Of the 394 patients in the practice, 107 enrolled in the study, and 54 were assigned randomly to the intervention group. Of these, 41 used SPPARO during the trial period. In questionnaires and interviews, patients were significantly more likely than physicians to anticipate benefits of SPPARO and less likely to anticipate problems. Attitudes of subjects did not diverge from controls after the intervention period. In posttrial focus groups, SPPARO users described its practical benefits. Comprehending medical jargon was a minor obstacle. Physicians anticipated that implementing SPPARO might increase their workload and distort their clinical interactions. In posttrial interviews, physicians and staff reported no change in their workload and no adverse consequences. All of the physicians ultimately supported the concept of giving patients online access to their clinical notes and test results. Conclusion: SPPARO was useful for a number of patients. Physicians initially voiced a number of concerns about implementing SPPARO, but their experience with it was far more positive. PMID:15187074

  10. Initial operation of the Lockheed Martin T4B experiment

    NASA Astrophysics Data System (ADS)

    Garrett, M. L.; Blinzer, A.; Ebersohn, F.; Gucker, S.; Heinrich, J.; Lohff, C.; McGuire, T.; Montecalvo, N.; Raymond, A.; Rhoads, J.; Ross, P.; Sommers, B.; Strandberg, E.; Sullivan, R.; Walker, J.

    2017-10-01

    The T4B experiment is a linear, encapsulated ring cusp confinement device, designed to develop a physics and technology basis for a follow-on high beta (β 1) machine. The experiment consists of 13 magnetic field coils (11 external, 2 internal), to produce a series of on-axis field nulls surrounded by modest magnetic fields of up to 0.3 T. The primary plasma source used on T4B is a lanthanum hexaboride (LaB6) cathode, capable of coupling over 100 kW into the plasma. Initial testing focused on commissioning of components and integration of diagnostics. Diagnostics include both long and short wavelength interferometry, bolometry, visible and X-ray spectroscopy, Langmuir and B-dot probes, Thomson scattering, flux loops, and fast camera imagery. Low energy discharges were used to begin validation of physics models and simulation efforts. Following the initial machine check-out, neutral beam injection (NBI) was integrated onto the device. Detailed results will be presented. 2017 Lockheed Martin Corporation. All Rights Reserved.

  11. The status and initial results of the Majorana demonstrator experiment

    NASA Astrophysics Data System (ADS)

    Guiseppe, V. E.; Abgrall, N.; Alvis, S. I.; Arnquist, I. J.; Avignone, F. T.; Barabash, A. S.; Barton, C. J.; Bertrand, F. E.; Bode, T.; Bradley, A. W.; Brudanin, V.; Busch, M.; Buuck, M.; Caldwell, T. S.; Chan, Y.-D.; Christofferson, C. D.; Chu, P.-H.; Cuesta, C.; Detwiler, J. A.; Dunagan, C.; Efremenko, Yu.; Ejiri, H.; Elliott, S. R.; Gilliss, T.; Giovanetti, G. K.; Green, M. P.; Gruszko, J.; Guinn, I. S.; Haufe, C. R.; Hehn, L.; Henning, R.; Hoppe, E. W.; Howe, M. A.; Keeter, K. J.; Kidd, M. F.; Konovalov, S. I.; Kouzes, R. T.; Lopez, A. M.; Martin, R. D.; Massarczyk, R.; Meijer, S. J.; Mertens, S.; Myslik, J.; O'Shaughnessy, C.; Othman, G.; Poon, A. W. P.; Radford, D. C.; Rager, J.; Reine, A. L.; Rielage, K.; Robertson, R. G. H.; Rouf, N. W.; Shanks, B.; Shirchenko, M.; Suriano, A. M.; Tedeschi, D.; Trimble, J. E.; Varner, R. L.; Vasilyev, S.; Vetter, K.; Vorren, K.; White, B. R.; Wilkerson, J. F.; Wiseman, C.; Xu, W.; Yakushev, E.; Yu, C.-H.; Yumatov, V.; Zhitnikov, I.; Zhu, B. X.

    2017-10-01

    Neutrinoless double-beta decay searches play a major role in determining the nature of neutrinos, the existence of a lepton violating process, and the effective Majorana neutrino mass. The Majorana Collaboration assembled an array of high purity Ge detectors to search for neutrinoless double-beta decay in 76Ge. The Majorana Demonstrator is comprised of 44.1 kg (29.7 kg enriched in 76Ge) of Ge detectors divided between two modules contained in a low-background shield at the Sanford Underground Research Facility in Lead, South Dakota, USA. The initial goals of the Demonstrator are to establish the required background and scalability of a Ge-based next-generation ton-scale experiment. Following a commissioning run that started in 2015, the first detector module started low-background data production in early 2016. The second detector module was added in August 2016 to begin operation of the entire array. We discuss results of the initial physics runs, as well as the status and physics reach of the full Majorana Demonstrator experiment.

  12. Comparison of access, outcomes and experiences of older adults and working age adults in psychological therapy.

    PubMed

    Chaplin, Robert; Farquharson, Lorna; Clapp, Melissa; Crawford, Mike

    2015-02-01

    This study aimed to evaluate the access, experiences and outcomes of older adults receiving psychological therapies in comparison with adults of working age Primary and secondary care providers of psychological therapy services participated in the National Audit of Psychological Therapies. The main standards of access, experience and outcomes were measured by retrospective case records audits of people who completed therapy and a service user questionnaire. Outcomes were measured pre-treatment and post-treatment on the PHQ-9 and GAD-7. A total of 220 services across 97 organisations took part, 137 (62%) in primary care. Service user questionnaires were received from 14 425 (20%) respondents. A total of 122 740 records were audited, of whom 7794 (6.4%) were older adults. They were under represented as 13% of the sample would have been expected to be over 65 years according to age adjusted psychiatric morbidity figures. People over 75 years had the third expected referral rate. Significantly, more older adults than working age adults completed therapy (59.6% vs 48.6%) and were assessed as having 'recovered' post-treatment (58.5% vs 45.5%). Older adults were more satisfied with waiting times and numbers of sessions, but there were no differences in self-reported experience of therapy. Although older adults are less likely to gain access to psychological therapies, they appear to have better outcomes than working age adults. Further work is needed to improve access for older people. Copyright © 2014 John Wiley & Sons, Ltd.

  13. The association between race and prostate cancer risk on initial biopsy in an equal access, multiethnic cohort

    PubMed Central

    Gaines, Alexis R.; Turner, Elizabeth L.; Moorman, Patricia G.; Freedland, Stephen J.; Keto, Christopher J.; McPhail, Megan E.; Grant, Delores J.; Vidal, Adriana C.

    2014-01-01

    Purpose Population-based studies have established a link between race and prostate cancer (PC) risk, but whether race predicts PC after adjusting for clinical characteristics is unclear. We investigated the association between race and risk of low- and high-grade PC in men undergoing initial prostate biopsy in an equal access medical center. Methods We conducted a retrospective record review of 887 men (48.6 % black, 51.4 % white) from the Durham Veterans Affairs Medical Center who underwent initial prostate biopsy between 2001 and 2009. Multivariable logistic regression analysis of race and biopsy outcome was conducted adjusting for age, body mass index, number of cores taken, prostate-specific antigen (PSA), and digital rectal examination findings. Multinomial logistic regression was used to test the association between black race and PC grade (Gleason <7 vs. ≥7). Results Black men were younger at biopsy (61 vs. 65 years, p <0.001) and had a higher pre-biopsy PSA (6.6 vs. 5.8 ng/ml, p = 0.001). A total of 499 men had PC on biopsy (245 low grade; 254 high grade). In multivariable analyses, black race was significantly predictive of PC overall [odds ratio 1.50, p = 0.006] and high-grade PC [relative risk ratio (RRR) 1.84, p = 0.001], but was not significantly associated with low-grade PC (RRR 1.29, p = 0.139). Conclusion In an equal access healthcare facility, black race was associated with greater risk of PC detection on initial biopsy and of high-grade PC after adjusting for clinical characteristics. Additional investigation of mechanisms linking black race and PC risk and PC aggressiveness is needed. PMID:24879044

  14. The association between race and prostate cancer risk on initial biopsy in an equal access, multiethnic cohort.

    PubMed

    Gaines, Alexis R; Turner, Elizabeth L; Moorman, Patricia G; Freedland, Stephen J; Keto, Christopher J; McPhail, Megan E; Grant, Delores J; Vidal, Adriana C; Hoyo, Cathrine

    2014-08-01

    Population-based studies have established a link between race and prostate cancer (PC) risk, but whether race predicts PC after adjusting for clinical characteristics is unclear. We investigated the association between race and risk of low- and high-grade PC in men undergoing initial prostate biopsy in an equal access medical center. We conducted a retrospective record review of 887 men (48.6 % black, 51.4 % white) from the Durham Veterans Affairs Medical Center who underwent initial prostate biopsy between 2001 and 2009. Multivariable logistic regression analysis of race and biopsy outcome was conducted adjusting for age, body mass index, number of cores taken, prostate-specific antigen (PSA), and digital rectal examination findings. Multinomial logistic regression was used to test the association between black race and PC grade (Gleason <7 vs. ≥7). Black men were younger at biopsy (61 vs. 65 years, p < 0.001) and had a higher pre-biopsy PSA (6.6 vs. 5.8 ng/ml, p = 0.001). A total of 499 men had PC on biopsy (245 low grade; 254 high grade). In multivariable analyses, black race was significantly predictive of PC overall [odds ratio 1.50, p = 0.006] and high-grade PC [relative risk ratio (RRR) 1.84, p = 0.001], but was not significantly associated with low-grade PC (RRR 1.29, p = 0.139). In an equal access healthcare facility, black race was associated with greater risk of PC detection on initial biopsy and of high-grade PC after adjusting for clinical characteristics. Additional investigation of mechanisms linking black race and PC risk and PC aggressiveness is needed.

  15. Increasing Access to Fruits and Vegetables: Perspectives From the New York City Experience

    PubMed Central

    Yi, Stella S.; Nonas, Cathy

    2015-01-01

    Broad recognition now exists that price, availability, and other structural factors are meaningful barriers to fruit and vegetable consumption, particularly among low-income adults. Beginning in 2005, the New York City Department of Health and Mental Hygiene used the social–ecological model to develop a multifaceted effort to increase fruit and vegetable access citywide, with emphasis in low-income neighborhoods. Overall, the percentage of New York City adults who reported consuming no fruits and vegetables in the previous day decreased slightly over a 10-year period (2002: 14.3% [95% confidence interval = 13.4%, 15.2%]; 2012: 12.5% [95% confidence interval = 11.4%, 13.6%]; P for trend < .001). Our approach hypothesizes that complementary initiatives, implemented simultaneously, will create a citywide food environment that fuels changes in social norms and cultural preferences, increases consumer demand, and supports sustainable access to affordable produce. PMID:25790427

  16. Increasing access to fruits and vegetables: perspectives from the New York City experience.

    PubMed

    Sacks, Rachel; Yi, Stella S; Nonas, Cathy

    2015-05-01

    Broad recognition now exists that price, availability, and other structural factors are meaningful barriers to fruit and vegetable consumption, particularly among low-income adults. Beginning in 2005, the New York City Department of Health and Mental Hygiene used the social-ecological model to develop a multifaceted effort to increase fruit and vegetable access citywide, with emphasis in low-income neighborhoods. Overall, the percentage of New York City adults who reported consuming no fruits and vegetables in the previous day decreased slightly over a 10-year period (2002: 14.3% [95% confidence interval = 13.4%, 15.2%]; 2012: 12.5% [95% confidence interval = 11.4%, 13.6%]; P for trend < .001). Our approach hypothesizes that complementary initiatives, implemented simultaneously, will create a citywide food environment that fuels changes in social norms and cultural preferences, increases consumer demand, and supports sustainable access to affordable produce.

  17. Experiments and simulations of single shock Richtmeyer-Meshkov Instability with measured, volumetric initial conditions

    NASA Astrophysics Data System (ADS)

    Sewell, Everest; Ferguson, Kevin; Greenough, Jeffrey; Jacobs, Jeffrey

    2014-11-01

    We describe new experiments of single shock Richtmeyer-Meshkov Instability (RMI) performed on the shock tube apparatus at the University of Arizona in which the initial conditions are volumetrically imaged prior to shock wave arrival. Initial perturbation plays a major role in the evolution of RMI, and previous experimental efforts only capture a narrow slice of the initial condition. The method presented uses a rastered laser sheet to capture additional images in the depth of the initial condition shortly before the experimental start time. These images are then used to reconstruct a volumetric approximation of the experimental perturbation, which is simulated using the hydrodynamics code ARES, developed at Lawrence Livermore National Laboratory (LLNL). Comparison is made between the time evolution of the interface width and the mixedness ratio measured from the experiments against the predictions from the numerical simulations.

  18. Cancer's Margins: Trans* and Gender Nonconforming People's Access to Knowledge, Experiences of Cancer Health, and Decision-Making

    PubMed Central

    Bryson, Mary K.

    2016-01-01

    Abstract Purpose: Research in Canada and the United States indicates that minority gender and sexuality status are consistently associated with health disparities and poor health outcomes, including cancer health. This article investigates experiences of cancer health and care, and access to knowledge for trans* and gender nonconforming people diagnosed with and treated for breast and/or gynecologic cancer. Our study contributes new understandings about gender minority populations that will advance knowledge concerning the provision of culturally appropriate care. This is the first study we are aware of that focuses on trans* and gender nonconforming peoples' experiences of cancer care and treatment, support networks, and access to and mobilization of knowledge. Methods: This article analyzes trans* and gender nonconforming patient interviews from the Cancer's Margins project (www.lgbtcancer.ca): Canada's first nationally-funded project that investigates the complex intersections of sexual and/or gender marginality, cancer knowledge, treatment experiences, and modes of the organization of support networks. Results: Our analysis documents how different bodies of knowledge relative to cancer treatment and gendered embodiment are understood, accessed, and mobilized by trans* and gender nonconforming patients. Findings reported here suggest that one's knowledge of a felt sense of gender is closely interwoven with knowledge concerning cancer treatment practices; a dynamic which organizes knowledge mobilities in cancer treatment. Conclusions: The findings support the assertion that cisgender models concerning changes to the body that occur as a result of biomedical treatment for breast and/or gynecologic cancer are wholly inadequate in order to account for trans* and gender nonconforming peoples' experiences of cancer treatments, and access to and mobilization of related knowledge. PMID:26789402

  19. Facilitators and hindrances in the experiences of Ugandans with and without disabilities when seeking access to microcredit schemes.

    PubMed

    Cramm, Jane Murray; Paauwe, Marthe; Finkenflügel, Harry

    2012-01-01

    This study aimed to identify facilitators and hindrances in the experiences of Ugandans with and without disabilities when seeking access to microcredit schemes. Thirty-five statements were presented to 80 people, 50 of whom were disabled. Q-methodology was used to identify factors influencing access to microcredit schemes. Running a business independently was solely identified by people with disabilities (PWD) as an important facilitator in accessing microcredit schemes, while relying on business skills was largely mentioned by people without disabilities. The disabled identified family-related items to be inhibiting factors. Having a group loan was ranked negatively by the disabled and ambivalently by the non-disabled. PWD experience different facilitators and barriers to access microcredit schemes compared to the non-disabled. PWD prefer individual loans and believe they can more successfully run a business on their own, instead of relying on family or having a group loan. Furthermore, they would benefit from microcredit schemes that take into account disability-specific circumstances. These are important findings to increase access to microcredit schemes and to let PWD benefit to the same extend from these programmes than do their non-disabled peers.

  20. Outcomes of Elderly Patients after Predialysis Vascular Access Creation

    PubMed Central

    Lee, Timmy; Thamer, Mae; Zhang, Yi; Zhang, Qian

    2015-01-01

    Uniform vascular access guidelines for elderly patients may be inappropriate because of the competing risk of death, high rate of arteriovenous fistula (AVF) maturation failure, and poor vascular access outcomes in this population. However, the outcomes in elderly patients with advanced CKD who receive permanent vascular access before dialysis initiation are unclear. We identified a large nationally representative cohort of 3418 elderly patients (aged ≥70 years) with CKD undergoing predialysis AVF or arteriovenous graft (AVG) creation from 2004 to 2009, and assessed the frequencies of dialysis initiation, death before dialysis initiation, and dialysis-free survival for 2 years after vascular access creation. In all, 67% of patients with predialysis AVF and 71% of patients with predialysis AVG creation initiated dialysis within 2 years of access placement, but the overall risk of dialysis initiation was modified by patient age and race. Only one half of patients initiated dialysis with a functioning AVF or AVG; 46.8% of AVFs were created <90 days before dialysis initiation. Catheter dependence at dialysis initiation was more common in patients receiving predialysis AVF than in patients receiving AVG (46.0% versus 28.5%; P<0.001). In conclusion, most elderly patients with advanced CKD who received predialysis vascular access creation initiated dialysis within 2 years. As a consequence of late predialysis placement or maturation failure, almost one half of patients receiving AVFs initiated dialysis with a catheter. Insertion of an AVG closer to dialysis initiation may serve as a “catheter-sparing” approach and allow delay of permanent access placement in selected elderly patients with CKD. PMID:25855782

  1. Cancer patients' attitudes and experiences of online access to their electronic medical records: A qualitative study.

    PubMed

    Rexhepi, Hanife; Åhlfeldt, Rose-Mharie; Cajander, Åsa; Huvila, Isto

    2018-06-01

    Patients' access to their online medical records serves as one of the cornerstones in the efforts to increase patient engagement and improve healthcare outcomes. The aim of this article is to provide in-depth understanding of cancer patients' attitudes and experiences of online medical records, as well as an increased understanding of the complexities of developing and launching e-Health services. The study result confirms that online access can help patients prepare for doctor visits and to understand their medical issues. In contrast to the fears of many physicians, the study shows that online access to medical records did not generate substantial anxiety, concerns or increased phone calls to the hospital.

  2. The experience of foot problems and decisions to access foot care in patients with rheumatoid arthritis: a qualitative study.

    PubMed

    Wilson, Oonagh; Kirwan, John; Dures, Emma; Quest, Enid; Hewlett, Sarah

    2017-01-01

    Although foot problems are common in rheumatoid arthritis (RA), the consequences of foot problems from the patient perspective have not been fully explored. The aims of this study were to explore the experience of foot problems and decisions to access foot care services or not in patients with RA. Semi structured, one-to-one interviews with patients recruited from 2 UK rheumatology units, purposively sampled for self-reported foot problems and a range of personal/disease characteristics. Inductive thematic analysis was used, with rigour provided by multiple independent analysers. Emerging themes were discussed and agreed by all authors. Twelve patients participated: 7 female; mean age 56 years (29-72); mean disease duration 12 years (2-27), 5 had accessed foot care services. The 'Impact' of foot problems was substantial and formed the underpinning theme, comprising three organising themes: 'Foot symptoms'; 'Consequences'; and 'Cost'. Foot symptoms such as pain and numbness required self-management, and affected daily life (walking, working) leading to social and emotional costs. The global theme, 'Decision to access foot care or not', also comprised three organising themes: 'Access perceived unnecessary' (no problem, can cope); 'Access hindered by patients' perception'; and 'Access supported by patient and clinician'. Decisions to access foot care or not were complex and influenced by patient beliefs regarding possible treatments and how to access these, and hindered by patient perceptions that their feet were ignored by rheumatology clinicians. Positive experience of foot care encouraged continued utilisation but negative experiences contributed to patients' decisions to discontinue foot care services. Foot problems are important issues for patients and impact on many aspects of their physical, social and emotional lives. Patients who had accessed foot care services prioritised their foot problems as an important health care need. However, for others who would

  3. Initial Results from the STEM Student Experiences Aboard Ships (STEMSEAS) Program

    NASA Astrophysics Data System (ADS)

    Lewis, J. C.; Cooper, S. K.; Thomson, K.; Rabin, B.; Alberts, J.

    2016-12-01

    The Science Technology Engineering and Math Student Experiences Aboard Ships (STEMSEAS) program was created as a response to NSF's call (through GEOPATHS) for improving undergraduate STEM education and enhancing diversity in the geosciences. It takes advantage of unused berths on UNOLS ships during transits between expeditions. During its 2016 pilot year - which consisted of three transits on three different research vessels in different parts of the country, each with a slightly different focus - the program has gained significant insights into how best to create and structure these opportunities and create impact on individual students. A call for applications resulted in nearly 900 applicants for 30 available spots. Of these applicants, 32% are from minority groups underrepresented in the geosciences (Black, Hispanic, or American Indian) and 20% attend community colleges. The program was able to sail socioeconomically diverse cohorts and include women, veterans, and students with disabilities and from two- and four-year colleges. Twenty-three are underrepresented minorities, 6 attend community colleges, 5 attend an HBCU or tribal college, and many are at HSIs or other MSIs. While longer term impact assessment will have to wait, initial results and 6-month tracking for the first cohort indicate that these kinds of relatively short but intense experiences can indeed achieve significant impacts on students' perception of the geosciences, in their understanding of STEM career opportunities, their desire to work in a geoscience lab setting, and to incorporate geosciences into non-STEM careers. Insights were also gained into the successful makeup of mentor/leader groups, factors to consider in student selection, necessary pre- and post-cruise logistics management, follow-up activities, structure of activities during daily life at sea, increasing student networks and access to mentorships, and leveraging of pre-existing resources and ship-based opportunities

  4. ACCESS, Absolute Color Calibration Experiment for Standard Stars: Integration, Test, and Ground Performance

    NASA Astrophysics Data System (ADS)

    Kaiser, Mary Elizabeth; Morris, Matthew; Aldoroty, Lauren; Kurucz, Robert; McCandliss, Stephan; Rauscher, Bernard; Kimble, Randy; Kruk, Jeffrey; Wright, Edward L.; Feldman, Paul; Riess, Adam; Gardner, Jonathon; Bohlin, Ralph; Deustua, Susana; Dixon, Van; Sahnow, David J.; Perlmutter, Saul

    2018-01-01

    Establishing improved spectrophotometric standards is important for a broad range of missions and is relevant to many astrophysical problems. Systematic errors associated with astrophysical data used to probe fundamental astrophysical questions, such as SNeIa observations used to constrain dark energy theories, now exceed the statistical errors associated with merged databases of these measurements. ACCESS, “Absolute Color Calibration Experiment for Standard Stars”, is a series of rocket-borne sub-orbital missions and ground-based experiments designed to enable improvements in the precision of the astrophysical flux scale through the transfer of absolute laboratory detector standards from the National Institute of Standards and Technology (NIST) to a network of stellar standards with a calibration accuracy of 1% and a spectral resolving power of 500 across the 0.35‑1.7μm bandpass. To achieve this goal ACCESS (1) observes HST/ Calspec stars (2) above the atmosphere to eliminate telluric spectral contaminants (e.g. OH) (3) using a single optical path and (HgCdTe) detector (4) that is calibrated to NIST laboratory standards and (5) monitored on the ground and in-flight using a on-board calibration monitor. The observations are (6) cross-checked and extended through the generation of stellar atmosphere models for the targets. The ACCESS telescope and spectrograph have been designed, fabricated, and integrated. Subsystems have been tested. Performance results for subsystems, operations testing, and the integrated spectrograph will be presented. NASA sounding rocket grant NNX17AC83G supports this work.

  5. Student Teachers' Prior Experiences of History, Geography and Science: Initial Findings of an All-Ireland Survey

    ERIC Educational Resources Information Center

    Waldron, Fionnuala; Pike, Susan; Varley, Janet; Murphy, Colette; Greenwood, Richard

    2007-01-01

    Research into student teachers' perceptions, attitudes and prior experiences of learning suggests that these experiences can exert an influence on practice which can be relatively undisturbed by their initial teacher education. This article is based on the initial findings of an all-Ireland survey of all first-year students on B.Ed. courses in…

  6. Overview of Initial NSTX-U Experimental Operations

    NASA Astrophysics Data System (ADS)

    Battaglia, Devon; the NSTX-U Team

    2016-10-01

    Initial operation of the National Spherical Torus Experiment Upgrade (NSTX-U) has satisfied a number of commissioning milestones, including demonstration of discharges that exceed the field and pulse length of NSTX. ELMy H-mode operation at the no-wall βN limit is obtained with Boronized wall conditioning. Peak H-mode parameters include: Ip = 1 MA, BT0 = 0.63 T, WMHD = 330 kJ, βN = 4, βN/li = 6, κ = 2.3, τE , tot >50 ms. Access to high-performance H-mode scenarios with long MHD-quiescent periods is enabled by the resilient timing of the L-H transition via feedback control of the diverting time and shape, and correction of the dominant n =1 error fields during the Ip ramp. Stationary L-mode discharges have been realized up to 1 MA with 2 s discharges achieved at Ip = 650 kA. The long-pulse L-mode discharges enabled by the new central solenoid supported initial experiments on error field measurements and correction, plasma shape control, controlled discharge ramp-down, L-mode transport and fast ion physics. Increased off-axis current drive and reduction of fast ion instabilities has been observed with the new, more tangential neutral beamline. The initial results support that access to increased field, current and heating at low-aspect-ratio expands the regimes available to develop scenarios, diagnostics and predictive models that inform the design and optimization of future burning plasma tokamak devices, including ITER. Work Supported by U.S. DOE Contract No. DE-AC02-09CH11466.

  7. Endoscopic thyroidectomy with the da Vinci robot system using the bilateral axillary breast approach (BABA) technique: our initial experience.

    PubMed

    Lee, Kyu Eun; Rao, Jaideepraj; Youn, Yeo-Kyu

    2009-06-01

    Robotic surgery is useful in areas with difficult access like the pelvis. The ideal indications for robotic surgery are still to be established. The neck area, especially the thyroid gland poses a difficult challenge for many endoscopic surgeons. Robotic surgery is useful in this area due to its excellent magnification and endowrist function. We present our initial experience with robotic endoscopic thyroidectomy using the bilateral axillary breast approach (BABA). Between March and May 2008, 15 patients diagnosed with papillary thyroid cancer underwent robotic-assisted endoscopic thyroidectomy using the BABA technique. The mean operating time was 218 minutes. There was a steady decrease in operative time from the initial case to the 15th case. The blood loss was minimal. The recurrent laryngeal nerve and parathyroid glands were identified in great detail with ease and preserved in all cases. There were no postoperative complications in any case. Robotic endoscopic thyroidectomy using the BABA technique is a feasible procedure and can be performed safely. It provides an excellent operative field view enabling easy identification of vital structures. It also gives the desired cosmetic results and minimal postoperative pain similar to conventional endoscopic thyroid surgery using the BABA technique.

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

    PubMed

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

    2015-03-01

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

  9. Increased use of heroin as an initiating opioid of abuse.

    PubMed

    Cicero, Theodore J; Ellis, Matthew S; Kasper, Zachary A

    2017-11-01

    Given the relatively recent growth in access to heroin and a more permissive atmosphere surrounding its use, we hypothesized that an increasing number of persons with limited experience and tolerance to opioids would experiment with heroin as their first opioid rather than more common prescription opioid analgesics. Individuals entering substance abuse treatment for an opioid use disorder in the period 2010-2016 (N=5885) were asked about the specific opioid they first regularly used to get high. To limit long-term recall and survival bias, analyses was restricted to opioid initiation that occurred in the past ten years (2005-2015). In 2005, only 8.7% of opioid initiators started with heroin, but this sharply increased to 33.3% (p<0.001) in 2015, with no evidence of stabilization. The use of commonly prescribed opioids, oxycodone and hydrocodone, dropped from 42.4% and 42.3% of opioid initiators, respectively, to 24.1% and 27.8% in 2015, such that heroin as an initiating opioid was now more frequently endorsed than prescription opioid analgesics. Our data document that, as the most commonly prescribed opioids - hydrocodone and oxycodone - became less accessible due to supply-side interventions, the use of heroin as an initiating opioid has grown at an alarming rate. Given that opioid novices have limited tolerance to opioids, a slight imprecision in dosing inherent in heroin use is likely to be an important factor contributing to the growth in heroin-related over dose fatalities in recent years. Copyright © 2017. Published by Elsevier Ltd.

  10. Outcomes of Elderly Patients after Predialysis Vascular Access Creation.

    PubMed

    Lee, Timmy; Thamer, Mae; Zhang, Yi; Zhang, Qian; Allon, Michael

    2015-12-01

    Uniform vascular access guidelines for elderly patients may be inappropriate because of the competing risk of death, high rate of arteriovenous fistula (AVF) maturation failure, and poor vascular access outcomes in this population. However, the outcomes in elderly patients with advanced CKD who receive permanent vascular access before dialysis initiation are unclear. We identified a large nationally representative cohort of 3418 elderly patients (aged ≥ 70 years) with CKD undergoing predialysis AVF or arteriovenous graft (AVG) creation from 2004 to 2009, and assessed the frequencies of dialysis initiation, death before dialysis initiation, and dialysis-free survival for 2 years after vascular access creation. In all, 67% of patients with predialysis AVF and 71% of patients with predialysis AVG creation initiated dialysis within 2 years of access placement, but the overall risk of dialysis initiation was modified by patient age and race. Only one half of patients initiated dialysis with a functioning AVF or AVG; 46.8% of AVFs were created <90 days before dialysis initiation. Catheter dependence at dialysis initiation was more common in patients receiving predialysis AVF than in patients receiving AVG (46.0% versus 28.5%; P<0.001). In conclusion, most elderly patients with advanced CKD who received predialysis vascular access creation initiated dialysis within 2 years. As a consequence of late predialysis placement or maturation failure, almost one half of patients receiving AVFs initiated dialysis with a catheter. Insertion of an AVG closer to dialysis initiation may serve as a "catheter-sparing" approach and allow delay of permanent access placement in selected elderly patients with CKD. Copyright © 2015 by the American Society of Nephrology.

  11. Commissioning and initial experimental program of the BGO-OD experiment at ELSA

    NASA Astrophysics Data System (ADS)

    Alef, S.; Bauer, P.; Bayadilov, D.; Beck, R.; Becker, M.; Bella, A.; Bielefeldt, P.; Böse, S.; Braghieri, A.; Brinkmann, K.; Cole, P.; Di Salvo, R.; Dutz, H.; Elsner, D.; Fantini, A.; Freyermuth, O.; Friedrich, S.; Frommberger, F.; Ganenko, V.; Geffers, D.; Gervino, G.; Ghio, F.; Görtz, S.; Gridnev, A.; Gutz, E.; Hammann, D.; Hannappel, J.; Hillert, W.; Ignatov, A.; Jahn, R.; Joosten, R.; Jude, T. C.; Klein, F.; Knaust, J.; Kohl, K.; Koop, K.; Krusche, B.; Lapik, A.; Levi Sandri, P.; Lopatin, I. V.; Mandaglio, G.; Messi, F.; Messi, R.; Metag, V.; Moricciani, D.; Mushkarenkov, A.; Nanova, M.; Nedorezov, V.; Novinskiy, D.; Pedroni, P.; Reitz, B.; Romaniuk, M.; Rostomyan, T.; Rudnev, N.; Schaerf, C.; Scheluchin, G.; Schmieden, H.; Stugelev, A.; Sumachev, V.; Tarakanov, V.; Vegna, V.; Walther, D.; Watts, D.; Zaunick, H.; Zimmermann, T.

    2016-11-01

    BGO-OD is a new meson photoproduction experiment at the ELSA facility of Bonn University. It aims at the investigation of non strange and strange baryon excitations, and is especially designed to be able to detect weekly bound meson-baryon type structures. The setup for the BGO-OD experiment is presented, the characteristics of the photon beam and the detector performances are shown and the initial experimental program is discussed.

  12. After Access: Underrepresented Students' Postmatriculation Perceptions of College Access Capital

    ERIC Educational Resources Information Center

    Means, Darris R.; Pyne, Kimberly B.

    2016-01-01

    This qualitative study explores the perceived impact of college-going capital gained during participation in a college access program. In three, semistructured interviews spanning the first-year college experience, 10 first-year college students who participated in a college access program articulate the value of access programming and also raise…

  13. Initial results from the LAPD wave-particle experiment and simulation

    NASA Astrophysics Data System (ADS)

    Bortnik, J.; Tao, X.; Albert, J. M.; Thorne, R. M.; Gekelman, W. N.; Pribyl, P.; Van Compernolle, B.

    2011-12-01

    We present the initial results obtained from a unique experiment-theory project. This project is designed to study the detailed nature of the wave-particle interactions between energetic electrons and whistler-mode waves. Using the Large-Plasma device at UCLA, whistler mode waves are injected into one end of the machine and a beam of energetic electrons is injected at the opposite ends. When the first-order resonance condition is met, the electron beam is scattered, which is measured with a novel energy-pitch-angle analyzer. To support the experiment, a flexible test-particle code is constructed which is able to quantify the scattering of charged particles in response to any distribution of waves, in an arbitrary field geometry. The results of the experiment are discussed and placed into the context of space physics and specifically the upcoming Radiation Belt Storm Probes mission.

  14. Alternative-Fuel Effects on Contrails & Cruise Emissions (ACCESS-2) Flight Experiment

    NASA Technical Reports Server (NTRS)

    Anderson, Bruce E.

    2015-01-01

    Although the emission performance of gas-turbine engines burning renewable aviation fuels have been thoroughly documented in recent ground-based studies, there is still great uncertainty regarding how the fuels effect aircraft exhaust composition and contrail formation at cruise altitudes. To fill this information gap, the NASA Aeronautics Research Mission Directorate sponsored the ACCESS flight series to make detailed measurements of trace gases, aerosols and ice particles in the near-field behind the NASA DC-8 aircraft as it burned either standard petroleum-based fuel of varying sulfur content or a 50:50 blend of standard fuel and a hydro-treated esters and fatty acid (HEFA) jet fuel produced from camelina plant oil. ACCESS 1, conducted in spring 2013 near Palmdale CA, focused on refining flight plans and sampling techniques and used the instrumented NASA Langley HU-25 aircraft to document DC-8 emissions and contrails on five separate flights of approx.2 hour duration. ACCESS 2, conducted from Palmdale in May 2014, engaged partners from the Deutsches Zentrum fuer Luft- und Raumfahrt (DLR) and National Research Council-Canada to provide additional scientific expertise and sampling aircraft (Falcon 20 and CT-133, respectively) with more extensive trace gas, particle, or air motion measurement capability. Eight, muliti-aircraft research flights of 2 to 4 hour duration were conducted to document the emissions and contrail properties of the DC-8 as it 1) burned low sulfur Jet A, high sulfur Jet A or low sulfur Jet A/HEFA blend, 2) flew at altitudes between 6 and 11 km, and 3) operated its engines at three different fuel flow rates. This presentation further describes the ACCESS flight experiments, examines fuel type and thrust setting impacts on engine emissions, and compares cruise-altitude observations with similar data acquired in ground tests.

  15. Web-Based Analysis and Publication of Flow Cytometry Experiments

    PubMed Central

    Kotecha, Nikesh; Krutzik, Peter O.; Irish, Jonathan M.

    2014-01-01

    Cytobank is a web-based application for storage, analysis, and sharing of flow cytometry experiments. Researchers use a web browser to log in and use a wide range of tools developed for basic and advanced flow cytometry. In addition to providing access to standard cytometry tools from any computer, Cytobank creates a platform and community for developing new analysis and publication tools. Figure layouts created on Cytobank are designed to allow transparent access to the underlying experiment annotation and data processing steps. Since all flow cytometry files and analysis data are stored on a central server, experiments and figures can be viewed or edited by anyone with the proper permissions from any computer with Internet access. Once a primary researcher has performed the initial analysis of the data, collaborators can engage in experiment analysis and make their own figure layouts using the gated, compensated experiment files. Cytobank is available to the scientific community at www.cytobank.org PMID:20578106

  16. Web-based analysis and publication of flow cytometry experiments.

    PubMed

    Kotecha, Nikesh; Krutzik, Peter O; Irish, Jonathan M

    2010-07-01

    Cytobank is a Web-based application for storage, analysis, and sharing of flow cytometry experiments. Researchers use a Web browser to log in and use a wide range of tools developed for basic and advanced flow cytometry. In addition to providing access to standard cytometry tools from any computer, Cytobank creates a platform and community for developing new analysis and publication tools. Figure layouts created on Cytobank are designed to allow transparent access to the underlying experiment annotation and data processing steps. Since all flow cytometry files and analysis data are stored on a central server, experiments and figures can be viewed or edited by anyone with the proper permission, from any computer with Internet access. Once a primary researcher has performed the initial analysis of the data, collaborators can engage in experiment analysis and make their own figure layouts using the gated, compensated experiment files. Cytobank is available to the scientific community at http://www.cytobank.org. (c) 2010 by John Wiley & Sons, Inc.

  17. Arteriovenous fistula maturation in patients with permanent access created prior to or after hemodialysis initiation.

    PubMed

    Duque, Juan C; Martinez, Laisel; Tabbara, Marwan; Dvorquez, Denise; Mehandru, Sushil K; Asif, Arif; Vazquez-Padron, Roberto I; Salman, Loay H

    2017-05-15

    Multiple factors and comorbidities have been implicated in the ability of arteriovenous fistulas (AVF) to mature, including vessel anatomy, advanced age, and the presence of coronary artery disease or peripheral vascular disease. However, little is known about the role of uremia on AVF primary failure. In this study, we attempt to evaluate the effect of uremia on AVF maturation by comparing AVF outcomes between pre-dialysis chronic kidney disease (CKD) stage five patients and those who had their AVF created after hemodialysis (HD) initiation. We included 612 patients who underwent AVF creation between 2003 and 2015 at the University of Miami Hospital and Jackson Memorial Hospital. Effects of uremia on primary failure were evaluated using univariate statistical comparisons and multivariate logistic regression analyses. Primary failure occurred in 28.1% and 26.3% of patients with an AVF created prior to or after HD initiation, respectively (p = 0.73). The time of HD initiation was not associated with AVF maturation in multivariate logistic regression analysis (p = 0.57). In addition, pre-operative blood urea nitrogen (p = 0.78), estimated glomerular filtration rate (p = 0.66), and serum creatinine levels (p = 0.14) were not associated with AVF primary failure in pre-dialysis patients. Our results show that clearance of uremia with regular HD treatments prior to AVF creation does not improve the frequency of vascular access maturation.

  18. Beyond procedure's content: the role of accessibility experiences and personal uncertainty in procedural justice judgements.

    PubMed

    Greifeneder, Rainer; Müller, Patrick; Stahlberg, Dagmar; Van den Bos, Kees; Bless, Herbert

    2011-01-01

    Procedural justice concerns play a critical role in economic settings, politics, and other domains of human life. Despite the vast evidence corroborating their relevance, considerably less is known about how procedural justice judgments are formed. Whereas earlier theorizing focused on the systematic integration of content information, the present contribution provides a new perspective on the formation of justice judgments by examining the influence of accessibility experiences. Specifically, we hypothesize that procedural justice judgments may be formed based on the ease or difficulty with which justice-relevant information comes to mind. Three experiments corroborate this prediction in that procedures were evaluated less positively when the retrieval of associated unfair aspects was easy compared to difficult. Presumably this is because when it feels easy (difficult) to retrieve unfair aspects, these are perceived as frequent (infrequent), and hence the procedure as unjust (just). In addition to demonstrating that ease-of-retrieval may influence justice judgments, the studies further revealed that reliance on accessibility experiences is high in conditions of personal certainty. We suggest that this is because personal uncertainty fosters systematic processing of content information, whereas personal certainty may invite less taxing judgmental strategies such as reliance on ease-of-retrieval.

  19. Initial experience with robotic pancreatic surgery in Singapore: single institution experience with 30 consecutive cases.

    PubMed

    Goh, Brian K P; Low, Tze-Yi; Lee, Ser-Yee; Chan, Chung-Yip; Chung, Alexander Y F; Ooi, London L P J

    2018-05-24

    Presently, the worldwide experience with robotic pancreatic surgery (RPS) is increasing although widespread adoption remains limited. In this study, we report our initial experience with RPS. This is a retrospective review of a single institution prospective database of 72 consecutive robotic hepatopancreatobiliary surgeries performed between 2013 and 2017. Of these, 30 patients who underwent RPS were included in this study of which 25 were performed by a single surgeon. The most common procedure was robotic distal pancreatectomy (RDP) which was performed in 20 patients. This included eight subtotal pancreatectomies, two extended pancreatecto-splenectomies (en bloc gastric resection) and 10 spleen-saving-RDP. Splenic preservation was successful in 10/11 attempted spleen-saving-RDP. Eight patients underwent pancreaticoduodenectomies (five hybrid with open reconstruction), one patient underwent a modified Puestow procedure and one enucleation of uncinate tumour. Four patients had extended resections including two RDP with gastric resection and two pancreaticoduodenectomies with vascular resection. There was one (3.3%) open conversion and seven (23.3%) major (>Grade II) morbidities. Overall, there were four (13.3%) clinically significant (Grade B) pancreatic fistulas of which three required percutaneous drainage. These occurred after three RDP and one robotic enucleation. There was one reoperation for port-site hernia and no 30-day/in-hospital mortalities. The median post-operative stay was 6.5 (range: 3-36) days and there were six (20%) 30-day readmissions. Our initial experience showed that RPS can be adopted safely with a low open conversion rate for a wide variety of procedures including pancreaticoduodenectomy. © 2018 Royal Australasian College of Surgeons.

  20. Parents' experiences in registering with and accessing funding under the National Disability Insurance Scheme for early intervention services for children with developmental disabilities.

    PubMed

    Ranasinghe, Tharangi; Jeyaseelan, Deepa; White, Deirdre; Russo, Ray

    2017-01-01

    To evaluate parents' feedback regarding their experience in registering and accessing funding with the National Disability Insurance Scheme (NDIS) and communicating with the National Disability Insurance Agency (NDIA). Parents of children less than 7 years of age, who were assessed through the Child Development Unit (CDU) at the Women's and Children's Health Network from July 2013 to June 2014 and referred to the NDIS, were invited to complete a study questionnaire regarding their experience with the NDIS. The questionnaire was initially mailed to the parents. If no response was returned, families were telephoned to complete the questionnaire by phone or to be sent another copy of the questionnaire to complete. Of 121 children eligible for the study, 42 (34.7%) parents completed the questionnaire. Thirty-six (85.7%) parents reported having no difficulty with the NDIS registration process, while six parents (14.3%) had difficulty. With regards to accessing funding, 27 (64.3%) reported having no difficulty, 11 (26.2%) stated that it was difficult and 4 parents did not comment. Twenty-six parents (61.9%) reported that it was easy to communicate with the NDIA, while 12 (28.6%) found it difficult. Overall, 26 (61.9%) parents were satisfied with the NDIS and NDIA, 6 (14.8%) were unsatisfied and 9 (21.4%) were neutral. The majority of parents were satisfied with both the processes required to register and access funding through the NDIS for early intervention services for their children with developmental disabilities, and their ability to communicate with the NDIA. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  1. Digital Access to a Sky Century at Harvard: Initial Photometry and Astrometry

    NASA Astrophysics Data System (ADS)

    Laycock, S.; Tang, S.; Grindlay, J.; Los, E.; Simcoe, R.; Mink, D.

    2010-10-01

    Digital Access to a Sky Century at Harvard (DASCH) is a project to digitize the collection of ~500,000 glass photographic plates held at Harvard College Observatory. The collection spans the time period from 1880 to 1985, during which time every point on the sky was been observed from 500 to 1000 times. In this paper, we describe the DASCH commissioning run, during which we developed the data-reduction pipeline, characterized the plates and fine-tuned the digitizer's performance and operation. This initial run consisted of 500 plates taken from a variety of different plate series, all containing the open cluster Praeseppe (M44). We report that accurate photometry at the 0.1 mag level is possible on the majority of plates, and demonstrate century-long light curves of various types of variable stars in and around M44. DASCH will generate a public online archive of the entire plate collection, including images, source catalogs, and light curves for nearly all astronomical objects brighter than about 17th magnitude.

  2. Promoting transparency, accountability, and access through a multi-stakeholder initiative: lessons from the medicines transparency alliance.

    PubMed

    Vian, Taryn; Kohler, Jillian C; Forte, Gilles; Dimancesco, Deirdre

    2017-01-01

    Barriers to expanding access to medicines include weak pharmaceutical sector governance, lack of transparency and accountability, inadequate attention to social services on the political agenda, and financing challenges. Multi-stakeholder initiatives such as the Medicines Transparency Alliance (MeTA) may help overcome these barriers. Between 2008 and 2015, MeTA engaged stakeholders in the pharmaceutical sectors of seven countries (Ghana, Jordan, Kyrgyzstan, Peru, Philippines, Uganda, and Zambia) to promote access goals through greater transparency. We reviewed archival data to document MeTA activities and results related to transparency and accountability in the seven countries where it was implemented. We identified common themes and content areas, noting specific activities used to make information transparent and accessible, how data were used to inform discussions, and the purpose and timing of meetings and advocacy activities to help set priorities and influence governance decisions. The cross-case analysis looked for pathways which might link the MeTA strategies to results such as better policies or program improvements. Countries used evidence gathering, open meetings, and proactive information dissemination to increase transparency. MeTA fostered policy dialogue to bring together the many government, civil society and private company stakeholders concerned with access issues, and provided them with information to understand barriers to access at policy, organizational, and community levels. We found strong evidence that transparency was enhanced. Some evidence suggests that MeTA efforts contributed to new policies and civil society capacity strengthening although the impact on government accountability is not clear. MeTA appears to have achieved its goal of creating a multi-stakeholder shared policy space in which government, civil society, and private sector players can come together and have a voice in the national pharmaceutical policy making process

  3. Space Experiment Module (SEM)

    NASA Technical Reports Server (NTRS)

    Brodell, Charles L.

    1999-01-01

    The Space Experiment Module (SEM) Program is an education initiative sponsored by the National Aeronautics and Space Administration (NASA) Shuttle Small Payloads Project. The program provides nationwide educational access to space for Kindergarten through University level students. The SEM program focuses on the science of zero-gravity and microgravity. Within the program, NASA provides small containers or "modules" for students to fly experiments on the Space Shuttle. The experiments are created, designed, built, and implemented by students with teacher and/or mentor guidance. Student experiment modules are flown in a "carrier" which resides in the cargo bay of the Space Shuttle. The carrier supplies power to, and the means to control and collect data from each experiment.

  4. Improving access to surgery in a developing country: experience from a surgical collaboration in Sierra Leone.

    PubMed

    Kushner, Adam L; Kamara, Thaim B; Groen, Reinou S; Fadlu-Deen, Betsy D; Doah, Kisito S; Kingham, T Peter

    2010-01-01

    Although surgery is increasingly recognized as an essential component of primary health care, there has been little documentation of surgical programs in low- and middle-income countries. Surgeons OverSeas (SOS) is a New York-based organization with a mission to save lives in developing countries by improving surgical care. This article highlights the surgical program in Sierra Leone as a possible model to improve access to surgery. An SOS team conducted a needs assessment of surgical capacity in Sierra Leone in February 2008. Interventions were then developed and programs were implemented. A follow-up assessment was conducted in December 2009, which included interviews of key Sierra Leone hospital personnel and a review of operating room log books. Based on an initial needs assessment, a program was developed that included training, salary support, and the provision of surgical supplies and equipment. Two 3-day workshops were conducted for a total of 44 health workers, salary support given to over 100 staff, and 2 containers of supplies and equipment were donated. Access to surgery, as measured by the number of major operations at Connaught Hospital, increased from 460 cases in 2007 to 768 cases in 2009. The SOS program in Sierra Leone highlights a method for improving access to surgery that incorporates an initial needs assessment with minimal external support and local staff collaboration. The program functions as a catalyst by providing training, salary support, and supplies. The beneficial results of the program can then be used to advocate for additional resources for surgery from policy makers. This model could be beneficial in other resource-poor countries in which improved access to surgery is desired. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. The Experiences of Early Career Teachers: New Initiatives and Old Problems

    ERIC Educational Resources Information Center

    Schuck, Sandy; Aubusson, Peter; Buchanan, John; Varadharajan, Meera; Burke, Paul F.

    2018-01-01

    The task of supporting beginning teachers has received considerable attention in recent years, and numerous initiatives have been implemented. In this article we investigate the experiences of early career teachers (ECTs) in New South Wales, Australia, at a time when their employing authority mandated the provision of mentors and a reduction in…

  6. The WIND-HAARP Experiment: Initial Results of High Power Radiowave Interactions with Space Plasmas

    DTIC Science & Technology

    1997-11-10

    Results from the first science experiment with the new HF Active Auroral Research Program ( HAARP ) facility in Alaska are reported. The initial...experiments involved transmission of high frequency waves from HAARP to the NASA/WIND satellite. The objective was to investigate the effects of space

  7. The Relationship of a Pilot's Educational Background, Aeronautical Experience and Recency of Experience to Performance In Initial Training at a Regional Airline

    NASA Astrophysics Data System (ADS)

    Shane, Nancy R.

    The purpose of this study was to determine how a pilot's educational background, aeronautical experience and recency of experience relate to their performance during initial training at a regional airline. Results show that variables in pilots' educational background, aeronautical experience and recency of experience do predict performance in training. The most significant predictors include years since graduation from college, multi-engine time, total time and whether or not a pilot had military flying experience. Due to the pilot shortage, the pilots entering regional airline training classes since August 2013 have varied backgrounds, aeronautical experience and recency of experience. As explained by Edward Thorndike's law of exercise and the law of recency, pilots who are actively using their aeronautical knowledge and exercising their flying skills should exhibit strong performance in those areas and pilots who have not been actively using their aeronautical knowledge and exercising their flying skills should exhibit degraded performance in those areas. Through correlation, chi-square and multiple regression analysis, this study tests this theory as it relates to performance in initial training at a regional airline.

  8. The Myth of Free and Barrier-Free Access: India's Right to Education Act--Private Schooling Costs and Household Experiences

    ERIC Educational Resources Information Center

    Srivastava, Prachi; Noronha, Claire

    2016-01-01

    We examine relative household costs and experiences of accessing private and government schooling under India's "Right of Children to Free and Compulsory Education Act, 2009" in the early implementation phase. The Act deems that no child should incur any fee, charges, or expenses in accessing schooling. Private schools are mandated to…

  9. [Evaluation of the influence of humidity and temperature on the drug stability by initial average rate experiment].

    PubMed

    He, Ning; Sun, Hechun; Dai, Miaomiao

    2014-05-01

    To evaluate the influence of temperature and humidity on the drug stability by initial average rate experiment, and to obtained the kinetic parameters. The effect of concentration error, drug degradation extent, humidity and temperature numbers, humidity and temperature range, and average humidity and temperature on the accuracy and precision of kinetic parameters in the initial average rate experiment was explored. The stability of vitamin C, as a solid state model, was investigated by an initial average rate experiment. Under the same experimental conditions, the kinetic parameters obtained from this proposed method were comparable to those from classical isothermal experiment at constant humidity. The estimates were more accurate and precise by controlling the extent of drug degradation, changing humidity and temperature range, or by setting the average temperature closer to room temperature. Compared with isothermal experiments at constant humidity, our proposed method saves time, labor, and materials.

  10. African American women's experiences with the initial discovery, diagnosis, and treatment of breast cancer.

    PubMed

    Lackey, N R; Gates, M F; Brown, G

    2001-04-01

    To describe the experiences of African American women living with breast cancer following the primary diagnosis and while undergoing initial treatment. Phenomenologic. 13 African American women (ages 30-66) purposefully selected from two oncology clinics in the mid-South. Phenomenologic interviews (transcribed verbatim) and field notes were analyzed using Colaizzi's method of phenomenologic description and analysis. Experience Trajectory, Femininity, and Spirituality were the three major themes. The Experience Trajectory subthemes were finding the lump, getting the diagnosis, undergoing surgery and adjuvant treatment. The Femininity subthemes were loss of all or part of the breast, loss of hair, and sexual attractiveness to a man. Spirituality was reflected as a reliance on God. Telling the story of their experience trajectory during their breast cancer experience is valuable in assessing African American women's feelings, emotions, and fears of body changes that occur during surgery and treatment. Their spirituality helps them through this experience. Research involving both African American women and their partners would provide greater insight into specific relationship patterns and communication related to sexuality during this experience. Nurses need to listen to the stories of African American women about the initial experience of discovery, diagnosis, and treatment of breast cancer so they can be more informed advocates for these women. African American women need more information from healthcare providers regarding the whole experience trajectory.

  11. Digital Storytelling for Inclusive Education: An Experience in Initial Teacher Training

    ERIC Educational Resources Information Center

    Lazzari, Marco

    2016-01-01

    We present an experience of digital storytelling conducted as part of a course for initial teacher training. The students of a special education course produced a digital story as partial fulfillment of their distance learning assignment. We describe the structure of the work completed by the students and discuss the results of a questionnaire…

  12. Children, Families and Interagency Work: Experiences of Partnership Work in Primary Education Settings

    ERIC Educational Resources Information Center

    Milbourne, Linda

    2005-01-01

    Despite UK government initiatives intended to address social exclusion, those with poor access to social and economic resources continue to experience unresponsive services. In these circumstances, small inter-agency projects may offer accessible alternatives. This article explores the implementation of inter-agency work at a local level, focusing…

  13. Are dispensaries indispensable? Patient experiences of access to cannabis from medical cannabis dispensaries in Canada.

    PubMed

    Capler, Rielle; Walsh, Zach; Crosby, Kim; Belle-Isle, Lynne; Holtzman, Susan; Lucas, Philippe; Callaway, Robert

    2017-09-01

    In 2001, Canada established a federal program for cannabis for therapeutic purposes (CTP). Medical cannabis dispensaries (dispensaries) are widely accessed as a source of CTP despite storefront sales of cannabis being illegal. The discrepancy between legal status and social practice has fuelled active debate regarding the role of dispensaries. The present study aims to inform this debate by analysing CTP user experiences with different CTP sources, and comparing dispensary users to those accessing CTP from other sources. We compared sociodemographic characteristics, health related factors and patterns of cannabis use of 445 respondents, 215 who accessed CTP from dispensaries with 230 who accessed other sources. We compared patients' ratings of CTP sources (dispensaries, Health Canada's supplier, self-production, other producer, friend or acquaintance, street dealer) for quality and availability of product, safety and efficiency of access, cost, and feeling respected while accessing. Patients using dispensaries were older, more likely to have arthritis and HIV/AIDS, and less likely to have mental health conditions than those not using dispensaries. Those accessing dispensaries used larger quantities of cannabis, placed greater value on access to specific strains, and were more likely to have legal authorization for CTP. Dispensaries were rated equally to or more favourably than other sources of CTP for quality, safety, availability, efficiency and feeling respected, and less favourably than self-production and other producer for cost. Given the high endorsement of dispensaries by patients, future regulations should consider including dispensaries as a source of CTP and address known barriers to access such as cost and health care provider support. Further research should assess the impact of the addition of licensed producers on the role and perceived value of dispensaries within the Canadian medical cannabis system. Copyright © 2017 Elsevier B.V. All rights

  14. Access and utilisation of maternity care for disabled women who experience domestic abuse: a systematic review

    PubMed Central

    2014-01-01

    Background Although disabled women are significantly more likely to experience domestic abuse during pregnancy than non-disabled women, very little is known about how maternity care access and utilisation is affected by the co-existence of disability and domestic abuse. This systematic review of the literature explored how domestic abuse impacts upon disabled women’s access to maternity services. Methods Eleven articles were identified through a search of six electronic databases and data were analysed to identify: the factors that facilitate or compromise access to care; the consequences of inadequate care for pregnant women’s health and wellbeing; and the effectiveness of existing strategies for improvement. Results Findings indicate that a mental health diagnosis, poor relationships with health professionals and environmental barriers can compromise women’s utilisation of maternity services. Domestic abuse can both compromise, and catalyse, access to services and social support is a positive factor when accessing care. Delayed and inadequate care has adverse effects on women’s physical and psychological health, however further research is required to fully explore the nature and extent of these consequences. Only one study identified strategies currently being used to improve access to services for disabled women experiencing abuse. Conclusions Based upon the barriers and facilitators identified within the review, we suggest that future strategies for improvement should focus on: understanding women’s reasons for accessing care; fostering positive relationships; being women-centred; promoting environmental accessibility; and improving the strength of the evidence base. PMID:25029907

  15. Transperineal prostate biopsy with ECHO-MRI fusion. Biopsee system. Initial experience.

    PubMed

    Romero-Selas, E; Cuadros, V; Montáns, J; Sánchez, E; López-Alcorocho, J M; Gómez-Sancha, F

    2016-06-01

    The aim of this study is to present our initial experience with the stereotactic echo-MRI fusion system for diagnosing prostate cancer. Between September 2014 and January 2015, we performed 50 prostate biopsies using the stereotactic echo-MRI fusion system. The 3-Tesla multiparameter MR images were superimposed using this image fusion system on 3D echo images obtained with the Biopsee system for the exact locating of areas suspected of prostate cancer. The lesions were classified using the Prostate Imaging Report and Date System. We assessed a total of 50 patients, with a mean age of 63 years (range, 45-79), a mean prostate-specific antigen level of 8 ng/mL (range, 1.9-20) and a mean prostate volume of 52mL (range, 12-118). Prostate cancer was diagnosed in 69% of the patients and intraepithelial neoplasia in 6%. The results of the biopsy were negative for 24% of the patients. The results of the biopsy and MRI were in agreement for 62% of the patients; however, 46% also had a tumour outside of the suspicious lesion. We diagnosed 46% anterior tumours and 33% apical tumours. One patient had a haematuria, another had a haematoma and a third had acute urine retention. Multiparametric prostatic MRI helps identify prostate lesions suggestive of cancer. The Biopsee echo-MRI fusion system provides for guided biopsy and increases the diagnostic performance, reducing the false negatives of classical biopsies and increasing the diagnosis of anterior tumours. Transperineal access minimises the risk of prostatic infection and sepsis. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Data Flow Infrastructure Initiative (DFII): Coupling Inventory Practices and Data collection Technology to Enhance Research Productivity and Information Access

    NASA Astrophysics Data System (ADS)

    Meyer, K.; Malin, R.; Rich, R. L.; Pierce, S. A.

    2011-12-01

    Shortening the cycle from data collection to research publications is a competitive advantage for researchers. Existing technologies for inventory systems such as UPC barcoding systems can be coupled with flexible mobile or handheld devices to advance efficiency, productivity, automation, and integrity in data flows, from data collection to sample processing to database management and analysis, and finally publication. At the University of Texas, the Data Flow Infrastructure Initiative (DFII) has introduced handheld devices with integrated barcode scanners as a mechanism to enhance research productivity and information access. These devices are established technology and provide a flexible but consistent platform for research data collection and data management. They are not in widespread use yet in the research community. Additional application benefits will accrue by using handheld devices to deliver data on demand in teaching applications. Introducing research scientists, graduate students, and the UT community to the merits and flexibility of these data collection technologies will provide avenues for innovation as well as improving efficiency. The objective of this project is to bring the technology and expertise with handheld systems to a diverse set of pilot projects and establish proficiency at The University of Texas at Austin necessary for widespread application. We have implemented a pilot project in three research labs covering the fields of microbial ecology, water resources decision support, and biogeochemistry to introduce these technologies. We used NautizX5 handheld devices that feature: barcode scanning, bluetooth, stylus, and keypad data inputs coupled with Pendragon Forms Software, a program that allows users to create custom data collection forms structured into an SQL or Access platform thus allowing concurrent data management, data collection and analysis in field and lab settings. Results include the elimination of most manual data entry

  17. Lower hybrid accessibility in a large, hot reversed field pinch

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dziubek, R.A.; Harvey, R.W.; Hokin, S.A.

    1995-11-01

    Accessibility and damping of the slow wave in a reversed field pinch (RFP) plasma is investigated theoretically, using projected Reversed Field Experiment (RFX) plasma parameters. By numerically solving the hot plasma dispersion relation, regions of propagation are found and the possibility of mode conversion is analyzed. If the parallel index of refraction of the wave is chosen judiciously at the edge of the plasma, the slow wave is accessible to a target region located just inside the reversal surface without mode conversion. Landau damping is also optimized in this region. A representative fast electron population is then added in ordermore » to determine its effect on accessibility and damping. The presence of these electrons, whose parameters were estimated by extrapolation of Madison Symmetric Torus (MST) data, does not affect the accessibility of the wave. However, the initial phase velocity of the wave needs to be increased somewhat in order to maintain optimal damping in the target zone.« less

  18. Barrier experiment: Shock initiation under complex loading

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Menikoff, Ralph

    2016-01-12

    The barrier experiments are a variant of the gap test; a detonation wave in a donor HE impacts a barrier and drives a shock wave into an acceptor HE. The question we ask is: What is the trade-off between the barrier material and threshold barrier thickness to prevent the acceptor from detonating. This can be viewed from the perspective of shock initiation of the acceptor subject to a complex pressure drive condition. Here we consider key factors which affect whether or not the acceptor undergoes a shock-to-detonation transition. These include the following: shock impedance matches for the donor detonation wavemore » into the barrier and then the barrier shock into the acceptor, the pressure gradient behind the donor detonation wave, and the curvature of detonation front in the donor. Numerical simulations are used to illustrate how these factors affect the reaction in the acceptor.« less

  19. An augmented SMS intervention to improve access to antenatal CD4 testing and ART initiation in HIV-infected pregnant women: a cluster randomized trial.

    PubMed

    Dryden-Peterson, Scott; Bennett, Kara; Hughes, Michael D; Veres, Adrian; John, Oaitse; Pradhananga, Rosina; Boyer, Matthew; Brown, Carolyn; Sakyi, Bright; van Widenfelt, Erik; Keapoletswe, Koona; Mine, Madisa; Moyo, Sikhulile; Asmelash, Aida; Siedner, Mark; Mmalane, Mompati; Shapiro, Roger L; Lockman, Shahin

    2015-01-01

    Less than one-third of HIV-infected pregnant women eligible for combination antiretroviral therapy (ART) globally initiate treatment prior to delivery, with lack of access to timely CD4 results being a principal barrier. We evaluated the effectiveness of an SMS-based intervention to improve access to timely antenatal ART. We conducted a stepped-wedge cluster randomized trial of a low-cost programmatic intervention in 20 antenatal clinics in Gaborone, Botswana. From July 2011-April 2012, 2 clinics were randomly selected every 4 weeks to receive an ongoing clinic-based educational intervention to improve CD4 collection and to receive CD4 results via an automated SMS platform with active patient tracing. CD4 testing before 26 weeks gestation and ART initiation before 30 weeks gestation were assessed. Three-hundred-sixty-six ART-naïve women were included, 189 registering for antenatal care under Intervention and 177 under Usual Care periods. Of CD4-eligible women, 100 (59.2%) women under Intervention and 79 (50.6%) women under Usual Care completed CD4 phlebotomy before 26 weeks gestation, adjusted odds ratio (aOR, adjusted for time that a clinic initiated Intervention) 0.87 (95% confidence interval [CI]0.47-1.63, P = 0.67). The SMS-based platform reduced time to clinic receipt of CD4 test result from median of 16 to 6 days (P<0.001), was appreciated by clinic staff, and was associated with reduced operational cost. However, rates of ART initiation remained low, with 56 (36.4%) women registering under Intervention versus 37 (24.2%) women under Usual Care initiating ART prior to 30 weeks gestation, aOR 1.06 (95%CI 0.53-2.13, P = 0.87). The augmented SMS-based intervention delivered CD4 results more rapidly and efficiently, and this type of SMS-based results delivery platform may be useful for a variety of tests and settings. However, the intervention did not appear to improve access to timely antenatal CD4 testing or ART initiation, as obstacles other than CD4 impeded

  20. An Augmented SMS Intervention to Improve Access to Antenatal CD4 Testing and ART Initiation in HIV-Infected Pregnant Women: A Cluster Randomized Trial

    PubMed Central

    Dryden-Peterson, Scott; Bennett, Kara; Hughes, Michael D.; Veres, Adrian; John, Oaitse; Pradhananga, Rosina; Boyer, Matthew; Brown, Carolyn; Sakyi, Bright; van Widenfelt, Erik; Keapoletswe, Koona; Mine, Madisa; Moyo, Sikhulile; Asmelash, Aida; Siedner, Mark; Mmalane, Mompati; Shapiro, Roger L.; Lockman, Shahin

    2015-01-01

    Background Less than one-third of HIV-infected pregnant women eligible for combination antiretroviral therapy (ART) globally initiate treatment prior to delivery, with lack of access to timely CD4 results being a principal barrier. We evaluated the effectiveness of an SMS-based intervention to improve access to timely antenatal ART. Methods We conducted a stepped-wedge cluster randomized trial of a low-cost programmatic intervention in 20 antenatal clinics in Gaborone, Botswana. From July 2011-April 2012, 2 clinics were randomly selected every 4 weeks to receive an ongoing clinic-based educational intervention to improve CD4 collection and to receive CD4 results via an automated SMS platform with active patient tracing. CD4 testing before 26 weeks gestation and ART initiation before 30 weeks gestation were assessed. Results Three-hundred-sixty-six ART-naïve women were included, 189 registering for antenatal care under Intervention and 177 under Usual Care periods. Of CD4-eligible women, 100 (59.2%) women under Intervention and 79 (50.6%) women under Usual Care completed CD4 phlebotomy before 26 weeks gestation, adjusted odds ratio (aOR, adjusted for time that a clinic initiated Intervention) 0.87 (95% confidence interval [CI]0.47–1.63, P = 0.67). The SMS-based platform reduced time to clinic receipt of CD4 test result from median of 16 to 6 days (P<0.001), was appreciated by clinic staff, and was associated with reduced operational cost. However, rates of ART initiation remained low, with 56 (36.4%) women registering under Intervention versus 37 (24.2%) women under Usual Care initiating ART prior to 30 weeks gestation, aOR 1.06 (95%CI 0.53–2.13, P = 0.87). Conclusions The augmented SMS-based intervention delivered CD4 results more rapidly and efficiently, and this type of SMS-based results delivery platform may be useful for a variety of tests and settings. However, the intervention did not appear to improve access to timely antenatal CD4 testing or ART

  1. Accessibility of antiretroviral therapy in Ghana: convenience of access.

    PubMed

    Addo-Atuah, Joyce; Gourley, Dick; Gourley, Greta; White-Means, Shelley I; Womeodu, Robin J; Faris, Richard J; Addo, Nii Akwei

    2012-01-01

    The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants' perceived convenience of accessing ART by PLWHA in Ghana. The convenience of accessing ART was evaluated from the reported travel and waiting times to receive care, the availability, or otherwise, of special considerations, with respect to the waiting time to receive care, for those PLWHA who were in active employment in the formal sector, the frequency of clinic visits before and after initiating ART, and whether the PLWHA saw the same or different providers at each clinic visit (continuity of care). This qualitative study used in-depth interviews based on Yin's case-study research design to collect data from 20 PLWHA and 24 ART healthcare providers as study participants. • Reported travel time to receive ART services ranged from 2 to 12 h for 30% of the PLWHA. • Waiting time to receive care was from 4 to 9 h. • While known government workers, such as teachers, were attended to earlier in some of the centres, this was not a consistent practice in all the four ART centres studied. • The PLWHA corroborated the providers' description of the procedure for initiating and monitoring ART in Ghana. • PLWHA did not see the same provider every time, but they were assured that this did not compromise the continuity of their care. Our study suggests that convenience of accessing ART is important to both PLWHA and ART healthcare providers, but the participants alluded to other factors, including open provider-patient communication, which might explain the PLWHA's understanding of the constraints under which they were receiving care. The current nation-wide coverage of the ART programme in Ghana, however, calls for the replication of this study to identify

  2. Evaluating the Impact of Open Access at Berkeley: Results from the 2015 Survey of Berkeley Research Impact Initiative (BRII) Funding Recipients

    ERIC Educational Resources Information Center

    Teplitzky, Samantha; Phillips, Margaret

    2016-01-01

    The Berkeley Research Impact Initiative (BRII) was one of the first campus-based open access (OA) funds to be established in North America and one of the most active, distributing more than $244,000 to support University of California (UC) Berkeley authors. In April 2015, we conducted a qualitative study of 138 individuals who had received BRII…

  3. Access to and Experiences with e-Health Technology Among Glaucoma Patients and Their Relationship with Medication Adherence.

    PubMed

    Newman-Casey, Paula Anne; Killeen, Olivia J; Renner, Morgan; Robin, Alan L; Lee, Paul; Heisler, Michele

    2018-04-23

    As online health information becomes common, it is important to assess patients' access to and experiences with online resources. We examined whether glaucoma patients' technology usage differs by medication adherence and whether adherence is associated with online education experiences. We included 164 adults with glaucoma taking ≥1 glaucoma medication. Participants completed a survey including demographic and health information, the Morisky Adherence Scale, and questions about online glaucoma resource usage. Differences in technology access, adherence, and age were compared with chi-squared, Fisher exact, and two-sample t-tests. Mean age was 66 years. Twenty-six percent reported poor adherence. Eighty percent had good technology access. Seventy-three percent of subjects with greater technology access wanted online glaucoma information and yet only 14% of patients had been directed to online resources by physicians. There was no relationship between technological connectivity and adherence (p = 0.51). Nonadherent patients were younger (mean age 58 years vs. 66 years for adherent patients, p = 0.002). Nonadherence was associated with negative feelings about online searches (68% vs. 42%, p = 0.06). Younger, poorly adherent patients navigate online glaucoma resources without physician input. These online searches are often unsatisfying. Technology should be leveraged to create high quality, online glaucoma resources that physicians can recommend to provide guidance for disease self-management.

  4. Exploring the experience of clients with tetraplegia utilizing assistive technology for computer access.

    PubMed

    Folan, Alyce; Barclay, Linda; Cooper, Cathy; Robinson, Merren

    2015-01-01

    Assistive technology for computer access can be used to facilitate people with a spinal cord injury to utilize mainstream computer applications, thereby enabling participation in a variety of meaningful occupations. The aim of this study was to gain an understanding of the experiences of clients with tetraplegia trialing assistive technologies for computer access during different stages in a public rehabilitation service. In order to explore the experiences of clients with tetraplegia trialing assistive technologies for computer use, qualitative methodology was selected. Data were collected from seven participants using semi-structured interviews, which were audio-taped, transcribed and analyzed thematically. Three main themes were identified. These were: getting back into life, assisting in adjusting to injury and learning new skills. The findings from this study demonstrated that people with tetraplegia can be assisted to return to previous life roles or engage in new roles, through developing skills in the use of assistive technology for computer access. Being able to use computers for meaningful activities contributed to the participants gaining an enhanced sense of self-efficacy, and thereby quality of life. Implications for Rehabilitation Findings from this pilot study indicate that people with tetraplegia can be assisted to return to previous life roles, and develop new roles that have meaning to them through the use of assistive technologies for computer use. Being able to use the internet to socialize, and complete daily tasks, contributed to the participants gaining a sense of control over their lives. Early introduction to assistive technology is important to ensure sufficient time for newly injured people to feel comfortable enough with the assistive technology to use the computers productively by the time of discharge. Further research into this important and expanding area is indicated.

  5. Effect of Pore Topology and Accessibility on Gas Adsorption Capacity in Zeolitic-Imidazolate Frameworks: Bringing Molecular Simulation Close to Experiment

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Babarao, Ravichandar; Dai, Sheng; Jiang, Deen

    2011-01-01

    When all cages are assumed to be accessible, popular force fields such as universal force field (UFF) and DREIDING dramatically overpredicted gas adsorption capacity in two widely studied zeolitic-imidazolate frameworks (ZIFs), ZIF-68 and -69. Instead of adjusting the force-field parameters to match the experiments, herein we show that when the pore topology and accessibility are correctly taken into account, simulations with the standard force fields agree very well with the experiments. Careful inspection shows that ZIF-68 and -69 have two one-dimensional channels, which are not interaccessible to gases. The small channel consists of alternating small (HPR) and medium (GME) cages,more » while the large channel comprises the large (KNO) cages. Our analysis indicates that the small channel is not accessible to gases such as CO{sub 2}. So when the cages in the small channel are intentionally blocked in our simulation, the predicted adsorption capacities of CO{sub 2}, CH{sub 4} and N{sub 2} at room temperature from standard force-field parameters for the framework show excellent agreement with the experimental results. In the case of H{sub 2}, all cages are accessible, so simulation results without cage-blocking show excellent agreement with experiment. Due to the promising potential of ZIFs in gas storage and separation, our work here shows that pore topology and accessibility should be carefully examined to understand how gases adsorb in ZIFs.« less

  6. The SPIRIT Telescope Initiative: six years on

    NASA Astrophysics Data System (ADS)

    Luckas, Paul

    2017-06-01

    Now in its sixth year of operation, the SPIRIT initiative remains unique in Australia, as a robust web-enabled robotic telescope initiative funded for education and outreach. With multiple modes of operation catering for a variety of usage scenarios and a fully supported education program, SPIRIT provides free access to contemporary astronomical tools for students and educators in Western Australia and beyond. The technical solution itself provides an excellent model for low cost robotic telescope installations, and the education program has evolved over time to include a broad range of student experiences-from engagement activities to authentic science. This paper details the robotic telescope solution, student interface and educational philosophy, summarises achievements and lessons learned and examines the possibilities for future enhancement including spectroscopy.

  7. Towards equitable access to medicines for the rural poor: analyses of insurance claims reveal rural pharmacy initiative triggers price competition in Kyrgyzstan.

    PubMed

    Waning, Brenda; Maddix, Jason; Tripodis, Yorghos; Laing, Richard; Leufkens, Hubert Gm; Gokhale, Manjusha

    2009-12-14

    A rural pharmacy initiative (RPI) designed to increase access to medicines in rural Kyrgyzstan created a network of 12 pharmacies using a revolving drug fund mechanism in 12 villages where no pharmacies previously existed. The objective of this study was to determine if the establishment of the RPI resulted in the unforeseen benefit of triggering medicine price competition in pre-existing (non-RPI) private pharmacies located in the region. We conducted descriptive and multivariate analyses on medicine insurance claims data from Kyrgyzstan's Mandatory Health Insurance Fund for the Jumgal District of Naryn Province from October 2003 to December 2007. We compared average quarterly medicine prices in competitor pharmacies before and after the introduction of the rural pharmacy initiative in October 2004 to determine the RPI impact on price competition. Descriptive analyses suggest competitors reacted to RPI prices for 21 of 30 (70%) medicines. Competitor medicine prices from the quarter before RPI introduction to the end of the study period decreased for 17 of 30 (57%) medicines, increased for 4 of 30 (13%) medicines, and remained unchanged for 9 of 30 (30%) medicines. Among the 9 competitor medicines with unchanged prices, five initially decreased in price but later reverted back to baseline prices. Multivariate analyses on 19 medicines that met sample size criteria confirm these findings. Fourteen of these 19 (74%) competitor medicines changed significantly in price from the quarter before RPI introduction to the quarter after RPI introduction, with 9 of 19 (47%) decreasing in price and 5 of 19 (26%) increasing in price. The RPI served as a market driver, spurring competition in medicine prices in competitor pharmacies, even when they were located in different villages. Initiatives designed to increase equitable access to medicines in rural regions of developing and transitional countries should consider the potential to leverage medicine price competition as a means

  8. Higher Education: Access, Experiences, and Outcomes

    ERIC Educational Resources Information Center

    Lehmann, Wolfgang

    2017-01-01

    This article reviews three books: (1) "Access to Higher Education: Theoretical Perspectives and Contemporary Challenges" (edited by A. Mountford-Zimdars and N. Harrison); (2) "Student Lives in Crisis: Deepening Inequality in Times of Austerity" (L. Antonucci); and (3) "Higher Education, Social Class and Social Mobility:…

  9. Embedding online patient record access in UK primary care: a survey of stakeholder experiences.

    PubMed

    Pagliari, Claudia; Shand, Tim; Fisher, Brian

    2012-05-01

    To explore the integration of online patient Record Access within UK Primary Care, its perceived impacts on workload and service quality, and barriers to implementation. Mixed format survey of clinicians, administrators and patients. Telephone interviews with non-users. Primary care centres within NHS England that had offered online record access for the preceding year. Of the 57 practices initially agreeing to pilot the system, 32 had adopted it and 16 of these returned questionnaires. The 42 individual respondents included 14 practice managers, 15 clinicians and 13 patients. Follow-up interviews were conducted with one participant from 15 of the 25 non-adopter practices. Most professionals believed that the system is easy to integrate within primary care; while most patients found it easy to integrate within their daily lives. Professionals perceived no increase in the volume of patient queries or clinical consultations as a result of Record Access; indeed some believed that these had decreased. Most clinicians and patients believed that the service had improved mutual trust, communication, patients' health knowledge and health behaviour. Inhibiting factors included concerns about security, liability and resource requirements. Non-adoption was most frequently attributed to competing priorities, rather than negative beliefs about the service. Record access has an important role to play in supporting patient-focused healthcare policies in the UK and may be easily accommodated within existing services. Additional materials to facilitate patient recruitment, inform system set-up processes, and assure clinicians of their legal position are likely to encourage more widespread adoption.

  10. A qualitative study on African immigrant and refugee families' experiences of accessing primary health care services in Manitoba, Canada: it's not easy!

    PubMed

    Woodgate, Roberta Lynn; Busolo, David Shiyokha; Crockett, Maryanne; Dean, Ruth Anne; Amaladas, Miriam R; Plourde, Pierre J

    2017-01-09

    Immigrant and refugee families form a growing proportion of the Canadian population and experience barriers in accessing primary health care services. The aim of this study was to examine the experiences of access to primary health care by African immigrant and refugee families. Eighty-three families originating from 15 African countries took part in multiple open ended interviews in western Canada. Qualitative data was collected in six different languages between 2013 and 2015. Data analysis involved delineating units of meaning from the data, clustering units of meaning to form thematic statements, and extracting themes. African immigrant and refugee families experienced challenges in their quest to access primary health care that were represented by three themes: Expectations not quite met, facing a new life, and let's buddy up to improve access. On the theme of expectations not quite met, families struggled to understand and become familiar with a new health system that presented with a number of barriers including lengthy wait times, a shortage of health care providers, high cost of medication and non-basic health care, and less than ideal care. On the theme of facing a new life, immigrant and refugee families talked of the difficulties of getting used to their new and unfamiliar environments and the barriers that impact their access to health care services. They talked of challenges related to transportation, weather, employment, language and cultural differences, and lack of social support in their quest to access health care services. Additionally, families expressed their lack of social support in accessing care. Privately sponsored families and families with children experienced even less social support. Importantly, in the theme of let's buddy up to improve access, families recommended utilizing networking approaches to engage and improve their access to primary health care services. African immigrant and refugee families experience barriers to accessing

  11. Initial resident refractive surgical experience: outcomes of PRK and LASIK for myopia.

    PubMed

    Wagoner, Michael D; Wickard, Joseph C; Wandling, George R; Milder, Lisa C; Rauen, Matthew P; Kitzmann, Anna S; Sutphin, John E; Goins, Kenneth M

    2011-03-01

    To evaluate and compare the outcome of initial resident surgical experience with photorefractive keratectomy (PRK) and LASIK. Retrospective review of all cases performed with the VISX Star S4 platform (Abbott Medical Optics) between July 1, 2003 and June 30, 2007. Inclusion criteria were spherical equivalent of -0.50 to -10.00 diopters (D), refractive astigmatic error of ≤3.00 D, intention to provide full distance correction, and minimum 3-month postoperative follow-up after initial ablation or retreatment (if performed). A total of 153 cases performed by 20 different residents met the inclusion criteria; 38 eyes underwent PRK and 115 eyes had LASIK. After initial treatment, mean Snellen uncorrected distance visual acuity (UDVA) after PRK was 20/17.3 and after LASIK was 20/19.5. Photorefractive keratectomy was associated with a significantly better approximation between preoperative corrected distance visual acuity (CDVA) and postoperative UDVA (ΔlogMAR 0.009 vs 0.091; P=.004) and a greater percentage of eyes that achieved UDVA of 20/20 or better (94.7% vs 78.3%; P=.02) or 20/30 or better (100% vs 87.8%; P=.02). There was a higher prevalence of retreatment in eyes that underwent LASIK (7.0% vs 0%; P=.20). One (0.9%) eye lost 2 lines of CDVA after LASIK. Supervised refractive surgery residents can achieve excellent visual outcomes in patients operated during their initial refractive experience. Photorefractive keratectomy was associated with better visual outcome than LASIK. Copyright 2011, SLACK Incorporated.

  12. Investigating the Effects of Access Initiatives for Underrepresented Groups

    ERIC Educational Resources Information Center

    Childs, Ruth A.; Hanson, Mark D.; Carnegie-Douglas, Sandra; Archbold, Alexis

    2017-01-01

    Efforts to increase access for and participation of groups that are underrepresented in postsecondary education (PSE) have included encouraging members of underrepresented groups to apply to PSE programmes, revising admission requirements to reduce barriers to attendance, providing assistance in completing applications for admission, and providing…

  13. Laparoscopic access with a visualizing trocar.

    PubMed

    Wolf, J S

    1997-01-01

    Although useful in most situations, there are several inherent disadvantages of the standard laparoscopic access techniques of Veress needle insertion and Hasson-type cannula placement. Veress needle placement may be hazardous in patients at high risk for intraabdominal adhesions and difficult in patients who are obese. The usual alternative, the Hasson-type cannula, often does not provide a good gas seal. As another option, the use of a visualizing trocar (OPTIVIEW) has proven to be effective in the initial experience at the University of Michigan. The inner trocar of the visualizing trocar is hollow except for a clear plastic conical tip with two external ridges. The trocar-cannula assembly is passed through tissue layers to enter the operative space under direct vision from a 10-mm zero-degree laparoscope placed into the trocar. Results suggest that this technique is an excellent alternative to Veress needle placement when laparoscopic access is likely to be hazardous or difficult.

  14. Experiments on the Richtmyer–Meshkov instability with an imposed, random initial perturbation

    DOE PAGES

    Jacobs, J. W.; Krivets, V. V.; Tsiklashvili, V.; ...

    2013-03-16

    A vertical shock tube is used to perform experiments on the Richtmyer–Meshkov instability with a three-dimensional random initial perturbation. A membraneless flat interface is formed by opposed gas flows in which the light and heavy gases enter the shock tube from the top and from the bottom of the shock tube driven section. An air/SF6 gas combination is used and a Mach number M = 1.2 incident shock wave impulsively accelerates the interface. Initial perturbations on the interface are created by vertically oscillating the gas column within the shock tube to produce Faraday waves on the interface resulting in amore » short wavelength, three-dimensional perturbation. Planar Mie scattering is used to visualize the flow in which light from a laser sheet is scattered by smoke seeded in the air, and image sequences are captured using three high-speed video cameras. Measurements of the integral penetration depth prior to reshock show two growth behaviors, both having power law growth with growth exponents in the range found in previous experiments and simulations. Following reshock, all experiments showvery consistent linear growth with a growth rate in good agreement with those found in previous studies.« less

  15. A newly developed oval-shaped port device (E•Z ACCESS Oval type) for use in reduced port surgery: initial clinical experiences with cholecystectomy.

    PubMed

    Shibao, Kazunori; Takagi, Tsuyoshi; Higure, Aiichiro; Yamaguchi, Koji

    2013-09-01

    We recently developed an oval-shaped E•Z Access device designed exclusively for use with the LAP PROTECTOR™ Oval type device (Hakko Co. Ltd., Tokyo, Japan). The transverse abdominal opening diameter made by round-shaped (Alexis® Wound Retractor, Applied Medical, Rancho Santa Margarita, CA; and LAP PROTECTOR™ Round type) and oval-shaped (LAP PROTECTOR™ Oval type) wound retractors was measured and compared in 5 patients with cholecystolithiasis. Each device was placed through a single 25-mm longitudinal umbilical incision, and the length of trocar separation was compared. LESS cholecystectomy was then performed using the oval-shaped E•Z ACCESS/LAP PROTECTOR™. The transverse abdominal opening diameter was maximized with the LAP PROTECTOR™ Oval type device. The average distance between the working-ports for the glove method, round-shaped, and oval-shaped E•Z ACCESS/LAP PROTECTOR™ devices in the 25-mm umbilical incisions were 20 ± 0.8 mm, 24 ± 1.5 mm, and 35 ± 0.8 mm, respectively. Wider trocar separation was achieved using the oval-shaped device, making the surgical procedures easier to perform. No perioperative port-related or surgical complications were observed. LESS cholecystectomy using the E•Z ACCESS Oval type device was found to be technically feasible. The Oval type device appears to allow for wider trocar separation, thereby reducing stress on the surgeon, ensuring patient safety, and providing cosmetic benefits.

  16. The Near Future Trend: Combining Web Access and Local CD Networks. Experience and a Few Suggestions.

    ERIC Educational Resources Information Center

    Ma, Wei

    1998-01-01

    Focuses on the trend to combine Web access and CD networks, benefits of considering the community network environment as a whole, and need for flexibility in considering new technologies. Describes the Occidental College Library (California) experience of building and sharing a network and network file server. (PEN)

  17. NASA Alternative-Fuel Effects on Contrails and Cruise Emissions (ACCESS) Flight Experiments

    NASA Astrophysics Data System (ADS)

    Anderson, B. E.; Moore, R.; Beyersdorf, A. J.; Thornhill, K. L., II; Shook, M.; Winstead, E.; Ziemba, L. D.; Bulzan, D. L.; Brown, A.; Beaton, B.; Schlager, H.

    2014-12-01

    Although the emission performance of gas-turbine engines burning renewable aviation fuels have been thoroughly documented in recent ground-based studies, there is still great uncertainty regarding how the fuels effect aircraft exhaust composition and contrail formation at cruise altitudes. To fill this information gap, the NASA Aeronautics Research Mission Directorate sponsored the ACCESS flight series to make detailed measurements of trace gases, aerosols and ice particles in the near-field behind the NASA DC-8 aircraft as it burned either standard petroleum-based fuel of varying sulfur content or a 50:50 blend of standard fuel and a hydro-treated esters and fatty acid (HEFA) jet fuel produced from camelina plant oil. ACCESS 1, conducted in spring 2013 near Palmdale CA, focused on refining flight plans and sampling techniques and used the instrumented NASA Langley HU-25 aircraft to document DC-8 emissions and contrails on five separate flights of ~2 hour duration. ACCESS 2, conducted from Palmdale in May 2014, engaged partners from the Deutsches Zentrum für Luft- und Raumfahrt (DLR) and National Research Council-Canada to provide additional scientific expertise and sampling aircraft (Falcon 20 and CT-133, respectively) with more extensive trace gas, particle, or air motion measurement capability. Eight, muliti-aircraft research flights of 2 to 4 hour duration were conducted to document the emissions and contrail properties of the DC-8 as it 1) burned low sulfur Jet A, high sulfur Jet A or low sulfur Jet A/HEFA blend, 2) flew at altitudes between 6 and 11 km, and 3) operated its engines at three different fuel flow rates. This presentation further describes the ACCESS flight experiments, examines fuel type and thrust setting impacts on engine emissions, and compares cruise-altitude observations with similar data acquired in ground-test venues.

  18. Experiences Accessing Abortion Care in Alabama among Women Traveling for Services.

    PubMed

    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.

  19. Evaluating the experiences and support needs of people living with chronic cancer: development and initial validation of the Chronic Cancer Experiences Questionnaire (CCEQ).

    PubMed

    Harley, Clare; Pini, Simon; Kenyon, Lucille; Daffu-O'Reilly, Amrit; Velikova, Galina

    2016-08-10

    Many advanced cancers are managed as chronic diseases, yet there are currently no international guidelines for the support of patients living with chronic cancer. It is important to understand whether care and service arrangements meet the needs of this rapidly growing patient group. This study aimed to develop and validate a questionnaire to capture patients' experiences of living with chronic cancer and their views of clinical and support services. The research was carried out between 1 July 2010 and 21 February 2013. A conceptual framework and initial item bank were derived from prior interviews with 56 patients with chronic cancer. Items were reviewed by 4 oncologists and 1 clinical nurse specialist and during 2 focus groups with 9 patients. Pilot questionnaires were completed by 416 patients across 5 cancer units. Item selection and scale reliability was explored using descriptive data, exploratory factor analysis, internal consistency analyses, multitrait scaling analyses and known-groups comparisons. The final Chronic Cancer Experiences Questionnaire (CCEQ) includes 75 items. 62 items contribute to 14 subscales with internal consistency between α 0·68-0·88 and minimal scaling errors. Known-groups comparisons confirmed subscale utility in distinguishing between patient groups. Subscales were labelled: managing appointments, coordination of care, general practitioner involvement, clinical trials, information and questions, making treatment decisions, symptom non-reporting, key worker, limitations, sustaining normality, financial advice, worries and anxieties, sharing feelings with others, and accessing support. 13 items assessing symptom experiences were retained as single items. The CCEQ has the potential to be used as a clinical instrument to assess patient experiences of chronic cancer or to screen for patient needs. It may also be used as an outcome measure for evaluating programmes and models of care and may identify areas for service development that

  20. Metal availability and bio-accessibility in water-logged soils: in vitro experiments.

    NASA Astrophysics Data System (ADS)

    Florido, M. C.; Madrid, F.; Madrid, L.; Ajmone-Marsan, F.

    2010-05-01

    Reducing conditions of submerged soils were simulated in vitro by keeping various soil samples for various times of reaction (between 1 and 15 days) in sealed flasks and N2 atmosphere under an aqueous solution, 0.01 M CaCl2 containing 1 g/l glucose. Surface samples of soils from urban green areas of Ljubljana (LJU), Torino (TOR) and Sevilla, were chosen. In the latter case, two samples of the same soil were included, before (SE-0) and after (SE-8) receiving a composted biosolid (two yearly doses of 80000 kg/ha) obtained from sewage sludge, often used as amendment by the Parks & Gardens Service of the local Government. A fifth soil (QUE) was chosen from the area affected by an accident where 2 million m3 of metal-rich mine tailings were spilled over the Guadiamar river (SW Spain) and its riparian areas. This highly polluted soil was included for comparison. Values of Eh, pH and several metal concentrations were determined in the solution after each time, and metal availability and bio-accessibility were estimated in the soils after treatment. The metals studied were Fe, Mn and some of those called 'urban' metals, namely Cu, Pb and Zn. The solution pH for LJU, TOR and SE-0 was slightly acidified in the first days and increased steadily afterwards. In contrast, QUE and SE-8 show pH increases from the beginning and a constant pH after 4-8 days. This agrees with the expected H+ consumption during reduction. Most soils show strong initial Eh decreases, subsequent slower increases up to 5-8 days and slow decreases afterwards. Solution Fe and Mn showed significant increases throughout the experiment, and Pb showed slight increases only up to 4 days. In contrast, other metals showed non-significant changes, and very low amounts were dissolved during the treatment. However, the amounts of available and, especially, bio-accessible urban metals in the solid phases were significantly increased by the treatment. Such increases may cause a greater leaching of metals to the water

  1. 10 CFR 710.22 - Initial decision process.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) The Manager shall make an initial decision as to the individual's access authorization eligibility... Officer refers the individual's case to the Manager in accordance with § 710.25(e) or § 710.26(b). (b..., the Manager's initial decision as to the individual's access authorization eligibility shall be made...

  2. Experimental apparatus with full optical access for combustion experiments with laminar flames from a single circular nozzle at elevated pressures.

    PubMed

    Joo, Peter H; Gao, Jinlong; Li, Zhongshan; Aldén, Marcus

    2015-03-01

    The design and features of a high pressure chamber and burner that is suitable for combustion experiments at elevated pressures are presented. The high pressure combustion apparatus utilizes a high pressure burner that is comprised of a chamber burner module and an easily accessible interchangeable burner module to add to its flexibility. The burner is well suited to study both premixed and non-premixed flames. The optical access to the chamber is provided through four viewports for direct visual observations and optical-based diagnostic techniques. Auxiliary features include numerous access ports and electrical connections and as a result, the combustion apparatus is also suitable to work with plasmas and liquid fuels. Images of methane flames at elevated pressures up to 25 atm and preliminary results of optical-based measurements demonstrate the suitability of the high pressure experimental apparatus for combustion experiments.

  3. Health Care Experiences and Perceived Barriers to Health Care Access: A Qualitative Study Among African Migrants in Guangzhou, Guangdong Province, China

    PubMed Central

    Brown, Katherine B.; Yu, Fan; Yang, Jingqi; Wang, Jason; Schrock, Joshua M.; Bodomo, Adams B.; Yang, Ligang; Yang, Bin; Nehl, Eric J.; Tucker, Joseph D.; Wong, Frank Y.

    2014-01-01

    Guangzhou, one of China's largest cities and a main trading port in South China, has attracted many African businessmen and traders migrating to the city for financial gains. Previous research has explored the cultural and economic roles of this newly emerging population; however, little is known about their health care experiences while in China. Semi-structured interviews and focus groups were used to assess health care experiences and perceived barriers to health care access among African migrants in Guangzhou, China. Overall, African migrants experienced various barriers to accessing health care and were dissatisfied with local health services. The principal barriers to care reported included affordability, legal issues, language barriers, and cultural differences. Facing multiple barriers, African migrants have limited access to care in Guangzhou. Local health settings are not accustomed to the African migrant population, suggesting that providing linguistically and culturally appropriate services may improve access to care for the migrants. PMID:25294415

  4. Cap- and initiator tRNA-dependent initiation of TYMV polyprotein synthesis by ribosomes: evaluation of the Trojan horse model for TYMV RNA translation.

    PubMed

    Matsuda, Daiki; Dreher, Theo W

    2007-01-01

    Turnip yellow mosaic virus (TYMV) RNA directs the translation of two overlapping open reading frames. Competing models have been previously published to explain ribosome access to the downstream polyprotein cistron. The Trojan horse model, based on cell-free experiments, proposes noncanonical cap-independent initiation in which the 3'-terminal tRNA-like structure (TLS) functionally replaces initiator tRNA, and the valine bound to the TLS becomes cis-incorporated into viral protein. The initiation coupling model, based on in vivo expression and ribosome toe-printing studies, proposes a variation of canonical leaky scanning. Here, we have re-examined the wheat germ extract experiments that led to the Trojan horse model, incorporating a variety of controls. We report that (1) translation in vitro from the polyprotein AUG of TYMV RNA is unchanged after removal of the 3' TLS but is stimulated by the presence of a 5'-cap; (2) the presence of free cap analog or edeine (which interferes with initiation at the ribosomal P site and its tRNA(i) (Met) involvement) inhibits translation from the polyprotein AUG; (3) the toe-prints of immediately post-initiation ribosomes on TYMV RNA are similar with and without an intact TLS; and (4) significant deacylation of valyl-TYMV RNA in wheat germ extract can complicate the detection of cis-incorporation. These results favor the initiation coupling model.

  5. Cap- and initiator tRNA-dependent initiation of TYMV polyprotein synthesis by ribosomes: Evaluation of the Trojan horse model for TYMV RNA translation

    PubMed Central

    Matsuda, Daiki; Dreher, Theo W.

    2007-01-01

    Turnip yellow mosaic virus (TYMV) RNA directs the translation of two overlapping open reading frames. Competing models have been previously published to explain ribosome access to the downstream polyprotein cistron. The Trojan horse model, based on cell-free experiments, proposes noncanonical cap-independent initiation in which the 3′-terminal tRNA-like structure (TLS) functionally replaces initiator tRNA, and the valine bound to the TLS becomes cis-incorporated into viral protein. The initiation coupling model, based on in vivo expression and ribosome toe-printing studies, proposes a variation of canonical leaky scanning. Here, we have re-examined the wheat germ extract experiments that led to the Trojan horse model, incorporating a variety of controls. We report that (1) translation in vitro from the polyprotein AUG of TYMV RNA is unchanged after removal of the 3′ TLS but is stimulated by the presence of a 5′-cap; (2) the presence of free cap analog or edeine (which interferes with initiation at the ribosomal P site and its tRNAi Met involvement) inhibits translation from the polyprotein AUG; (3) the toe-prints of immediately post-initiation ribosomes on TYMV RNA are similar with and without an intact TLS; and (4) significant deacylation of valyl-TYMV RNA in wheat germ extract can complicate the detection of cis-incorporation. These results favor the initiation coupling model. PMID:17095542

  6. High/Scope Preschool Key Experiences: Initiative and Social Relations. [with] Curriculum Videotape.

    ERIC Educational Resources Information Center

    Graves, Michelle

    As preschoolers develop the ability to carry out their ideas and play alone and with others, they are developing the foundation for social competence. This booklet and a companion videotape help teachers and parents recognize and support nine High/Scope key experiences in initiative and social relations: (1) making and expressing choices, plans,…

  7. An MHD Dynamo Experiment.

    NASA Astrophysics Data System (ADS)

    O'Connell, R.; Forest, C. B.; Plard, F.; Kendrick, R.; Lovell, T.; Thomas, M.; Bonazza, R.; Jensen, T.; Politzer, P.; Gerritsen, W.; McDowell, M.

    1997-11-01

    A MHD experiment is being constructed which will have the possibility of showing dynamo action: the self--generation of currents from fluid motion. The design allows sufficient experimental flexibility and diagnostic access to study a variety of issues central to dynamo theory, including mean--field electrodynamics and saturation (backreaction physics). Initially, helical flows required for dynamo action will be driven by propellers embedded in liquid sodium. The flow fields will first be measured using laser doppler velocimetry in a water experiment with an identical fluid Reynolds number. The magnetic field evolution will then be predicted using a MHD code, replacing the water with sodium; if growing magnetic fields are found, the experiment will be repeated with sodium.

  8. Shock timing experiments on the National Ignition Facility: Initial results and comparison with simulation

    NASA Astrophysics Data System (ADS)

    Robey, H. F.; Boehly, T. R.; Celliers, P. M.; Eggert, J. H.; Hicks, D.; Smith, R. F.; Collins, R.; Bowers, M. W.; Krauter, K. G.; Datte, P. S.; Munro, D. H.; Milovich, J. L.; Jones, O. S.; Michel, P. A.; Thomas, C. A.; Olson, R. E.; Pollaine, S.; Town, R. P. J.; Haan, S.; Callahan, D.; Clark, D.; Edwards, J.; Kline, J. L.; Dixit, S.; Schneider, M. B.; Dewald, E. L.; Widmann, K.; Moody, J. D.; Döppner, T.; Radousky, H. B.; Throop, A.; Kalantar, D.; DiNicola, P.; Nikroo, A.; Kroll, J. J.; Hamza, A. V.; Horner, J. B.; Bhandarkar, S. D.; Dzenitis, E.; Alger, E.; Giraldez, E.; Castro, C.; Moreno, K.; Haynam, C.; LaFortune, K. N.; Widmayer, C.; Shaw, M.; Jancaitis, K.; Parham, T.; Holunga, D. M.; Walters, C. F.; Haid, B.; Mapoles, E. R.; Sater, J.; Gibson, C. R.; Malsbury, T.; Fair, J.; Trummer, D.; Coffee, K. R.; Burr, B.; Berzins, L. V.; Choate, C.; Brereton, S. J.; Azevedo, S.; Chandrasekaran, H.; Eder, D. C.; Masters, N. D.; Fisher, A. C.; Sterne, P. A.; Young, B. K.; Landen, O. L.; Van Wonterghem, B. M.; MacGowan, B. J.; Atherton, J.; Lindl, J. D.; Meyerhofer, D. D.; Moses, E.

    2012-04-01

    Capsule implosions on the National Ignition Facility (NIF) [Lindl et al., Phys. Plasmas 11, 339 (2004)] are underway with the goal of compressing deuterium-tritium (DT) fuel to a sufficiently high areal density (ρR) to sustain a self-propagating burn wave required for fusion power gain greater than unity. These implosions are driven with a carefully tailored sequence of four shock waves that must be timed to very high precision in order to keep the DT fuel on a low adiabat. Initial experiments to measure the strength and relative timing of these shocks have been conducted on NIF in a specially designed surrogate target platform known as the keyhole target. This target geometry and the associated diagnostics are described in detail. The initial data are presented and compared with numerical simulations. As the primary goal of these experiments is to assess and minimize the adiabat in related DT implosions, a methodology is described for quantifying the adiabat from the shock velocity measurements. Results are contrasted between early experiments that exhibited very poor shock timing and subsequent experiments where a modified target geometry demonstrated significant improvement.

  9. The SPIRIT Telescope Initiative: Six Years On (Abstract)

    NASA Astrophysics Data System (ADS)

    Luckas, P.

    2017-12-01

    (Abstract only) Now in its sixth year of operation, the SPIRIT initiative remains unique in Australia, as a robust web-enabled robotic telescope initiative funded for education and outreach. With multiple modes of operation catering for a variety of usage scenarios and a fully supported education program, SPIRIT provides free access to contemporary astronomical tools for students and educators in Western Australia and beyond. The technical solution itself provides an excellent model for low cost robotic telescope installations, and the education program has evolved over time to include a broad range of student experiences - from engagement activities to authentic science. This paper details the robotic telescope solution, student interface, and educational philosophy, summarizes achievements and lessons learned, and examines the possibilities for future enhancement including spectroscopy.

  10. The experiences of parents of children with mental disability regarding access to mental health care.

    PubMed

    Coomer, R A

    2013-07-01

    The aim of this qualitative study was to describe the problems that parents or caregivers of children with mental health disabilities and disorders in Namibia experience when accessing healthcare resources for their children. Data was collected through focus group discussions with the participants and individual interviews with the key informants. Overall, a total of 41 people provided information for this study. Thematic data analysis was used to assess the data. The main barriers experienced by the parents were poor service provision, transport and money, whilst access to education services facilitated access to healthcare services. The challenges go beyond commonly-reported problems such as sub-optimal service provision and include the basic challenge of lack of transportation to reach healthcare services. Many of the barriers identified in this study have been related to general problems with the healthcare system in Namibia. Therefore there is a need to address general concerns about healthcare provision as well as improve specific services for children with mental health disabilities and disorders in Namibia.

  11. Initiation of a thrust fault revealed by analog experiments

    NASA Astrophysics Data System (ADS)

    Dotare, Tatsuya; Yamada, Yasuhiro; Adam, Juergen; Hori, Takane; Sakaguchi, Hide

    2016-08-01

    To reveal in detail the process of initiation of a thrust fault, we conducted analog experiments with dry quartz sand using a high-resolution digital image correlation technique to identify minor shear-strain patterns for every 27 μm of shortening (with an absolute displacement accuracy of 0.5 μm). The experimental results identified a number of "weak shear bands" and minor uplift prior to the initiation of a thrust in cross-section view. The observations suggest that the process is closely linked to the activity of an adjacent existing thrust, and can be divided into three stages. Stage 1 is characterized by a series of abrupt and short-lived weak shear bands at the location where the thrust will subsequently be generated. The area that will eventually be the hanging wall starts to uplift before the fault forms. The shear strain along the existing thrust decreases linearly during this stage. Stage 2 is defined by the generation of the new thrust and active displacements along it, identified by the shear strain along the thrust. The location of the new thrust may be constrained by its back-thrust, generally produced at the foot of the surface slope. The activity of the existing thrust falls to zero once the new thrust is generated, although these two events are not synchronous. Stage 3 of the thrust is characterized by a constant displacement that corresponds to the shortening applied to the model. Similar minor shear bands have been reported in the toe area of the Nankai accretionary prism, SW Japan. By comparing several transects across this subduction margin, we can classify the lateral variations in the structural geometry into the same stages of deformation identified in our experiments. Our findings may also be applied to the evaluation of fracture distributions in thrust belts during unconventional hydrocarbon exploration and production.

  12. Comparison between initial Magnetized Liner Inertial Fusion experiments and integrated simulations

    NASA Astrophysics Data System (ADS)

    Sefkow, A. B.; Gomez, M. R.; Geissel, M.; Hahn, K. D.; Hansen, S. B.; Harding, E. C.; Peterson, K. J.; Slutz, S. A.; Koning, J. M.; Marinak, M. M.

    2014-10-01

    The Magnetized Liner Inertial Fusion (MagLIF) approach to ICF has obtained thermonuclear fusion yields using the Z facility. Integrated magnetohydrodynamic simulations provided the design for the first neutron-producing experiments using capabilities that presently exist, and the initial experiments measured stagnation radii rstag < 75 μm, temperatures around 3 keV, and isotropic neutron yields up to YnDD = 2 ×1012 from imploded liners reaching peak velocities around 70 km/s over an implosion time of about 60 ns. We present comparisons between the experimental observables and post-shot degraded integrated simulations. Sandia is a multiprogram laboratory operated by Sandia Corporation, a Lockheed Martin Company, for the National Nuclear Security Administration under Contract DE-AC04-94AL85000.

  13. Initial experience with a donor egg bank.

    PubMed

    Akin, James W; Bell, Katrina A; Thomas, Diana; Boldt, Jeffrey

    2007-08-01

    To report on the establishment of a commercial donor egg bank (CryoEggs International, LP) and to present our initial experience from the first four patients to receive eggs. Case report. Private fertility clinic. The four recipient women were aged 43, 43, 40, and 33 years. All had cycle day FSH levels greater than 25 mIU/mL. All were given the option of fresh donor egg IVF but opted to use frozen donor oocytes. Purchased and quarantined frozen donor eggs were thawed and inseminated using intracytoplasmic sperm injection (ICSI). Subsequent embryos were transferred on day 3. Clinical pregnancy as defined by presence of cardiac activity. There was a thawed egg survival rate of 76%, a fertilization rate of 74%, a pregnancy rate (PR) of 50%, with an average of 2.75 embryos per transfer and an implantation rate of 27%. Although very preliminary, these results indicate that more widespread use of frozen donor eggs obtained from a commercial egg bank may be feasible in the future, changing the landscape of donor egg IVF.

  14. An In-Store Experiment on the Effect of Accessibility on Sales of Wholegrain and White Bread in Supermarkets

    PubMed Central

    de Wijk, René A.; Maaskant, Anna J.; Polet, Ilse A.; Holthuysen, Nancy T. E.; van Kleef, Ellen; Vingerhoeds, Monique H.

    2016-01-01

    Even though whole grain foods have various health benefits, consumers have been found not to eat enough of them. Nudging interventions are built on the premise that food purchases and consumption are strongly influenced by the environment in which decisions are made. Little research has been conducted to examine the influence of a small and inexpensive nudging intervention on bread choices in a real-life supermarket context. An in-store experiment was conducted in two six-week periods in two supermarkets to investigate the effects of accessibility on consumers’ purchase of healthier whole grain and other types of bread. In the high accessibility condition, healthier bread was placed in a more convenient location for the shopper on the left side of the shelves where it was encountered first. In the low accessibility condition, it was placed on the right side. There were consistent significant differences in sales between supermarkets, types of bread, day of the week, but not between low and high accessibility. Additional research is needed to better understand the effects of convenience and accessibility on bread choices. PMID:27010704

  15. An In-Store Experiment on the Effect of Accessibility on Sales of Wholegrain and White Bread in Supermarkets.

    PubMed

    de Wijk, René A; Maaskant, Anna J; Polet, Ilse A; Holthuysen, Nancy T E; van Kleef, Ellen; Vingerhoeds, Monique H

    2016-01-01

    Even though whole grain foods have various health benefits, consumers have been found not to eat enough of them. Nudging interventions are built on the premise that food purchases and consumption are strongly influenced by the environment in which decisions are made. Little research has been conducted to examine the influence of a small and inexpensive nudging intervention on bread choices in a real-life supermarket context. An in-store experiment was conducted in two six-week periods in two supermarkets to investigate the effects of accessibility on consumers' purchase of healthier whole grain and other types of bread. In the high accessibility condition, healthier bread was placed in a more convenient location for the shopper on the left side of the shelves where it was encountered first. In the low accessibility condition, it was placed on the right side. There were consistent significant differences in sales between supermarkets, types of bread, day of the week, but not between low and high accessibility. Additional research is needed to better understand the effects of convenience and accessibility on bread choices.

  16. Rural Colleges as Catalysts for Community Change: The RCCI Experience.

    ERIC Educational Resources Information Center

    Rubin, Sarah

    2001-01-01

    The Rural Community College Initiative challenges colleges in economically distressed regions to become catalysts for economic and community development and improved access to education. Led by college-community teams, the 24 sites have experimented with strategic approaches that include leadership development, entrepreneurship education, small…

  17. Mapping patients' experiences from initial symptoms to gout diagnosis: a qualitative exploration.

    PubMed

    Liddle, Jennifer; Roddy, Edward; Mallen, Christian D; Hider, Samantha L; Prinjha, Suman; Ziebland, Sue; Richardson, Jane C

    2015-09-14

    To explore patients' experiences from initial symptoms to receiving a diagnosis of gout. Data from in-depth semistructured interviews were used to construct themes to describe key features of patients' experiences of gout diagnosis. A maximum variation sample of 43 UK patients with gout (29 men; 14 women; age range 32-87 years) were recruited from general practices, rheumatology clinics, gout support groups and through online advertising. Severe joint pain, combined with no obvious signs of physical trauma or knowledge of injury, caused confusion for patients attempting to interpret their symptoms. Reasons for delayed consultation included self-diagnosis and/or self-medication, reluctance to seek medical attention, and financial/work pressures. Factors potentially contributing to delayed diagnosis after consultation included reported misdiagnosis, attacks in joints other than the first metatarsophalangeal joint, and female gender. The limitations in using serum uric acid (SUA) levels for diagnostic purposes were not always communicated effectively to patients, and led to uncertainty and lack of confidence in the accuracy of the diagnosis. Resistance to the diagnosis occurred in response to patients' beliefs about the causes of gout and characteristics of the people likely to be affected. Diagnosis prompted actions, such as changes in diet, and evidence was found of self-monitoring of SUA levels. This study is the first to report data specifically about patients' pathways to initial consultation and subsequent experiences of gout diagnosis. A more targeted approach to information provision at diagnosis would improve patients' experiences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Microcomputer-Analyzed Initial Rate Kinetics of the Benzene-Enhanced Unfolding of Myoglobin: A Biophysical Chemistry Experiment.

    ERIC Educational Resources Information Center

    Schuh, Merlyn D.

    1988-01-01

    Describes a biophysical chemistry experiment that introduces students to globular protein conformation and microcomputer analysis of initial rate data for the unfolding of proteins. Presents background, materials needed and methodology. Uses a visible spectrometer for analysis. Lists educational benefits derived from the experiment. (ML)

  19. Initial experience with a composite autologous skin substitute.

    PubMed

    Sheridan, R L; Morgan, J R; Cusick, J L; Petras, L M; Lydon, M M; Tompkins, R G

    2001-08-01

    Patients with large burns are surviving in increasing numbers, but there remains no durable and reliable permanent skin replacement. After initial favorable small animal experiments, a pilot trial of a composite skin replacement was performed in patients with massive burns. A composite skin replacement (CSR) was developed by culturing autologous keratinocytes on acellular allogenic dermis. This material was engrafted in patients with massive burns and compared to a matched wound covered with split thickness autograft. With human studies committee approval, 12 wounds in 7 patients were grafted with CSR while a matched control wound was covered with split thickness autograft. These 7 children had an average age of 6.4+/-1.4 yr and burn size of 75.9+/-5.0% of the body surface. Nine wounds were acute burns and three were reconstructive releases. Successful vascularization at 14 days averaged 45.7+/-14.2% (range 0-100%) in the study wounds and 98+/-1% (range 90-100%) in the control sites (P<0.05). Reduced CSR take seemed to correlate with wound colonization. All children survived. While CSR did not engraft with the reliability of standard autograft, this pilot experience is encouraging in that successful wound closure with this material is possible, if not yet dependable. It is hoped that a more mature epidermal layer may facilitate engraftment, and trials to explore this possibility are in progress.

  20. Initiation process of a thrust fault revealed by analog experiments

    NASA Astrophysics Data System (ADS)

    Yamada, Yasuhiro; Dotare, Tatsuya; Adam, Juergen; Hori, Takane; Sakaguchi, Hide

    2016-04-01

    We conducted 2D (cross-sectional) analog experiments with dry sand using a high resolution digital image correlation (DIC) technique to reveal initiation process of a thrust fault in detail, and identified a number of "weak shear bands" and minor uplift prior to the thrust initiation. The observations suggest that the process can be divided into three stages. Stage 1: characterized by a series of abrupt and short-lived weak shear bands at the location where the thrust will be generated later. Before initiation of the fault, the area to be the hanging wall starts to uplift. Stage 2: defined by the generation of the new thrust and its active displacement. The location of the new thrust seems to be constrained by its associated back-thrust, produced at the foot of the surface slope (by the previous thrust). The activity of the previous thrust turns to zero once the new thrust is generated, but the timing of these two events is not the same. Stage 3: characterized by a constant displacement along the (new) thrust. Similar minor shear bands can be seen in the toe area of the Nankai accretionary prism, SW Japan and we can correlate the along-strike variations in seismic profiles to the model results that show the characteristic features in each thrust development stage.

  1. "Education Will Get You to the Station": Marginalized Students' Experiences and Perceptions of Merit in Accessing University

    ERIC Educational Resources Information Center

    James, Carl E.; Taylor, Leanne

    2008-01-01

    This article explores how four minority students in a university access program reconciled their presence on merit. They shared their experiences over two years through their application statements, life history interviews, weekly group sessions, and personal journal entries. Consistent with the discourse of merit, participants believed that by…

  2. The Ocean Observatories Initiative: Unprecedented access to real-time data streaming from the Cabled Array through OOI Cyberinfrastructure

    NASA Astrophysics Data System (ADS)

    Knuth, F.; Vardaro, M.; Belabbassi, L.; Smith, M. J.; Garzio, L. M.; Crowley, M. F.; Kerfoot, J.; Kawka, O. E.

    2016-02-01

    The National Science Foundation's Ocean Observatories Initiative (OOI), is a broad-scale, multidisciplinary facility that will transform oceanographic research by providing users with unprecedented access to long-term datasets from a variety of deployed physical, chemical, biological, and geological sensors. The Cabled Array component of the OOI, installed and operated by the University of Washington, is located on the Juan de Fuca tectonic plate off the coast of Oregon. It is a unique network of >100 cabled instruments and instrumented moorings transmitting data to shore in real-time via fiber optic technology. Instruments now installed include HD video and digital still cameras, mass spectrometers, a resistivity-temperature probe inside the orifice of a high-temperature hydrothermal vent, upward-looking ADCP's, pH and pC02 sensors, Horizontal Electrometer Pressure Inverted Echosounders and many others. Here, we present the technical aspects of data streaming from the Cabled Array through the OOI Cyberinfrastructure. We illustrate the types of instruments and data products available, data volume and density, processing levels and algorithms used, data delivery methods, file formats and access methods through the graphical user interface. Our goal is to facilitate the use and access to these unprecedented, co-registered oceanographic datasets. We encourage researchers to collaborate through the use of these simultaneous, interdisciplinary measurements, in the exploration of short-lived events (tectonic, volcanic, biological, severe storms), as well as long-term trends in ocean systems (circulation patterns, climate change, ocean acidity, ecosystem shifts).

  3. Assessing the engagement, learning, and overall experience of students operating an atomic absorption spectrophotometer with remote access technology.

    PubMed

    Erasmus, Daniel J; Brewer, Sharon E; Cinel, Bruno

    2015-01-01

    The use of internet-based technologies in the teaching of laboratories has emerged as a promising education tool. This study evaluated the effectiveness of using remote access technology to operate an atomic absorption spectrophotometer in analyzing the iron content in a crude myoglobin extract. Sixty-two students were surveyed on their level of engagement, learning, and overall experience. Feedback from students suggests that the use of remote access technology is effective in teaching students the principles of chemical analysis by atomic absorption spectroscopy. © 2014 The International Union of Biochemistry and Molecular Biology.

  4. Preparing Beginning Reading Teachers: An Experimental Comparison of Initial Early Literacy Field Experiences

    ERIC Educational Resources Information Center

    Al Otaiba, Stephanie; Lake, Vickie E.; Greulich, Luana; Folsom, Jessica S.; Guidry, Lisa

    2012-01-01

    This randomized-control trial examined the learning of preservice teachers taking an initial Early Literacy course in an early childhood education program and of the kindergarten or first grade students they tutored in their field experience. Preservice teachers were randomly assigned to one of two tutoring programs: Book Buddies and Tutor…

  5. Ethnic differences in social support after initial receipt of an abnormal mammogram.

    PubMed

    Molina, Yamile; Hohl, Sarah D; Nguyen, Michelle; Hempstead, Bridgette H; Weatherby, Shauna Rae; Dunbar, Claire; Beresford, Shirley A A; Ceballos, Rachel M

    2016-10-01

    We examine access to and type of social support after initial receipt of an abnormal mammogram across non-Latina White (NLW), African American, and Latina women. This cross-sectional study used a mixed method design, with quantitative and qualitative measures. Women were recruited through 2 community advocates and 3 breast-health-related care organizations. With regard to access, African American women were less likely to access social support relative to NLW counterparts. Similar nonsignificant differences were found for Latinas. Women did not discuss results with family and friends to avoid burdening social networks and negative reactions. Networks' geographic constraints and medical mistrust influenced Latina and African American women's decisions to discuss results. With regard to type of social support, women reported emotional support across ethnicity. Latina and African American women reported more instrumental support, whereas NLW women reported more informational support in the context of their well-being. There are shared and culturally unique aspects of women's experiences with social support after initially receiving an abnormal mammogram. Latina and African American women may particularly benefit from informational support from health care professionals. Communitywide efforts to mitigate mistrust and encourage active communication about cancer may improve ethnic disparities in emotional well-being and diagnostic resolution during initial receipt of an abnormal mammogram. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  6. Memory availability and referential access

    PubMed Central

    Johns, Clinton L.; Gordon, Peter C.; Long, Debra L.; Swaab, Tamara Y.

    2013-01-01

    Most theories of coreference specify linguistic factors that modulate antecedent accessibility in memory; however, whether non-linguistic factors also affect coreferential access is unknown. Here we examined the impact of a non-linguistic generation task (letter transposition) on the repeated-name penalty, a processing difficulty observed when coreferential repeated names refer to syntactically prominent (and thus more accessible) antecedents. In Experiment 1, generation improved online (event-related potentials) and offline (recognition memory) accessibility of names in word lists. In Experiment 2, we manipulated generation and syntactic prominence of antecedent names in sentences; both improved online and offline accessibility, but only syntactic prominence elicited a repeated-name penalty. Our results have three important implications: first, the form of a referential expression interacts with an antecedent’s status in the discourse model during coreference; second, availability in memory and referential accessibility are separable; and finally, theories of coreference must better integrate known properties of the human memory system. PMID:24443621

  7. Experiences of Healthcare Professionals to the Introduction in Sweden of a Public eHealth Service: Patients' Online Access to their Electronic Health Records.

    PubMed

    Ålander, Ture; Scandurra, Isabella

    2015-01-01

    Patients' increasing demands for medical information, the digitization of health records and the fast spread of Internet access form a basis of introducing new eHealth services. An international trend is to provide access for patients to health information of various kind. In Sweden, access by patients to their proper electronic health record (EHR) has been provided in a pilot county since November 2012. This eHealth service is controversial and criticism has arised from the clinical professions, mainly physicians. Two web surveys were conducted to discover whether the opinions of healthcare professionals differ; between staff that have had experience with patients accessing their own EHR and those who have no such expericence. Experienced nurses found the EHR more important for the patients and a better reform, compared to unexperienced nurses in the rest of the country. Similarly, physicians with their own experience had a more positive attitude compared to non-experienced physicians. The conclusion of this study is that healthcare professionals must be involved in the implementation of public eHealth services such as EHRs and that real experiences of the professionals should be better disseminated to their inexperienced peers.

  8. Differences in Healthcare Access, Use, and Experiences Within a Community Sample of Racially Diverse Lesbian, Gay, Bisexual, Transgender, and Questioning Emerging Adults.

    PubMed

    Macapagal, Kathryn; Bhatia, Ramona; Greene, George J

    2016-12-01

    Health services research involving lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) individuals has focused on differences in healthcare access, use, and experiences between cisgender, heterosexual adults and LGBTQ adults. Yet these factors may differ within the LGBTQ community and have not been well-studied among emerging adults (18-29 years), a group with unique barriers to healthcare. We sought to characterize healthcare challenges within a sample of LGBTQ emerging adults. From 2012 to 2013, 206 participants aged 18-27 (86% racial/ethnic minority, 10% transgender) completed questionnaires assessing healthcare access, use, and experiences during a longitudinal study. Descriptive statistics established patterns of healthcare access, use, and experiences, and nonparametric tests examined differences related to sociodemographic variables, HIV status, sexual orientation identity, and gender identity. Overall, 68% of participants reported relatively easy access to care. White and bisexual participants reported higher rates of insurance than racial/ethnic minority (P = 0.01) and gay or lesbian participants (P = 0.005), respectively. Although most participants did not report having negative experiences in healthcare settings related to their LGBTQ identity, transgender participants were more likely to delay care (P < 0.001) and report negative effects of disclosure to their provider (P < 0.001) compared with cisgender participants. Participants who identified as queer or were questioning their sexual orientation identity reported negative healthcare experiences more frequently than LGB-identified participants (P = 0.001). Although LGBTQ emerging adults experienced fewer barriers to care than observed in previous studies on LGBTQ adults, the results suggest that queer, questioning, and transgender individuals may face additional healthcare challenges compared with their LGB and cisgender counterparts.

  9. The experience of initiating injection drug use and its social context: a qualitative systematic review and thematic synthesis.

    PubMed

    Guise, Andy; Horyniak, Danielle; Melo, Jason; McNeil, Ryan; Werb, Dan

    2017-12-01

    Understanding the experience of initiating injection drug use and its social contexts is crucial to inform efforts to prevent transitions into this mode of drug consumption and support harm reduction. We reviewed and synthesized existing qualitative scientific literature systematically to identify the socio-structural contexts for, and experiences of, the initiation of injection drug use. We searched six databases (Medline, Embase, PsychINFO, CINAHL, IBSS and SSCI) systematically, along with a manual search, including key journals and subject experts. Peer-reviewed studies were included if they qualitatively explored experiences of or socio-structural contexts for injection drug use initiation. A thematic synthesis approach was used to identify descriptive and analytical themes throughout studies. From 1731 initial results, 41 studies reporting data from 1996 participants were included. We developed eight descriptive themes and two analytical (higher-order) themes. The first analytical theme focused on injecting initiation resulting from a social process enabled and constrained by socio-structural factors: social networks and individual interactions, socialization into drug-using identities and choices enabled and constrained by social context all combine to produce processes of injection initiation. The second analytical theme addressed pathways that explore varying meanings attached to injection initiation and how they link to social context: seeking pleasure, responses to increasing tolerance to drugs, securing belonging and identity and coping with pain and trauma. Qualitative research shows that injection drug use initiation has varying and distinct meanings for individuals involved and is a dynamic process shaped by social and structural factors. Interventions should therefore respond to the socio-structural influences on injecting drug use initiation by seeking to modify the contexts for initiation, rather than solely prioritizing the reduction of individual

  10. Kinds of access: different methods for report reveal different kinds of metacognitive access

    PubMed Central

    Overgaard, Morten; Sandberg, Kristian

    2012-01-01

    In experimental investigations of consciousness, participants are asked to reflect upon their own experiences by issuing reports about them in different ways. For this reason, a participant needs some access to the content of her own conscious experience in order to report. In such experiments, the reports typically consist of some variety of ratings of confidence or direct descriptions of one's own experiences. Whereas different methods of reporting are typically used interchangeably, recent experiments indicate that different results are obtained with different kinds of reporting. We argue that there is not only a theoretical, but also an empirical difference between different methods of reporting. We hypothesize that differences in the sensitivity of different scales may reveal that different types of access are used to issue direct reports about experiences and metacognitive reports about the classification process. PMID:22492747

  11. The experience of living with sensory hyperreactivity-accessibility, financial security, and social relationships.

    PubMed

    Söderholm, Anna; Söderberg, Anna; Nordin, Steven

    2011-08-01

    Odor intolerance is a frequently reported problem, predominantly among women. Our purpose was to illuminate how individuals living with sensory hyperreactivity (SHR; a form of odor intolerance) experience its impact on accessibility, financial security, and social relationships. Data were collected by having 12 women with SHR write descriptive texts. These texts were analyzed with qualitative content analysis. Six themes were identified: Being limited in participating in society, being forced to behave incompatibly with one's personality, experiencing lack of understanding and respect from others, experiencing insecurity, being dependent on others, and being forced to choose between the plague and cholera.

  12. Early Experience with Technology-Based Eye Care Services (TECS): A Novel Ophthalmologic Telemedicine Initiative.

    PubMed

    Maa, April Y; Wojciechowski, Barbara; Hunt, Kelly J; Dismuke, Clara; Shyu, Jason; Janjua, Rabeea; Lu, Xiaoqin; Medert, Charles M; Lynch, Mary G

    2017-04-01

    The aging population is at risk of common eye diseases, and routine eye examinations are recommended to prevent visual impairment. Unfortunately, patients are less likely to seek care as they age, which may be the result of significant travel and time burdens associated with going to an eye clinic in person. A new method of eye-care delivery that mitigates distance barriers and improves access was developed to improve screening for potentially blinding conditions. We present the quality data from the early experience (first 13 months) of Technology-Based Eye Care Services (TECS), a novel ophthalmologic telemedicine program. With TECS, a trained ophthalmology technician is stationed in a primary care clinic away from the main hospital. The ophthalmology technician follows a detailed protocol that collects information about the patient's eyes. The information then is interpreted remotely. Patients with possible abnormal findings are scheduled for a face-to-face examination in the eye clinic. Any patient with no known ocular disease who desires a routine eye screening examination is eligible. Technology-Based Eye Care Services was established in 5 primary care clinics in Georgia surrounding the Atlanta Veterans Affairs hospital. Four program operation metrics (patient satisfaction, eyeglass remakes, disease detection, and visit length) and 2 access-to-care metrics (appointment wait time and no-show rate) were tracked. Care was rendered to 2690 patients over the first 13 months of TECS. The program has been met with high patient satisfaction (4.95 of 5). Eyeglass remake rate was 0.59%. Abnormal findings were noted in 36.8% of patients and there was >90% agreement between the TECS reading and the face-to-face findings of the physician. TECS saved both patient (25% less) and physician time (50% less), and access to care substantially improved with 99% of patients seen within 14 days of contacting the eye clinic, with a TECS no-show rate of 5.2%. The early experience with

  13. Consumers’ experiences of back pain in rural Western Australia: access to information and services, and self-management behaviours

    PubMed Central

    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

  14. Staying healthy "under the sheets": Inuit youth experiences of access to sexual and reproductive health and rights in Arviat, Nunavut, Canada.

    PubMed

    Corosky, Gregory J; Blystad, Astrid

    2016-01-01

    Inuit youth are reported to experience considerably worse sexual and reproductive health and rights (SRHR) outcomes than Canadian youth in general, as evidenced through public health data on sexually transmitted infections, unintended young pregnancies and rates of sexual violence in Nunavut compared to national averages. Existing literature on Inuit SRHR has identified the impact of westernization and colonialism on health outcomes, though gaps remain in addressing youth- and community-specific experiences of SRHR. This study aims to generate youth-focused evidence on experiences of SRHR relating to access to care in Arviat in order to better inform locally authored interventions geared towards improving youth SRHR. The Piliriqatigiinniq Partnership Community Health Research Model (PRM) developed by the Qaujigiartiit Health Research Centre was followed to generate data on youth experiences of SRHR support access in Arviat. In-depth interviews were conducted with 9 male youth (ages 17-22 years), 10 female youth (ages 16-22 years) and 6 community leaders (aged 25+). Snowball sampling was used to engage informants, and data analysis followed an approach similar to conventional content analysis, where emphasis was placed on "immersion and crystallization" of data, corresponding to the Inuit concept of Iqqaumaqatigiinniq in the PRM. Findings were continuously checked with community members in Arviat during the analysis phase, and their feedback was incorporated into the report. Youth in Arviat were found to face significant barriers to SRHR care and support. Three major themes emerged as important factors conditioning youth access to SRHR resources in the community: trust of support workers in the community; stigma/taboos surrounding SRHR topics; and feelings of powerlessness impeding female and lesbian/gay/bisexual/transgender/queer youth in particular from accessing care. The locally specific ways these themes emerged revealed important structural factors at play in

  15. Mechanisms that improve referential access*

    PubMed Central

    Gernsbacher, Morton Ann

    2015-01-01

    Two mechanisms, suppression and enhancement, are proposed to improve referential access. Enhancement improves the accessibility of previously mentioned concepts by increasing or boosting their activation; suppression improves concepts’ accessibility by decreasing or dampening the activation of other concepts. Presumably, these mechanisms are triggered by the informational content of anaphors. Six experiments investigated this proposal by manipulating whether an anaphoric reference was made with a very explicit, repeated name anaphor or a less explicit pronoun. Subjects read sentences that introduced two participants in their first clauses, for example, “Ann predicted that Pam would lose the track race,” and the sentences referred to one of the two participants in their second clauses, “but Pam/she came in first very easily.” While subjects read each sentence, the activation level of the two participants was measured by a probe verification task. The first two experiments demonstrated that explicit, repeated name anaphors immediately trigger the enhancement of their own antecedents and immediately trigger the suppression of other (nonantecedent) participants. The third experiment demonstrated that less explicit, pronoun anaphors also trigger the suppression of other nonantecedents, but they do so less quickly—even when, as in the fourth experiment, the semantic information to identify their antecedents occurs prior to the pronouns (e.g., “Ann predicted that Pam would lose the track race. But after winning the race, she …”). The fifth experiment demonstrated that more explicit pronouns – pronouns that match the gender of only one participant—trigger suppression more powerfully. A final experiment demonstrated that it is not only rementioned participants who improve their referential access by triggering the suppression of other participants; newly introduced participants do so too (e.g., “Ann predicted that Pam would lose the track race, but

  16. Videothoracoscopy in the treatment of spontaneous pneumothorax: an initial experience.

    PubMed Central

    Waller, D. A.; Yoruk, Y.; Morritt, G. N.; Forty, J.; Dark, J. H.

    1993-01-01

    We report an initial experience with the new and potentially advantageous technique of videothoracoscopy in the treatment of pneumothorax. A series of 18 consecutive patients (14 male, 4 female) presenting with spontaneous pneumothorax over a 4-month period underwent surgical treatment by this method. The indication for surgery was recurrent pneumothorax in nine patients and persistent air leak in the remainder (median duration 15 days, range 5-28 days). Stapled apical bullectomy with apical parietal pleurectomy was performed in 14 patients, bullectomy alone was performed in one patient and pleurectomy alone in three patients. Additional talc pleurodesis was carried out in three of these patients. Median duration of operation was 53.5 min (range 35-120 min). The median postoperative drainage was 300 ml in 24 h (range 50-580 ml). The median duration of intercostal drainage was 48 h (range 24-384 h) and of postoperative hospital stay 4 days (range 3-18 days). The mean postoperative analgesic requirement was 1.3 mg morphine/h. Three complications required reoperation. In two patients a large air leak persisted after operation; one proceeded to thoracotomy for suturing of the air leak and in the other this was accomplished by videothoracoscopy. A further patient re-presented at 2 weeks with recurrent pneumothorax which was treated at thoracotomy. At a median follow-up of 68.5 days (range 10-124 days) this is the only recurrence. These complications were caused by errors in surgical technique early in our series. This initial experience of videothoracoscopic pleurectomy suggests it is an effective, well-tolerated treatment of spontaneous pneumothorax. PMID:8379623

  17. Robonaut Mobile Autonomy: Initial Experiments

    NASA Technical Reports Server (NTRS)

    Diftler, M. A.; Ambrose, R. O.; Goza, S. M.; Tyree, K. S.; Huber, E. L.

    2006-01-01

    A mobile version of the NASA/DARPA Robonaut humanoid recently completed initial autonomy trials working directly with humans in cluttered environments. This compact robot combines the upper body of the Robonaut system with a Segway Robotic Mobility Platform yielding a dexterous, maneuverable humanoid ideal for interacting with human co-workers in a range of environments. This system uses stereovision to locate human teammates and tools and a navigation system that uses laser range and vision data to follow humans while avoiding obstacles. Tactile sensors provide information to grasping algorithms for efficient tool exchanges. The autonomous architecture utilizes these pre-programmed skills to form complex behaviors. The initial behavior demonstrates a robust capability to assist a human by acquiring a tool from a remotely located individual and then following the human in a cluttered environment with the tool for future use.

  18. Where are we now? A multicountry qualitative study to explore access to pre-antiretroviral care services: a precursor to antiretroviral therapy initiation

    PubMed Central

    Bukenya, Dominic; Wringe, Alison; Skovdal, Morten; Ssekubugu, Robert; Paparini, Sara; McLean, Estelle; Bonnington, Oliver; Wamoyi, Joyce; Seeley, Janet

    2017-01-01

    Objective To explore barriers and facilitators to accessing postdiagnosis HIV care in five sub-Saharan African countries. Methods In-depth interviews were conducted with 77 people living with HIV (PLHIV) in pre-antiretroviral therapy care or not-yet-in care and 46 healthcare workers. Participants were purposely selected from health and demographic surveillance sites in Karonga (Malawi), Manicaland (Zimbabwe), uMkhanyakude (South Africa), Kisesa (Tanzania) and Rakai and Kyamulibwa (Uganda). Thematic content analysis was conducted, guided by the constructs of affordability, availability and acceptability of care.- Results Affordability: Transport and treatment costs were a barrier to HIV care, although some participants travelled to distant clinics to avoid being seen by people who knew them or for specific services. Broken equipment and drug stock-outs in local clinics could also necessitate travel to other facilities. Availability: Some facilities did not offer full HIV care, or only offered all services intermittently. PLHIV who frequently travelled complained that care was seldom available to them in places they visited. Acceptability: Severe pain or sickness was a key driver for accessing postdiagnosis care, whereas asymptomatic PLHIV often delayed care-seeking. A belief in witchcraft was a deterrent to accessing clinical care following diagnosis. Changing antiretroviral therapy guidelines generated uncertainty among PLHIV about when to start treatment and delayed postdiagnosis care. PLHIV reported that healthcare workers’ knowledge, attitudes and behaviours, and their ability to impart health education, also influenced whether they accessed HIV care. Conclusion Despite efforts to decentralise services over the past decade, many barriers to accessing HIV care persist. There is a need to increase sustained access to care for PLHIV not yet on treatment, with initiatives that encompass biomedical aspects of care alongside considerations for individual and

  19. Liver transplantations in Bulgaria--initial experience.

    PubMed

    Vladov, N; Mihaylov, V; Takorov, I; Vasilevski, I; Lukanova, T; Odisseeva, E; Katzarov, K; Simonova, M; Tomova, D; Konakchieva, M; Petrov, N; Mladenov, N; Sergeev, S; Mutafchiiski, V

    2014-01-01

    The filed of liver transplantation (LT) continues to evolve and is highly effective therapy for many patients with acute and chronic liver failure resulting from a variety of causes. Improvement of perioperative care, surgical technique and immunosuppression in recent years has led to its transformation into a safe and routine procedure with steadily improving results. The aim of this paper is to present the initial experience of the transplant team at Military Medical Academy - Sofia, Bulgaria. For the period of April 2007 - August 2014 the team performed 38 liver transplants in 37 patients (one retransplantation). Patients were followed up prospectively and retrospectively. In 36 (95%) patients a graft from a cadaveric donor was used and in two cases--a right liver grafts from live donor. The mean MELD score of the transplanted patients was 17 (9-40). The preferred surgical technique was "piggyback" with preservation of inferior vena cava in 33 (86%) of the cases and classical technique in 3 (8%) patients. The overall complication rate was 48%. Early mortality rate was 13% (5 patients). The overall 1- and 5-year survival is 81% and 77% respectivelly. The setting of a new LT program is a complex process which requires the effort and effective colaboration of a wide range of speciacialists (hepatologists, surgeons, anesthesiologists, psychologists, therapists, coordinators, etc.) and institutions. The good results are function of a proper selection of the donors and the recipients. Living donation is an alternative in the shortage of cadaveric donors.

  20. Modified robotic-assisted thyroidectomy: an initial experience with the retroauricular approach.

    PubMed

    Kandil, Emad; Saeed, Ahmad; Mohamed, Salah E; Alsaleh, Nuha; Aslam, Rizwan; Moulthrop, Thomas

    2015-03-01

    New approaches for robotic-assisted thyroidectomy, including the retroauricular approach, were recently described. We have modified the established surgical approach for retroauricular robotic thyroidectomy. Herein, we report our initial experience to identify challenges and limitations of this new surgical approach. Prospective case series. This study was performed under institutional review board approval for patients who underwent retroauricular robotic hemithyroidectomy at an academic North American institution. The retroauricular approach was modified by using the space between the two heads of the sternocleidomastoid muscle as our working space. Additionally, selected patients underwent concomitant neck lift surgery with robotic thyroid surgery. Clinical characteristics, total operative time, blood loss, surgical outcomes, and length of hospital stay were evaluated. Twelve female patients were included in this study. Mean age was 45 ± 4.43 years, and mean body mass index was 28.6 ± 2.15. Mean thyroid nodule size was 1.15 ± 0.26 cm(3). All cases were completed successfully via single retroauricular incision. There was no conversion to an open approach. Four out of 12 patients (33%) underwent additional concomitant neck lift surgery, with a mean total operative time of 156 ± 15.88 minutes. The mean operative time for the remaining eight patients who underwent the robotic approach without additional neck lift surgery was 145.4 ± 10.08 minutes. There were no cases of permanent vocal cord paralysis or permanent hypoparathyroidism. Mean blood loss was 22.4 ± 4.32 mL. Four patients (33%) were discharged home on the same day of surgery, and the remaining eight patients were discharged after an overnight stay. Single-incision retroauricular robotic hemithyroidectomy can be a safe and feasible alternative to other remote access techniques. Neck lift surgery can be performed safely in a select group of patients. However, future studies are

  1. Differences in Healthcare Access, Use, and Experiences Within a Community Sample of Racially Diverse Lesbian, Gay, Bisexual, Transgender, and Questioning Emerging Adults

    PubMed Central

    Bhatia, Ramona; Greene, George J.

    2016-01-01

    Abstract Purpose: Health services research involving lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) individuals has focused on differences in healthcare access, use, and experiences between cisgender, heterosexual adults and LGBTQ adults. Yet these factors may differ within the LGBTQ community and have not been well-studied among emerging adults (18–29 years), a group with unique barriers to healthcare. We sought to characterize healthcare challenges within a sample of LGBTQ emerging adults. Methods: From 2012 to 2013, 206 participants aged 18–27 (86% racial/ethnic minority, 10% transgender) completed questionnaires assessing healthcare access, use, and experiences during a longitudinal study. Descriptive statistics established patterns of healthcare access, use, and experiences, and nonparametric tests examined differences related to sociodemographic variables, HIV status, sexual orientation identity, and gender identity. Results: Overall, 68% of participants reported relatively easy access to care. White and bisexual participants reported higher rates of insurance than racial/ethnic minority (P = 0.01) and gay or lesbian participants (P = 0.005), respectively. Although most participants did not report having negative experiences in healthcare settings related to their LGBTQ identity, transgender participants were more likely to delay care (P < 0.001) and report negative effects of disclosure to their provider (P < 0.001) compared with cisgender participants. Participants who identified as queer or were questioning their sexual orientation identity reported negative healthcare experiences more frequently than LGB-identified participants (P = 0.001). Conclusions: Although LGBTQ emerging adults experienced fewer barriers to care than observed in previous studies on LGBTQ adults, the results suggest that queer, questioning, and transgender individuals may face additional healthcare challenges compared with their LGB and

  2. The effect of tail stretching on the ionospheric accessibility of relativistic electron beam experiments

    NASA Astrophysics Data System (ADS)

    Willard, J.; Johnson, J.; Sanchez, E. R.; Kaganovich, I.; Greklek-McKeon, M.; Powis, T.

    2017-12-01

    New accelerator technologies have made it possible to install a lightweight electron beam accelerator onto small to medium satellites. Electron beams fired along the geomagnetic field would be able to carry energy flux into the ionosphere if they were fired into the loss cone, making these particles observable from the ground. Such an experiment would provide a way to accurately map field lines. One of the important challenges to utilizing this concept is understanding accessibility of these electrons to the ionosphere. While relativistic electron beams are generally more stable than lower energy beams, they are more sensitive to the effects of field-line curvature, which can significantly modify the loss cone [Porazik et al., 2014] making accessibility to the ionosphere sensitive to the launch angle with respect to the magnetic field. We examine the loss cone for 1 MeV electrons in a realistic magnetospheric geometry considering, in particular, the role of field-line stretching. To map the loss cone, we consider conservation of the first adiabatic invariant to second order in ρ/L using the asymptotic series derived by Gardner [Phys Fluids, 1966], which is valid on the midnight meridian. We investigate the loss cones for different magnetic field models controlled by a stretching parameter over the entire midnight meridian. We found that, because tail stretching increases field line curvature near the midplane but decreases curvature elsewhere, accessibility to the ionosphere is increased by tail stretching in regions above and below the midplane, although accessibility of particles passing through the midplane is reduced. This result implies that satellites armed with electron beam accelerators may be able to visibly affect the atmosphere from distances greater than previously anticipated.

  3. Adverse childhood experiences and the association with ever using alcohol and initiating alcohol use during adolescence.

    PubMed

    Dube, Shanta R; Miller, Jacqueline W; Brown, David W; Giles, Wayne H; Felitti, Vincent J; Dong, Maxia; Anda, Robert F

    2006-04-01

    Alcohol is the most common and frequently used drug and has the potential to cause multiple deleterious effects throughout the lifespan. Because early age at initiation of alcohol use increases this potential and programs and laws are in place to attempt to delay the onset of alcohol use, we studied the relationship between multiple adverse childhood experiences (ACEs) and both the likelihood of ever drinking and the age at initiating alcohol use. This was a retrospective cohort study of 8417 adult health maintenance organization (HMO) members in California who completed a survey about ACEs, which included childhood abuse and neglect, growing up with various forms of household dysfunction and alcohol use in adolescence and adulthood. The main outcomes measured were ever drinking and age at initiating alcohol use among ever-drinkers for four age categories: < or = 14 years (early adolescence), 15 to 17 years (mid adolescence), and 18 to 20 years (late adolescence); age > or = 21 years was the referent. The relationship between the total number of adverse childhood experiences (ACE score) and early initiation of alcohol use (< or =14 years) among four birth cohorts dating back to 1900 was also examined. Eighty-nine percent of the cohort reported ever drinking; all individual ACEs except physical neglect increased the risk of ever using alcohol (p < .05). Among ever drinkers, initiating alcohol use by age 14 years was increased two- to threefold by individual ACEs (p < .05). ACEs also accounted for a 20% to 70% increased likelihood of alcohol use initiated during mid adolescence (15-17 years). The total number of ACEs (ACE score) had a very strong graded relationship to initiating alcohol use during early adolescence and a robust but somewhat less strong relationship to initiation during mid adolescence. For each of the four birth cohorts, the ACE score had a strong, graded relationship to initiating alcohol use by age 14 years (p < .05). Adverse childhood experiences

  4. Initial experience with percutaneous selective embolization: A truly minimally invasive treatment of the adolescent varicocele with no risk of hydrocele development.

    PubMed

    Storm, Douglas W; Hogan, Mark J; Jayanthi, Venkata R

    2010-12-01

    Postoperative hydrocele development is a frustrating complication of varicocele surgical repair. To avoid this complication, we began to offer percutaneous embolization as a treatment option. We present our initial experience with this technique. A retrospective review of all patients who underwent percutaneous embolization and sclerotherapy of a varicocele at our institution was performed. There were 27 patients with a mean age of 16 years (range 13-19 years). Indications included pain (48%), varicocele size (30%) and persistent testicular asymmetry (22%). Four patients had experienced failure of a previous surgical repair. Follow-up data were available for 21 patients (mean 9 months). The varicocele resolved in 19 patients (91%) with no evidence of hydrocele formation in any of the boys. There was resolution of pain in all patients for whom this was the indication for the procedure. In the two failures, access to the lower spermatic vein was not possible owing to the number and tortuosity of the vessels. Percutaneous embolization and sclerotherapy represent a truly minimally invasive treatment with low morbidity, minimal pain and rapid recovery. In our early experience, since lymphatic channels are completely avoided, there appears to be no risk of hydrocele formation. Copyright © 2010 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  5. Barriers to accessing termination of pregnancy in a remote and rural setting: a qualitative study.

    PubMed

    Heller, R; Purcell, C; Mackay, L; Caird, L; Cameron, S T

    2016-09-01

    To explore the experiences of women from a remote and rural setting who had a termination of pregnancy (TOP), in relation to any barriers they may have experienced trying to access TOP. Qualitative interview study. Scottish Highlands and Western Isles. Women who had undergone TOP in the Scottish Highlands National Health Service between October 2014 and May 2015. Sixteen semi-structured, audio-recorded telephone interviews were conducted by a researcher with women who had consented to be interviewed at their initial assessment. Six stages of thematic analysis were followed to explore themes in and across participant accounts. Themes derived from interview transcripts. Four themes emerged relating to barriers to access and experience: (1) the impact of travel for TOP, (2) temporal factors unique to this population and how they affected women, (3) the attitude of health professionals, notably general practitioners, as a result of local culture, and (4) stigma surrounding TOP and the expectation that abortion will be traumatising. Women in remote and rural areas experience barriers to accessing TOP. Prompt referrals, more providers of TOP and tackling stigma associated with TOP could make delivery of this service more equitable and improve women's journey through TOP. Women in remote and rural areas of Scotland face multiple barriers to accessing termination of pregnancy. © 2016 Royal College of Obstetricians and Gynaecologists.

  6. Electronic availability of microgravity experiments safety and integration requirements documents

    NASA Technical Reports Server (NTRS)

    Hogan, Jean M.

    1995-01-01

    This follow-on to NASA Contractor Report 195447, Microgravity Experiments Safety and Integration Requirements Document Tree, provides the details for accessing the systems that contain the official, electronic versions of the documents initially researched in NASA Contractor Report 195447. The data in this report serves as a valuable information source for the NASA Lewis Research Center Project Documentation Center (PDC), as well as for all developers of space experiments. The PDC has acquired the hardware, software, ID's, and passwords necessary to access most of these systems and is now able to provide customers with current document information as well as immediate delivery of available documents in either electronic or hard copy format.

  7. Illness identity as an important component of candidacy: Contrasting experiences of help-seeking and access to care in cancer and heart disease.

    PubMed

    Macdonald, Sara; Blane, David; Browne, Susan; Conway, Ellie; Macleod, Una; May, Carl; Mair, Frances

    2016-11-01

    How and when we use health services or healthcare provision has dominated exploration of and debates around healthcare access. Levels of utilisation are assumed as a proxy for access. Yet, focusing on utilisation conceals an important aspect of the access conundrum: the relationships that patients and potential patients have with the healthcare system and the professionals within those systems. Candidacy has been proposed as an antidote to traditional utilisation models. The Candidacy construct offers the ability to include patient-professional aspects alongside utilisation and thus promotes a deeper understanding of access. Originally applied to healthcare access for vulnerable populations, additional socio-demographic factors, including age and ethnicity, have also been shown to influence the Candidacy process. Here we propose a further extension of the Candidacy construct and illustrate the importance of illness identities when accessing healthcare. Drawing on a secondary data analysis of three data sets of qualitative interviews from colorectal cancer and heart failure patients we found that though similar access issues are apparent pre-diagnosis, diagnosis marks a critical juncture in the experience of access. Cancer patients describe a person-centred responsive healthcare system where their patienthood requires only modest assertion. Cancer speaks for itself. In marked contrast heart failure patients, describe struggling within a seemingly impermeable system to understand their illness, its implications and their own legitimacy as patients. Our work highlights the pressing need for healthcare professionals, systems and policies to promote a person centred approach, which is responsive and timely, regardless of illness category. To achieve this, attitudes regarding the importance or priority afforded to different categories of illness need to be tackled as they directly influence ideas of Candidacy and consequently access and experiences of care. Copyright

  8. New Insights into Dialysis Vascular Access: What Is the Optimal Vascular Access Type and Timing of Access Creation in CKD and Dialysis Patients?

    PubMed

    Woo, Karen; Lok, Charmaine E

    2016-08-08

    Optimal vascular access planning begins when the patient is in the predialysis stages of CKD. The choice of optimal vascular access for an individual patient and determining timing of access creation are dependent on a multitude of factors that can vary widely with each patient, including demographics, comorbidities, anatomy, and personal preferences. It is important to consider every patient's ESRD life plan (hence, their overall dialysis access life plan for every vascular access creation or placement). Optimal access type and timing of access creation are also influenced by factors external to the patient, such as surgeon experience and processes of care. In this review, we will discuss the key determinants in optimal access type and timing of access creation for upper extremity arteriovenous fistulas and grafts. Copyright © 2016 by the American Society of Nephrology.

  9. Initial Retrieval Validation from the Joint Airborne IASI Validation Experiment (JAIVEx)

    NASA Technical Reports Server (NTRS)

    Zhou, Daniel K.; Liu, Xu; Smith, WIlliam L.; Larar, Allen M.; Taylor, Jonathan P.; Revercomb, Henry E.; Mango, Stephen A.; Schluessel, Peter; Calbet, Xavier

    2007-01-01

    The Joint Airborne IASI Validation Experiment (JAIVEx) was conducted during April 2007 mainly for validation of the Infrared Atmospheric Sounding Interferometer (IASI) on the MetOp satellite, but also included a strong component focusing on validation of the Atmospheric InfraRed Sounder (AIRS) aboard the AQUA satellite. The cross validation of IASI and AIRS is important for the joint use of their data in the global Numerical Weather Prediction process. Initial inter-comparisons of geophysical products have been conducted from different aspects, such as using different measurements from airborne ultraspectral Fourier transform spectrometers (specifically, the NPOESS Airborne Sounder Testbed Interferometer (NAST-I) and the Scanning-High resolution Interferometer Sounder (S-HIS) aboard the NASA WB-57 aircraft), UK Facility for Airborne Atmospheric Measurements (FAAM) BAe146-301 aircraft insitu instruments, dedicated dropsondes, radiosondes, and ground based Raman Lidar. An overview of the JAIVEx retrieval validation plan and some initial results of this field campaign are presented.

  10. Does basic energy access generate socioeconomic benefits? A field experiment with off-grid solar power in India.

    PubMed

    Aklin, Michaël; Bayer, Patrick; Harish, S P; Urpelainen, Johannes

    2017-05-01

    This article assesses the socioeconomic effects of solar microgrids. The lack of access to electricity is a major obstacle to the socioeconomic development of more than a billion people. Off-grid solar technologies hold potential as an affordable and clean solution to satisfy basic electricity needs. We conducted a randomized field experiment in India to estimate the causal effect of off-grid solar power on electricity access and broader socioeconomic development of 1281 rural households. Within a year, electrification rates in the treatment group increased by 29 to 36 percentage points. Daily hours of access to electricity increased only by 0.99 to 1.42 hours, and the confidence intervals are wide. Kerosene expenditure on the black market decreased by 47 to 49 rupees per month. Despite these strong electrification and expenditure effects, we found no systematic evidence for changes in savings, spending, business creation, time spent working or studying, or other broader indicators of socioeconomic development.

  11. Does basic energy access generate socioeconomic benefits? A field experiment with off-grid solar power in India

    PubMed Central

    Aklin, Michaël; Bayer, Patrick; Harish, S. P.; Urpelainen, Johannes

    2017-01-01

    This article assesses the socioeconomic effects of solar microgrids. The lack of access to electricity is a major obstacle to the socioeconomic development of more than a billion people. Off-grid solar technologies hold potential as an affordable and clean solution to satisfy basic electricity needs. We conducted a randomized field experiment in India to estimate the causal effect of off-grid solar power on electricity access and broader socioeconomic development of 1281 rural households. Within a year, electrification rates in the treatment group increased by 29 to 36 percentage points. Daily hours of access to electricity increased only by 0.99 to 1.42 hours, and the confidence intervals are wide. Kerosene expenditure on the black market decreased by 47 to 49 rupees per month. Despite these strong electrification and expenditure effects, we found no systematic evidence for changes in savings, spending, business creation, time spent working or studying, or other broader indicators of socioeconomic development. PMID:28560328

  12. Faculty experiences with the National Institutes of Health (NIH) public access policy, compliance issues, and copyright practices.

    PubMed

    Charbonneau, Deborah H; McGlone, Jonathan

    2013-01-01

    The research assessed faculty awareness of the National Institutes of Health (NIH) public access policy and faculty experiences with the copyright terms in their author agreements with publishers. During the fall of 2011, 198 faculty members receiving funding from NIH at a large urban academic institution were invited to participate in an anonymous online survey. A total of 94 faculty members responded to the survey, representing a response rate of 47%. Thirty percent of the survey respondents were either unaware of or not familiar with the NIH policy. Further, a significant number of faculty members (97.8%) indicated that they usually signed their copyright forms "as is." The findings show that time, confusing instructions, and unclear journal policies are challenges experienced by NIH-funded faculty in complying with the federal mandate. There is a need to educate faculty with respect to the value of retaining their copyrights and self-archiving their publications to help advance public access and open access scholarship.

  13. Experiences of Trans Women and Two-Spirit Persons Accessing Women-Specific Health and Housing Services in a Downtown Neighborhood of Vancouver, Canada.

    PubMed

    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.

  14. Experiences of Trans Women and Two-Spirit Persons Accessing Women-Specific Health and Housing Services in a Downtown Neighborhood of Vancouver, Canada

    PubMed Central

    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

  15. Geography of primary mental health care through the Better Access initiative in South Australia 2006-2010.

    PubMed

    Carson, Dean; Bidargaddi, Niranjan; Schrader, Geoffrey; Allison, Stephen; Jones, Gabrielle Margaret; Bastiampillai, Tarun; Strobel, Jörg

    2016-06-01

    To examine how the rates of the use of particular face-to-face primary mental health care services changed in the first 4 years (2006-2010) of the Better Access initiative in both urban and rural regions of South Australia. Time-series analysis of the number of psychology session, psychiatry assessment and general practitioner care plan services recorded in Medicare Australia data. South Australia. Pre-existing data set of South Australian residents who accessed Medicare between 2006 and 2010 MAIN OBJECTIVE MEASURE: Number of services per 100 000 population (service rate). Psychology session service rates increased in all regions, but continued to follow a 'location gradient', being higher in areas closer to Adelaide and lower in areas more distant from Adelaide. Psychiatry assessment service rates increased in Adelaide but did not change in other regions. Rates in remote areas were subject to substantial variation over time. General practitioner care plan service rates increased in Adelaide and in the Riverland, but declined in the Murray Mallee region. Overall, service rates increased in Adelaide and nearby regions, but the results for rural and remote regions were mixed. Possible explanations for the geographical variability include population characteristics (such as socio-economic status), methods of service delivery (visiting practitioners, telepsych), the relative proportion of total health services provided by general practitioners versus other practitioners, or real variations in the need for primary mental health services. © 2015 National Rural Health Alliance Inc.

  16. Custom-fit total knee arthroplasty: our initial experience with 30 knees.

    PubMed

    Bonicoli, Enrico; Andreani, Lorenzo; Parchi, Paolo; Piolanti, Nicola; Lisanti, Michele

    2014-10-01

    We report our initial experience of total knee arthroplasty (TKA) using customized cutting block technology in 30 TKAs from December 2010 to September 2012. Customized blocks were generated for each of the knees using preoperative magnetic resonance imaging of knee and long-leg weight-bearing radiographs. At 30 days, long-leg radiographs were obtained to evaluate the coronal alignment. Twenty-six of the 30 knees had a mechanical axis restored to within 3° of neutral. We conclude that this technology can be safely used in most of the cases of osteoarthritis.

  17. The Year-Two Decline: Exploring the Incremental Experiences of a 1:1 Technology Initiative

    ERIC Educational Resources Information Center

    Swallow, Meredith

    2015-01-01

    Reports on one-to-one (1:1) technology initiatives emphasize overall favorable results; however, comprehensive multiyear studies looked at understate the progressive experiences of teachers and students. A small body of research suggested the second year of 1:1 technology programs manifested difficulties and struggles which significantly…

  18. A Conditions Data Management System for HEP Experiments

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Laycock, P. J.; Dykstra, D.; Formica, A.

    Conditions data infrastructure for both ATLAS and CMS have to deal with the management of several Terabytes of data. Distributed computing access to this data requires particular care and attention to manage request-rates of up to several tens of kHz. Thanks to the large overlap in use cases and requirements, ATLAS and CMS have worked towards a common solution for conditions data management with the aim of using this design for data-taking in Run 3. In the meantime other experiments, including NA62, have expressed an interest in this cross- experiment initiative. For experiments with a smaller payload volume and complexity,more » there is particular interest in simplifying the payload storage. The conditions data management model is implemented in a small set of relational database tables. A prototype access toolkit consisting of an intermediate web server has been implemented, using standard technologies available in the Java community. Access is provided through a set of REST services for which the API has been described in a generic way using standard Open API specications, implemented in Swagger. Such a solution allows the automatic generation of client code and server stubs and further allows changes in the backend technology transparently. An important advantage of using a REST API for conditions access is the possibility of caching identical URLs, addressing one of the biggest challenges that large distributed computing solutions impose on conditions data access, avoiding direct DB access by means of standard web proxy solutions.« less

  19. The Access Vermont Initiative: An Investigation of Team Development in Two Vermont Catchment Areas Providing Services to Children with Severe Emotional Disturbances and Their Families.

    ERIC Educational Resources Information Center

    Fox, Barbara J.; Wright, Leanne M.

    This study was designed to document the processes and dynamics of two multidisciplinary teams under the Access Vermont program, which provides services for children and youth with serious emotional disabilities and their families. In both cases, local interagency teams in the largely rural catchment areas developed plans for an initiative focused…

  20. Improving outpatient access and patient experiences in academic ambulatory care.

    PubMed

    O'Neill, Sarah; Calderon, Sherry; Casella, Joanne; Wood, Elizabeth; Carvelli-Sheehan, Jayne; Zeidel, Mark L

    2012-02-01

    Effective scheduling of and ready access to doctor appointments affect ambulatory patient care quality, but these are often sacrificed by patients seeking care from physicians at academic medical centers. At one center, Beth Israel Deaconess Medical Center, the authors developed interventions to improve the scheduling of appointments and to reduce the access time between telephone call and first offered appointment. Improvements to scheduling included no redirection to voicemail, prompt telephone pickup, courteous service, complete registration, and effective scheduling. Reduced access time meant being offered an appointment with a physician in the appropriate specialty within three working days of the telephone call. Scheduling and access were assessed using monthly "mystery shopper" calls. Mystery shoppers collected data using standardized forms, rated the quality of service, and transcribed their interactions with schedulers. Monthly results were tabulated and discussed with clinical leaders; leaders and frontline staff then developed solutions to detected problems. Eighteen months after the beginning of the intervention (in June 2007), which is ongoing, schedulers had gone from using 60% of their registration skills to over 90%, customer service scores had risen from 2.6 to 4.9 (on a 5-point scale), and average access time had fallen from 12 days to 6 days. The program costs $50,000 per year and has been associated with a 35% increase in ambulatory volume across three years. The authors conclude that academic medical centers can markedly improve the scheduling process and access to care and that these improvements may result in increased ambulatory care volume.

  1. To Explore the Experiences of Women on Reasons in Initiating and Maintaining Breastfeeding in Urban Area of Karachi, Pakistan: An Exploratory Study

    PubMed Central

    Shaheen Premani, Zahra; Kurji, Zohra; Mithani, Yasmin

    2011-01-01

    This is an exploratory study that explores the experiences of lactating women in initiating, continuing, or discontinuing breastfeeding in an urban area of Karachi, Pakistan. Objectives. To explore the experiences of lactating women and to understand their support and hindering mechanisms in initiating and maintaining breastfeeding. Methods. This is an exploratory design assisting in exploring the participant's experiences of initiating and maintaining breastfeeding to better understand their world. Purposive sampling was used, and data was analyzed through manual thematic analysis. Results. The data revealed that mother's knowledge, sociocultural environment, breastfeeding decision, and self- and professional support acted as driving forces for the participants. However, sociocultural environment, physiological changes, time management, and being a housewife to breastfeed their children were all challenges and barriers that the participants thought hindered their breastfeeding initiation and maintenance. Conclusion. Breastfeeding is a natural but taxing phenomenon, and breastfeeding mothers experience supporting and hindering factors in initiating and maintaining breastfeeding. PMID:22389780

  2. Ballistic representation for kinematic access

    NASA Astrophysics Data System (ADS)

    Alfano, Salvatore

    2011-01-01

    This work uses simple two-body orbital dynamics to initially determine the kinematic access for a ballistic vehicle. Primarily this analysis was developed to assess when a rocket body might conjunct with an orbiting satellite platform. A family of access opportunities can be represented as a volume for a specific rocket relative to its launch platform. Alternately, the opportunities can be represented as a geographical footprint relative to aircraft or satellite position that encompasses all possible launcher locations for a specific rocket. A thrusting rocket is treated as a ballistic vehicle that receives all its energy at launch and follows a coasting trajectory. To do so, the rocket's burnout energy is used to find its equivalent initial velocity for a given launcher's altitude. Three kinematic access solutions are then found that account for spherical Earth rotation. One solution finds the maximum range for an ascent-only trajectory while another solution accommodates a descending trajectory. In addition, the ascent engagement for the descending trajectory is used to depict a rapid access scenario. These preliminary solutions are formulated to address ground-, sea-, or air-launched vehicles.

  3. Pathways to multidrug-resistant tuberculosis diagnosis and treatment initiation: a qualitative comparison of patients' experiences in the era of rapid molecular diagnostic tests.

    PubMed

    Naidoo, Pren; van Niekerk, Margaret; du Toit, Elizabeth; Beyers, Nulda; Leon, Natalie

    2015-10-28

    Although new molecular diagnostic tests such as GenoType MTBDRplus and Xpert® MTB/RIF have reduced multidrug-resistant tuberculosis (MDR-TB) treatment initiation times, patients' experiences of diagnosis and treatment initiation are not known. This study aimed to explore and compare MDR-TB patients' experiences of their diagnostic and treatment initiation pathway in GenoType MTBDRplus and Xpert® MTB/RIF-based diagnostic algorithms. The study was undertaken in Cape Town, South Africa where primary health-care services provided free TB diagnosis and treatment. A smear, culture and GenoType MTBDRplus diagnostic algorithm was used in 2010, with Xpert® MTB/RIF phased in from 2011-2013. Participants diagnosed in each algorithm at four facilities were purposively sampled, stratifying by age, gender and MDR-TB risk profiles. We conducted in-depth qualitative interviews using a semi-structured interview guide. Through constant comparative analysis we induced common and divergent themes related to symptom recognition, health-care access, testing for MDR-TB and treatment initiation within and between groups. Data were triangulated with clinical information and health visit data from a structured questionnaire. We identified both enablers and barriers to early MDR-TB diagnosis and treatment. Half the patients had previously been treated for TB; most recognised recurring symptoms and reported early health-seeking. Those who attributed symptoms to other causes delayed health-seeking. Perceptions of poor public sector services were prevalent and may have contributed both to deferred health-seeking and to patient's use of the private sector, contributing to delays. However, once on treatment, most patients expressed satisfaction with public sector care. Two patients in the Xpert® MTB/RIF-based algorithm exemplified its potential to reduce delays, commencing MDR-TB treatment within a week of their first health contact. However, most patients in both algorithms experienced

  4. Access to electronic health knowledge in five countries in Africa: a descriptive study.

    PubMed

    Smith, Helen; Bukirwa, Hasifa; Mukasa, Oscar; Snell, Paul; Adeh-Nsoh, Sylvester; Mbuyita, Selemani; Honorati, Masanja; Orji, Bright; Garner, Paul

    2007-05-17

    Access to medical literature in developing countries is helped by open access publishing and initiatives to allow free access to subscription only journals. The effectiveness of these initiatives in Africa has not been assessed. This study describes awareness, reported use and factors influencing use of on-line medical literature via free access initiatives. Descriptive study in four teaching hospitals in Cameroon, Nigeria, Tanzania and Uganda plus one externally funded research institution in The Gambia. Survey with postgraduate doctors and research scientists to determine Internet access patterns, reported awareness of on-line medical information and free access initiatives; semi structured interviews with a sub-sample of survey participants to explore factors influencing use. In the four African teaching hospitals, 70% of the 305 postgraduate doctors reported textbooks as their main source of information; 66% had used the Internet for health information in the last week. In two hospitals, Internet cafés were the main Internet access point. For researchers at the externally-funded research institution, electronic resources were their main source, and almost all had used the Internet in the last week. Across all 333 respondents, 90% had heard of PubMed, 78% of BMJ on line, 49% the Cochrane Library, 47% HINARI, and 19% BioMedCentral. HINARI use correlates with accessing the Internet on computers located in institutions. Qualitative data suggested there are difficulties logging into HINARI and that sometimes it is librarians that limit access to passwords. Text books remain an important resource for postgraduate doctors in training. Internet use is common, but awareness of free-access initiatives is limited. HINARI and other initiatives could be more effective with strong institutional endorsement and management to promote and ensure access.

  5. Beyond Higher Education. A Survey and Analysis of the Experience of Access Students Proceeding through the Polytechnic of North London and into Employment.

    ERIC Educational Resources Information Center

    Rosen, Verna

    Access to Learning for Adults (ALFA) links education providers and organizations in collaborative work to extend and improve access to education opportunities for adults underrepresented in the system. A survey followed the progress, performance, and experiences of 86 former ALFA students, aged 25 to 49, in London, England, in their seeking of…

  6. Initial development of a patient-reported outcome measure of experience with cognitive impairment associated with schizophrenia.

    PubMed

    Welch, Lisa C; Trudeau, Jeremiah J; Silverstein, Steven M; Sand, Michael; Henderson, David C; Rosen, Raymond C

    2017-01-01

    Cognitive impairment is a serious, often distressing aspect of schizophrenia that affects patients' day-to-day lives. Although several interview-based instruments exist to assess cognitive functioning, a reliable measure developed based on the experiences of patients facing cognitive difficulties is needed to complement the objective performance-based assessments. The present article describes the initial development of a patient-reported outcome (PRO) measure to assess the subjective experience of cognitive impairment among patients with schizophrenia, the Patient-Reported Experience of Cognitive Impairment in Schizophrenia (PRECIS). The phases of development included the construction of a conceptual model based on the existing knowledge and two sets of qualitative interviews with patients: 1) concept elicitation interviews to ensure face and content validity from the perspective of people with schizophrenia and 2) cognitive debriefing of the initial item pool. Input from experts was elicited throughout the process. The initial conceptual model included seven domains. The results from concept elicitation interviews (n=80) supported these domains but yielded substantive changes to concepts within domains and to terminology. Based on these results, an initial pool of 53 items was developed to reflect the most common descriptions and languages used by the study participants. Cognitive debriefing interviews (n=22) resulted in the removal of 18 items and modification of 22 other items. The remaining 35 items represented 23 concepts within six domains plus two items assessing bother. The draft PRO measure is currently undergoing psychometric testing as a precursor to broad-based clinical and research use.

  7. GRACES, the Gemini remote access CFHT ESPaDOnS spectrograph: initial design and testing

    NASA Astrophysics Data System (ADS)

    Tollestrup, Eric V.; Pazder, John; Barrick, Gregory; Martioli, Eder; Schiavon, Ricardo; Anthony, André; Halman, Mark; Veillet, Christian

    2012-09-01

    The Gemini Remote Access CFHT ESPaDOnS Spectrograph (GRACES) is an innovative instrumentation experiment that will demonstrate if ESPaDOnS, a bench-mounted high-resolution optical spectrograph at CFHT, can be fed by a 270-m long fiber from the Gemini-North telescope with low enough losses to remain competitive with conventional spectrographs on other 8 to 10-m telescopes. Detailed simulations have shown that GRACES should be more sensitive than the HIRES spectrograph at Keck Observatory at wavelengths longer than about 600-700 nm. This result is possible by using FPB-type of optical fibers made by Polymicro Technologies and by keeping the critical focal ratio degradation (FRD) losses to less than 10%. Laboratory tests on these FPB optical fibers are underway and show that for 36-m lengths that the FRD losses are as low as 0.8% with a repeatability of 1%. Tests are currently underway on 280-m lengths.

  8. Experiences of Racism and Breastfeeding Initiation and Duration Among First-Time Mothers of the Black Women's Health Study.

    PubMed

    Griswold, Michele K; Crawford, Sybil L; Perry, Donna J; Person, Sharina D; Rosenberg, Lynn; Cozier, Yvette C; Palmer, Julie R

    2018-02-12

    Breastfeeding rates are lower for black women in the USA compared with other groups. Breastfeeding and lactation are sensitive time points in the life course, centering breastfeeding as a health equity issue. In the USA, experiences of racism have been linked to poor health outcomes but racism relative to breastfeeding has not been extensively investigated. This study aims to investigate the association between experiences of racism, neighborhood segregation, and nativity with breastfeeding initiation and duration. This is a prospective secondary analysis of the Black Women's Health Study, based on data collected from 1995 through 2005. Daily and institutional (job, housing, police) racism, nativity, and neighborhood segregation in relation to breastfeeding were examined. Odds ratios and 95% confidence intervals were calculated using binomial logistic regression for the initiation outcomes (N = 2705) and multinomial logistic regression for the duration outcomes (N = 2172). Racism in the job setting was associated with lower odds of breastfeeding duration at 3-5 months. Racism with the police was associated with higher odds of breastfeeding initiation and duration at 3-5 and 6 months. Being born in the USA or having a parent born in the USA predicted lower odds of breastfeeding initiation and duration. Living in a segregated neighborhood (primarily black residents) as a child was associated with decreased breastfeeding initiation and duration relative to growing up in a predominantly white neighborhood. Experiences of institutionalized racism influenced breastfeeding initiation and duration. Structural-level interventions are critical to close the gap of racial inequity in breastfeeding rates in the USA.

  9. Large-Scale 1:1 Computing Initiatives: An Open Access Database

    ERIC Educational Resources Information Center

    Richardson, Jayson W.; McLeod, Scott; Flora, Kevin; Sauers, Nick J.; Kannan, Sathiamoorthy; Sincar, Mehmet

    2013-01-01

    This article details the spread and scope of large-scale 1:1 computing initiatives around the world. What follows is a review of the existing literature around 1:1 programs followed by a description of the large-scale 1:1 database. Main findings include: 1) the XO and the Classmate PC dominate large-scale 1:1 initiatives; 2) if professional…

  10. Initial experience with a nuclear medicine viewing workstation

    NASA Astrophysics Data System (ADS)

    Witt, Robert M.; Burt, Robert W.

    1992-07-01

    Graphical User Interfaced (GUI) workstations are now available from commercial vendors. We recently installed a GUI workstation in our nuclear medicine reading room for exclusive use of staff and resident physicians. The system is built upon a Macintosh platform and has been available as a DELTAmanager from MedImage and more recently as an ICON V from Siemens Medical Systems. The workstation provides only display functions and connects to our existing nuclear medicine imaging system via ethernet. The system has some processing capabilities to create oblique, sagittal and coronal views from transverse tomographic views. Hard copy output is via a screen save device and a thermal color printer. The DELTAmanager replaced a MicroDELTA workstation which had both process and view functions. The mouse activated GUI has made remarkable changes to physicians'' use of the nuclear medicine viewing system. Training time to view and review studies has been reduced from hours to about 30-minutes. Generation of oblique views and display of brain and heart tomographic studies has been reduced from about 30-minutes of technician''s time to about 5-minutes of physician''s time. Overall operator functionality has been increased so that resident physicians with little prior computer experience can access all images on the image server and display pertinent patient images when consulting with other staff.

  11. Interactive Plasma Physics Education Using Data from Fusion Experiments

    NASA Astrophysics Data System (ADS)

    Calderon, Brisa; Davis, Bill; Zwicker, Andrew

    2010-11-01

    The Internet Plasma Physics Education Experience (IPPEX) website was created in 1996 to give users access to data from plasma and fusion experiments. Interactive material on electricity, magnetism, matter, and energy was presented to generate interest and prepare users to understand data from a fusion experiment. Initially, users were allowed to analyze real-time and archival data from the Tokamak Fusion Test Reactor (TFTR) experiment. IPPEX won numerous awards for its novel approach of allowing users to participate in ongoing research. However, the latest revisions of IPPEX were in 2001 and the interactive material is no longer functional on modern browsers. Also, access to real-time data was lost when TFTR was shut down. The interactive material on IPPEX is being rewritten in ActionScript3.0, and real-time and archival data from the National Spherical Tokamak Experiment (NSTX) will be made available to users. New tools like EFIT animations, fast cameras, and plots of important plasma parameters will be included along with an existing Java-based ``virtual tokamak.'' Screenshots from the upgraded website and future directions will be presented.

  12. Routine transradial access for conventional cerebral angiography: a single operator's experience of its feasibility and safety.

    PubMed

    Lee, D H; Ahn, J H; Jeong, S S; Eo, K S; Park, M S

    2004-10-01

    The purpose of this study is to describe a single operator's experience with the feasibility and safety of transradial access in conventional cerebral angiography. 153 patients were enrolled consecutively. Among them, 20 patients were not suitable for transradial access. A Simmons catheter was used. Haemostasis was achieved using a compressive dressing of the wrist. We analysed the success rates of the arterial puncture and the successful catheterization rate for each supra-aortic vessel as well as all complications. The arterial access was successful in 96.3%. The supra-aortic vessels were catheterized with success rates of 99.2% (127/128) for the left subclavian artery and 100% for the other arteries. The mean procedure time was 19.3 min (range 10-55 min). Haemostasis was successfully achieved in every case. The most frequent complication was arm pain which occurred in 37 patients (28.9%). In conclusion, transradial selective cerebral angiography with a reversed-angle catheter is technically feasible and safe. It might be helpful in imaging follow-up of patients with arterial stenting or coil embolisation of the cerebral aneurysms. Modification of the catheter design is required to improve the selectivity of the supra-aortic branches.

  13. OER, Resources for Learning--Experiences from an OER Project in Sweden

    ERIC Educational Resources Information Center

    Ossiannilsson, Ebba S. I.; Creelman, Alastair M.

    2012-01-01

    This article aims to share experience from a Swedish project on the introduction and implementation of Open Educational Resources (OER) in higher education with both national and international perspectives. The project, "OER--resources for learning", was part of the National Library of Sweden Open Access initiative and aimed at exploring, raising…

  14. Virtual Patterson Experiment - A Way to Access the Rheology of Aggregates and Melanges

    NASA Astrophysics Data System (ADS)

    Delannoy, Thomas; Burov, Evgueni; Wolf, Sylvie

    2014-05-01

    Understanding the mechanisms of lithospheric deformation requires bridging the gap between human-scale laboratory experiments and the huge geological objects they represent. Those experiments are limited in spatial and time scale as well as in choice of materials (e.g., mono-phase minerals, exaggerated temperatures and strain rates), which means that the resulting constitutive laws may not fully represent real rocks at geological spatial and temporal scales. We use the thermo-mechanical numerical modelling approach as a tool to link both experiments and nature and hence better understand the rheology of the lithosphere, by enabling us to study the behavior of polymineralic aggregates and their impact on the localization of the deformation. We have adapted the large strain visco-elasto-plastic Flamar code to allow it to operate at all spatial and temporal scales, from sub-grain to geodynamic scale, and from seismic time scales to millions of years. Our first goal was to reproduce real rock mechanics experiments on deformation of mono and polymineralic aggregates in Patterson's load machine in order to deepen our understanding of the rheology of polymineralic rocks. In particular, we studied in detail the deformation of a 15x15 mm mica-quartz sample at 750 °C and 300 MPa. This mixture includes a molten phase and a solid phase in which shear bands develop as a result of interactions between ductile and brittle deformation and stress concentration at the boundaries between weak and strong phases. We used digitized x-ray scans of real samples as initial configuration for the numerical models so the model-predicted deformation and stress-strain behavior can match those observed in the laboratory experiment. Analyzing the numerical experiments providing the best match with the press experiments and making other complementary models by changing different parameters in the initial state (strength contrast between the phases, proportions, microstructure, etc.) provides a

  15. Accessing Sexual and Reproductive Health Information and Services: A Mixed Methods Study of Young Women's Needs and Experiences in Soweto, South Africa.

    PubMed

    Lince-Deroche, Naomi; Hargey, Adila; Holt, Kelsey; Shochet, Tara

    2015-03-01

    Young women and girls in South Africa are at high risk of unintended pregnancy and HIV. Previous studies have reported barriers to contraceptive and other sexual and reproductive health (SRH) services among young women in this context. We aimed to assess young women's SRH knowledge and experiences and to determine how they get SRH information and services in Soweto, South Africa using quantitative and qualitative methods. Young women, aged 18-24, recruited from primary health clinics and a shopping mall, reported that they have access to SRH information and know where to obtain services. However there are challenges to accessing and utilizing information and services including providers' unsupportive attitudes, uneven power dynamics in relationships and communication issues with parents and community members. There is a need to assist young women in understanding the significance of SRH information. They need access to age-appropriate, youth-friendly services in order to have healthy sexual experiences.

  16. Accessible Fixed Route Bus Service Experience

    DOT National Transportation Integrated Search

    1981-05-01

    The research report discusses the operator and user experience with lifting devices on regular bus transit services that facilitate the entry and exit of wheelchair users and semi-ambulatory passengers. The study draws data mainly from experiences at...

  17. Model and experiences of initiating collaboration with traditional healers in validation of ethnomedicines for HIV/AIDS in Namibia

    PubMed Central

    Chinsembu, Kazhila C

    2009-01-01

    Many people with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) in Namibia have access to antiretroviral drugs but some still use traditional medicines to treat opportunistic infections and offset side-effects from antiretroviral medication. Namibia has a rich biodiversity of indigenous plants that could contain novel anti-HIV agents. However, such medicinal plants have not been identified and properly documented. Various ethnomedicines used to treat HIV/AIDS opportunistic infections have not been scientifically validated for safety and efficacy. These limitations are mostly attributable to the lack of collaboration between biomedical scientists and traditional healers. This paper presents a five-step contextual model for initiating collaboration with Namibian traditional healers in order that candidate plants that may contain novel anti-HIV agents are identified, and traditional medicines used to treat HIV/AIDS opportunistic infections are subjected to scientific validation. The model includes key structures and processes used to initiate collaboration with traditional healers in Namibia; namely, the National Biosciences Forum, a steering committee with the University of Namibia (UNAM) as the focal point, a study tour to Zambia and South Africa where other collaborative frameworks were examined, commemorations of the African Traditional Medicine Day (ATMD), and consultations with stakeholders in north-eastern Namibia. Experiences from these structures and processes are discussed. All traditional healers in north-eastern Namibia were willing to collaborate with UNAM in order that their traditional medicines could be subjected to scientific validation. The current study provides a framework for future collaboration with traditional healers and the selection of candidate anti-HIV medicinal plants and ethnomedicines for scientific testing in Namibia. PMID:19852791

  18. Initial utility experience with cluster of three Mod-2 wind turbine systems

    NASA Technical Reports Server (NTRS)

    Seely, D. B.; Warchol, E. J.; Butler, N. G.; Ciranny, S.

    1982-01-01

    This paper describes the initial utility experiences of operating three MOD-2s during the Engineering Acceptance Testing. Electrical quantities of bus voltage, phase currents and power are initially being recorded to evaluate impacts to customers on the 69-kV subtransmission line during synchronization and operation of one or more WTSs. To date, effects on the system have been essentially undetectable. Measurements of television signal strengths were taken at an existing television remote pickup and relay station at the WTS site. Potential TV signal interference problems from the WTSs have been avoided by replacing the remote pickups with microwave repeater links for the four TV channels received from Portland, Oregon. Preliminary measurements of audible and sub-audible noise levels indicate that the upwind rotor, tubular tower design of the MOD-2 does not have the pulsing high intensity infrasound problems experienced by the MOD-1 machine at Boone, North Carolina.

  19. Access America for Students. Strategic Plan.

    ERIC Educational Resources Information Center

    National Partnership for Reinventing Government, Washington, DC.

    This report provides an overview of a federal initiative, entitled Access America for Students, which is designed to re-engineer the way training and educational services are delivered to students. Part of the National Partnership for Reinventing Government, the initiative's major objectives are to implement privacy and security processes for…

  20. Initial Results of HamSCI Ham Radio 21 August 2017 Eclipse Ionospheric Experiments

    NASA Astrophysics Data System (ADS)

    Frissell, N. A.; Gerrard, A. J.; Vega, J. S.; Katz, J. D.; West, M. L.; Gunning, S. W.; Moses, M. L.; Miller, E. S.; Erickson, P. J.; Huba, J.; Silver, H. W.; Ceglia, F.; Smith, P.; Williams, R.; Shovkoplyas, A.; Earle, G. D.; Gerzoff, R.; Gladstone, P.; Reyer, S. E.; Ackermann, J. R.; Bern, D.; Rose, S. W.

    2017-12-01

    On 21 August 2017, a total solar eclipse will cause the shadow of the moon to traverse the United States from Oregon to South Carolina in just over 90 minutes. The sudden absence of sunlight due to the eclipse, especially solar UV and x-rays, provides an impulse function to the upper atmosphere that modifies the neutral dynamics, plasma concentrations, and related properties. Despite more than 60 years of research, questions remain regarding eclipse-induced ionospheric impacts. Ham radio operators' advanced technical skills and inherent interest in ionospheric science make the amateur radio community ideal for contributing to and and participating in large-scale ionospheric sounding experiments. We present initial results from three amateur radio experiments designed to study the 2017 total solar eclipse: the Solar Eclipse QSO Party (SEQP), the HF Wideband Recording Experiment, and the Eclipse Frequency Measurement Test (FMT). These experiments are coordinated by HamSCI, the Ham Radio Science Citizen Investigation, a citizen science organization that connects the amateur radio community to the professional space science research community for mutual benefit.

  1. The 'SAFARI' Technique Using Retrograde Access Via Peroneal Artery Access

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zhuang, Kun Da, E-mail: zkunda@gmail.com; Tan, Seck Guan; Tay, Kiang Hiong

    2012-08-15

    The 'SAFARI' technique or subintimal arterial flossing with antegrade-retrograde intervention is a method for recanalisation of chronic total occlusions (CTOs) when subintimal angioplasty fails. Retrograde access is usually obtained via the popliteal, distal anterior tibial artery (ATA)/dorsalis pedis (DP), or distal posterior tibial artery (PTA). Distal access via the peroneal artery has not been described and has a risk of continued bleeding, leading to compartment syndrome due to its deep location. We describe our experience in two patients with retrograde access via the peroneal artery and the use of balloon-assisted hemostasis for these retrograde punctures. This approach may potentially givemore » more options for endovascular interventions in lower limb CTOs.« less

  2. Do Diabetic Patients Living in Racially Segregated Neighborhoods Experience Different Access and Quality of Care?

    PubMed Central

    Chan, Kitty S.; Gaskin, Darrell J.; Dinwiddie, Gniesha Y.; McCleary, Rachael

    2012-01-01

    Background Place of residence, particularly residential segregation, has been implicated in health and health care disparities. However, prior studies have not focused on care for diabetes, a prevalent condition for minority populations. Objective To examine the association of residential segregation with a range of access and quality of care outcomes among Black and Hispanic diabetics using a nationally representative U.S. sample. Research Design Cross-sectional study using data for 1598 adult diabetics from the 2006 Medical Expenditure Panel Survey (MEPS) linked to residential segregation information for Blacks and Hispanics based on the 2000 census. Relationships of five dimensions of residential segregation (dissimilarity, isolation, clustering, concentration and centralization) with access and quality of care outcomes were examined using linear, logistic and multinomial logistic regression models, controlling for respondent characteristics and community utilization and hospital capacity. Results Black and Hispanic diabetics had comparable or better access to providers, but received fewer recommended services. Living in a segregated community was associated with more recommended services received, but also problems with seeing a specialist. The relationship of residential segregation to diabetes care varied depending on type of segregation and race/ethnic group assessed. Conclusions Residential segregation influences the care experience of diabetics in the U.S. Our study highlights the importance of investigating how different types of segregation may affect diabetes care received by patients from different race and ethnic groups. PMID:22525608

  3. The ARL Scholars Portal Initiative.

    ERIC Educational Resources Information Center

    Jackson, Mary E.

    2002-01-01

    Describes an initiative of the Association of Research Libraries (ARL), the Scholars Portal Initiative, a three-year collaborative effort which seeks to provide tools for an academic community to have a single point of access on the Web to find high-quality information resources and to deliver the information and related services directly to the…

  4. Multinational Experiment 7: Protecting Access to Space

    DTIC Science & Technology

    2013-07-08

    access to space cost to the design, engineering , production and operation of the spacecraft. They also have an impact on spacecraft mass, thermal...station and provide engineering support to receive data in the agreed format. Step 5 – Implementing interoperability. Once a framework has been...procedures or using alternative means (for example, high-altitude airships ). A7. The results support the view that better mitigation approaches need to

  5. Vascular access for home haemodialysis.

    PubMed

    Al Shakarchi, Julien; Day, C; Inston, N

    2018-03-01

    Home haemodialysis has been advocated due to improved quality of life. However, there are very little data on the optimum vascular access for it. A retrospective cohort study was carried on all patients who initiated home haemodialysis between 2011 and 2016 at a large university hospital. Access-related hospital admissions and interventions were used as primary outcome measures. Our cohort consisted of 74 patients. On initiation of home haemodialysis, 62 individuals were using an arteriovenous fistula as vascular access, while the remaining were on a tunnelled dialysis catheter. Of the 12 patients who started on a tunnelled dialysis catheter, 5 were subsequently converted to either an arteriovenous fistula ( n = 4) or an arteriovenous graft ( n = 1). During the period of home haemodialysis use, four arteriovenous fistula failed or thrombosed with patients continuing on home haemodialysis using an arteriovenous graft ( n = 3) or a tunnelled dialysis catheter ( n = 1). To maintain uninterrupted home haemodialysis, interventional rates were 0.32 per arteriovenous fistula/arteriovenous graft access-year and 0.4 per tunnelled dialysis catheter access-year. Hospital admission rates for patients on home haemodialysis were 0.33 per patient-year. Our study has shown that home haemodialysis can be safely and independently performed at home within a closely managed home haemodialysis programme. The authors also advocate the use of arteriovenous fistulas for this cohort of patients due to both low complication and intervention rates.

  6. The Impact of a History of Adverse Childhood Experiences on Breastfeeding Initiation and Exclusivity: Findings from a National Population Health Survey.

    PubMed

    Ukah, Ugochinyere Vivian; Adu, Prince A; De Silva, Dane A; von Dadelszen, Peter

    2016-12-01

    Exclusive breastfeeding is strongly recommended by the World Health Organization. Given the low rate of exclusive breastfeeding in Canada and the increasing reports of a history of adverse childhood experiences, this study sought to investigate the association between a history of adverse childhood experiences and breastfeeding initiation and breastfeeding. Data used for this study were based on the 2011-2012 Canadian Community Health Survey, collected using a cross-sectional survey. The outcome measures were breastfeeding initiation and exclusive breastfeeding for 6 months or more. History of adverse childhood experiences was the main explanatory variable. Multivariable logistic regression models were developed to investigate the effect on breastfeeding initiation and on exclusive breastfeeding in women who gave birth within 5 years before when the surveys were conducted. The study sample included 697 and 633 women for analyses on breastfeeding initiation and breastfeeding, respectively. The proportion of women with breastfeeding initiation and exclusive breastfeeding for up to 6 months in this study were 96.8% and 42.8%, respectively. After controlling for age and highest level of education, having a history of adverse childhood experiences was not significantly associated with breastfeeding initiation (odds ratio [OR] 0.46, 95% confidence interval [CI] 0.10-1.87), but mothers with such history were less likely to exclusively breastfeed for up to 6 months compared with those without (OR 0.53, 95% CI 0.31-0.90). These findings suggest the need for more breastfeeding monitoring programs beyond the hospital environment to provide more support to Canadian mothers, especially those who have experienced adverse childhood experiences or trauma in the past.

  7. Minimal access treatment of pectus carinatum: a preliminary report.

    PubMed

    Hock, András

    2009-04-01

    Unlike the minimal access repair of pectus excavatum (PE), a minimal access repair of pectus carinatum (PC) has not been established. This initial experience reports the correction of PC using a minimal access technique in five patients. The procedure was performed by insertion of a pectus bar through either bilateral or only left midaxillary incision. The pectus bar was placed so that the elevated sternum could be depressed. Thoracoscopy was not employed during the procedures and no stabiliser plates were used. On completion of the procedure, a chest tube was inserted into the thoracic cavity to evacuate the air from the thoracic cavity followed by wound closure. The operation time ranged from 75 to 110 min. The chest tube was removed on the second postoperative day and the patients were discharged between the fifth and seventh postoperative day. There was one dislocation in which the bar was finally removed, and in three patients a prolapse of the end of the strut through intercostal space necessitated refixation using wires. Despite a small series, this method offers a minimal access repair of PC, which is comparable to the technique used for PE. The invasiveness of our method is obviously far less, than of those different open surgical techniques performed worldwide presently. Our postoperative results warrant the application of this technique in patients with PC.

  8. Initial clinical experience with a sac-anchoring endoprosthesis for aortic aneurysm repair.

    PubMed

    Donayre, Carlos E; Zarins, Christopher K; Krievins, Dainis K; Holden, Andrew; Hill, Andrew; Calderas, Carlos; Velez, Jaime; White, Rodney A

    2011-03-01

    All current aortic endografts depend on proximal and distal fixation to prevent migration. However, migration and rupture can occur, particularly in patients with aortic necks that are short or angulated, or both. We present our initial clinical experience with a new sac-anchoring endoprosthesis designed to anchor and seal the device within the aneurysm sac. The initial worldwide experience using a new endoprosthesis for the treatment of aortic aneurysms (Nellix Endovascular, Palo Alto, Calif) was reviewed. The endoprosthesis consists of dual balloon-expandable endoframes surrounded by polymer-filled endobags designed to obliterate the aneurysm sac and maintain endograft position. Clinical results and follow-up contrast computed tomography (CT) scans at 30 days and 6 and 12 months were reviewed. The endograft was successfully deployed in 21 patients with infrarenal aortic aneurysms measuring 5.7 ± 0.7 cm (range, 4.3-7.4 cm). Two patients with common iliac aneurysms were treated with sac-anchoring extenders that maintained patency of the internal iliac artery. Infusion of 71 ± 37 mL of polymer (range, 19-158 mL) into the aortic endobags resulted in complete aneurysm exclusion in all patients. Mean implant time was 76 ± 35 minutes, with 33 ± 17 minutes of fluoroscopy time and 180 ± 81 mL of contrast; estimated blood loss was 174 ± 116 mL. One patient died during the postoperative period (30-day mortality, 4.8%), and one died at 10 months from non-device-related causes. During a mean follow-up of 8.7 ± 3.1 months and a median of 6.3 months, there were no late aneurysm- or device-related adverse events and no secondary procedures. CT imaging studies at 6 months and 1 year revealed no increase in aneurysm size, no device migration, and no new endoleaks. One patient had a limited proximal type I endoleak at 30 days that resolved at 60 days and remained sealed. One patient has an ongoing distal type I endoleak near the iliac bifurcation, with no change in aneurysm

  9. ‘They will be afraid to touch you’: LGBTI people and sex workers' experiences of accessing healthcare in Zimbabwe—an in-depth qualitative study

    PubMed Central

    Hunt, Jennifer; Bristowe, Katherine; Chidyamatare, Sybille; Harding, Richard

    2017-01-01

    Objectives To examine experiences of key populations (lesbian, gay, bisexual, trans and intersex (LGBTI) people, men who have sex with men (MSM) and sex workers) in Zimbabwe regarding access to, and experiences of, healthcare. Design Qualitative study using in-depth interviews and focus groups, with thematic analysis. Participants Sixty individuals from key populations in Zimbabwe. Setting Participants were recruited from four locations (Harare, Bulawayo, Mutare, Beitbridge/Masvingo). Results Participants described considerable unmet needs and barriers to accessing basic healthcare due to discrimination regarding key population status, exacerbated by the sociopolitical/legal environment. Three main themes emerged: (1) key populations' illnesses were caused by their behaviour; (2) equal access to healthcare is conditional on key populations conforming to ‘sexual norms’ and (3) perceptions that healthcare workers were ill-informed about key populations, and that professionals' personal attitudes affected care delivery. Participants felt unable to discuss their key population status with healthcare workers. Their healthcare needs were expected to be met almost entirely by their own communities. Conclusions This is one of very few studies of healthcare access beyond HIV for key populations in Africa. Discrimination towards key populations discourages early diagnosis, limits access to healthcare/treatment and increases risk of transmission of infectious diseases. Key populations experience unnecessary suffering from untreated conditions, exclusion from healthcare and extreme psychological distress. Education is needed to reduce stigma and enhance sensitive clinical interviewing skills. Clinical and public health implications of discrimination in healthcare must be addressed through evidence-based interventions for professionals, particularly in contexts with sociopolitical/legal barriers to equality. PMID:28589012

  10. APPLaUD: access for patients and participants to individual level uninterpreted genomic data.

    PubMed

    Thorogood, Adrian; Bobe, Jason; Prainsack, Barbara; Middleton, Anna; Scott, Erick; Nelson, Sarah; Corpas, Manuel; Bonhomme, Natasha; Rodriguez, Laura Lyman; Murtagh, Madeleine; Kleiderman, Erika

    2018-02-17

    There is a growing support for the stance that patients and research participants should have better and easier access to their raw (uninterpreted) genomic sequence data in both clinical and research contexts. We review legal frameworks and literature on the benefits, risks, and practical barriers of providing individuals access to their data. We also survey genomic sequencing initiatives that provide or plan to provide individual access. Many patients and research participants expect to be able to access their health and genomic data. Individuals have a legal right to access their genomic data in some countries and contexts. Moreover, increasing numbers of participatory research projects, direct-to-consumer genetic testing companies, and now major national sequencing initiatives grant individuals access to their genomic sequence data upon request. Drawing on current practice and regulatory analysis, we outline legal, ethical, and practical guidance for genomic sequencing initiatives seeking to offer interested patients and participants access to their raw genomic data.

  11. Minimal access surgery of pediatric inguinal hernias: a review.

    PubMed

    Saranga Bharathi, Ramanathan; Arora, Manu; Baskaran, Vasudevan

    2008-08-01

    Inguinal hernia is a common problem among children, and herniotomy has been its standard of care. Laparoscopy, which gained a toehold initially in the management of pediatric inguinal hernia (PIH), has managed to steer world opinion against routine contralateral groin exploration by precise detection of contralateral patencies. Besides detection, its ability to repair simultaneously all forms of inguinal hernias (indirect, direct, combined, recurrent, and incarcerated) together with contralateral patencies has cemented its role as a viable alternative to conventional repair. Numerous minimally invasive techniques for addressing PIH have mushroomed in the past two decades. These techniques vary considerably in their approaches to the internal ring (intraperitoneal, extraperitoneal), use of ports (three, two, one), endoscopic instruments (two, one, or none), sutures (absorbable, nonabsorbable), and techniques of knotting (intracorporeal, extracorporeal). In addition to the surgeons' experience and the merits/limitations of individual techniques, it is the nature of the defect that should govern the choice of technique. The emerging techniques show a trend toward increasing use of extracorporeal knotting and diminishing use of working ports and endoscopic instruments. These favor wider adoption of minimal access surgery in addressing PIH by surgeons, irrespective of their laparoscopic skills and experience. Growing experience, wider adoption, decreasing complications, and increasing advantages favor emergence of minimal access surgery as the gold standard for the treatment of PIH in the future. This article comprehensively reviews the laparoscopic techniques of addressing PIH.

  12. Modifying mixing and instability growth through the adjustment of initial conditions in a high-energy-density counter-propagating shear experiment on OMEGA

    DOE PAGES

    Merritt, E. C.; Doss, F. W.; Loomis, E. N.; ...

    2015-06-24

    Counter-propagating shear experiments conducted at the OMEGA Laser Facility have been evaluating the effect of target initial conditions, specifically the characteristics of a tracer foil located at the shear boundary, on Kelvin-Helmholtz instability evolution and experiment transition toward nonlinearity and turbulence in the high-energy-density (HED) regime. Experiments are focused on both identifying and uncoupling the dependence of the model initial turbulent length scale in variable-density turbulence models of k-ϵ type on competing physical instability seed lengths as well as developing a path toward fully developed turbulent HED experiments. We present results from a series of experiments controllably and independently varyingmore » two initial types of scale lengths in the experiment: the thickness and surface roughness (surface perturbation scale spectrum) of a tracer layer at the shear interface. We show that decreasing the layer thickness and increasing the surface roughness both have the ability to increase the relative mixing in the system, and thus theoretically decrease the time required to begin transitioning to turbulence in the system. In addition, we also show that we can connect a change in observed mix width growth due to increased foil surface roughness to an analytically predicted change in model initial turbulent scale lengths.« less

  13. Staying healthy “under the sheets”: Inuit youth experiences of access to sexual and reproductive health and rights in Arviat, Nunavut, Canada

    PubMed Central

    Corosky, Gregory J; Blystad, Astrid

    2016-01-01

    Background Inuit youth are reported to experience considerably worse sexual and reproductive health and rights (SRHR) outcomes than Canadian youth in general, as evidenced through public health data on sexually transmitted infections, unintended young pregnancies and rates of sexual violence in Nunavut compared to national averages. Existing literature on Inuit SRHR has identified the impact of westernization and colonialism on health outcomes, though gaps remain in addressing youth- and community-specific experiences of SRHR. Objective This study aims to generate youth-focused evidence on experiences of SRHR relating to access to care in Arviat in order to better inform locally authored interventions geared towards improving youth SRHR. Design The Piliriqatigiinniq Partnership Community Health Research Model (PRM) developed by the Qaujigiartiit Health Research Centre was followed to generate data on youth experiences of SRHR support access in Arviat. In-depth interviews were conducted with 9 male youth (ages 17–22 years), 10 female youth (ages 16–22 years) and 6 community leaders (aged 25+). Snowball sampling was used to engage informants, and data analysis followed an approach similar to conventional content analysis, where emphasis was placed on “immersion and crystallization” of data, corresponding to the Inuit concept of Iqqaumaqatigiinniq in the PRM. Findings were continuously checked with community members in Arviat during the analysis phase, and their feedback was incorporated into the report. Results Youth in Arviat were found to face significant barriers to SRHR care and support. Three major themes emerged as important factors conditioning youth access to SRHR resources in the community: trust of support workers in the community; stigma/taboos surrounding SRHR topics; and feelings of powerlessness impeding female and lesbian/gay/bisexual/transgender/queer youth in particular from accessing care. Conclusions The locally specific ways these themes

  14. Circadian activity rhythms and voluntary ethanol intake in male and female ethanol-preferring rats: effects of long-term ethanol access.

    PubMed

    Rosenwasser, Alan M; McCulley, Walter D; Fecteau, Matthew

    2014-11-01

    Chronic alcohol (ethanol) intake alters fundamental properties of the circadian clock. While previous studies have reported significant alterations in free-running circadian period during chronic ethanol access, these effects are typically subtle and appear to require high levels of intake. In the present study we examined the effects of long-term voluntary ethanol intake on ethanol consumption and free-running circadian period in male and female, selectively bred ethanol-preferring P and HAD2 rats. In light of previous reports that intermittent access can result in escalated ethanol intake, an initial 2-week water-only baseline was followed by either continuous or intermittent ethanol access (i.e., alternating 15-day epochs of ethanol access and ethanol deprivation) in separate groups of rats. Thus, animals were exposed to either 135 days of continuous ethanol access or to five 15-day access periods alternating with four 15-day periods of ethanol deprivation. Animals were maintained individually in running-wheel cages under continuous darkness throughout the experiment to allow monitoring of free-running activity and drinking rhythms, and 10% (v/v) ethanol and plain water were available continuously via separate drinking tubes during ethanol access. While there were no initial sex differences in ethanol drinking, ethanol preference increased progressively in male P and HAD2 rats under both continuous and intermittent-access conditions, and eventually exceeded that seen in females. Free-running period shortened during the initial ethanol-access epoch in all groups, but the persistence of this effect showed complex dependence on sex, breeding line, and ethanol-access schedule. Finally, while females of both breeding lines displayed higher levels of locomotor activity than males, there was little evidence for modulation of activity level by ethanol access. These results are consistent with previous findings that chronic ethanol intake alters free-running circadian

  15. Circadian Activity Rhythms and Voluntary Ethanol Intake in Male and Female Ethanol-Preferring Rats: Effects of Long-Term Ethanol Access

    PubMed Central

    Rosenwasser, Alan M.; McCulley, Walter D.; Fecteau, Matthew

    2014-01-01

    Chronic alcohol (ethanol) intake alters fundamental properties of the circadian clock. While previous studies have reported significant alterations in free-running circadian period during chronic ethanol access, these effects are typically subtle and appear to require high levels of intake. In the present study we examined the effects of long-term voluntary ethanol intake on ethanol consumption and free-running circadian period in male and female, selectively bred ethanol-preferring P and HAD2 rats. In light of previous reports that intermittent access can result in escalated ethanol intake, an initial 2-week water-only baseline was followed by either continuous or intermittent ethanol access (i.e., alternating 15-day epochs of ethanol access and ethanol deprivation) in separate groups of rats. Thus, animals were exposed to either 135 days of continuous ethanol access or to five 15-day access periods alternating with four 15-day periods of ethanol deprivation. Animals were maintained individually in running-wheel cages under continuous darkness throughout the experiment to allow monitoring of free-running activity and drinking rhythms, and 10% (v/v) ethanol and plain water were available continuously via separate drinking tubes during ethanol access. While there were no initial sex differences in ethanol drinking, ethanol preference increased progressively in male P and HAD2 rats under both continuous and intermittent-access conditions, and eventually exceeded that seen in females. Free-running period shortened during the initial ethanol-access epoch in all groups, but the persistence of this effect showed complex dependence on sex, breeding line, and ethanol-access schedule. Finally, while females of both breeding lines displayed higher levels of locomotor activity than males, there was little evidence for modulation of activity level by ethanol access. These results are consistent with previous findings that chronic ethanol intake alters free-running circadian

  16. Birth and initial developments of experiments with resonant detectors searching for gravitational waves

    NASA Astrophysics Data System (ADS)

    Pizzella, G.

    2016-12-01

    A history of the experiments for the search of gravitational waves, with emphasis on the experiments made by the Rome group, is given. The search for gravitational waves was initiated by the brilliant scientific acumen of Joseph Weber. In this paper we start from the early times of the resonant detectors at room temperature and continue with the cryogenic resonant detectors: STANFORD, ALLEGRO, AURIGA, EXPLORER, NAUTILUS and NIOBE. These cryogenic detectors reached a sensitivity able to observe gravitational waves generated by the conversion of about 0.001 solar masses in the Galaxy. This was an improvement by a factor of a few thousand in energy with respect to the early room temperature experiments. No clear signals due to gravitational waves have been observed with this technique. This research, that has lasted four decades, has paved the way to the more sensitive detectors for gravitational waves, the long-arm laser interferometers, which announced, on February 12th 2016, the first observation of gravitational waves.

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

    PubMed

    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

  18. Experiences of girls with hearing impairment in accessing reproductive health care services in Ibadan, Nigeria.

    PubMed

    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.

  19. College and Career Counseling Training Initiative

    ERIC Educational Resources Information Center

    Southern Regional Education Board (SREB), 2014

    2014-01-01

    The Southern Regional Education Board's (SREB) College and Career Counseling Training Initiative works to increase the knowledge and skills of counselors who advise students on their postsecondary aspirations. Membership in the initiative provides access to Strategies in College and Career Counseling, a series of online training modules that can…

  20. Sea-change or change challenge? Health information access in developing countries: The U.S. National Library of Medicine experience.

    PubMed

    Royall, J; Lyon, B

    2011-09-01

    Health professionals in developing countries want access to information to help them make changes in health care and contribute to medical research. However, they face challenges of technology limitations, lack of training, and, on the village level, culture and language. This report focuses on the U.S. National Library of Medicine experience with access: for the international medical/scientific community to health information which has been published by researchers in developing countries; for scientists and clinicians in developing countries to their own literature and to that of their colleagues around the world; for medical librarians who are a critical conduit for students, faculty, researchers, and, increasingly, the general public; and for the front line workers at the health center in the village at the end of the line. The fundamental question of whether or not information communication technology can make a difference in access and subsequently in health is illustrated by an anecdote regarding an early intervention in Africa in 1992. From that point, we examine programs to improve access involving malaria researchers, medical journal editors, librarians, and medical students working with local health center staff in the village. Although access is a reality, the positive change in health that the information technology intervention might produce often remains a mirage. Information and technology are not static elements in the equation for better access. They must function together, creating a dialectic in which they transform and inform one another and those whom their combination touches.

  1. The Workplace Experiences of Beginning Teachers in Three Countries: A Message for Initial Teacher Education from the Field

    ERIC Educational Resources Information Center

    du Plessis, Anna Elizabeth; Sunde, Eva

    2017-01-01

    Previous research indicates that beginning teachers are not fully prepared for what awaits them in the workforce. This study highlights the value of partnerships among higher education providers, schools and employers and links the experiences of beginning teachers to initial teacher education (ITE). Real-life experiences from the field provide…

  2. The Influence of Students' Pre-College Characteristics, High School Experiences, College Expectations, and Initial Enrollment Characteristics on Degree Attainment

    ERIC Educational Resources Information Center

    Pike, Gary R.; Hansen, Michele J.; Childress, Janice E.

    2014-01-01

    The present research examined the extent to which pre-college characteristics, high school experiences, college expectations, and initial enrollment characteristics were related to graduation from college. Data from admission applications, the "ACT Compass" survey, and initial enrollment measures for Fall 2004 and Fall 2005 first-time…

  3. Access to antiretroviral drugs and AIDS management in Senegal.

    PubMed

    Desclaux, Alice; Ciss, Mounirou; Taverne, Bernard; Sow, Papa S; Egrot, Marc; Faye, Mame A; Lanièce, Isabelle; Sylla, Omar; Delaporte, Eric; Ndoye, Ibrahima

    2003-07-01

    Description and analysis of the Senegalese Antiretroviral Drug Access Initiative (ISAARV), the first governmental highly active antiretroviral therapy (HAART) treatment programme in Africa, launched in 1998. ISAARV was initially an experimental project designed to evaluate the feasibility, efficacy and acceptability of HAART in an African context. It was based on four principles: collective definition of the strategy, with involvement of the health professionals who would be called on to execute the programme; matching the objectives to available means (gradual enrollment according to drug availability); monitoring by several research programmes; and ongoing adaptation of treatment and follow-up according to the latest international recommendations. Persons qualifying for antiretroviral (ARV) therapy are selected on the basis of immunological and clinical criteria, regardless of economic and social considerations. A system of subsidies was created to favor access to ARV. Following the ARV price reductions that occurred in November 2000, 100% subsidies were created for the poorest participants. Optimal adherence was ensured by monthly follow-up by pharmacists and support groups held by social workers and patient associations. The chosen supply and distribution system allowed drug dispensing to be strictly controlled. The ISAARV programme demonstrates that HAART can be successfully prescribed in Africa. This experience has served as the basis for the creation of a national treatment programme in Senegal planned to treat 7000 patients by 2006.

  4. The Impact of Financial Aid on Student College Access and Success: The San Antonio Experience

    ERIC Educational Resources Information Center

    Perez, Eyra A.; Ortiz, Noé C.

    2014-01-01

    The success of the financial aid initiative is founded on the premise that the truest impact occurs when the greater community owns and develops solutions to issues that impede student progress. Co-authored by two community leaders, Noé Ortiz and Eyra Pérez, the San Antonio experience demonstrates how a community can partner across different…

  5. Accessible Earth: An accessible study abroad capstone for the geoscience curriculum

    NASA Astrophysics Data System (ADS)

    Bennett, R. A.; Lamb, D. A.

    2017-12-01

    International capstone field courses offer geoscience-students opportunities to reflect upon their knowledge, develop intercultural competence, appreciate diversity, and recognize themselves as geoscientists on a global scale. Such experiences are often described as pivotal to a geoscientist's education, a right of passage. However, field-based experiences present insurmountable barriers to many students, undermining the goal of inclusive excellence. Nevertheless, there remains a widespread belief that successful geoscientists are those able to traverse inaccessible terrain. One path forward from this apparent dilemma is emerging as we take steps to address a parallel challenge: as we move into the 21st century the geoscience workforce will require an ever increasing range of skills, including analysis, modeling, communication, and computational proficiency. Computer programing, laboratory experimentation, numerical simulation, etc, are inherently more accessible than fieldwork, yet equally valuable. Students interested in pursuing such avenues may be better served by capstone experiences that align more closely with their career goals. Moreover, many of the desirable learning outcomes attributed to field-based education are not unique to immersion in remote inaccessible locations. Affective and cognitive gains may also result from social bonding through extended time with peers and mentors, creative synthesis of knowledge, project-based learning, and intercultural experience. Developing an inclusive course for the geoscience curriculum requires considering all learners, including different genders, ages, physical abilities, familial dynamics, and a multitude of other attributes. The Accessible Earth Study Abroad Program endeavors to provide geoscience students an inclusive capstone experience focusing on modern geophysical observation systems (satellite based observations and permanent networks of ground-based instruments), computational thinking and methods of

  6. SPIDER ® sleeve gastrectomy--a new concept in single-trocar bariatric surgery: initial experience and technical details.

    PubMed

    Noel, P; Nedelcu, M; Gagner, M

    2014-04-01

    Single port instrument delivery extended reach (SPIDER(®)) surgical system is a revolutionary surgical platform that allows triangulation of the surgical instruments while eliminating the crossing of instruments, the problematic characteristic of single access laparoscopic surgery. The purpose of this study was to analyze our initial experience with SPIDER(®) sleeve gastrectomy and to present the technical details of this new minimally invasive approach, performed in ten patients at the La Casamance Private Hospital between November 2012 and April 2013. All patients were reviewed at scheduled post-operative consultations at 1, 3 and 6 months. In addition to clinical examination, the post-operative consultation at one month also included a satisfaction survey using the Moorehead-Ardelt questionnaire. An initial series of ten sleeve gastrectomies were performed in female patients with a mean age of 41.5 years (range: 2-52). The mean BMI was 40.11 (range: 37.25-44.3). The intervention was performed through a single trocar in all patients with no "conversion" to classic laparoscopy or open surgery. The mean operative time was 61 ± 15.22 minutes (SD=standard deviation) (range: 43-96 min). The mean BMI at one month was 35.5 (SD:± 3.58, SEM: ± 1.13) (SEM=standard error of mean) with an average percentage of excess weight loss (%EWL) of 32.9% (SD:± 8.56%, SEM:± 2.71%). The mean BMI at three months was 32.4 (SD: ± 2.78, SEM: ± 0.88) with an average %EWL of 52.7% (SD: ± 8.64%, SEM: ± 2.73%). The mean BMI at six months was 29.9 (SD:± 2.60, SEM: ± 0.98) with a mean %EWL of 68.8% (SD: ± 8.38%, SEM:± 3.17%). Complete remission of co-morbid conditions was observed in four patients, improvement in three others, and no change in a single patient. The mean duration of hospitalization was 3.1 days. The mean follow-up period was 161 days (SD:± 57.4 days, range: 90-243 days). There was no mortality and no intra-operative and post-operative complications were noted. The

  7. Access to Triptans for Acute Episodic Migraine: A Qualitative Study.

    PubMed

    Khan, Sobia; Mascarenhas, Alekhya; Moore, Julia E; Knowles, Sandra; Gomes, Tara

    2015-01-01

    Our study aims to examine factors related to access of triptans among multiple stakeholder groups. Triptans are a cornerstone of pain management for the acute treatment of migraine, but actual utilization of triptans is lower than ideal. Initial and continued access to triptans may be an important clinical issue in the acute treatment of migraines, but factors affecting access at the patient, provider, and health-care system levels have not been comprehensively explored. A qualitative study was conducted in Ontario, Canada, between August 2013 and January 2014. Three participant groups were recruited to the qualitative study: (1) migraineurs who have experience accessing triptans; (2) physicians, including primary care physicians (PCPs) and neurologists, who have prescribed triptans; and (3) pharmacists who have dispensed triptans. Qualitative data were collected through one-on-one, semi-structured telephone interviews. The framework approach was used for data collection and analysis. Data collected from 19 migraineurs, 6 physicians, and 8 pharmacists were included in the analysis. Study participants discussed various factors that facilitate or hinder access to triptans, which were synthesized into four themes that emerged at the patient, provider, and health-care systems levels: (1) awareness; (2) apathy; (3) advocacy; and (4) affordability. Across all participant groups, awareness of available treatments and coverage policies for those treatments were potential factors relating to timely drug provision. Participants describe apathy in terms of patients' health-seeking behaviors and physicians' lack of concern toward migraine, which were seen as factors that could delay diagnosis and provision of appropriate treatment. Patients engaging in self-advocacy enhanced their ability to seek timely and appropriate provision of triptans at the patient level. At the health-care provider level, pharmacists were identified by patients as advocates for receiving more effective

  8. A novel rapid access testicular cancer clinic: prospective evaluation after one year.

    PubMed

    Carey, K; Davis, N F; Elamin, S; Ahern, P; Brady, C M; Sweeney, P

    2016-02-01

    Our institution has recently developed a rapid access outpatient clinic to investigate men with testicular lumps and/or pain suspicious for testicular cancer (TCa). To present our experience after 12 months. All referrals to the rapid access testicular clinic (RATC) clinic were prospectively analysed from 01/01/2013 to 01/01/2014. The primary outcome variable was incidence of TCa in the referred patient cohort. Secondary outcome variables were waiting times prior to clinical review and waiting times prior to radical orchidectomy in patients diagnosed with TCa. Seventy-four new patients were referred to the RATC during the 1-year period and the mean age was 34 (range 15-81 years). TCa was the most common diagnosis and was found in 18 (25 %) patients. Patients diagnosed with TCa underwent radical orchidectomy, a median of 3 (range 1-5) days after their initial GP referral. Patients requiring surgical intervention for benign scrotal pathology underwent their procedure a median of 32 (range 3-61) days after their initial referral. Of the 18 patients diagnosed with TCa, 9 (50 %) were diagnosed with a seminomatous germ cell tumour on histopathology. The RATC is a new initiative in Ireland that provides expedient and definitive treatment of patients with newly diagnosed TCa. Early treatment will ultimately improve long-term prognosis in this patient cohort.

  9. The impact of patient-perceived restricted access to anti-TNF therapy for rheumatoid arthritis: a qualitative study

    PubMed Central

    Sanderson, Tessa; Calnan, Michael; Morris, Marianne; Richards, Pam; Hewlett, Sarah

    2010-01-01

    Objective To explore rheumatoid arthritis patients’ experience of access to anti-TNF therapy in the UK, and of switching therapies after an initial failure. Methods Patients were asked about their experience of accessing, receiving and discontinuing anti-TNF therapy in face-to-face informal interviews, within the context of the larger study about treatment outcomes. 17 individuals with a diagnosis of rheumatoid arthritis and experience of receiving anti-TNF therapy were interviewed in one hospital trust in England. Results Different emotions (Theme 1) surrounded the process of accessing anti-TNF therapy: hope, desperation, apprehension, anxiety, and frustration. Experience of receiving anti-TNF therapy (Theme 2) included not only positive transformation, but also fear of failure and discontinuation. The subsequent value that patients placed on anti-TNF therapy (Theme 3) included having a right to receive therapy and being lucky. These three themes were underpinned by the core category of ‘willing to try anything’. Those switching therapies reported increased caution over the possibility of recurring side effects, but some suggestion of benefit. There was a perception that access to anti-TNF therapy was restricted by cost, rather than being recommended for those in clinical need. Conclusions Anti-TNF therapies may have a sudden and dramatic impact on RA patients’ lives that contrasts with other available medications. However, the stress of the patient’s journey through the need to “qualify” for anti-TNF therapy, and the fear of failing or discontinuation of therapy should not be underestimated by clinicians. PMID:19127529

  10. Out of Africa: Uganda and UNAIDS advance a bold experiment.

    PubMed

    Zuniga, J

    1999-10-01

    The UNAIDS HIV Drug Access Initiative was launched in 1997 to aid four resource-limited countries: Chile, Cote d'Ivoire, Uganda, and Viet Nam. This multipronged initiative between pharmaceutical companies and government officials aims to expand access to HIV-related drugs on a small, sustainable scale in developing countries. Uganda's experience in the implementation of the UNAIDS HIV Drug Access Initiative is presented. Ugandan President Yoweri Museveni was struck by the reality of AIDS in 1986 when he learned that up to 25 percent of Ugandan troops might be HIV-infected. The overall Ugandan incidence of AIDS has been reduced since that time from 30 percent to about 14.5 percent due, in part, to cooperation between government and international institutions. Various charts are included, indicating cost estimates for the delivery of HIV care, and a flow chart diagrams drug procurement from six pharmaceutical companies for distribution to Ugandans living with HIV/AIDS. Minister of Health Crispus Kiyonga appointed a 15-member National Advisory Board in 1998 that established subcommittees on Drug Policy and Financing, Care and Practice, and Vertical Transmission to implement and oversee responsibilities. The establishment of Uganda's antiretroviral (ARV) treatment guidelines, standards, and educational and treatment efforts are discussed.

  11. Lateral Root Initiation in Arabidopsis: Developmental Window, Spatial Patterning, Density and Predictability

    PubMed Central

    DUBROVSKY, J. G.; GAMBETTA, G. A.; HERNÁNDEZ-BARRERA, A.; SHISHKOVA, S.; GONZÁLEZ, I.

    2006-01-01

    • Background and Aims The basic regulatory mechanisms that control lateral root (LR) initiation are still poorly understood. An attempt is made to characterize the pattern and timing of LR initiation, to define a developmental window in which LR initiation takes place and to address the question of whether LR initiation is predictable. • Methods The spatial patterning of LRs and LR primordia (LRPs) on cleared root preparations were characterized. New measures of LR and LRP densities (number of LRs and/or LRPs divided by the length of the root portions where they are present) were introduced and illustrate the shortcomings of the more customarily used measure through a comparative analysis of the mutant aux1-7. The enhancer trap line J0121 was used to monitor LR initiation in time-lapse experiments and a plasmolysis-based method was developed to determine the number of pericycle cells between successive LRPs. • Key Results LRP initiation occurred strictly acropetally and no de novo initiation events were found between already developed LRs or LRPs. However, LRPs did not become LRs in a similar pattern. The longitudinal spacing of lateral organs was variable and the distance between lateral organs was proportional to the number of cells and the time between initiations of successive LRPs. There was a strong tendency towards alternation in LR initiation between the two pericycle cell files adjacent to the protoxylem poles. LR density increased with time due to the emergence of slowly developing LRPs and appears to be unique for individual Arabidopsis accessions. • Conclusions. In Arabidopsis there is a narrow developmental window for LR initiation, and no specific cell-count or distance-measuring mechanisms have been found that determine the site of successive initiation events. Nevertheless, the branching density and lateral organ density (density of LRs and LRPs) are accession-specific, and based on the latter density the average distance between successive

  12. Access to Effective Teaching for Disadvantaged Students. NCEE 2014-4001

    ERIC Educational Resources Information Center

    Isenberg, Eric; Max, Jeffrey; Gleason, Philip; Potamites, Liz; Santillano, Robert; Hock, Heinrich; Hansen, Michael

    2013-01-01

    Recent federal initiatives emphasize measuring teacher effectiveness and ensuring that disadvantaged students have equal access to effective teachers. This study substantially broadens the existing evidence on access to effective teaching by examining access in 29 geographically dispersed school districts over the 2008-2009 to 2010-2011 school…

  13. Systematically excluded: Young women's experiences of accessing child support grants in South Africa.

    PubMed

    Gibbs, Andrew; Washington, Laura; Jama Shai, Nwabisa; Sikweyiya, Yandisa; Willan, Samantha

    2018-03-13

    Unconditional cash transfers have risen in prominence for their potential to improve the health of the world's most marginalised and bring them into a relationship with the state. Typically, challenges to accessing grants are described in terms of technical issues such as access to documents and distance to offices. This paper explores the challenges of 30 young, poor, black South African women in accessing the Child Support Grant (CSG), an unconditional cash transfer provided by the South African government. Data suggest that while there were 'technical' issues, young women were systematically excluded from accessing the CSG in two ways. First, women were symbolically marginalised by state officials, who humiliated them, forcing women to sit quietly and acquiesce to state power to access the CSG. Second, there were large distances for women to travel to access state services, despite these being geared to serve the poor. Rather than promoting the active citizenship of the poorest in South Africa, accessing the CSG reinforced marginalisation. Transforming this will not be achieved through technical solutions, rather the barriers to access need to be recognised as political.

  14. Student Experiences: the 2013 Cascadia Initiative Expedition Team's Apply to Sail Program

    NASA Astrophysics Data System (ADS)

    Mejia, H.; Hooft, E. E.; Fattaruso, L.

    2013-12-01

    During the summer of 2013, the Cascadia Initiative Expedition Team led six oceanographic expeditions to recover and redeploy ocean bottom seismometers (OBSs) across the Cascadia subduction zone and Juan de Fuca plate. The Cascadia Initiative (CI) is an onshore/offshore seismic and geodetic experiment to study questions ranging from megathrust earthquakes to volcanic arc structure to the formation, deformation and hydration of the Juan de Fuca and Gorda plates with the overarching goal of understanding the entire subduction zone system. The Cascadia Initiative Expedition Team is a team of scientists charged with leading the oceanographic expeditions to deploy and recover CI OBSs and developing the associated Education and Outreach effort. Students and early career scientists were encouraged to apply to join the cruises via the Cascadia Initiative Expedition Team's Apply to Sail Program. The goal of this call for open participation was to help expand the user base of OBS data by providing opportunities for students and scientists to directly experience at-sea acquisition of OBS data. Participants were required to have a strong interest in learning field techniques, be willing to work long hours at sea assisting in OBS deployment, recovery and preliminary data processing and have an interest in working with the data collected. In total, there were 51 applicants to the Apply to Sail Program from the US and 4 other countries; 21 graduate students as well as a few undergraduate students, postdocs and young scientists from the US and Canada were chosen to join the crew. The cruises lasted from 6 to 14 days in length. OBS retrievals comprised the three first legs, of which the first two were aboard the Research Vessel Oceanus. During each of the retrievals, multiple acoustic signals were sent while the vessel completed a semi-circle around the OBS to accurately determine its position, a final signal was sent to drop the seismometer's anchor, and finally the ship and crew

  15. Progress on the Fabric for Frontier Experiments Project at Fermilab

    NASA Astrophysics Data System (ADS)

    Box, Dennis; Boyd, Joseph; Dykstra, Dave; Garzoglio, Gabriele; Herner, Kenneth; Kirby, Michael; Kreymer, Arthur; Levshina, Tanya; Mhashilkar, Parag; Sharma, Neha

    2015-12-01

    The FabrIc for Frontier Experiments (FIFE) project is an ambitious, major-impact initiative within the Fermilab Scientific Computing Division designed to lead the computing model for Fermilab experiments. FIFE is a collaborative effort between experimenters and computing professionals to design and develop integrated computing models for experiments of varying needs and infrastructure. The major focus of the FIFE project is the development, deployment, and integration of Open Science Grid solutions for high throughput computing, data management, database access and collaboration within experiment. To accomplish this goal, FIFE has developed workflows that utilize Open Science Grid sites along with dedicated and commercial cloud resources. The FIFE project has made significant progress integrating into experiment computing operations several services including new job submission services, software and reference data distribution through CVMFS repositories, flexible data transfer client, and access to opportunistic resources on the Open Science Grid. The progress with current experiments and plans for expansion with additional projects will be discussed. FIFE has taken a leading role in the definition of the computing model for Fermilab experiments, aided in the design of computing for experiments beyond Fermilab, and will continue to define the future direction of high throughput computing for future physics experiments worldwide.

  16. From diagnosis through survivorship: health-care experiences of colorectal cancer survivors with ostomies.

    PubMed

    Sun, Virginia; Grant, Marcia; McMullen, Carmit K; Altschuler, Andrea; Mohler, M Jane; Hornbrook, Mark C; Herrinton, Lisa J; Krouse, Robert S

    2014-06-01

    The journey from diagnosis through treatment to survivorship can be challenging for colorectal cancer (CRC) survivors with permanent ostomies. Memories of both the positive and negative health-care interactions can persist years after the initial diagnosis and treatment. The purpose of this paper is to describe the health-care experiences of long-term (>5 years) CRC survivors with ostomies. Thirty-three CRC survivors with ostomies who were members of Kaiser Permanente, an integrated care organization, in Oregon, southwestern Washington and northern California participated in eight focus groups. Discussions from the focus groups were recorded, transcribed, and analyzed for potential categories and themes. Health-care-related themes described CRC survivors' experiences with diagnosis, treatment decision-making, initial experiences with ostomy, and survivorship. Participants discussed both positive and negative health-care-related experiences, including the need for continued access to trained nurses for ostomy self-care, access to peer support, and resources related to managing persistent, debilitating symptoms. Long-term CRC survivors with ostomies have both positive and negative health-care experiences, regardless of health-related quality of life (HRQOL) and gender. Long-term support mechanisms and quality survivorship care that CRC survivors with ostomies can access are needed to promote positive adjustments and improved HRQOL. The current literature in CRC survivorship suggests that HRQOL concerns can persist years after treatment completion. The coordination of care to manage persistent late- and long-term effects are still lacking for CRC survivors living with an ostomy. Findings from this qualitative analysis will aid in the development of support strategies that foster more positive adjustments for CRC survivors living with an ostomy and support their ongoing ostomy-related needs.

  17. Accessing specialty behavioral health treatment in private health plans.

    PubMed

    Merrick, Elizabeth L; Horgan, Constance M; Garnick, Deborah W; Reif, Sharon; Stewart, Maureen T

    2009-10-01

    Connecting people to mental health and substance abuse services is critical, given the extent of unmet need. The way health plans structure access to care can play a role. This study examined treatment entry procedures for specialty behavioral health care in private health plans and their relationship with behavioral health contracting arrangements, focusing primarily on initial entry into outpatient treatment. The data source was a nationally representative health plan survey on behavioral health services in 2003 (N = 368 plans with 767 managed care products; 83% response rate). Most health plan products initially authorized six or more outpatient visits if authorization was required, did not routinely conduct telephonic clinical assessment, had standards for timely access, and monitored wait time. Products with carve-outs differed on several treatment entry dimensions. Findings suggest that health plans focus on timely access and typically do not heavily manage initial entry into outpatient treatment.

  18. Sexual minority women's experiences of sexual pressure: a qualitative investigation of recipients' and initiators' reports.

    PubMed

    Budge, Stephanie L; Keller, Bethany L; Sherry, Alissa R

    2015-05-01

    Sexual pressure can have detrimental effects to individuals both physically and emotionally; however, research in this area is lacking regarding the experiences by lesbian, gay, bisexual, queer, and questioning (LGBQ) women. This online study qualitatively examined sexual pressure experienced and explained by LGBQ women (n = 50) using grounded theory methodology. Participants responded to open-ended questions by providing perspectives from both those who were on the receiving end of the sexual pressure (recipients) and from those who pressured their partners (initiators). Results indicated that there were eight overarching themes, 43 higher order categories, and 241 line-by-line codes. The eight overarching themes included: Reasons to Not Want Sex, Reasons for Pressuring, Reasons for Giving In, Actions of Initiators, Expectations, Communication, Negative Outcomes, and Positive Reactions. Negative Outcomes was the most common theme endorsed. Several higher order categories indicated the unique experiences of sexual minority women, namely trying to be "normal" (e.g., engaging in sexual acts as a result of internalized homophobia), experiencing more pressure from men, and self-consciousness (specifically related to lack of knowledge about sex with women). Implications for the current study include the importance of addressing sexual pressure with sexual minority women and creating interventions, such as assertiveness training and communication skills, that could assist both recipients and initiators with engaging in mutually satisfactory sexual practices.

  19. Strategies of arteriovenous dialysis access.

    PubMed

    Weiswasser, Jonathan M; Kellicut, Dwight; Arora, Subodh; Sidawy, Anton N

    2004-03-01

    Surgical management of the patient who requires hemodialysis access, while continuing to demand more attention from the vascular surgeon, suffers from discrepancies of approach and strategy. With the increase in incidence of dialysis dependent renal failure among our population, many have attempted to present a uniform, logical strategy with which the vascular surgeon can most effectively treat the hemodialysis patient in the long term. Most notably, the multidisciplinary Dialysis Outcomes Quality Initiative (DOQI) guidelines present the surgeon with a rough outline of hemodialysis access insertion strategy, and it has become nationally recognized as an acceptable summary of treatment strategy and goals. The decision as to the most appropriate surgical access to offer a patient depends on immediate need for hemodialysis, history and physical examination findings, and suitability of available veins in the extremity. While percutaneous, catheter based access affords the luxury of immediate access, these devices suffer from several complicating factors, such as infection, and damage to large, proximal veins. For long-term access, the autogenous access, while perhaps less successful in the immediate short term, is always the preferred access type given its favorable longevity. The surgeons should focus on sites distally on the extremity, reserving proximal sites for potential future access insertions should the primary access fail. In the absence of suitable vein, prosthetic access may be considered. When both the upper and lower aspects of both upper extremities have been exhausted, the surgeon should consider access insertion elsewhere, such as the lower extremity.

  20. Relating Women's Experience and Skills to Competencies Required in Selected Occupations and Vocational Education Programs. Project Report, Task C1, Revised Competency Analysis: Credentialing Women's Life Experiences (Project ACCESS).

    ERIC Educational Resources Information Center

    Ekstrom, Ruth B.; And Others

    Competency scales were developed for 10 direct-entry occupations and 10 vocational education programs as part of Project ACCESS, a project to assess women's life experience learning for entrance into employment and for advanced placement in vocational education programs. Development of the occupational scales involved employer interviews, followed…

  1. Minimal access portoenterostomy: advantages and disadvantages of standard laparoscopic and robotic techniques.

    PubMed

    Dutta, Sanjeev; Woo, Russell; Albanese, Craig T

    2007-04-01

    Minimal access portoenterostomy (Kasai procedure) for biliary atresia represents a technically challenging operation. The standard laparoscopic approach yields results comparable to the open technique. After an initial experience with standard laparoscopy, we assessed the potentially superior optics and dexterity of a surgical robotic system for performing portoenterostomy. We reviewed our experience with minimal access portoenterostomy to compare the relative advantages and disadvantages of standard laparoscopic and robotic approaches to biliary atresia. We reviewed the charts of all patients who underwent either laparoscopic or robotic portoenterostomy at our institution between October 2002 and October 2005. Outcome measures included the need to convert to laparotomy, complications, functional outcome expressed either as the direct bilirubin at most recent follow-up (> or = 3 months) or age at transplant, and density of adhesions at transplant. Surgeons' impressions of the two minimal access modalities were also reviewed. A total of 10 patients underwent minimal access portoenterostomy (7 standard laparoscopy; 3 robotic-assisted). Mean follow-up was 20 months (range, 1-36 months). There were no conversions to laparotomy and no intraoperative complications. There was one port site infection that resolved with antibiotics. Five patients (4 laparoscopic, 1 robotic) had progressed to transplantation at the time of follow-up. At transplant, one patient had mild adhesions and two had dense adhesions. Adhesions were not noted for 2 patients. We believe both surgical modalities are feasible from a technical point of view. However, the optical and dexterity advantages of the robotic system were offset by the large instrument size and lack of force feedback.

  2. Sexual Behaviors, Experiences of Sexual Violence, and Substance Use among Women Who inject Drugs: Accessing Health and Prevention Services in Puerto Rico.

    PubMed

    Collazo-Vargas, Erika M; Dodge, Brian; Herbenick, Debby; Guerra-Reyes, Lucia; Mowatt, Rasul; Otero-Cruz, Ilia M; Rodríguez-Díaz, Carlos

    2018-06-01

    People who inject drugs (PWID) face numerous gender-specific health risks, which increase their susceptibility to adverse outcomes, including violence. There is a need for research on female PWID to capture their unique experiences and understand behavioral and gender-based differences. This study aimed to understand which drug use and sexual behaviors are the most prevalent among female PWID accessing health services in Puerto Rico and to gather preliminary information on those individuals' experiences of sexual violence. Utilizing a transformative theoretical perspective, a mixed-methods study was conducted with a sample of 90 Puerto Rican women who reported recent (past 12 months) injection drug use (IDU) This manuscript focused on Phase 1, in which participants completed an interviewer-administered survey eliciting information about sexual behaviors, drug use, experiences of sexual violence, and access to healthcare services. Phase 2 involved an in-depth interview focused on sexual health and access to healthcare services. Female PWID were found to engage in a variety of sexual behaviors throughout their lifespans and at their most recent sexual events. There were significant differences across age groups for participants, those being time of most recent sexual event (p = 0.007), partner's sex (p = 0.039), relationship with partner (p = 0.023), contraception method used (p = 0.057), and reports of partner orgasm (p = 0.055). Over half of all participants reported having experienced sexual violence in their lifetime. This study extends the literature on PWID in Puerto Rico by underscoring the diversity of female PWID sexual experiences and needs while illustrating how those experiences are often mediated by drug use. The findings highlight the need for further research on female PWID in Puerto Rico to better develop programs that include sexual violence prevention as part of future interventions for this population.

  3. Supporting the whole student: Inclusive program design for making undergraduate research experiences accessible

    NASA Astrophysics Data System (ADS)

    Haacker-Santos, R.; Allen, L.; Batchelor, R. L.

    2013-12-01

    As undergraduate research experiences have become an unofficial pre-requisite to enter graduate school programs in the sciences, we have to make sure that these experiences are inclusive and accessible to all students. Program managers who make a conscious effort to recruit students from traditionally under-represented groups, including veterans, non-traditional students or students with disabilities, are often unaware of the financial and program implications these students require, and discover that their current program design might inadvertently exclude or not fully support these students. The SOARS Program, an undergraduate-to-graduate bridge program in the atmospheric sciences, has supported this group of students for over 15 years. We have found that we needed to adjust some program elements and secure extra funding sources to holistically support our students in their research experience, however, the program and the students have reaped tremendous benefits. Involving non-traditional students or veterans in our program has raised the maturity level and problem solving skills of the group, and having students with disabilities participate has been a vehicle for broadening perspective and diverse knowledge into the field of study, e.g. researching weather and climate beyond what you can 'see'. This presentation will highlight some of the findings from the SOARS program experience, and will share practices for recruitment and holistic support to ensure student success. We will share resources and tips on inclusive program design, including working with students with family commitments or physical disabilities, and will report on the enormous program benefits and peer learning these students have brought to the student cohorts and research labs they are working in.

  4. Accessing and managing open medical resources in Africa over the Internet

    NASA Astrophysics Data System (ADS)

    Hussein, Rada; Khalifa, Aly; Jimenez-Castellanos, Ana; de la Calle, Guillermo; Ramirez-Robles, Maximo; Crespo, Jose; Perez-Rey, David; Garcia-Remesal, Miguel; Anguita, Alberto; Alonso-Calvo, Raul; de la Iglesia, Diana; Barreiro, Jose M.; Maojo, Victor

    2014-10-01

    Recent commentaries have proposed the advantages of using open exchange of data and informatics resources for improving health-related policies and patient care in Africa. Yet, in many African regions, both private medical and public health information systems are still unaffordable. Open exchange over the social Web 2.0 could encourage more altruistic support of medical initiatives. We have carried out some experiments to demonstrate the feasibility of using this approach to disseminate open data and informatics resources in Africa. After the experiments we developed the AFRICA BUILD Portal, the first Social Network for African biomedical researchers. Through the AFRICA BUILD Portal users can access in a transparent way to several resources. Currently, over 600 researchers are using distributed and open resources through this platform committed to low connections.

  5. 12 CFR 404.15 - Initial determination.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Initial determination. 404.15 Section 404.15 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES INFORMATION DISCLOSURE Access to Records Under the Privacy Act of 1974 § 404.15 Initial determination. (a) Time for processing. The Freedom of...

  6. Collaborative Pediatric Bone Tumor Program to Improve Access to Specialized Care: An Initiative by the Lebanese Children’s Oncology Group

    PubMed Central

    Merabi, Zeina; Abboud, Miguel R.; Muwakkit, Samar; Noun, Peter; Gemayel, Gladys; Bechara, Elie; Khalifeh, Hassan; Farah, Roula; Kabbara, Nabil; El-Khoury, Tarek; Al-Yousef, Rasha; Haidar, Rachid; Saghieh, Said; Eid, Toufic; Akel, Samir; Khoury, Nabil; Bayram, Layal; Krasin, Matthew J.; Jeha, Sima; El-Solh, Hassan

    2017-01-01

    Background Children with malignant bone tumors have average 5-year survival rates of 60% to 70% with current multimodality therapy. Local control modalities aimed at preserving function greatly influence the quality of life of long-term survivors. In developing countries, the limited availability of multidisciplinary care and limited expertise in specialized surgery and pediatric radiation therapy, as well as financial cost, all form barriers to achieving optimal outcomes in this population. Methods We describe the establishment of a collaborative pediatric bone tumor program among a group of pediatric oncologists in Lebanon and Syria. This program provides access to specialized local control at a tertiary children’s cancer center to pediatric patients with newly diagnosed bone tumors at participating sites. Central review of pathology, staging, and treatment planning is performed in a multidisciplinary tumor board setting. Patients receive chemotherapy at their respective centers on a unified treatment plan. Surgery and/or radiation therapy are performed centrally by specialized staff at the children’s cancer center. Cost barriers were resolved through a program development initiative led by St Jude Children’s Research Hospital. Once program feasibility was achieved, the Children’s Cancer Center of Lebanon Foundation, via fundraising efforts, provided continuation of program-directed funding. Results Findings over a 3-year period showed the feasibility of this project, with timely local control and protocol adherence at eight collaborating centers. We report success in providing standard-of-care multidisciplinary therapy to this patient population with complex needs and financially challenging surgical procedures. Conclusion This initiative can serve as a model, noting that facilitating access to specialized multidisciplinary care, resolution of financial barriers, and close administrative coordination all greatly contributed to the success of the program

  7. Accessing Faith-Based Organizations Using Public Transportation.

    PubMed

    Lewinson, Terri; Maley, Olivia; Esnard, Ann-Margaret

    2017-01-01

    Nondriving aging adults are at risk of experiencing mobility barriers that inhibit access to important community resources for managing health and wellbeing. This multimethod study explores bus transportation experiences of older adults who live in extended stay hotels and use faith-based organizations to access resources. Interviews from 17 nondriving older adults were analyzed for perspectives about using faith-based organizations and residents' experiences navigating to faith-based organizations through available bus transportation in their communities. Residents described both favorable and unfavorable experiences when reaching out for help from faith-based organizations. Although they report reliance on faith-based organizations for a variety of resources, residents were challenged by an ineffective bus system that interfered with resource accessibility. Suggestions for improving bus transit systems and providing alternative, aging-friendly transportation options are discussed.

  8. Access to Anti-smoking Information among School Children and its Potential Impact on Preventing Smoking Initiation: Results from the Global Youth Tobacco Use Survey (GYTS) 2014 in Viet Nam.

    PubMed

    Minh, Hoang Van; Minh, Hoang Van; Giang, Kim Bao; Hai, Phan Thi; Hoang, Trinh Dinh; Huyen, Doan Thu; Khue, Luong Ngoc; Linh, Nguyen Thuy; Lam, Nguyen Tuan; Nga, Pham Thi Quynh

    2016-01-01

    Scientific evidence on all aspects of smoking amongst youth is very important for designing appropriate interventions to reduce smoking among this vulnerable population. This paper describes current access to antismoking information among school children aged 13 to 15 years in Vietnam in 2014 and examines its potential impact on preventing smoking initiation. The data used in this paper were obtained from the 2014 Global Youth Tobacco Survey (GYTS) in Vietnam. Students were asked questions about their level of awareness of anti-smoking information from various sources in the past 30 days and about lessons in school regarding the dangers of tobacco use during the last 12 months. Those who have never smoked were asked "whether or not they thought about avoiding cigarettes because of health warnings on cigarette packages" and answers were analyzed in combination with data on access to anti-smoking information from other sources. The prevalence of exposure to antismoking campaigns was high among school children in Viet Nam: 55.3% of current smokers reported thoughts of smoking cessation because of health warnings on cigarette packages; 60.5% of never smokers avoided initiating smoking because of the same health warnings. The potential impact of graphic health warnings to prevent school-aged children from smoking initiation would be stronger if there was concurrent access to anti-smoking programs on the dangers of tobacco use in schools. However, school education for tobacco prevention and control has not been as strong as expected. A more comprehensive school curriculum on tobacco prevention and control is recommended to reinforce antismoking messages among school children.

  9. Prospect for Development of Open Access in Argentina

    ERIC Educational Resources Information Center

    Miguel, Sandra; Bongiovani, Paola C.; Gomez, Nancy D.; Bueno-de-la-Fuente, Gema

    2013-01-01

    This perspective article presents an overview of the Open Access movement in Argentina, from a global and regional (Latin American) context. The article describes the evolution and current state of initiatives by examining two principal approaches to Open Access in Argentina: "golden" and "green roads". The article will then…

  10. Subliminal access to abstract face representations does not rely on attention.

    PubMed

    Harry, Bronson; Davis, Chris; Kim, Jeesun

    2012-03-01

    The present study used masked repetition priming to examine whether face representations can be accessed without attention. Two experiments using a face recognition task (fame judgement) presented masked repetition and control primes in spatially unattended locations prior to target onset. Experiment 1 (n=20) used the same images as primes and as targets and Experiment 2 (n=17) used different images of the same individual as primes and targets. Repetition priming was observed across both experiments regardless of whether spatial attention was cued to the location of the prime. Priming occurred for both famous and non-famous targets in Experiment 1 but was only reliable for famous targets in Experiment 2, suggesting that priming in Experiment 1 indexed access to view-specific representations whereas priming in Experiment 2 indexed access to view-invariant, abstract representations. Overall, the results indicate that subliminal access to abstract face representations does not rely on attention. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Patterns in Crew-Initiated Photography of Earth from ISS - Is Earth Observation a Salutogenic Experience?

    NASA Technical Reports Server (NTRS)

    Robinson, Julie A.; Slack, Kelley; Olson, V.; Trenchard, M.; Willis, K.; Baskin, P.

    2006-01-01

    This viewgraph presentation asks the question "Is the observation of earth from the ISS a positive (salutogenic) experience for crew members?"All images are distributed to the public via the "Gateway to Astronaut Photography of Earth at http://eol.jsc.nasa.gov. The objectives of the study are (1) Mine the dataset of Earth Observation photography--What can it tell us about the importance of viewing the Earth as a positive experience for the crewmembers? (2) Quantify extent to which photography was self-initiated (not requested by scientists) (3) Identify patterns photography activities versus scientific requested photography.

  12. Early adolescent adversity inflates threat estimation in females and promotes alcohol use initiation in both sexes.

    PubMed

    Walker, Rachel A; Andreansky, Christopher; Ray, Madelyn H; McDannald, Michael A

    2018-06-01

    Childhood adversity is associated with exaggerated threat processing and earlier alcohol use initiation. Conclusive links remain elusive, as childhood adversity typically co-occurs with detrimental socioeconomic factors, and its impact is likely moderated by biological sex. To unravel the complex relationships among childhood adversity, sex, threat estimation, and alcohol use initiation, we exposed female and male Long-Evans rats to early adolescent adversity (EAA). In adulthood, >50 days following the last adverse experience, threat estimation was assessed using a novel fear discrimination procedure in which cues predict a unique probability of footshock: danger (p = 1.00), uncertainty (p = .25), and safety (p = .00). Alcohol use initiation was assessed using voluntary access to 20% ethanol, >90 days following the last adverse experience. During development, EAA slowed body weight gain in both females and males. In adulthood, EAA selectively inflated female threat estimation, exaggerating fear to uncertainty and safety, but promoted alcohol use initiation across sexes. Meaningful relationships between threat estimation and alcohol use initiation were not observed, underscoring the independent effects of EAA. Results isolate the contribution of EAA to adult threat estimation, alcohol use initiation, and reveal moderation by biological sex. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. Exaggerating Accessible Differences: When Gender Stereotypes Overestimate Actual Group Differences.

    PubMed

    Eyal, Tal; Epley, Nicholas

    2017-09-01

    Stereotypes are often presumed to exaggerate group differences, but empirical evidence is mixed. We suggest exaggeration is moderated by the accessibility of specific stereotype content. In particular, because the most accessible stereotype contents are attributes perceived to differ between groups, those attributes are most likely to exaggerate actual group differences due to regression to the mean. We tested this hypothesis using a highly accessible gender stereotype: that women are more socially sensitive than men. We confirmed that the most accessible stereotype content involves attributes perceived to differ between groups (pretest), and that these stereotypes contain some accuracy but significantly exaggerate actual gender differences (Experiment 1). We observe less exaggeration when judging less accessible stereotype content (Experiment 2), or when judging individual men and women (Experiment 3). Considering the accessibility of specific stereotype content may explain when stereotypes exaggerate actual group differences and when they do not.

  14. The EuPA Biobank Initiative: Meeting the future challenges of biobanking in proteomics & systems medicine.

    PubMed

    Wheelock, Åsa M; Paulson, Linda; Litton, Jan-Eric

    2015-09-08

    In this News & Reviews Discussion, the recently launched EuPA (European Proteomics Association) Biobank Initiative is introduced in the context of current and future challenges in biobanking. The purpose of the initiative is to provide a forumand knowledge platform for integrating the extensive experiences collected by the EuPA community, and link it to the European and international biobanking communities at large. The specific impact of providing a forum and easy access to this type of information to the EuPA community is the potential of improving the quality of future sample collections and biobanks, the quality of the research produced from these sample collections, as well as the output and productivity from existing biobanks. The underutilization of biobanks has recently been identified as an emerging issue of biobankingworldwide. Measures to improve our ability to locate and access appropriate sample collections for a wide range of research purposes may enhance both the scientific quality and biobank sustainability, thereby contributing to the important task of moving our research beyond basic findings and mere publications, into clinical practice. This manuscript is intended as a Discussion piece, and represents a recollection of the presentation under the “EuPA Initiative” session at HUPO/EuPA 2014 in Madrid. The launch of the EuPA (European Proteomics Association) Biobank Initiative in the context of current and future challenges in biobanking is discussed. The purpose of the initiative is to provide a forum and knowledge base for integrating the extensive experiences collected by the EuPA community, and link it to the European and international biobanking communities at large. The specific impact of providing a forumand easy access to this type of information to the EuPA community is the potential of improving the quality of future sample collections and biobanks, the quality of the research produced from these sample collections, aswell as the

  15. Multiple Intimate Partner Violence Experiences: Knowledge, Access, Utilization and Barriers to Utilization of Resources by Women of the African Diaspora.

    PubMed

    Sabri, Bushra; Huerta, Julia; Alexander, Kamila A; St Vil, Noelle M; Campbell, Jacquelyn C; Callwood, Gloria B

    2015-11-01

    This study examined knowledge, access, utilization, and barriers to use of resources among Black women exposed to multiple types of intimate partner violence in Baltimore, Maryland and the U.S. Virgin Islands (USVI). We analyzed quantitative survey data collected by 163 women recruited from primary care, prenatal or family planning clinics in Baltimore and the USVI. In addition we analyzed qualitative data from in-depth interviews with 11 women. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using thematic analysis. A substantial proportion of Black women with multiple types of violence experiences lacked knowledge of, did not have access to, and did not use resources. Barriers to resource use were identified at the individual, relationship, and community levels. There is need for programs to develop awareness, promote access and utilization of resources, and eliminate barriers to resource use among abused Black women.

  16. An initial experience with hip resurfacing versus cementless total hip arthroplasty.

    PubMed

    Arndt, Justin Michael; Wera, Glenn D; Goldberg, Victor M

    2013-07-01

    Hip resurfacing is an alternative to total hip arthroplasty. We aimed to compare an experienced hip surgeon's initial clinical results of hip resurfacing with a new cementless total hip arthroplasty (THA). The first 55 consecutive hip resurfacing arthroplasties were compared to 100 consecutive cementless THAs using a cylindrical tapered femoral stem. The learning curve between the two procedures was compared utilizing the incidence of reoperation, complications, Harris Hip Scores (HHS), and implant survivorship. The reoperation rate was significantly higher (p = 0.019) for hip resurfacing (14.5%) versus THA (4%). The overall complication rate between the two groups was not significantly different (p = 0.398). Preoperative HHS were similar between the two groups (p = 0.2). The final mean HHS was similar in both the resurfacing and THA groups (96 vs. 98.3, respectively, p < 0.65). Kaplan-Meier survival analysis with an endpoint of reoperation suggests complications occurred earlier in the resurfacing group versus the THA group (log-rank test, p = 0.007). In comparison to our initial experience with a cementless THA stem, operative complications occur earlier and more often after hip resurfacing during the learning period. The clinical outcomes in both groups however are similar at 5 year follow-up.

  17. Racial disparities in human papillomavirus vaccination: does access matter?

    PubMed

    Gelman, Amanda; Miller, Elizabeth; Schwarz, Eleanor Bimla; Akers, Aletha Y; Jeong, Kwonho; Borrero, Sonya

    2013-12-01

    To examine the association between race/ethnicity and human papillomavirus (HPV) vaccine initiation and to determine how access to health care influences this relationship. We used nationally representative data from the National Survey of Family Growth to assess HPV vaccine initiation in 2,168 females aged 15-24 years. A series of regression analyses were performed to determine the independent effect of race/ethnicity on HPV vaccine initiation after controlling for sociodemographic variables and health care access measures. Age-stratified regression analyses were also performed to assess whether the relationship between race/ethnicity and HPV vaccine initiation differed among females aged 15-18 and 19-24 years. There were significant racial/ethnic disparities in HPV vaccination; United States (US)-born Hispanics, foreign-born Hispanics, and African-Americans were less likely to have initiated vaccination than were whites (p < .001). Adjusting for sociodemographic characteristics attenuated the disparity for both US-born and foreign-born Hispanics (adjusted odds ratio [AOR], .76; 95% confidence interval [CI], .50-1.16; and AOR, .67; 95% CI, .37-1.19) but not for African-Americans (AOR, .47, 95% CI, .33-.66). Adding health care access measures further attenuated the disparity for US-born and foreign-born Hispanics (AOR, .85, 95% CI, .54-1.34; and AOR, .84, 95% CI, .45-1.55). However, African-Americans remained less likely than whites to have initiated vaccination (AOR, .49, 95% CI, .36-.68). These racial/ethnic trends were similar for females aged 15-18 and 19-24 years. Lower rates of HPV vaccination among African-American females do not appear to be explained by differential access to health care. More research is necessary to elucidate factors contributing to HPV vaccination in this population. Published by Elsevier Inc.

  18. Initial experience with laparoscopic inferior epigastric vessel ligation for delayed transverse rectus abdominus musculocutaneous flap breast reconstruction.

    PubMed

    Trus, Thadeus L; Collins, E Dale; Demas, Christopher; Kerrigan, Carolyn

    2007-04-01

    Transverse rectus abdominus musculocutaneous (TRAM) flap breast reconstruction provides excellent cosmetic results. Pedicle flap viability is greatly enhanced by prereconstruction inferior epigastric vessel ligation, which encourages collateral arterial flow (delayed TRAM). We report our initial experience with laparoscopic inferior epigastric vessel ligation. Prospective case series. Tertiary academic center. Female patients with breast cancer who chose pedicle TRAM reconstruction. Vessel ligations were performed 7 to 14 days prior to reconstruction. Abdominal access was achieved with a 3-mm umbilical trocar. A 5-mm trocar was placed lateral to the rectus sheath in the right lower quadrant. Five-millimeter Teflon clips were used to ligate the vessels near their origin. Complications of surgery and subsequent flap viability. From January 2001 to July 2006, 130 patients had laparoscopic inferior epigastric vessel ligation, of whom 123 patients had bilateral ligation. Additional procedures in conjunction with vessel ligation were performed in 38 patients (sentinel node biopsy [27], bilateral oophorectomy [7], liver biopsy [2], breast biopsy [1], and Nissen fundoplication [1]). Median operative time for those patients undergoing ligation only was 32.6 minutes (range, 14-121 minutes). The inferior epigastric vessels were not identified in 2 patients. Metastatic breast cancer involving the liver was found in 1 patient. There were no conversions or complications. Subsequent TRAM flap viability was excellent in most cases, with 1 complete flap necrosis in a high-risk, morbidly obese patient. Laparoscopic inferior epigastric vessel ligation for delayed TRAM flap breast reconstruction is a safe, effective procedure.

  19. Progress on the FabrIc for Frontier Experiments project at Fermilab

    DOE PAGES

    Box, Dennis; Boyd, Joseph; Dykstra, Dave; ...

    2015-12-23

    The FabrIc for Frontier Experiments (FIFE) project is an ambitious, major-impact initiative within the Fermilab Scientific Computing Division designed to lead the computing model for Fermilab experiments. FIFE is a collaborative effort between experimenters and computing professionals to design and develop integrated computing models for experiments of varying needs and infrastructure. The major focus of the FIFE project is the development, deployment, and integration of Open Science Grid solutions for high throughput computing, data management, database access and collaboration within experiment. To accomplish this goal, FIFE has developed workflows that utilize Open Science Grid sites along with dedicated and commercialmore » cloud resources. The FIFE project has made significant progress integrating into experiment computing operations several services including new job submission services, software and reference data distribution through CVMFS repositories, flexible data transfer client, and access to opportunistic resources on the Open Science Grid. Hence, the progress with current experiments and plans for expansion with additional projects will be discussed. FIFE has taken a leading role in the definition of the computing model for Fermilab experiments, aided in the design of computing for experiments beyond Fermilab, and will continue to define the future direction of high throughput computing for future physics experiments worldwide« less

  20. [Initial clinical experience of proton therapy at Shizuoka Cancer Center].

    PubMed

    Murayama, Shigeyuki; Fuji, Hiroshi; Yamashita, Haruo; Futami, Yasuyuki; Numano, Masumi; Harada, Hideyuki; Kamata, Minoru; Nishimura, Tetsuo

    2005-10-01

    To present the initial experience and preliminary clinical results of patients treated mainly with proton irradiation at the newly developed proton therapy facility at Shizuoka Cancer Center. We reviewed 125 patients who underwent proton therapy between July 2003 and December 2004. Of these 125 patients, 11 had head and neck malignancies, 15 non-small cell lung cancers, 22 hepatocellular carcinomas, 62 prostate cancers, and 15 other malignant tumors. Most patients experienced Grade 0-1 acute morbidities (NCI-CTC) in skin or mucosa, while a temporary Grade 2-3 reaction was observed in a high dose area. Response rates were 73% for H & N malignancies, 100% for NSCLC, and 77% for HCC. PSA evaluation for patients with prostate cancer revealed a high rate of complete response. The efficacy and safety of proton therapy at Shizuoka Cancer Center was demonstrated for patients with early-stage cancer or locally advanced disease.

  1. Improving acute patient flow and resolving emergency department overcrowding in New Zealand hospitals--the major challenges and the promising initiatives.

    PubMed

    Ardagh, Michael W; Tonkin, Gary; Possenniskie, Clare

    2011-10-14

    To determine the most common challenges to improving acute patient flow and resolving emergency department (ED) overcrowding in New Zealand hospitals, and to share some of the promising initiatives that have been implemented in response to them. To facilitate progress towards achievement of the Shorter Stays in Emergency Departments Health Target (the Target), the authors visited every District Health Board (DHB) in New Zealand. These visits followed a standardised visit format and subsequent to each visit a report was produced that noted the observed challenges, initiatives and successes in relation to the DHB's pursuit of the Target. Using these reports, the significant challenges and the promising initiatives across all of the DHBs were collated. Access to hospital beds, access to diagnostic tests and inpatient team delays were the most common challenges, followed by increased demand for ED services, ED facility deficiencies, ED staff deficiencies, delay to discharge of inpatients, difficulty engaging hospital clinical staff in changes, difficulty accessing aged care beds, and problems at nights and weekends. Promising initiatives were noted in relation to each of these. To improve acute care, resolve ED overcrowding and achieve the Target we need a comprehensive, whole of system approach and some significant changes to the way we use our physical and human resources. To address common challenges we need to share our experiences and expertise.

  2. Do open access biomedical journals benefit smaller countries? The Slovenian experience.

    PubMed

    Turk, Nana

    2011-06-01

    Scientists from smaller countries have problems gaining visibility for their research. Does open access publishing provide a solution? Slovenia is a small country with around 5000 medical doctors, 1300 dentists and 1000 pharmacists. A search of Slovenia's Bibliographic database was carried out to identity all biomedical journals and those which are open access. Slovenia has 18 medical open access journals, but none has an impact factor and only 10 are indexed by Slovenian and international bibliographic databases. The visibility and quality of medical papers is poor. The solution might be to reduce the number of journals and encourage Slovenian scientists to publish their best articles in them. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  3. Initiating Transdisciplinarity in Academic Case Study Teaching: Experiences from a Regional Development Project in Salzburg, Austria

    ERIC Educational Resources Information Center

    Muhar, Andreas; Vilsmaier, Ulli; Glanzer, Michaela; Freyer, Bernhard

    2006-01-01

    Purpose: The purpose of this paper is to describe experiences with the initiation of transdisciplinarity in academic case study teaching with special reference to regional planning, based on the case study "Leben 2014 (Life 2014)--perspectives for regional development in the national park region Ober-pinz-gau, Salzburg".…

  4. [Initial experience in robot-assisted colorectal surgery in Mexico].

    PubMed

    Villanueva-Sáenz, Eduardo; Ramírez-Ramírez, Moisés Marino; Zubieta-O'Farrill, Gregorio; García-Hernández, Luis

    Colorectal surgery has advanced notably since the introduction of the mechanical suture and the minimally invasive approach. Robotic surgery began in order to satisfy the needs of the patient-doctor relationship, and migrated to the area of colorectal surgery. An initial report is presented on the experience of managing colorectal disease using robot-assisted surgery, as well as an analysis of the current role of this platform. A retrospective study was conducted in order to review five patients with colorectal disease operated using a robot-assisted technique over one year in the initial phase of the learning curve. Gender, age, diagnosis and surgical indication, surgery performed, surgical time, conversion, bleeding, post-operative complications, and hospital stay, were analysed and described. A literature review was performed on the role of robotic assisted surgery in colorectal disease and cancer. The study included 5 patients, 3 men and 2 women, with a mean age of 62.2 years. Two of them were low anterior resections with colorectal primary anastomoses, one of them extended with a loop protection ileostomy, a Frykman-Goldberg procedure, and two left hemicolectomies with primary anastomoses. The mean operating time was 6hours and robot-assisted 4hours 20minutes. There were no conversions and the mean hospital stay was 5 days. This technology is currently being used worldwide in different surgical centres because of its advantages that have been clinically demonstrated by various studies. We report the first colorectal surgical cases in Mexico, with promising results. There is enough evidence to support and recommend the use of this technology as a viable and safe option. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  5. Using Controlled Landslide Initiation Experiments to Test Limit-Equilibrium Analyses of Slope Stability

    NASA Astrophysics Data System (ADS)

    Reid, M. E.; Iverson, R. M.; Brien, D. L.; Iverson, N. R.; Lahusen, R. G.; Logan, M.

    2004-12-01

    Most studies of landslide initiation employ limit equilibrium analyses of slope stability. Owing to a lack of detailed data, however, few studies have tested limit-equilibrium predictions against physical measurements of slope failure. We have conducted a series of field-scale, highly controlled landslide initiation experiments at the USGS debris-flow flume in Oregon; these experiments provide exceptional data to test limit equilibrium methods. In each of seven experiments, we attempted to induce failure in a 0.65m thick, 2m wide, 6m3 prism of loamy sand placed behind a retaining wall in the 31° sloping flume. We systematically investigated triggering of sliding by groundwater injection, by prolonged moderate-intensity sprinkling, and by bursts of high intensity sprinkling. We also used vibratory compaction to control soil porosity and thereby investigate differences in failure behavior of dense and loose soils. About 50 sensors were monitored at 20 Hz during the experiments, including nests of tiltmeters buried at 7 cm spacing to define subsurface failure geometry, and nests of tensiometers and pore-pressure sensors to define evolving pore-pressure fields. In addition, we performed ancillary laboratory tests to measure soil porosity, shear strength, hydraulic conductivity, and compressibility. In loose soils (porosity of 0.52 to 0.55), abrupt failure typically occurred along the flume bed after substantial soil deformation. In denser soils (porosity of 0.41 to 0.44), gradual failure occurred within the soil prism. All failure surfaces had a maximum length to depth ratio of about 7. In even denser soil (porosity of 0.39), we could not induce failure by sprinkling. The internal friction angle of the soils varied from 28° to 40° with decreasing porosity. We analyzed stability at failure, given the observed pore-pressure conditions just prior to large movement, using a 1-D infinite-slope method and a more complete 2-D Janbu method. Each method provides a static

  6. Improving efficiency and access to mental health care: combining integrated care and advanced access.

    PubMed

    Pomerantz, Andrew; Cole, Brady H; Watts, Bradley V; Weeks, William B

    2008-01-01

    To provide an example of implementation of a new program that enhances access to mental health care in primary care. A general and specialized mental health service was redesigned to introduce open access to comprehensive mental health care in a primary care clinic. Key variables measured before and after implementation of the clinic included numbers of completed referrals, waiting time for appointments and clinic productivity. Workload and pre/post-implementation waiting time data were gathered through a computerized electronic monitoring system. Waiting time for new appointments was shortened from a mean of 33 days to 19 min. Clinician productivity and evaluations of new referrals more than doubled. These improvements have been sustained for 4 years. Moving mental health services into primary care, initiating open access and increasing use of technological aids led to dramatic improvements in access to mental health care and efficient use of resources. Implementation and sustainability of the program were enhanced by using a quality improvement approach.

  7. The maxillary molar endodontic access opening: A microscope-based approach

    PubMed Central

    Mamoun, John Sami

    2016-01-01

    This article reviews the basic clinical techniques of performing a maxillary molar endodontic access opening, starting from the initial access opening into the pulp chamber, to the point where a size #10 file has been advanced to the apices of all three or four (or more) canals. The article explains how the use of the dental surgical operating microscope or microscope-level loupes magnification of ×6–8 or greater, combined with head-mounted or coaxial illumination, improve the ability of a dentist to identify microscopic root canal orifices, which facilitates the efficient creation of conservative access openings with adequate straight-line access in maxillary molars. Magnified photos illustrate various microscopic anatomical structures or landmarks of the initial access opening. Techniques are explored for implementing an access opening for teeth with vital versus necrotic pulpal tissues. The article also explores the use of piezoelectric or ultrasonic instruments for revealing root canal orifices and for removing pulp stones or calcified pulpal tissue inside the pulp chamber. PMID:27403069

  8. Metadata, Cataloging, Digitization and Retrieval--Who's Doing What to Whom: The Colorado Digitization Project Experience.

    ERIC Educational Resources Information Center

    Bishoff, Liz; Garrison, William A.

    This paper describes the experiences of the Colorado Digitization Project (CDP) related to accessing a diverse set of primary resources held by many different cultural heritage institutions. The CDP is a collaborative initiative involving Colorado's archives, historical societies, libraries, and museums. The CDP's goal is to create a virtual…

  9. Towards a joint approach for access to environmental research infrastructures

    NASA Astrophysics Data System (ADS)

    Mann, Ingrid; Tjulin, Anders; Pappalardo, Gelsomina; Gagliardi, Simone; Philippin, Sabine; Sellegri, Karine; Chabbi, Abad

    2016-04-01

    Geoscience is a multi-disciplinary field and in many cases its research benefits from considering different kinds of observational results. Geoscience observations are in some cases of direct interest also to the public. For these reasons effective knowledge transfer and access also across disciplines are especially important for research infrastructures (RIs) in the environmental domain. More generally, the ultimate success of a RI is measured by its scientific outcome and this is best achieved based on efficient access for a broad scientific community. In this presentation the authors report activities to develop governance tools so that the access to environmental RIs and to the data that they provide is common, fair and based on scientific rationale, regarding at the same time economically and technically reasonable use of limited resources. Implementing such governance tools will indeed foster and widen the access to RIs across environmental science domains while addressing societal challenges. The strategies also need to be flexible and sustainable over the expected lifetimes of the RIs. The reported activities involve researchers from different projects and environmental subdomains that come together in the project ENVRI_plus. ENVRI_plus is a Cluster project of RIs that brings together the current ESFRI roadmap RIs in the environmental domain and other relevant existing and developing RIs and projects. ENVRI_plus also offers opportunities for free-of-charge transnational access to four multi-disciplinary research platforms. These calls for access target research groups and companies wishing to conduct research or to test instruments for cross-disciplinary topics within the environmental domains atmosphere, biosphere, marine, and solid earth. They are initiated specifically to gain experience with access across different disciplines (further information is given at www.envriplus.eu). ENVRI_plus receives funding from the European Union's Horizon 2020 research

  10. The AGING Initiative experience: a call for sustained support for team science networks.

    PubMed

    Garg, Tullika; Anzuoni, Kathryn; Landyn, Valentina; Hajduk, Alexandra; Waring, Stephen; Hanson, Leah R; Whitson, Heather E

    2018-05-18

    Team science, defined as collaborative research efforts that leverage the expertise of diverse disciplines, is recognised as a critical means to address complex healthcare challenges, but the practical implementation of team science can be difficult. Our objective is to describe the barriers, solutions and lessons learned from our team science experience as applied to the complex and growing challenge of multiple chronic conditions (MCC). MCC is the presence of two or more chronic conditions that have a collective adverse effect on health status, function or quality of life, and that require complex healthcare management, decision-making or coordination. Due to the increasing impact on the United States society, MCC research has been identified as a high priority research area by multiple federal agencies. In response to this need, two national research entities, the Healthcare Systems Research Network (HCSRN) and the Claude D. Pepper Older Americans Independence Centers (OAIC), formed the Advancing Geriatrics Infrastructure and Network Growth (AGING) Initiative to build nationwide capacity for MCC team science. This article describes the structure, lessons learned and initial outcomes of the AGING Initiative. We call for funding mechanisms to sustain infrastructures that have demonstrated success in fostering team science and innovation in translating findings to policy change necessary to solve complex problems in healthcare.

  11. From diagnosis through survivorship: health-care experiences of colorectal cancer survivors with ostomies

    PubMed Central

    Grant, Marcia; McMullen, Carmit K.; Altschuler, Andrea; Mohler, M. Jane; Hornbrook, Mark C.; Herrinton, Lisa J.; Krouse, Robert S.

    2014-01-01

    Purpose The journey from diagnosis through treatment to survivorship can be challenging for colorectal cancer (CRC) survivors with permanent ostomies. Memories of both the positive and negative health-care interactions can persist years after the initial diagnosis and treatment. The purpose of this paper is to describe the health-care experiences of long-term (>5 years) CRC survivors with ostomies. Methods Thirty-three CRC survivors with ostomies who were members of Kaiser Permanente, an integrated care organization, in Oregon, southwestern Washington and northern California participated in eight focus groups. Discussions from the focus groups were recorded, transcribed, and analyzed for potential categories and themes. Results Health-care-related themes described CRC survivors’ experiences with diagnosis, treatment decision-making, initial experiences with ostomy, and survivorship. Participants discussed both positive and negative health-care-related experiences, including the need for continued access to trained nurses for ostomy self-care, access to peer support, and resources related to managing persistent, debilitating symptoms. Conclusions Long-term CRC survivors with ostomies have both positive and negative health-care experiences, regardless of health-related quality of life (HRQOL) and gender. Long-term support mechanisms and quality survivorship care that CRC survivors with ostomies can access are needed to promote positive adjustments and improved HRQOL. Structured abstract The current literature in CRC survivor-ship suggests that HRQOL concerns can persist years after treatment completion. The coordination of care to manage persistent late- and long-term effects are still lacking for CRC survivors living with an ostomy. Findings from this qualitative analysis will aid in the development of support strategies that foster more positive adjustments for CRC survivors living with an ostomy and support their ongoing ostomy-related needs. PMID:24442998

  12. Experiences of French Speaking Immigrants and Non-immigrants Accessing Health Care Services in a Large Canadian City

    PubMed Central

    Ngwakongnwi, Emmanuel; Hemmelgarn, Brenda R.; Musto, Richard; Quan, Hude; King-Shier, Kathryn M.

    2012-01-01

    French speakers residing in predominantly English-speaking communities have been linked to difficulties accessing health care. This study examined health care access experiences of immigrants and non-immigrants who self-identify as Francophone or French speakers in a mainly English speaking province of Canada. We used semi-structured interviews to gather opinions of recent users of physician and hospital services (N = 26). Language barriers and difficulties finding family doctors were experienced by both French speaking immigrants and non-immigrants alike. This was exacerbated by a general preference for health services in French and less interest in using language interpreters during a medical consultation. Some participants experienced emotional distress, were discontent with care received, often delayed seeking care due to language barriers. Recent immigrants identified lack of insurance coverage for drugs, transportation difficulties and limited knowledge of the healthcare system as major detractors to achieving health. This study provided the groundwork for future research on health issues of official language minorities in Canada. PMID:23202772

  13. The Comprehensive Primary Care Initiative: Effects On Spending, Quality, Patients, And Physicians.

    PubMed

    Peikes, Deborah; Dale, Stacy; Ghosh, Arkadipta; Taylor, Erin Fries; Swankoski, Kaylyn; O'Malley, Ann S; Day, Timothy J; Duda, Nancy; Singh, Pragya; Anglin, Grace; Sessums, Laura L; Brown, Randall S

    2018-06-01

    The Comprehensive Primary Care Initiative (CPC), a health care delivery model developed by the Centers for Medicare and Medicaid Services (CMS), tested whether multipayer support of 502 primary care practices across the country would improve primary care delivery, improve care quality, or reduce spending. We evaluated the initiative's effects on care delivery and outcomes for fee-for-service Medicare beneficiaries attributed to initiative practices, relative to those attributed to matched comparison practices. CPC practices reported improvements in primary care delivery, including care management for high-risk patients, enhanced access, and improved coordination of care transitions. The initiative slowed growth in emergency department visits by 2 percent in CPC practices, relative to comparison practices. However, it did not reduce Medicare spending enough to cover care management fees or appreciably improve physician or beneficiary experience or practice performance on a limited set of Medicare claims-based quality measures. As CMS and other payers increasingly use alternative payment models that reward quality and value, CPC provides important lessons about supporting practices in transforming care.

  14. Multiple Intimate Partner Violence Experiences: Knowledge, Access, Utilization and Barriers to Utilization of Resources by Women of the African Diaspora

    PubMed Central

    Sabri, Bushra; Huerta, Julia; Alexander, Kamila A.; St.Vil, Noelle M.; Campbell, Jacquelyn C.; Callwood, Gloria B.

    2016-01-01

    Objective This study examined knowledge, access, utilization, and barriers to use of resources among Black women exposed to multiple types of intimate partner violence in Baltimore, Maryland and the U.S. Virgin Islands (USVI). Methods We analyzed quantitative survey data collected by 163 women recruited from primary care, prenatal or family planning clinics in Baltimore and the USVI. In addition we analyzed qualitative data from in-depth interviews with 11 women. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using thematic analysis. Results A substantial proportion of Black women with multiple types of violence experiences lacked knowledge of, did not have access to, and did not use resources. Barriers to resource use were identified at the individual, relationship, and community levels. Conclusion There is need for programs to develop awareness, promote access and utilization of resources, and eliminate barriers to resource use among abused Black women. PMID:26548679

  15. Developing design principles for a Virtual Hospice: improving access to care.

    PubMed

    Taylor, Andrea; French, Tara; Raman, Sneha

    2018-03-01

    Providing access to hospice services will become increasingly difficult due to the pressures of an ageing population and limited resources. To help address this challenge, a small number of services called Virtual Hospice have been established. This paper presents early-stage design work on a Virtual Hospice to improve access to services provided by a hospice (Highland Hospice) serving a largely remote and rural population in Scotland, UK. The study was structured as a series of Experience Labs with Highland Hospice staff, healthcare professionals and patients. Experience Labs employ a participatory design approach where participants are placed at the centre of the design process, helping to ensure that the resultant service meets their needs. Data from the Experience Labs were analysed using qualitative thematic analysis and design analysis. A number of themes and barriers to accessing Highland Hospice services were identified. In response, an initial set of seven design principles was developed. Design principles are high-level guidelines that are used to improve prioritisation and decision making during the design process by ensuring alignment with research insights. The design principles were piloted with a group of stakeholders and gained positive feedback. The design principles are intended to guide the ongoing development of the Highland Hospice Virtual Hospice. However, the challenges faced by Highland Hospice in delivering services in a largely remote and rural setting are not unique. The design principles, encompassing digital and non-digital guidelines, or the design approach could be applied by other hospices in the UK or overseas. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Semantic Repositories for eGovernment Initiatives: Integrating Knowledge and Services

    NASA Astrophysics Data System (ADS)

    Palmonari, Matteo; Viscusi, Gianluigi

    In recent years, public sector investments in eGovernment initiatives have depended on making more reliable existing governmental ICT systems and infrastructures. Furthermore, we assist at a change in the focus of public sector management, from the disaggregation, competition and performance measurements typical of the New Public Management (NPM), to new models of governance, aiming for the reintegration of services under a new perspective in bureaucracy, namely a holistic approach to policy making which exploits the extensive digitalization of administrative operations. In this scenario, major challenges are related to support effective access to information both at the front-end level, by means of highly modular and customizable content provision, and at the back-end level, by means of information integration initiatives. Repositories of information about data and services that exploit semantic models and technologies can support these goals by bridging the gap between the data-level representations and the human-level knowledge involved in accessing information and in searching for services. Moreover, semantic repository technologies can reach a new level of automation for different tasks involved in interoperability programs, both related to data integration techniques and service-oriented computing approaches. In this chapter, we discuss the above topics by referring to techniques and experiences where repositories based on conceptual models and ontologies are used at different levels in eGovernment initiatives: at the back-end level to produce a comprehensive view of the information managed in the public administrations' (PA) information systems, and at the front-end level to support effective service delivery.

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

    PubMed

    Brickle, Colleen M; Self, Karl D

    2017-09-01

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

  18. Initial experience with the new da Vinci single-port robot-assisted platform.

    PubMed

    Ballestero Diego, R; Zubillaga Guerrero, S; Truan Cacho, D; Carrion Ballardo, C; Velilla Diez, G; Calleja Hermosa, P; Gutiérrez Baños, J L

    2017-06-01

    To describe our experience in the first cases of urological surgeries performed with the da Vinci single-port robot-assisted platform. We performed 5 single-port robot-assisted surgeries (R-LESS) between May and October 2014. We performed 3 ureteral reimplant surgeries, one ureteropyeloplasty in an inverted kidney and 1 partial nephrectomy. The perioperative and postoperative results were collected, as well as a report of the complications according to the Clavien classification system. Of the 5 procedures, 4 were performed completely by LESS, while 1 procedure was reconverted to multiport robot-assisted surgery. There were no intraoperative complications. We observed perioperative complications in 4 patients, all of which were grade 1 or 2. The mean surgical time was 262minutes (range, 230-300). In our initial experience with the da Vinci device, R-LESS surgery was feasible and safe. There are still a number of limitations in its use, which require new and improved R-LESS platforms. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

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

    PubMed Central

    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

  20. Reproductive health and access to healthcare facilities: risk factors for depression and anxiety in women with an earthquake experience

    PubMed Central

    2011-01-01

    Background The reproductive and mental health of women contributes significantly to their overall well-being. Three of the eight Millennium Development Goals are directly related to reproductive and sexual health while mental disorders make up three of the ten leading causes of disease burden in low and middle-income countries. Among mental disorders, depression and anxiety are two of the most prevalent. In the context of slower progress in achieving Millennium Development Goals in developing countries and the ever-increasing man-made and natural disasters in these areas, it is important to understand the association between reproductive health and mental health among women with post-disaster experiences. Methods This was a cross-sectional study with a sample of 387 women of reproductive age (15-49 years) randomly selected from the October 2005 earthquake affected areas of Pakistan. Data on reproductive health was collected using the Centers for Disease Control reproductive health assessment toolkit. Depression and anxiety were measured using the Hopkins Symptom Checklist-25, while earthquake experiences were captured using the Harvard Trauma Questionnaire. The association of either depression or anxiety with socio-demographic variables, earthquake experiences, reproductive health and access to health facilities was estimated using multivariate logistic regression. Results Post-earthquake reproductive health events together with economic deprivation, lower family support and poorer access to health care facilities explained a significant proportion of differences in the experiencing of clinical levels of depression and anxiety. For instance, women losing resources for subsistence, separation from family and experiencing reproductive health events such as having a stillbirth, having had an abortion, having had abnormal vaginal discharge or having had genital ulcers, were at significant risk of depression and anxiety. Conclusion The relationship between women's post

  1. Reproductive health and access to healthcare facilities: risk factors for depression and anxiety in women with an earthquake experience.

    PubMed

    Anwar, Jasim; Mpofu, Elias; Matthews, Lynda R; Shadoul, Ahmed Farah; Brock, Kaye E

    2011-06-30

    The reproductive and mental health of women contributes significantly to their overall well-being. Three of the eight Millennium Development Goals are directly related to reproductive and sexual health while mental disorders make up three of the ten leading causes of disease burden in low and middle-income countries. Among mental disorders, depression and anxiety are two of the most prevalent. In the context of slower progress in achieving Millennium Development Goals in developing countries and the ever-increasing man-made and natural disasters in these areas, it is important to understand the association between reproductive health and mental health among women with post-disaster experiences. This was a cross-sectional study with a sample of 387 women of reproductive age (15-49 years) randomly selected from the October 2005 earthquake affected areas of Pakistan. Data on reproductive health was collected using the Centers for Disease Control reproductive health assessment toolkit. Depression and anxiety were measured using the Hopkins Symptom Checklist-25, while earthquake experiences were captured using the Harvard Trauma Questionnaire. The association of either depression or anxiety with socio-demographic variables, earthquake experiences, reproductive health and access to health facilities was estimated using multivariate logistic regression. Post-earthquake reproductive health events together with economic deprivation, lower family support and poorer access to health care facilities explained a significant proportion of differences in the experiencing of clinical levels of depression and anxiety. For instance, women losing resources for subsistence, separation from family and experiencing reproductive health events such as having a stillbirth, having had an abortion, having had abnormal vaginal discharge or having had genital ulcers, were at significant risk of depression and anxiety. The relationship between women's post-earthquake mental health and

  2. Initial blood storage experiment

    NASA Technical Reports Server (NTRS)

    Surgenor, Douglas MACN.

    1988-01-01

    The possibility of conducting experiments with the formed elements of the blood under conditions of microgravity opens up important opportunities to improve the understanding of basic formed element physiology, as well as, contribution to improved preservation of the formed elements for use in transfusion. The physiological, biochemical, and physical changes of the membrane of the erythrocyte, platelet, and leukocyte was studied during storage under two specific conditions: standard blood bank conditions and microgravity, utilizing three FDA approved plastic bags. Storage lesions; red cell storage on Earth; platelet storage on Earth; and leukocyte storage Earth were examined. The interaction of biomaterials and blood cells was studied during storage.

  3. Enhancing Access to Situational Vocabulary by Leveraging Geographic Context

    ERIC Educational Resources Information Center

    Patel, Rupal; Radhakrishnan, Rajiv

    2007-01-01

    Users of augmentative and alternative communication (AAC) aids could benefit from novel methods for accelerating access to contextually relevant vocabulary. This paper describes our initial efforts toward improving access to situational vocabulary through the use of geographic context to predict vocabulary. A corpus of spoken data produced by one…

  4. Limited accessibility to HIV services for persons with disabilities living with HIV in Ghana, Uganda and Zambia.

    PubMed

    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

  5. Limited accessibility to HIV services for persons with disabilities living with HIV in Ghana, Uganda and Zambia

    PubMed Central

    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

  6. High Optical Access Trap 2.0.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Maunz, Peter Lukas Wilhelm

    2016-01-26

    The High Optical Access (HOA) trap was designed in collaboration with the Modular Universal Scalable Ion-trap Quantum Computer (MUSIQC) team, funded along with Sandia National Laboratories through IARPA's Multi Qubit Coherent Operations (MQCO) program. The design of version 1 of the HOA trap was completed in September 2012 and initial devices were completed and packaged in February 2013. The second version of the High Optical Access Trap (HOA-2) was completed in September 2014 and is available at IARPA's disposal.

  7. Genelab: Scientific Partnerships and an Open-Access Database to Maximize Usage of Omics Data from Space Biology Experiments

    NASA Technical Reports Server (NTRS)

    Reinsch, S. S.; Galazka, J..; Berrios, D. C; Chakravarty, K.; Fogle, H.; Lai, S.; Bokyo, V.; Timucin, L. R.; Tran, P.; Skidmore, M.

    2016-01-01

    NASA's mission includes expanding our understanding of biological systems to improve life on Earth and to enable long-duration human exploration of space. The GeneLab Data System (GLDS) is NASA's premier open-access omics data platform for biological experiments. GLDS houses standards-compliant, high-throughput sequencing and other omics data from spaceflight-relevant experiments. The GeneLab project at NASA-Ames Research Center is developing the database, and also partnering with spaceflight projects through sharing or augmentation of experiment samples to expand omics analyses on precious spaceflight samples. The partnerships ensure that the maximum amount of data is garnered from spaceflight experiments and made publically available as rapidly as possible via the GLDS. GLDS Version 1.0, went online in April 2015. Software updates and new data releases occur at least quarterly. As of October 2016, the GLDS contains 80 datasets and has search and download capabilities. Version 2.0 is slated for release in September of 2017 and will have expanded, integrated search capabilities leveraging other public omics databases (NCBI GEO, PRIDE, MG-RAST). Future versions in this multi-phase project will provide a collaborative platform for omics data analysis. Data from experiments that explore the biological effects of the spaceflight environment on a wide variety of model organisms are housed in the GLDS including data from rodents, invertebrates, plants and microbes. Human datasets are currently limited to those with anonymized data (e.g., from cultured cell lines). GeneLab ensures prompt release and open access to high-throughput genomics, transcriptomics, proteomics, and metabolomics data from spaceflight and ground-based simulations of microgravity, radiation or other space environment factors. The data are meticulously curated to assure that accurate experimental and sample processing metadata are included with each data set. GLDS download volumes indicate strong

  8. Mainstreaming, the Regular Education Initiative, and Inclusion as Lived Experience, 1974-2004: A Practitioner's View

    ERIC Educational Resources Information Center

    Harkin, Seth B.

    2012-01-01

    This article is an auto-ethnography detailing the lived experience of the mainstreaming, Regular Education Initiative, and inclusion movements from the teacher and administrator perspectives. The article illustrates the challenges of integrating students with disabilities in general education and the sociopolitical contexts within which this…

  9. The Model Parameter Estimation Experiment (MOPEX): Its structure, connection to other international initiatives and future directions

    USGS Publications Warehouse

    Wagener, T.; Hogue, T.; Schaake, J.; Duan, Q.; Gupta, H.; Andreassian, V.; Hall, A.; Leavesley, G.

    2006-01-01

    The Model Parameter Estimation Experiment (MOPEX) is an international project aimed at developing enhanced techniques for the a priori estimation of parameters in hydrological models and in land surface parameterization schemes connected to atmospheric models. The MOPEX science strategy involves: database creation, a priori parameter estimation methodology development, parameter refinement or calibration, and the demonstration of parameter transferability. A comprehensive MOPEX database has been developed that contains historical hydrometeorological data and land surface characteristics data for many hydrological basins in the United States (US) and in other countries. This database is being continuously expanded to include basins from various hydroclimatic regimes throughout the world. MOPEX research has largely been driven by a series of international workshops that have brought interested hydrologists and land surface modellers together to exchange knowledge and experience in developing and applying parameter estimation techniques. With its focus on parameter estimation, MOPEX plays an important role in the international context of other initiatives such as GEWEX, HEPEX, PUB and PILPS. This paper outlines the MOPEX initiative, discusses its role in the scientific community, and briefly states future directions.

  10. 'As many options as there are, there are just not enough for me': contraceptive use and barriers to access among Australian women.

    PubMed

    Dixon, Suzanne C; Herbert, Danielle L; Loxton, Deborah; Lucke, Jayne C

    2014-10-01

    A comprehensive life course perspective of women's experiences in obtaining and using contraception in Australia is lacking. This paper explores free-text comments about contraception provided by women born between 1973 and 1978 who participated in the Australian Longitudinal Study on Women's Health (ALSWH). The ALSWH is a national population-based cohort study involving over 40,000 women from three age groups, who are surveyed every three years. An initial search identified 1600 comments from 690 women across five surveys from 1996 (when they were aged 18-23 years) to 2009 (31-36 years). The analysis included 305 comments from 289 participants. Factors relating to experiences of barriers to access and optimal contraceptive use were identified and explored using thematic analysis. Five themes recurred across the five surveys as women aged: (i) side effects affecting physical and mental health; (ii) lack of information about contraception; (iii) negative experiences with health services; (iv) contraceptive failure; and (v) difficulty with accessing contraception. Side effects of hormonal contraception and concerns about contraceptive failure influence women's mental and physical health. Many barriers to effective contraception persist throughout women's reproductive lives. Further research is needed into reducing barriers and minimising negative experiences, to ensure optimal contraceptive access for Australian women.

  11. A Matter of Discipline: Open Access, the Humanities, and Art History

    ERIC Educational Resources Information Center

    Tomlin, Patrick

    2009-01-01

    Recent events suggest that open access has gained new momentum in the humanities, but the slow and uneven development of open-access initiatives in humanist fields continues to hinder the consolidation of efforts across the university. Although various studies have traced the general origins of the humanities' reticence to embrace open access, few…

  12. Geobrowser Enhanced Access of Real-Time Antarctic Data

    NASA Astrophysics Data System (ADS)

    Breen, P.; Judge, D.; Cunningham, N.; Kirsch, P. J.

    2007-12-01

    A proof of principle project was initiated in the Fall of 2006 to develop a system enabling remote field station and ship borne data, collected in near real-time to be discovered, visualised and acquired through a web accessible framework. The two principal enabling drivers for this system were the recent improvements in communications with remote field stations and ships and the advent of low cost, easily accessible geobrowser technology providing the ability to visualise multiple, sometimes physically disparate datasets within a common interface. Strongly spatial in nature the oceanographic datasets suggested the incorporation of geobrowser (Google Earth) technology into this framework. A number of scientific benefits were identified by the project, these include the overall enhancing of the value of many of the datasets through their real-time contribution to forecasting models, satellite ground truthing and calibration of autonomous instrumentation. Improved efficacy of fieldwork led to rapid discovery of problems and the ability to deal with them promptly. The ability to correct or improve experiment parameters and increase capability of routine collection of high-quality data. In the past it may have been over a year before data arrived back at HQ potentially unusable, definitely unrepeatable and significantly reducing or delaying scientific output. The geobrowser interface provides the platform from which the spatial data is discovered, for example ship tracks and aspects of the physical oceanography such as sea surface temperature can be directly visualized. Importantly, ancillary and auxiliary information and metadata can be linked to the cruise data in a straightforward and accessible manner; scientists in Cambridge using a geobrowser were able to access and visualize cruise data from the Southern ocean 20 minutes after collection.

  13. Access to What? Access, Diversity and Participation in India's Schools. Research Monograph No. 32

    ERIC Educational Resources Information Center

    Juneja, Nalini

    2010-01-01

    India has witnessed substantial diversification of provision to basic education. Policy changes from 1980s onwards, has seen the creation of para-formal delivery systems and the inclusion in the system of non state providers. The Education Guarantee Scheme and the Alternate Initiatives in Education programmes have generated new pathways to access.…

  14. Building a Propulsion Experiment Project Management Environment

    NASA Technical Reports Server (NTRS)

    Keiser, Ken; Tanner, Steve; Hatcher, Danny; Graves, Sara

    2004-01-01

    What do you get when you cross rocket scientists with computer geeks? It is an interactive, distributed computing web of tools and services providing a more productive environment for propulsion research and development. The Rocket Engine Advancement Program 2 (REAP2) project involves researchers at several institutions collaborating on propulsion experiments and modeling. In an effort to facilitate these collaborations among researchers at different locations and with different specializations, researchers at the Information Technology and Systems Center,' University of Alabama in Huntsville, are creating a prototype web-based interactive information system in support of propulsion research. This system, to be based on experience gained in creating similar systems for NASA Earth science field experiment campaigns such as the Convection and Moisture Experiments (CAMEX), will assist in the planning and analysis of model and experiment results across REAP2 participants. The initial version of the Propulsion Experiment Project Management Environment (PExPM) consists of a controlled-access web portal facilitating the drafting and sharing of working documents and publications. Interactive tools for building and searching an annotated bibliography of publications related to REAP2 research topics have been created to help organize and maintain the results of literature searches. Also work is underway, with some initial prototypes in place, for interactive project management tools allowing project managers to schedule experiment activities, track status and report on results. This paper describes current successes, plans, and expected challenges for this project.

  15. Experiment Management System for the SND Detector

    NASA Astrophysics Data System (ADS)

    Pugachev, K.

    2017-10-01

    We present a new experiment management system for the SND detector at the VEPP-2000 collider (Novosibirsk). An important part to report about is access to experimental databases (configuration, conditions and metadata). The system is designed in client-server architecture. User interaction comes true using web-interface. The server side includes several logical layers: user interface templates; template variables description and initialization; implementation details. The templates are meant to involve as less IT knowledge as possible. Experiment configuration, conditions and metadata are stored in a database. To implement the server side Node.js, a modern JavaScript framework, has been chosen. A new template engine having an interesting feature is designed. A part of the system is put into production. It includes templates dealing with showing and editing first level trigger configuration and equipment configuration and also showing experiment metadata and experiment conditions data index.

  16. Web-Based Consumer Health Information: Public Access, Digital Division, and Remainders

    PubMed Central

    Lorence, Daniel; Park, Heeyoung

    2006-01-01

    Public access Internet portals and decreasing costs of personal computers have created a growing consensus that unequal access to information, or a “digital divide,” has largely disappeared for US consumers. A series of technology initiatives in the late 1990s were believed to have largely eliminated the divide. For healthcare patients, access to information is an essential part of the consumer-centric framework outlined in the recently proposed national health information initiative. Data from a recent study of health information-seeking behaviors on the Internet suggest that a “digitally underserved group” persists, effectively limiting the planned national health information infrastructure to wealthier Americans. PMID:16926743

  17. 78 FR 23329 - Aircraft Access to SWIM Working Group Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-18

    ... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Aircraft Access to SWIM Working Group... in FAA NextGen technologies to attend and participate in an Aircraft Access to SWIM Working Group... information environment. The AAtS initiative will utilize commercial air/ground network providers...

  18. Wide-bore 1.5 T MRI-guided deep brain stimulation surgery: initial experience and technique comparison.

    PubMed

    Sillay, Karl A; Rusy, Deborah; Buyan-Dent, Laura; Ninman, Nancy L; Vigen, Karl K

    2014-12-01

    We report results of the initial experience with magnetic resonance image (MRI)-guided implantation of subthalamic nucleus (STN) deep brain stimulating (DBS) electrodes at the University of Wisconsin after having employed frame-based stereotaxy with previously available MR imaging techniques and microelectrode recording for STN DBS surgeries. Ten patients underwent MRI-guided DBS implantation of 20 electrodes between April 2011 and March 2013. The procedure was performed in a purpose-built intraoperative MRI suite configured specifically to allow MRI-guided DBS, using a wide-bore (70 cm) MRI system. Trajectory guidance was accomplished with commercially available system consisting of an MR-visible skull-mounted aiming device and a software guidance system processing intraoperatively acquired iterative MRI scans. A total of 10 patients (5 male, 5 female)-representative of the Parkinson Disease (PD) population-were operated on with standard technique and underwent 20 electrode placements under MRI-guided bilateral STN-targeted DBS placement. All patients completed the procedure with electrodes successfully placed in the STN. Procedure time improved with experience. Our initial experience confirms the safety of MRI-guided DBS, setting the stage for future investigations combining physiology and MRI guidance. Further follow-up is required to compare the efficacy of the MRI-guided surgery cohort to that of traditional frame-based stereotaxy. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Vascular Access Guidelines: Summary, Rationale, and Controversies.

    PubMed

    Sequeira, Adrian; Naljayan, Mihran; Vachharajani, Tushar J

    2017-03-01

    Dialysis vascular access management in the United States changed significantly after National Kidney Foundation-Kidney Disease Outcome Quality Initiative (NKF-KDOQI) clinical practice guidelines were first published in 1997. The Centers for Medicare and Medicaid Service adopted these guidelines and in collaboration with the End-Stage Renal Disease Networks established the Fistula First Breakthrough Initiative (FFBI) in 2003 to improve the rate of arteriovenous fistula use over arteriovenous graft and central venous catheter in the dialysis population. The implementation of guidelines and FFBI has led to a significant increase in the arteriovenous fistula use in the prevalent dialysis population. The guidelines are criticized for being opinion based and often impractical. Over the past 2 decades, the patient population undergoing dialysis has become older with complex comorbidities and challenges for creating an ideal vascular access. Advancing knowledge about access pathophysiology, improved treatment options, and improved process of care with team approach model point toward diminishing relevance of few of the existing guidelines. Moreover, several guidelines remain controversial and may be leading to clinical decisions that may be unfavorable to the patients. The review discusses the historical aspect of vascular access care in the United States and evolution of current practice standards and controversies surrounding few of these guidelines in the current time. Published by Elsevier Inc.

  20. Envisioning Effective Laptop Initiatives

    ERIC Educational Resources Information Center

    Clausen, Jon M.; Britten, Jody; Ring, Gail

    2008-01-01

    A recent survey of 74 building-level school administrators in Indiana challenged many of the assumptions regarding 1:1 laptop initiatives and how 1:1 access would affect teaching and learning. It also revealed disturbing realities regarding instructional practices of teachers, as well as efforts to improve school technology integration. The intent…

  1. A study of the effect of ADA accessibility on Kansas roundabouts.

    DOT National Transportation Integrated Search

    2008-11-01

    The Access Board, with authority to enforce provisions of the American Disabilities Act (ADA), initially determined : that roundabouts are not accessible by blind pedestrians and drafted proposed guidelines to require pedestrian : signals at all roun...

  2. Assessment of the experiences and coping strategies of people working in the informal sector in their quest to access health care services: the case of Dar es Salaam, Tanzania.

    PubMed

    Munga, Michael A; Gideon, Gilbert M

    2009-02-01

    Addressing inequities in health care provision and financing has been at the center stage of Health Sector Reform (HSR) discussions since the early 1980s. The poor, women, and informal health sector workers in most developing countries are rarely covered by formal health insurance mechanisms that are meant to ensure access to essential health services. They are also sidelined in formal banking and credit systems due to their being predominantly low income earners, with little resources to meet eligibility criteria for borrowing and also to be considered creditworthy. In light of this fact, the present paper analyzes both quantitative and qualitative data in an attempt to explore and discuss the experiences and coping strategies of women and men employed in the informal sector economy in their daily attempts to access health care services. The paper employs Malaria as a tracer disease and gender as a unit of analysis. Analysis indicated the significance, as perceived by interviewees, of both informal credit networks and formal insurance and banking systems as important shock-absorbers for vulnerable populations in their struggle to access basic health services in times of need. The paper further highlights and discusses diverse coping strategies that households employ in dealing with illness-related costs and a greater willingness to be integrated into both formal and informal financial mechanisms. The paper finally concludes that the government must take the following steps: 1) enhance existing formal and communitybased initiatives to make them sustainable, 2) devise ways to reduce the lack of flexibility in membership requirements for insurance schemes/financial institutions, and 3) reduce perverse incentives inherent in the health system that may prevent people from seeking membership in available insurance mechanisms. In addition, deliberate steps must be taken by the government to employ 'targeted measures' to ensure that health care access is improved and

  3. Vascular access registry of Serbia: a 4-year experience.

    PubMed

    Jemcov, Tamara; Dimkovic, Nada

    2017-02-01

    Adequate and functional long-term vascular access (VA) is pivotal for the efficient hemodialysis (HD). It has been shown that the most reliable VA is autogenous arteriovenous fistulas (AVFs) as compared with arteriovenous grafts (AVGs) and vascular catheters (VCs). The vascular access register (VAR) has been established since 2010, and the 4-year trend of VA in Serbia is presented in this paper. All HD centers in Serbia provided their data by fulfilling the questionnaire that included prevalent and incident HD patients on December 31, 2010-1013. AVF is the most frequent prevalent VA (89.5-93.1 %) and also the most frequent newly created VA (87-89 %) during the observational period. The number of preemptive AVF is increasing, but it is still low (7.8 % in 2010 and 14.6 % in 2013). The percentage of incident AVG is constant (~3.4 %) as well as the number of permanent VC (8.2 % in 2010 and 7.8 % in 2013). The number of incident patients who started HD with AVF is decreasing (from 37 to 27 %), and the number of urgent start with VC is on the increase (from 63 to 73 %). In almost all relevant dialysis centers, vascular access is created by surgeons. Temporal VCs are placed by anesthesiologists (all centers), nephrologists (up to 25 % of centers) and vascular surgeons (up to 20 %). VCs are located mainly in jugular vein, but the number of femoral catheters remains high (up to 69 %). Although we have favorable data, the VAR is of a great importance and ensures continuous quality improvement.

  4. Two-Year Costs and Quality in the Comprehensive Primary Care Initiative.

    PubMed

    Dale, Stacy B; Ghosh, Arkadipta; Peikes, Deborah N; Day, Timothy J; Yoon, Frank B; Taylor, Erin Fries; Swankoski, Kaylyn; O'Malley, Ann S; Conway, Patrick H; Rajkumar, Rahul; Press, Matthew J; Sessums, Laura; Brown, Randall

    2016-06-16

    The 4-year, multipayer Comprehensive Primary Care Initiative was started in October 2012 to determine whether several forms of support would produce changes in care delivery that would improve the quality and reduce the costs of care at 497 primary care practices in seven regions across the United States. Support included the provision of care-management fees, the opportunity to earn shared savings, and the provision of data feedback and learning support. We tracked changes in the delivery of care by practices participating in the initiative and used difference-in-differences regressions to compare changes over the first 2 years of the initiative in Medicare expenditures, health care utilization, claims-based measures of quality, and patient experience for Medicare fee-for-service beneficiaries attributed to initiative practices and a group of matched comparison practices. During the first 2 years, initiative practices received a median of $115,000 per clinician in care-management fees. The practices reported improvements in approaches to the delivery of primary care in areas such as management of the care of high-risk patients and enhanced access to care. Changes in average monthly Medicare expenditures per beneficiary did not differ significantly between initiative and comparison practices when care-management fees were not taken into account (-$11; 95% confidence interval [CI], -$23 to $1; P=0.07; negative values indicate less growth in spending at initiative practices) or when these fees were taken into account ($7; 95% CI, -$5 to $19; P=0.27). The only significant differences in other measures were a 3% reduction in primary care visits for initiative practices relative to comparison practices (P<0.001) and changes in two of the six domains of patient experience--discussion of decisions regarding medication with patients and the provision of support for patients taking care of their own health--both of which showed a small improvement in initiative practices

  5. 76 FR 47275 - Postal Service Initiative on Retail Postal Locations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-04

    ... POSTAL REGULATORY COMMISSION [Docket No. N2011-1; Order No. 778] Postal Service Initiative on... noticing a recently-filed Postal Service request for an advisory opinion on an initiative involving... centrally directed Retail Access Optimization (RAO) initiative for examining the continuation of service at...

  6. Open science initiatives: challenges for public health promotion.

    PubMed

    Holzmeyer, Cheryl

    2018-03-07

    While academic open access, open data and open science initiatives have proliferated in recent years, facilitating new research resources for health promotion, open initiatives are not one-size-fits-all. Health research particularly illustrates how open initiatives may serve various interests and ends. Open initiatives not only foster new pathways of research access; they also discipline research in new ways, especially when associated with new regimes of research use and peer review, while participating in innovation ecosystems that often perpetuate existing systemic biases toward commercial biomedicine. Currently, many open initiatives are more oriented toward biomedical research paradigms than paradigms associated with public health promotion, such as social determinants of health research. Moreover, open initiatives too often dovetail with, rather than challenge, neoliberal policy paradigms. Such initiatives are unlikely to transform existing health research landscapes and redress health inequities. In this context, attunement to social determinants of health research and community-based local knowledge is vital to orient open initiatives toward public health promotion and health equity. Such an approach calls for discourses, norms and innovation ecosystems that contest neoliberal policy frameworks and foster upstream interventions to promote health, beyond biomedical paradigms. This analysis highlights challenges and possibilities for leveraging open initiatives on behalf of a wider range of health research stakeholders, while emphasizing public health promotion, health equity and social justice as benchmarks of transformation.

  7. Patient perspectives on choosing buprenorphine over methadone in an urban, equal-access system.

    PubMed

    Gryczynski, Jan; Jaffe, Jerome H; Schwartz, Robert P; Dušek, Kristi A; Gugsa, Nishan; Monroe, Cristin L; O'Grady, Kevin E; Olsen, Yngvild K; Mitchell, Shannon Gwin

    2013-01-01

    Recent policy initiatives in Baltimore City, MD significantly reduced access disparities between methadone and buprenorphine in the publicly funded treatment sector. This study examines reasons for choosing buprenorphine over methadone among patients with access to both medications. This study was embedded within a larger clinical trial conducted at two outpatient substance abuse treatment programs offering buprenorphine. Qualitative and quantitative data on treatment choice were collected for new patients starting buprenorphine treatment (n = 80). The sample consisted of predominantly urban African American (94%) heroin users who had prior experience with non-prescribed street buprenorphine (85%), and opioid agonist treatment (68%). Qualitative data were transcribed and coded for themes, while quantitative data were analyzed using descriptive and bivariate statistics. Participants typically conveyed their choice of buprenorphine treatment as a decision against methadone. Buprenorphine was perceived as a helpful medication while methadone was perceived as a harmful narcotic with multiple unwanted physical effects. Positive experiences with non-prescribed "street buprenorphine" were a central factor in participants' decisions to seek buprenorphine treatment. Differences in service structure between methadone and buprenorphine did not strongly influence treatment-seeking decisions in this sample. Personal experiences with medications and the street narrative surrounding them play an important role in treatment selection decisions. This study characterizes important decision factors that underlie patients' selection of buprenorphine over methadone treatment. Copyright © American Academy of Addiction Psychiatry.

  8. Patient Perspectives on Choosing Buprenorphine over Methadone in an Urban Equal Access System

    PubMed Central

    Gryczynski, Jan; Jaffe, Jerome H.; Schwartz, Robert P.; Dušek, Kristi A.; Gugsa, Nishan; Monroe, Cristin L.; O'Grady, Kevin E.; Olsen, Yngvild K.; Mitchell, Shannon Gwin

    2014-01-01

    Background Recent policy initiatives in Baltimore City, MD significantly reduced access disparities between methadone and buprenorphine in the publicly-funded treatment sector. Objectives This study examines reasons for choosing buprenorphine over methadone among patients with access to both medications. Methods This study was embedded within a larger clinical trial conducted at two outpatient substance abuse treatment programs offering buprenorphine. Qualitative and quantitative data on treatment choice were collected for new patients starting buprenorphine treatment (n=80). The sample consisted of predominantly urban African American (94%) heroin users who had prior experience with non-prescribed street buprenorphine (85%) and opioid agonist treatment (68%). Qualitative data were transcribed and coded for themes, while quantitative data were analyzed using descriptive and bivariate statistics. Results Participants typically conveyed their choice of buprenorphine treatment as a decision against methadone. Buprenorphine was perceived as a helpful medication while methadone was perceived as a harmful narcotic with multiple unwanted physical effects. Positive experiences with non-prescribed “street buprenorphine” were a central factor in participants’ decisions to seek buprenorphine treatment. Conclusions Differences in service structure between methadone and buprenorphine did not strongly influence treatment-seeking decisions in this sample. Personal experiences with medications and the street narrative surrounding them play an important role in treatment selection decisions. Scientific Significance This study characterizes important decision factors that underlie patients’ selection of buprenorphine over methadone treatment. PMID:23617873

  9. Cancer initiatives in developing countries.

    PubMed

    Mellstedt, H

    2006-06-01

    The coming decades will bring dramatic increases in morbidity and mortality from cancer in the developing world. The burden of cancer is increasing globally, with an expected 20 million new cases per year in 2020, half of which will be in low- and middle-income countries. Despite an already overwhelming burden of health problems, developing countries must somehow address this cancer pandemic and their alarming share of cancer illness. Many large-scale and innovative worldwide initiatives have been launched in the fight against cancer. These programs represent colossal efforts to expand resources for health education among people and healthcare workers in developing countries and to increase awareness of cancer prevention. Many novel evidence-based and culturally-relevant programs are being implemented for screening and early prevention of common cancers. Several key initiatives are supporting clinical research, guideline development, oncology training, and appropriate technology transfer, such as access to electronic medical literature. Treatment programs are expanding access and quality of radiologic and pharmacologic therapies for cancer. These initiatives represent an unprecedented level of and cooperation among international agencies, governmental and nongovernmental organizations, international foundations, scientific societies, local institutions, and industry. This review examines the scope of need in response to the increasing burden of cancer in the developing world and major initiatives that have been created to respond to these needs.

  10. Shock Initiation Experiments with Ignition and Growth Modeling on the HMX-Based Explosive LX-14

    NASA Astrophysics Data System (ADS)

    Vandersall, Kevin S.; Dehaven, Martin R.; Strickland, Shawn L.; Tarver, Craig M.; Springer, H. Keo; Cowan, Matt R.

    2017-06-01

    Shock initiation experiments on the HMX-based explosive LX-14 were performed to obtain in-situ pressure gauge data, characterize the run-distance-to-detonation behavior, and provide a basis for Ignition and Growth reactive flow modeling. A 101 mm diameter gas gun was utilized to initiate the explosive charges with manganin piezoresistive pressure gauge packages placed between sample disks pressed to different densities ( 1.57 or 1.83 g/cm3 that corresponds to 85 or 99% of theoretical maximum density (TMD), respectively). The shock sensitivity was found to increase with decreasing density as expected. Ignition and Growth model parameters were derived that yielded reasonable agreement with the experimental data at both initial densities. The shock sensitivity at the tested densities will be compared to prior work published on other HMX-based formulations. This work performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344. This work was funded in part by the Joint DoD-DOE Munitions Program.

  11. The dynamics of access to groups in working memory.

    PubMed

    Farrell, Simon; Lelièvre, Anna

    2012-11-01

    The finding that participants leave a pause between groups when attempting serial recall of temporally grouped lists has been taken to indicate access to a hierarchical representation of the list in working memory. An alternative explanation is that the dynamics of serial recall solely reflect output (rather than memorial) processes, with the temporal pattern at input merely suggesting a basis for the pattern of output buffering. Three experiments are presented here that disentangle input structure from output buffering in serial recall. In Experiment 1, participants were asked to recall a subset of visually presented digits from a temporally grouped list in their original order, where either within-group position or group position was kept constant. In Experiment 2, participants performed more standard serial recall of spoken digits, and input and output position were dissociated by asking participants to initiate recall from a post-cued position in the list. In Experiment 3, participants were asked to serially recall temporally grouped lists of visually presented digits where the grouping structure was unpredictable, under either articulatory suppression or silent conditions. The 3 experiments point to a tight linkage between implied memorial structures (i.e., the pattern of grouping at encoding) and the output structure implied by retrieval times and call into question a purely motoric account of the dynamics of recall.

  12. Airway management and vascular access simulation during a medical student rotation.

    PubMed

    Sakawi, Yasser; Vetter, Thomas R

    2011-03-01

    Medical students electing to spend a month in anaesthesiology during their third or fourth year often experience airway management and vascular access for the first time on an actual patient. An airway management and vascular access simulation course for medical students was developed and implemented at our institution. The purpose of this study was to assess the subjective comfort level after implementing this teaching tool in medical students. A brief didactic course on airway management and vascular access was provided to medical students on the first day of their anaesthesiology rotation. A survey was presented to the students immediately after a focused 1-hour lecture and prior to a simulation session. The pre-simulation survey was comprised of eight questions asking the medical students to rate their level of comfort with both types of procedures. The lecture was followed by a 1-hour simulation course on manikins. The medical students were asked to complete a post-simulation survey, which was comprised of the same initial eight questions. After participating in the didactic course and manikin simulation, the self-perceived comfort level of medical students with airway management (p < 0.0005), vascular access (p < 0.0005) and interpretation of the vascular pressure waveforms (p < 0.0005) demonstrated significant improvement. The results of this study suggest that providing medical students with a brief didactic session on airway and vascular access, including simulation on manikins, prior to the start of their encounter with actual surgical patients, can improve their comfort level in performing both procedures. © Blackwell Publishing Ltd 2011.

  13. Accessibility and use of primary healthcare for immigrants living in the Niagara Region.

    PubMed

    Lum, Irene D; Swartz, Rebecca H; Kwan, Matthew Y W

    2016-05-01

    Although the challenges of accessing and using primary healthcare for new immigrants to Canada have been fairly well documented, the focus has primarily been on large cities with significant immigrant populations. The experiences of immigrants living in smaller, less diverse urban centres remain largely unknown. The purpose of this study was to examine the lived experiences of immigrants living in a small urban centre with regards to the primary healthcare system. A total of 13 immigrants living in the Greater Niagara Region participated in semi-structured interviews. All interviews were recorded, transcribed, and then coded and analyzed for emergent themes using NVivo. Five factors were found to impact primary care access and use: lack of social contacts, lack of universal healthcare coverage during their initial arrival, language as a barrier, treatment preferences, and geographic distance to primary care. Overall findings suggest that immigrants moving to smaller areas such as the Niagara Region face similar barriers to primary care as those moving into large cities. Some barriers, however, appear to be specific to the context of smaller urban centres, further exacerbated by living in a small city due to a smaller immigrant population, fewer services for immigrants, and less diversity in practicing physicians. More research is required to understand the contextual factors inhibiting primary care access and use among immigrants moving to smaller urban centres, and determine effective strategies to overcome these barriers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Acute Kidney Injury before Dialysis Initiation Predicts Adverse Outcomes in Hemodialysis Patients.

    PubMed

    Lee, Timmy; Shah, Silvi; Leonard, Anthony C; Parikh, Pratik; Thakar, Charuhas V

    2018-06-07

    Acute kidney injury (AKI) is associated with increased morbidity and mortality. Mortality in end-stage renal disease (ESRD) patients is highest during the first year of dialysis. The impact of pre-ESRD AKI events on long-term outcomes in incident ESRD patients remains unknown. We evaluated a retrospective cohort of 47,341 incident hemodialysis patients from the United States Renal Data System with linked Medicare data for at least 2 years prior to hemodialysis initiation. We examined the impact of pre-ESRD AKI events in the 2-year pre-ESRD period on the type of vascular access used at hemodialysis initiation (central venous catheter (CVC) versus arteriovenous access), and 1-year all-cause mortality after initiating hemodialysis. The mean age was 72 ± 11 years. Of the study cohort, 18% initiated hemodialysis with arteriovenous access, and 54% of patients had at least one pre-ESRD AKI event. One-year, all-cause mortality was 32%. Compared to 75% for patients without a pre-ESRD AKI event, 89% of patients with a pre-ESRD AKI event initiated hemodialysis with CVC than arteriovenous access (p < 0.001). A pre-ESRD AKI event was associated with lower adjusted odds of starting hemodialysis with an arteriovenous access (OR 0.47; 95% CI 0.44-0.50, p < 0.001), and higher adjusted odds of 1-year mortality (OR 1.36; 95% CI 1.30-1.42, p < 0.001). An AKI event prior to initiating hemodialysis independently increases the risk of CVC use and predicts 1-year mortality. Improving processes of care after AKI events may improve dialysis outcomes in patients who progress to ESRD. © 2018 S. Karger AG, Basel.

  15. STRengthening Analytical Thinking for Observational Studies: the STRATOS initiative

    PubMed Central

    Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G; le Cessie, Saskia; Carpenter, James

    2014-01-01

    The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, many of these methodological developments are ignored in practice. Consequently, design and analysis of observational studies often exhibit serious weaknesses. The lack of guidance on vital practical issues discourages many applied researchers from using more sophisticated and possibly more appropriate methods when analyzing observational studies. Furthermore, many analyses are conducted by researchers with a relatively weak statistical background and limited experience in using statistical methodology and software. Consequently, even ‘standard’ analyses reported in the medical literature are often flawed, casting doubt on their results and conclusions. An efficient way to help researchers to keep up with recent methodological developments is to develop guidance documents that are spread to the research community at large. These observations led to the initiation of the strengthening analytical thinking for observational studies (STRATOS) initiative, a large collaboration of experts in many different areas of biostatistical research. The objective of STRATOS is to provide accessible and accurate guidance in the design and analysis of observational studies. The guidance is intended for applied statisticians and other data analysts with varying levels of statistical education, experience and interests. In this article, we introduce the STRATOS initiative and its main aims, present the need for guidance documents and outline the planned approach and progress so far. We encourage other biostatisticians to become involved. PMID:25074480

  16. STRengthening analytical thinking for observational studies: the STRATOS initiative.

    PubMed

    Sauerbrei, Willi; Abrahamowicz, Michal; Altman, Douglas G; le Cessie, Saskia; Carpenter, James

    2014-12-30

    The validity and practical utility of observational medical research depends critically on good study design, excellent data quality, appropriate statistical methods and accurate interpretation of results. Statistical methodology has seen substantial development in recent times. Unfortunately, many of these methodological developments are ignored in practice. Consequently, design and analysis of observational studies often exhibit serious weaknesses. The lack of guidance on vital practical issues discourages many applied researchers from using more sophisticated and possibly more appropriate methods when analyzing observational studies. Furthermore, many analyses are conducted by researchers with a relatively weak statistical background and limited experience in using statistical methodology and software. Consequently, even 'standard' analyses reported in the medical literature are often flawed, casting doubt on their results and conclusions. An efficient way to help researchers to keep up with recent methodological developments is to develop guidance documents that are spread to the research community at large. These observations led to the initiation of the strengthening analytical thinking for observational studies (STRATOS) initiative, a large collaboration of experts in many different areas of biostatistical research. The objective of STRATOS is to provide accessible and accurate guidance in the design and analysis of observational studies. The guidance is intended for applied statisticians and other data analysts with varying levels of statistical education, experience and interests. In this article, we introduce the STRATOS initiative and its main aims, present the need for guidance documents and outline the planned approach and progress so far. We encourage other biostatisticians to become involved. © 2014 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

  17. "Minimally invasive video-assisted thyroidectomy. Initial experience in a general surgery department".

    PubMed

    Dobrinja, Chiara; Trevisan, Giuliano; Liguori, Gennaro

    2009-03-01

    The aim of this study is to analyze our preliminary results from minimally invasive video-assisted thyroidectomy (MIVAT) and demonstrate the feasibility of MIVAT also in non-referral centers. We report our initial experience based on a series of 47 patients selected for MIVAT at General Surgery Department of University of Trieste during a period from May 2005 to February 2007. The eligibility criteria were rigorously observed. Age, goiter volume, major diameter of the dominant nodule, operative times, pathologic findings, postoperative pain, length of hospital stay, cosmetic results, and complications were retrospectively analyzed. Thyroid lobectomy was successfully accomplished in 33 cases, total thyroidectomy in 14. Conversion to standard cervicotomy was required in three patients (6%). Mean operative time of lobectomy was 82.6 min and 118.7 for total thyroidectomy. Postoperative complications included 11 (23.4%) transient hypocalcemias, 2 (4.2%) hematomas, and 2 (4.2%) temporary laryngeal nerve palsies. None-recurrent nerve palsies was observed. The cosmetic result was excellent in most cases. Our experience demonstrates that MIVAT, after adequate training, is feasible and safe, with results comparable to conventional thyroidectomy, also in a General Surgery Department, from a dedicated team, with a sufficient and specific activity volume.

  18. Impact Assessment of a Department-Wide Science Education Initiative Using Students' Perceptions of Teaching and Learning Experiences

    ERIC Educational Resources Information Center

    Jones, Francis

    2017-01-01

    Evaluating major post-secondary education improvement projects involves multiple perspectives, including students' perceptions of their experiences. In the final year of a seven-year department-wide science education initiative, we asked students in 48 courses to rate the extent to which each of 39 teaching or learning strategies helped them learn…

  19. Solar-terrestrial data access distribution and archiving

    NASA Technical Reports Server (NTRS)

    1984-01-01

    It is recommended that a central data catalog and data access network (CDC/DAN) for solar-terrestrial research be established, initially as a NASA pilot program. The system is envisioned to be flexible and to evolve as funds permit, starting from a catalog to an access network for high-resolution data. The report describes the various functional requirements for the CDC/DAN, but does not specify the hardware and software architectures as these are constantly evolving. The importance of a steering committee, working with the CDC/DAN organization, to provide scientific guidelines for the data catalog and for data storage, access, and distribution is also stressed.

  20. The Ocean Observatories Initiative: A new initiative for sea floor observatory research in the United States

    NASA Astrophysics Data System (ADS)

    Clark, H. L.; Isern, A. R.

    2003-04-01

    The Division of Ocean Sciences of the American National Science Foundation (NSF) plans to initiate construction of an integrated observatory network that will provide the oceanographic research and education communities with a new mode of access to the ocean. This observatory system will have three elements: 1) a regional cabled network consisting of interconnected sites on the seafloor spanning several geological and oceanographic features and processes, 2) several relocatable deep-sea buoys that could also be deployed in harsh environments such as the Southern Ocean, and 3) new construction or enhancements to existing facilities leading to an expanded network of coastal observatories. The primary infrastructure for all components of the Ocean Observatories Initiative (OOI) consists of an array of seafloor junction boxes connected to cables running along the seafloor to individual instruments or instrument clusters. These junction boxes include undersea connectors that provide not only the power and two-way communication needed to support seafloor instrumentation, but also the capability to exchange instrumentation in situ when necessary for conducting new experiments or for repairing existing instruments. Depending upon proximity to the coast and other engineering requirements, the junction box will be either terminated by a long dedicated fiber-optic cable to shore, or by a shorter cable to a surface buoy that is capable of two-way communications with a shore station. The scientific problems driving the need for an ocean observing system are broad in scope and encompass nearly every area of ocean science including: ecological characterizations; role of the ocean in climate; fluids, chemistry, and life in the oceanic crust; dynamics of the oceanic lithosphere and imaging of the earth’s interior; seafloor spreading and subduction; organic carbon fluxes; turbulent mixing and biophysical interaction; and coastal ocean processes. Thirty years ago, NSF leadership

  1. Understanding policy enactment: the New Orleans Fresh Food Retailer Initiative.

    PubMed

    Ulmer, Vanessa M; Rathert, Adrienne R; Rose, Donald

    2012-09-01

    Healthy-food financing initiatives have been endorsed as a way to improve food access, but relatively little research exists on understanding the formulation of such policies. This paper investigates the development of the New Orleans Fresh Food Retailer Initiative (FFRI) to highlight factors that enabled and impeded its enactment. In 2010 and 2011, semistructured interviews were conducted with 22 key informants with firsthand experience of this case, including representatives from the private sector, nonprofit organizations, and government. A participant-observer approach was used to synthesize these observations with archived written materials and the authors' own observations. Historical disparities in food access in New Orleans were exacerbated by Hurricane Katrina, which also generated neighborhood activism and a pressing need to rebuild the city. A Food Policy Advisory Committee (FPAC) was formed from diverse groups. This paper describes the evolution of FPAC, its deliberations and report to the City Council, and actions to promote a financing initiative, as well as delays encountered in the process. Enactment of the FFRI was facilitated by a window of opportunity that opened in the storm's aftermath, broad-based stakeholder buy-in, the existence of political champions, and policy-relevant information that was simple and convincing. Impediments to success included the constant turnover of city staff, a skeptical state bureaucracy, and the many competing priorities in New Orleans. This study highlights the importance of having a clear policy objective to address a well-defined and illustrated problem, key advocates in diverse organizations, and broad-based support for its implementation. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  2. Summative Evaluation of the Learning Initiatives Program (LIP). Final Report

    ERIC Educational Resources Information Center

    Human Resources and Skills Development Canada, 2005

    2005-01-01

    The Learning Initiatives Program (LIP), formerly the Learning Initiatives Fund (LIF), is a contribution program which was established in 1994 to encourage and support initiatives that contribute to the development of a results-oriented, accessible, relevant and accountable learning system in Canada. Through this program, Human Resources and Skills…

  3. Patients' experiences when accessing their on-line electronic patient records in primary care.

    PubMed Central

    Pyper, Cecilia; Amery, Justin; Watson, Marion; Crook, Claire

    2004-01-01

    BACKGROUND: Patient access to on-line primary care electronic patient records is being developed nationally. Knowledge of what happens when patients access their electronic records is poor. AIM: To enable 100 patients to access their electronic records for the first time to elicit patients' views and to understand their requirements. DESIGN OF STUDY: In-depth interviews using semi-structured questionnaires as patients accessed their electronic records, plus a series of focus groups. SETTING: Secure facilities for patients to view their primary care records privately. METHOD: One hundred patients from a randomised group viewed their on-line electronic records for the first time. The questionnaire and focus groups addressed patients' views on the following topics: ease of use; confidentiality and security; consent to access; accuracy; printing records; expectations regarding content; exploitation of electronic records; receiving new information and bad news. RESULTS: Most patients found the computer technology used acceptable. The majority found viewing their record useful and understood most of the content, although medical terms and abbreviations required explanation. Patients were concerned about security and confidentiality, including potential exploitation of records. They wanted the facility to give informed consent regarding access and use of data. Many found errors, although most were not medically significant. Many expected more detail and more information. Patients wanted to add personal information. CONCLUSION: Patients have strong views on what they find acceptable regarding access to electronic records. Working in partnership with patients to develop systems is essential to their success. Further work is required to address legal and ethical issues of electronic records and to evaluate their impact on patients, health professionals and service provision. PMID:14965405

  4. Systemic barriers accessing HIV treatment among people who inject drugs in Russia: a qualitative study.

    PubMed

    Sarang, Anya; Rhodes, Tim; Sheon, Nicolas

    2013-10-01

    Achieving 'universal access' to antiretroviral HIV treatment (ART) in lower income and transitional settings is a global target. Yet, access to ART is shaped by local social condition and is by no means universal. Qualitative studies are ideally suited to describing how access to ART is socially situated. We explored systemic barriers to accessing ART among people who inject drugs (PWID) in a Russian city (Ekaterinburg) with a large burden of HIV treatment demand. We undertook 42 in-depth qualitative interviews with people living with HIV with current or recent experience of injecting drug use. Accounts were analysed thematically, and supplemented here with an illustrative case study. Three core themes were identified: 'labyrinthine bureaucracy' governing access to ART; a 'system Catch 22' created by an expectation that access to ART was conditional upon treated drug use in a setting of limited drug treatment opportunity; and 'system verticalization', where a lack of integration across HIV, tuberculosis (TB) and drug treatment compromised access to ART. Taken together, we find that systemic factors play a key role in shaping access to ART with the potential adverse effects of reproducing treatment initiation delay and disengagement from treatment. We argue that meso-level systemic factors affecting access to ART for PWID interact with wider macro-level structural forces, including those related to drug treatment policy and the social marginalization of PWID. We note the urgent need for systemic and structural changes to improve access to ART for PWID in this setting, including to simplify bureaucratic procedures, foster integrated HIV, TB and drug treatment services, and advocate for drug treatment policy reform.

  5. [Management of recurrent urethrocutaneous fistula after hypospadias surgery in pediatric patients: initial experience with dermal regeneration sheet Integra].

    PubMed

    Casal-Beloy, I; Somoza Argibay, I; García-González, M; García-Novoa, A M; Míguez Fortes, L; Blanco, C; Dargallo Carbonell, T

    2017-10-25

    To present our initial experience using a dermal regeneration sheet as an urethral cover in the repair of recurrent urethrocutaneous fistulae in pediatric patients. Since May 2016 to March a total of 8 fistulaes were repaired using this new technique. We performed the ddissection of the fistulous tract and posterior closure of the urethral defect. A dermal regeneration sheet was used to cover the urethral suture. Finally a rotational flap was performed to avoid overlap sutures. During the follow-up (average 6 months), one patient presented in the immediate postoperative period infection of the surgical wound. This patient presented recurrence of the fistula. 88% of the patients included presented a good evolution with no other complications. In our initial experience the new technique seems easy, safe and effective in the management of the recurrent urethrocutaneous fistulae in pediatric patients. More studies are needed to prove these results.

  6. Crossing the gender boundaries: The gender experiences of male nursing students in initial nursing clinical practice in Taiwan.

    PubMed

    Liu, Hsing-Yuan; Li, Yun Ling

    2017-11-01

    The initial nursing clinical practice is the necessary practicum required for nursing students. Because of the changing learning style, many of them are under great pressure for environmental change and therefore their daily routine is severe affected. Interacting directly with patients in a female-dominated occupation, along with the general gender stereotypes, the impact is especially significant to male nursing students than to female nursing students. The purpose of this preliminary qualitative study is to explore the gendered experiences of male nursing students during their first initial nursing clinical practice. Both focus group interviews and individual interviews are conducted with twenty-two sophomore nursing students from a university of technology in northern Taiwan, with ten male students and twelve female students. Two main themes emerge from the gendered experiences shared by the nursing students: Gender consciousness awakening and thus maintaining masculinity, and male advantage in the learning environments. The results identify the specific gendered experiences of nursing students, providing implications for future nursing education and counseling service. Further, this study may serve to promote an active yet gender-sensitive nursing education for training nursing professionals. Published by Elsevier Ltd.

  7. Paravertebral anaesthesia for breast surgery an initial experience at the University Hospital of the West Indies.

    PubMed

    Crawford-Sykes, A M; Chin, D E; Hambleton, I R

    2004-06-01

    Paravertebral blockade (PVB) is a regional anaesthetic technique that allows the injection of local anaesthetic agents into the paravertebral space. It has been used for acute and chronic pain relief and as an anaesthetic technique for unilateral surgery of the chest, breast, shoulder, kidney, and inguinal region. Paravertebral blockade has been performed on a limited basis for breast surgery at the University Hospital of the West Indies (UHWI) since 1998. This retrospective review was undertaken to report the initial experience with this block. We reviewed the notes of all patients who were given a PVB alone, or in combination with general anaesthesia (GA). Twenty-one patients had P VB: twenty females and one male, with age range of 24 to 90 years. Six were attempted with PVB alone, but two of these needed supplementation with a GA. Fifteen were done in combination with GA. No complications were recorded The initial experience shows that the performance of PVB is both possible and safe; it may offer an alternative to GA for breast surgery. A randomized prospective study is underway to allow a detailed comparison between the two methods.

  8. Characterizing Design Cognition of High School Students: Initial Analyses Comparing Those with and without Pre-Engineering Experiences

    ERIC Educational Resources Information Center

    Wells, John; Lammi, Matthew; Gero, John; Grubbs, Michael E.; Paretti, Marie; Williams, Christopher

    2016-01-01

    Reported in this article are initial results from of a longitudinal study to characterize the design cognition and cognitive design styles of high school students with and without pre-engineering course experience over a 2-year period, and to compare them with undergraduate engineering students. The research followed a verbal protocol analysis…

  9. Initial experience of coiling cerebral aneurysms using the new Comaneci device

    PubMed Central

    Lawson, Aimee Louise Deborah; Chandran, Arun; Puthuran, Mani; Goddard, Tony; Nahser, Hans; Patankar, Tufail

    2015-01-01

    We present our initial patient experience with an innovative temporary bridging device, the Comaneci (Rapid Medical, Israel), to assist in the coiling of cerebral aneurysms. The Comaneci device confers the same benefits as balloon remodeling but without the risks of parent artery occlusion. This alleviates time pressure on the clinician, and could reduce the risk of parent artery thrombosis. Three patients were treated with the Comaneci device. Two patients had acute ruptured posterior communicating aneurysms and one patient was treated electively for a carotico-ophthalmic aneurysm. Excellent occlusion of all three aneurysms was obtained. One patient developed a distal middle cerebral artery clot, that was treated with intravenous aspirin, with minor neurological consequences. These early results show that the Comaneci device can be used to achieve good cerebral aneurysm occlusion. Vessel patency is maintained throughout the procedure with potential advantages over conventional balloon assisted coiling. PMID:26123460

  10. Initial performance of the COSINE-100 experiment

    NASA Astrophysics Data System (ADS)

    Adhikari, G.; Adhikari, P.; de Souza, E. Barbosa; Carlin, N.; Choi, S.; Choi, W. Q.; Djamal, M.; Ezeribe, A. C.; Ha, C.; Hahn, I. S.; Hubbard, A. J. F.; Jeon, E. J.; Jo, J. H.; Joo, H. W.; Kang, W. G.; Kang, W.; Kauer, M.; Kim, B. H.; Kim, H.; Kim, H. J.; Kim, K. W.; Kim, M. C.; Kim, N. Y.; Kim, S. K.; Kim, Y. D.; Kim, Y. H.; Kudryavtsev, V. A.; Lee, H. S.; Lee, J.; Lee, J. Y.; Lee, M. H.; Leonard, D. S.; Lim, K. E.; Lynch, W. A.; Maruyama, R. H.; Mouton, F.; Olsen, S. L.; Park, H. K.; Park, H. S.; Park, J. S.; Park, K. S.; Pettus, W.; Pierpoint, Z. P.; Prihtiadi, H.; Ra, S.; Rogers, F. R.; Rott, C.; Scarff, A.; Spooner, N. J. C.; Thompson, W. G.; Yang, L.; Yong, S. H.

    2018-02-01

    COSINE is a dark matter search experiment based on an array of low background NaI(Tl) crystals located at the Yangyang underground laboratory. The assembly of COSINE-100 was completed in the summer of 2016 and the detector is currently collecting physics quality data aimed at reproducing the DAMA/LIBRA experiment that reported an annual modulation signal. Stable operation has been achieved and will continue for at least 2 years. Here, we describe the design of COSINE-100, including the shielding arrangement, the configuration of the NaI(Tl) crystal detection elements, the veto systems, and the associated operational systems, and we show the current performance of the experiment.

  11. Access To The PMM's Pixel Database

    NASA Astrophysics Data System (ADS)

    Monet, D.; Levine, S.

    1999-12-01

    The U.S. Naval Observatory Flagstaff Station is in the process of enabling access to the Precision Measuring Machine (PMM) program's pixel database. The initial release will include the pixels from the PMM's scans of the Palomar Observatory Sky Survey I (POSS-I) -O and -E surveys, the Whiteoak Extension, the European Southern Observatory-R survey, the Science and Engineering Council-J, -EJ, and -ER surveys, and the Anglo- Australian Observatory-R survey. (The SERC-ER and AAO-R surveys are currently incomplete.) As time allows, access to the POSS-II -J, -F, and -N surveys, the Palomar Infrared Milky Way Atlas, the Yale/San Juan Southern Proper Motion survey, and plates rejected by various surveys will be added. (POSS-II -J and -F are complete, but -N was never finished.) Eventually, some 10 Tbytes of pixel data will be available. Due to funding and technology limitations, the initial interface will have only limited functionality, and access time will be slow since the archive is stored on Digital Linear Tape (DLT). Usage of the pixel data will be restricted to non-commercial, scientific applications, and agreements on copyright issues have yet to be finalized. The poster presentation will give the URL.

  12. The Education Equality Initiative and the Citizen Learner

    ERIC Educational Resources Information Center

    Shannon, Denise

    2005-01-01

    The Education Equality Initiative (EEI) has been established by the Department of Education and Science in an attempt to address educational disadvantage through the strategic allocation of funding to promote equality of access, treatment and outcomes within a lifelong learning framework for individuals and groups. The aim of this initiative is to…

  13. Self-taught axillary vein access without venography for pacemaker implantation: prospective randomized comparison with the cephalic vein access.

    PubMed

    Squara, Fabien; Tomi, Julien; Scarlatti, Didier; Theodore, Guillaume; Moceri, Pamela; Ferrari, Emile

    2017-12-01

    Axillary vein access for pacemaker implantation is uncommon in many centres because of the lack of training in this technique. We assessed whether the introduction of the axillary vein technique was safe and efficient as compared with cephalic vein access, in a centre where no operators had any previous experience in axillary vein puncture. Patients undergoing pacemaker implantation were randomized to axillary or cephalic vein access. All three operators had no experience nor training in axillary vein puncture, and self-learned the technique by reading a published review. Axillary vein puncture was fluoroscopy-guided without contrast venography. Cephalic access was performed by dissection of delto-pectoral groove. Venous access success, venous access duration (from skin incision to guidewire or lead in superior vena cava), procedure duration, X-ray exposure, and peri-procedural (1 month) complications were recorded. results We randomized 74 consecutive patients to axillary (n = 37) or cephalic vein access (n = 37). Axillary vein was successfully accessed in 30/37 (81.1%) patients vs. 28/37 (75.7%) of cephalic veins (P = 0.57). Venous access time was shorter in axillary group than in cephalic group [5.7 (4.4-8.3) vs. 12.2 (10.5-14.8) min, P < 0.001], as well as procedure duration [34.8 (30.6-38.4) vs. 42.0 (39.1-46.6) min, P = 0.043]. X-ray exposure and peri-procedural overall complications were comparable in both groups. Axillary puncture was safe and faster than cephalic access even for the five first procedures performed by each operator. Self-taught axillary vein puncture for pacemaker implantation seems immediately safe and faster than cephalic vein access, when performed by electrophysiologists trained to pacemaker implantation but not to axillary vein puncture. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For Permissions, please email: journals.permissions@oup.com.

  14. Features and selection of vascular access devices.

    PubMed

    Sansivero, Gail Egan

    2010-05-01

    To review venous anatomy and physiology, discuss assessment parameters before vascular access device (VAD) placement, and review VAD options. Journal articles, personal experience. A number of VAD options are available in clinical practice. Access planning should include comprehensive assessment, with attention to patient participation in the planning and selection process. Careful consideration should be given to long-term access needs and preservation of access sites. Oncology nurses are uniquely suited to perform a key role in VAD planning and placement. With knowledge of infusion therapy, anatomy and physiology, device options, and community resources, nurses can be key leaders in preserving vascular access and improving the safety and comfort of infusion therapy. Copyright 2010 Elsevier Inc. All rights reserved.

  15. Access to resources shapes maternal decision making: evidence from a factorial vignette experiment.

    PubMed

    Kushnick, Geoff

    2013-01-01

    The central assumption of behavioral ecology is that natural selection has shaped individuals with the capacity to make decisions that balance the fitness costs and benefits of behavior. A number of factors shape the fitness costs and benefits of maternal care, but we lack a clear understanding how they, taken together, play a role in the decision-making process. In animal studies, the use of experimental methods has allowed for the tight control of these factors. Standard experimentation is inappropriate in human behavioral ecology, but vignette experiments may solve the problem. I used a confounded factorial vignette experiment to gather 640 third-party judgments about the maternal care decisions of hypothetical women and their children from 40 female karo Batak respondents in rural Indonesia. This allowed me to test hypotheses derived from parental investment theory about the relative importance of five binary factors in shaping maternal care decisions with regard to two distinct scenarios. As predicted, access to resources--measured as the ability of a woman to provide food for her children--led to increased care. A handful of other factors conformed to prediction, but they were inconsistent across scenarios. The results suggest that mothers may use simple heuristics, rather than a full accounting for costs and benefits, to make decisions about maternal care. Vignettes have become a standard tool for studying decision making, but have made only modest inroads to evolutionarily informed studies of human behavior.

  16. The Shine-Dalgarno sequence of riboswitch-regulated single mRNAs shows ligand-dependent accessibility bursts

    NASA Astrophysics Data System (ADS)

    Rinaldi, Arlie J.; Lund, Paul E.; Blanco, Mario R.; Walter, Nils G.

    2016-01-01

    In response to intracellular signals in Gram-negative bacteria, translational riboswitches--commonly embedded in messenger RNAs (mRNAs)--regulate gene expression through inhibition of translation initiation. It is generally thought that this regulation originates from occlusion of the Shine-Dalgarno (SD) sequence upon ligand binding; however, little direct evidence exists. Here we develop Single Molecule Kinetic Analysis of RNA Transient Structure (SiM-KARTS) to investigate the ligand-dependent accessibility of the SD sequence of an mRNA hosting the 7-aminomethyl-7-deazaguanine (preQ1)-sensing riboswitch. Spike train analysis reveals that individual mRNA molecules alternate between two conformational states, distinguished by `bursts' of probe binding associated with increased SD sequence accessibility. Addition of preQ1 decreases the lifetime of the SD's high-accessibility (bursting) state and prolongs the time between bursts. In addition, ligand-jump experiments reveal imperfect riboswitching of single mRNA molecules. Such complex ligand sensing by individual mRNA molecules rationalizes the nuanced ligand response observed during bulk mRNA translation.

  17. Complications of the access during aortic valve implantation through transfemoral access.

    PubMed

    Alsac, Jean-Marc; Zegdi, Rachid; Blanchard, Didier; Achouh, Paul; Cholley, Bernard; Berrebi, Alain; Julia, Pierre; Fabiani, Jean-Noël

    2011-08-01

    Aortic valve implantation (AVI) is a booming therapeutic option in high-risk patients with calcific aortic stenosis. Retrograde femoral approach drawbacks include vascular complications owing to the size of the introduction system (22- and 24-F).The aim of this study was to retrospectively analyze the incidence and the treatment of vascular complications in the first 2 years of transfemoral AVI experience with the first generation of Edwards SAPIEN transcatheter heart valves. Since December 2007, AVI has been performed in 71 patients, 21 times by the transapical route and 50 times by the transfemoral route through an inguinal approach with the first generation of Edwards SAPIEN transcatheter heart valves (23 and 26 mm). The incidence and the treatment of vascular complications were evaluated as main criteria for transfemoral AVI. All the procedures could be successfully performed by a femoral route, except for three cases when the introducing device could not be fixed on the thoracic aorta because of vascular access problems. Vascular access-related complications occurred in nine patients (18%), including three iliac dissections, two aortic dissections, three femoral lesions, and one thoracic aorta rupture. These complications were treated either in a conservative way (n = 2), or in an endovascular way using a contralateral approach (n = 3), or surgically through an inguinal approach (n = 3). A traumatic rupture of the thoracic aorta resulted in the death of a female patient. In our experience, transfemoral AVI gives a satisfying technical success rate in the selected patients. The incidence of complications involving the vascular access remains an important limitation of this new technique. Although a conservative or endovascular treatment can be applied in most cases, improving the introduction devices is highly expected because it would reduce the complications rate of vascular access. Copyright © 2011 Annals of Vascular Surgery Inc. Published by Elsevier Inc

  18. Disparities in Health, Health Care Access, and Life Experience Between American Indian and White Adults in South Dakota.

    PubMed

    Moon, Heehyul; Roh, Soonhee; Lee, Yeon-Shim; Goins, R Turner

    2016-06-01

    The objective of this study is to investigate the factors associated with depressive symptoms and chronic illnesses in American Indians compared with White adults born in the post-World War II period, 1946 to 1964, and living in South Dakota. A cross-sectional design of American Indian and White adults aged 50 and older in South Dakota (Brookings, Vermillion, Sioux Falls, and all others areas of South Dakota) between January 2013 and May 2013 was used. American Indian and White adults (born between 1946 and 1964; N = 349). Data included sociodemographic factors and measures of chronic physical health condition, health care access, adverse childhood experiences, body mass index (BMI), Alcohol Use Disorders Identification Test, Technology Acceptance Model, and Multidimensional Scale of Perceived Social Support and Depressive Symptoms. American Indian adults reported more chronic diseases and conditions, a lower self-perceived physical health, were more likely to be overweight or obese, had more adverse childhood experience (ACE), and reported a lower level of alcohol intake compared to White adults. BMI was significantly associated with an increased number of chronic conditions for both groups, and American Indians' better perception of their physical health was significantly associated with lower total number of chronic conditions. Self-perceived mental health, a better level of access to health care, and a higher degree of social support were significantly inversely associated with the number of depressive symptoms for American Indian adults, while a greater level of ACE was significantly associated with an increased number of depressive symptoms for this group. The current study not only support previous studies but also contributes to understanding the disparities in and risk factors potentially impacting American Indians' physical and mental health. Our findings highlight the need to investigate the American Indians' perceptions and knowledge about health

  19. Novel Sources of Witchweed (Striga) Resistance from Wild Sorghum Accessions.

    PubMed

    Mbuvi, Dorothy A; Masiga, Clet W; Kuria, Eric; Masanga, Joel; Wamalwa, Mark; Mohamed, Abdallah; Odeny, Damaris A; Hamza, Nada; Timko, Michael P; Runo, Steven

    2017-01-01

    Sorghum is a major food staple in sub-Saharan Africa (SSA), but its production is constrained by the parasitic plant Striga that attaches to the roots of many cereals crops and causes severe stunting and loss of yield. Away from cultivated farmland, wild sorghum accessions grow as weedy plants and have shown remarkable immunity to Striga . We sought to determine the extent of the resistance to Striga in wild sorghum plants. Our screening strategy involved controlled laboratory assays of rhizotrons, where we artificially infected sorghum with Striga , as well as field experiments at three sites, where we grew sorghum with a natural Striga infestation. We tested the resistance response of seven accessions of wild sorghum of the aethiopicum, drummondii, and arundinaceum races against N13, which is a cultivated Striga resistant landrace. The susceptible control was farmer-preferred variety, Ochuti. From the laboratory experiments, we found three wild sorghum accessions (WSA-1, WSE-1, and WSA-2) that had significantly higher resistance than N13. These accessions had the lowest Striga biomass and the fewest and smallest Striga attached to them. Further microscopic and histological analysis of attached Striga haustorium showed that wild sorghum accessions hindered the ingression of Striga haustorium into the host endodermis. In one of the resistant accessions (WSE-1), host and parasite interaction led to the accumulation of large amounts of secondary metabolites that formed a dark coloration at the interphase. Field experiments confirmed the laboratory screening experiments in that these same accessions were found to have resistance against Striga . In the field, wild sorghum had low Area under the Striga Number Progressive curve (AUSNPC), which measures emergence of Striga from a host over time. We concluded that wild sorghum accessions are an important reservoir for Striga resistance that could be used to expand the genetic basis of cultivated sorghum for resistance to

  20. Remote Access Laboratories in Australia and Europe

    ERIC Educational Resources Information Center

    Ku, H.; Ahfock, T.; Yusaf, T.

    2011-01-01

    Remote access laboratories (RALs) were first developed in 1994 in Australia and Switzerland. The main purposes of developing them are to enable students to do their experiments at their own pace, time and locations and to enable students and teaching staff to get access to facilities beyond their institutions. Currently, most of the experiments…

  1. Big Earth Data Initiative: Metadata Improvement: Case Studies

    NASA Technical Reports Server (NTRS)

    Kozimor, John; Habermann, Ted; Farley, John

    2016-01-01

    Big Earth Data Initiative (BEDI) The Big Earth Data Initiative (BEDI) invests in standardizing and optimizing the collection, management and delivery of U.S. Government's civil Earth observation data to improve discovery, access use, and understanding of Earth observations by the broader user community. Complete and consistent standard metadata helps address all three goals.

  2. New perspectives on sea use management: initial findings from European experience with marine spatial planning.

    PubMed

    Douvere, Fanny; Ehler, Charles N

    2009-01-01

    Increased development pressures on the marine environment and the potential for multiple use conflicts, arising as a result of the current expansion of offshore wind energy, fishing and aquaculture, dredging, mineral extraction, shipping, and the need to meet international and national commitments to biodiversity conservation, have led to increased interest in sea use planning with particular emphasis on marine spatial planning. Several European countries, on their own initiative or driven by the European Union's Marine Strategy and Maritime Policy, the Bergen Declaration of the North Sea Conference, and the EU Recommendation on Integrated Coastal Zone Management, have taken global leadership in implementing marine spatial planning. Belgium, The Netherlands, and Germany in the North Sea, and the United Kingdom in the Irish Sea, have already completed preliminary sea use plans and zoning proposals for marine areas within their national jurisdictions. This paper discusses the nature and context of marine spatial planning, the international legal and policy framework, and the increasing need for marine spatial planning in Europe. In addition, the authors review briefly three marine spatial planning initiatives in the North Sea and conclude with some initial lessons learned from these experiences.

  3. Independence and Interdependence: An Analysis of Pre-Service Candidates' Use of Focused Assignments on an Electronic Discussion Forum during the Initial Field Experience

    ERIC Educational Resources Information Center

    Fisch, Audrey A.; Bennett, Deborah J.

    2011-01-01

    This article describes a case study using an electronic learning platform for creating an interactive learning community through asynchronous discussion to enhance the initial field experience of secondary math and English teacher candidates enrolled in Field Experience. We identified three problems with the field experience course--lack of…

  4. Development and initial porcine and cadaver experience with three-dimensional printing of endoscopic and laparoscopic equipment.

    PubMed

    del Junco, Michael; Okhunov, Zhamshid; Yoon, Renai; Khanipour, Ramtin; Juncal, Samuel; Abedi, Garen; Lusch, Achim; Landman, Jaime

    2015-01-01

    Recent advances in three-dimensional (3D) printing technology have made it possible to print surgical devices. We report our initial experience with the printing and deployment of endoscopic and laparoscopic equipment. We created computer-aided designs for ureteral stents and laparoscopic trocars using SolidWorks. We developed three generations of stents, which were printed with an Objet500 Connex printer, and a fourth generation was printed with an EOSINT P395 printer. The trocars were printed with an Objet30 Pro printer. We deployed the printed stents and trocars in a female cadaver and in vivo porcine model. We compared the printed trocars to two standard trocars for defect area and length using a digital caliper. Paired T-tests and ANOVA were used to test for statistical difference. The first two generations of stents (7F and 9F) were functional failures as their diminutive inner lumen failed to allow the passage of a 0.035 guidewire. The third generation 12F stent allowed passage of a 0.035 guidewire. The 12F diameter limited its deployment, but it was introduced in a cadaver through a ureteral access sheath. The fourth-generation 9F stents were printed and deployed in a porcine model using the standard Seldinger technique. The printed trocars were functional for the maintenance of the pneumoperitoneum and instrument passage. The printed trocars had larger superficial defect areas (p<0.001) and lengths (p=0.001) compared to Karl Storz and Ethicon trocars (29.41, 18.06, and 17.22 mm(2), respectively, and 14.29, 11.39, and 12.15 mm, respectively). In this pilot study, 3D printing of ureteral stents and trocars is feasible, and these devices can be deployed in the porcine and cadaver models. Three-dimensional printing is rapidly advancing and may be clinically viable in the future.

  5. Missouri: Early Head Start Initiative

    ERIC Educational Resources Information Center

    Center for Law and Social Policy, Inc. (CLASP), 2012

    2012-01-01

    Missouri's Early Head Start/Child Care Partnership Project expands access to Early Head Start (EHS) services for children birth to age 3 by developing partnerships between federal Head Start, EHS contractors, and child care providers. Head Start and EHS contractors that participate in the initiative provide services through community child care…

  6. Talking to Strangers--A Sociolinguistic Experiment: Variation in Initial Dyadic Interactions between Spanish-Speakers in Early 21st Century Buenos Aires, Argentina

    ERIC Educational Resources Information Center

    Dziugis, Mary Ann

    2010-01-01

    What are the chances of a dyad of Spanish-speaking strangers using informal address in casual, initial interactions in Buenos Aires, Argentina, today? To discover the pattern(s) of contemporary address, the Principal Investigator (PI) conducted a sociolinguistic experiment focusing on strangers' initial interactions to minimize the influence of…

  7. Initial Experiences with Machine-Assisted Reconsiderative Test Scoring: A New Method for Partial Credit and Multiple Correct Responses.

    ERIC Educational Resources Information Center

    Anderson, Paul S.

    Initial experiences with computer-assisted reconsiderative scoring are described. Reconsiderative scoring occurs when student responses are received and reviewed by the teacher before points for correctness are assigned. Manually scored completion-style questions are reconsiderative. A new method of machine assistance produces an item analysis on…

  8. Barriers to Accessing Emergency Medical Services in Accra, Ghana: Development of a Survey Instrument and Initial Application in Ghana

    PubMed Central

    Mould-Millman, Nee-Kofi; Rominski, Sarah D; Bogus, Joshua; Ginde, Adit A; Zakariah, Ahmed N; Boatemaah, Christiana A; Yancey, Arthur H; Akoriyea, Samuel Kaba; Campbell, Thomas B

    2015-01-01

    Background: Emergency medical services (EMS) systems provide professional prehospital emergency medical care and transportation to help improve outcomes from emergency conditions. Ghana’s national ambulance service has relatively low public utilization in comparison with the large burden of acute disease. Methods: A survey instrument was developed using Pechansky and Thomas’s model of access covering 5 dimensions of availability, accessibility, accommodation, affordability, and acceptability. The instrument was used in a cross-sectional survey in 2013 in Accra, Ghana; eligible participants were those 18 years and older who spoke English, French, or Twi. Although the analysis was mainly descriptive, logistic regression was used to identify factors associated with reported intention to call for an ambulance in the case of a medical emergency. Results: 468 participants completed surveys, with a response rate of 78.4%. Few (4.5%) respondents had ever used an ambulance in prior emergency situations. A substantial proportion (43.8%) knew about the public access medical emergency telephone number, but of those only 37.1% knew it was a toll-free call. Most (54.7%) respondents believed EMTs offered high-quality care, but 78.0% believed taxis were faster than ambulances and 69.2% thought the number of ambulances in Accra insufficient. Many (23.4%) thought using ambulances to transport corpses would be appropriate. In two hypothetical emergency scenarios, respondents most commonly reported taxis as the preferred transportation (63.6% if a family member were burned in a house fire, 64.7% if a pedestrian were struck by a vehicle). About 1 in 5 respondents said they would call an ambulance in either scenario (20.7% if a family member were burned in a house fire, 23.3% if a pedestrian were struck by a vehicle) while 15.5% and 10.2%, respectively, would use any available vehicle. Those aged 18–35 years were more likely than older respondents to prefer an ambulance (odds

  9. Barriers to Accessing Emergency Medical Services in Accra, Ghana: Development of a Survey Instrument and Initial Application in Ghana.

    PubMed

    Mould-Millman, Nee-Kofi; Rominski, Sarah D; Bogus, Joshua; Ginde, Adit A; Zakariah, Ahmed N; Boatemaah, Christiana A; Yancey, Arthur H; Akoriyea, Samuel Kaba; Campbell, Thomas B

    2015-12-01

    Emergency medical services (EMS) systems provide professional prehospital emergency medical care and transportation to help improve outcomes from emergency conditions. Ghana's national ambulance service has relatively low public utilization in comparison with the large burden of acute disease. A survey instrument was developed using Pechansky and Thomas's model of access covering 5 dimensions of availability, accessibility, accommodation, affordability, and acceptability. The instrument was used in a cross-sectional survey in 2013 in Accra, Ghana; eligible participants were those 18 years and older who spoke English, French, or Twi. Although the analysis was mainly descriptive, logistic regression was used to identify factors associated with reported intention to call for an ambulance in the case of a medical emergency. 468 participants completed surveys, with a response rate of 78.4%. Few (4.5%) respondents had ever used an ambulance in prior emergency situations. A substantial proportion (43.8%) knew about the public access medical emergency telephone number, but of those only 37.1% knew it was a toll-free call. Most (54.7%) respondents believed EMTs offered high-quality care, but 78.0% believed taxis were faster than ambulances and 69.2% thought the number of ambulances in Accra insufficient. Many (23.4%) thought using ambulances to transport corpses would be appropriate. In two hypothetical emergency scenarios, respondents most commonly reported taxis as the preferred transportation (63.6% if a family member were burned in a house fire, 64.7% if a pedestrian were struck by a vehicle). About 1 in 5 respondents said they would call an ambulance in either scenario (20.7% if a family member were burned in a house fire, 23.3% if a pedestrian were struck by a vehicle) while 15.5% and 10.2%, respectively, would use any available vehicle. Those aged 18-35 years were more likely than older respondents to prefer an ambulance (odds ratio [OR], 2.27; confidence interval

  10. Systemic barriers accessing HIV treatment among people who inject drugs in Russia: a qualitative study

    PubMed Central

    Sarang, Anya; Rhodes, Tim; Sheon, Nicolas

    2013-01-01

    Achieving ‘universal access’ to antiretroviral HIV treatment (ART) in lower income and transitional settings is a global target. Yet, access to ART is shaped by local social condition and is by no means universal. Qualitative studies are ideally suited to describing how access to ART is socially situated. We explored systemic barriers to accessing ART among people who inject drugs (PWID) in a Russian city (Ekaterinburg) with a large burden of HIV treatment demand. We undertook 42 in-depth qualitative interviews with people living with HIV with current or recent experience of injecting drug use. Accounts were analysed thematically, and supplemented here with an illustrative case study. Three core themes were identified: ‘labyrinthine bureaucracy’ governing access to ART; a ‘system Catch 22’ created by an expectation that access to ART was conditional upon treated drug use in a setting of limited drug treatment opportunity; and ‘system verticalization’, where a lack of integration across HIV, tuberculosis (TB) and drug treatment compromised access to ART. Taken together, we find that systemic factors play a key role in shaping access to ART with the potential adverse effects of reproducing treatment initiation delay and disengagement from treatment. We argue that meso-level systemic factors affecting access to ART for PWID interact with wider macro-level structural forces, including those related to drug treatment policy and the social marginalization of PWID. We note the urgent need for systemic and structural changes to improve access to ART for PWID in this setting, including to simplify bureaucratic procedures, foster integrated HIV, TB and drug treatment services, and advocate for drug treatment policy reform. PMID:23197431

  11. ACCESS: integration and pre-flight performance

    NASA Astrophysics Data System (ADS)

    Kaiser, Mary Elizabeth; Morris, Matthew J.; Aldoroty, Lauren N.; Pelton, Russell; Kurucz, Robert; Peacock, Grant O.; Hansen, Jason; McCandliss, Stephan R.; Rauscher, Bernard J.; Kimble, Randy A.; Kruk, Jeffrey W.; Wright, Edward L.; Orndorff, Joseph D.; Feldman, Paul D.; Moos, H. Warren; Riess, Adam G.; Gardner, Jonathan P.; Bohlin, Ralph; Deustua, Susana E.; Dixon, W. V.; Sahnow, David J.; Perlmutter, Saul

    2017-09-01

    Establishing improved spectrophotometric standards is important for a broad range of missions and is relevant to many astrophysical problems. ACCESS, "Absolute Color Calibration Experiment for Standard Stars", is a series of rocket-borne sub-orbital missions and ground-based experiments designed to enable improvements in the precision of the astrophysical flux scale through the transfer of absolute laboratory detector standards from the National Institute of Standards and Technology (NIST) to a network of stellar standards with a calibration accuracy of 1% and a spectral resolving power of 500 across the 0.35 - 1.7μm bandpass. This paper describes the sub-system testing, payload integration, avionics operations, and data transfer for the ACCESS instrument.

  12. Perceptions of emergency care in Kenyan communities lacking access to formalised emergency medical systems: a qualitative study

    PubMed Central

    Broccoli, Morgan C; Calvello, Emilie J B; Skog, Alexander P; Wachira, Benjamin; Wallis, Lee A

    2015-01-01

    Objectives We undertook this study in Kenya to understand the community's emergency care needs and barriers they face when trying to access care, and to seek community members’ thoughts regarding high impact solutions to expand access to essential emergency services. Design We used a qualitative research methodology to conduct 59 focus groups with 528 total Kenyan community member participants. Data were coded, aggregated and analysed using the content analysis approach. Setting Participants were uniformly selected from all eight of the historical Kenyan provinces (Central, Coast, Eastern, Nairobi, North Eastern, Nyanza, Rift Valley and Western), with equal rural and urban community representation. Results Socioeconomic and cultural factors play a major role both in seeking and reaching emergency care. Community members in Kenya experience a wide range of medical emergencies, and seem to understand their time-critical nature. They rely on one another for assistance in the face of substantial barriers to care—a lack of: system structure, resources, transportation, trained healthcare providers and initial care at the scene. Conclusions Access to emergency care in Kenya can be improved by encouraging recognition and initial treatment of emergent illness in the community, strengthening the pre-hospital care system, improving emergency care delivery at health facilities and creating new policies at a national level. These community-generated solutions likely have a wider applicability in the region. PMID:26586324

  13. The Mystic River Watershed Initiative Steering Committee Purpose and Structure

    EPA Pesticide Factsheets

    The Mystic River Watershed Initiative (MRWI) works to improve water quality and public access to open spaces in the Mystic River watershed. The MRWI Steering Committee meets regularly to discuss key issues and priority actions related to this initiative.

  14. Custom-fit total knee arthroplasty: our initial experience in 32 knees.

    PubMed

    Bali, Kamal; Walker, Peter; Bruce, Warwick

    2012-06-01

    We share our initial experience of total knee arthroplasty (TKA) using customized cutting block technology in 32 TKAs from May 2010 to March 2011. Ten of these patients had prior TKA done on the other side using conventional or navigation-assisted TKA. Customized cutting blocks were generated for each of the knee using preoperative magnetic resonance imaging of knee and long-leg weight-bearing radiographs. At 6 weeks, long-leg radiographs were obtained to evaluate the coronal alignment. There were no adverse intraoperative events. Twenty-nine of the 32 knees had a mechanical axis restored to within 3°° of neutral. Of 10 patients with prior TKA without custom-fit technology, the mean blood loss and the mean skin-to-skin time was found to be lower in knees that had undergone custom-fit TKA. We conclude that this technology can be safely used in most of the cases of osteoarthritis. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. [Port device central venous access in children with chronic renal disease--personal experience].

    PubMed

    Szczepańska, Maria; Szprynger, Krystyna; Stoksik, Piotr; Morawiec-Knysak, Aurelia; Adamczyk, Piotr; Ziora, Katarzyna; Oswiecimska, Joanna

    2006-01-01

    The application of central venous lines in children has been widely accepted in the case of pediatric cancer treatment. This is of particular importance when the treatment must be continued during the long period of time. The indication to long-term application of central venous lines became significantly frequent within last years. They are necessary in the treatment of chronic pediatric patients, in whom the central venous line allows continuous access for medication, parenteral rehydration, nutrition and frequent blood sampling. In the current study authors present their experience in subcutaneous port devices application in children with kidney disease. The case history data obtained from 8 children were retrospectively analysed. In these children subcutaneous port devices were applied for mean 26.7 months (totally 9 port devices). The mean age at the time of implantation was 2.2 years, and the mean body weight--10.6 kg. Peripheral venous access in all children was bad. In one child during the time of implantation the hematoma of coli and chest was present. Infectious complications connected with implanted port device were not detected. Thrombotic complications were present in 6 children with chronic renal failure--in 5 the lumen of port device has been successfully recanalysed, in 3 cases even several times. In 1 child the thrombus on the tip of central venous line was detected. In 2 children the removal of port device was necessary because of breakage of venous line and in the second case because of port device thrombosis. Two children died with functioning port device. The cause of death was not connected with implanted port device. The application of subcutaneous port devices definitely improved the comfort of treatment but was significantly associated with thrombotic complications. Infectious complications were not detected as compared to hematological group of patients.

  16. Evaluation of ultrasound-guided vascular access in dogs.

    PubMed

    Chamberlin, Scott C; Sullivan, Lauren A; Morley, Paul S; Boscan, Pedro

    2013-01-01

    To describe the technique and determine the feasibility, success rate, perceived difficulty, and time to vascular access using ultrasound guidance for jugular vein catheterization in a cardiac arrest dog model. Prospective descriptive study. University teaching hospital. Nine Walker hounds. A total of 27 jugular catheterizations were performed postcardiac arrest using ultrasound guidance. Catheterizations were recorded based on the order in which they were performed and presence/absence of a hematoma around the vein. Time (minutes) until successful vascular access and perceived difficulty in achieving vascular access (scale of 1 = easy to 10 = difficult) were recorded for each catheterization. Mean time to vascular access was 1.9 minutes (95% confidence interval, 1.1-3.4 min) for catheterizations without hematoma, versus 4.3 minutes (1.8-10.1 min) for catheterizations with hematoma (P = 0.1). Median perceived difficulty was 2 of 10 (range 1-7) for catheterizations without hematoma, versus 2 of 10 (range 1-8) for catheterizations with hematoma (P = 0.3). A learning curve was evaluated by comparing mean time to vascular access and perceived difficulty in initial versus subsequent catheterizations. Mean time to vascular access was 2.5 minutes (1.0-6.4 min) in the initial 13 catheterizations versus 3.3 minutes (1.5-7.5 min) in the subsequent 14 catheterizations (P = 0.6). Median perceived difficulty in the first 13 catheterizations (3, range 1-8) was significantly greater (P = 0.049) than median perceived difficulty in the subsequent 14 catheterizations (2, range 1-6). Ultrasound-guided jugular catheterization is associated with a learning curve but is successful in obtaining rapid vascular access in dogs. Further prospective studies are warranted to confirm the utility of this technique in a clinical setting. © Veterinary Emergency and Critical Care Society 2013.

  17. Family Experiences with Accessing Information, Social and Resource Supports as Participants in Services for Their Special Needs Child over Three Years of Age

    ERIC Educational Resources Information Center

    Busillo-Aguayo, Joannie

    2010-01-01

    Families of children with special needs often experience substantial stress and an increased need for informational, social, or resource support throughout their child's growth and development. However, supports for families of children older than three often report a severe shortage of supports and difficulty accessing and utilizing them. Using…

  18. Initial experience of using high field strength intraoperative MRI for neurosurgical procedures.

    PubMed

    Raheja, Amol; Tandon, Vivek; Suri, Ashish; Sarat Chandra, P; Kale, Shashank S; Garg, Ajay; Pandey, Ravindra M; Kalaivani, Mani; Mahapatra, Ashok K; Sharma, Bhawani S

    2015-08-01

    We report our initial experience to optimize neurosurgical procedures using high field strength intraoperative magnetic resonance imaging (IOMRI) in 300 consecutive patients as high field strength IOMRI rapidly becomes the standard of care for neurosurgical procedures. Three sequential groups (groups A, B, C; n=100 each) were compared with respect to time management, complications and technical difficulties to assess improvement in these parameters with experience. We observed a reduction in the number of technical difficulties (p<0.001), time to induction (p<0.001) and total anesthesia time (p=0.007) in sequential groups. IOMRI was performed for neuronavigation guidance (n=252) and intraoperative validation of extent of resection (EOR; n=67). Performing IOMRI increased the EOR over and beyond the primary surgical attempt in 20.5% (29/141) and 18% (11/61) of patients undergoing glioma and pituitary surgery, respectively. Overall, EOR improved in 59.7% of patients undergoing IOMRI (40/67). Intraoperative tractography and real time navigation using re-uploaded IOMRI images (accounting for brain shift) helps in intraoperative planning to reduce complications. IOMRI is an asset to neurosurgeons, helping to augment the EOR, especially in glioma and pituitary surgery, with no significant increase in morbidity to the patient. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. The Obstetric Hemorrhage Initiative (OHI) in Florida: The Role of Intervention Characteristics in Influencing Implementation Experiences among Multidisciplinary Hospital Staff.

    PubMed

    Vamos, Cheryl A; Cantor, Allison; Thompson, Erika L; Detman, Linda A; Bronson, Emily A; Phelps, Annette; Louis, Judette M; Gregg, Anthony R; Curran, John S; Sappenfield, William M

    2016-10-01

    Objectives Obstetric hemorrhage is one of the leading causes of maternal mortality. The Florida Perinatal Quality Collaborative coordinates a state-wide Obstetric Hemorrhage Initiative (OHI) to assist hospitals in implementing best practices related to this preventable condition. This study examined intervention characteristics that influenced the OHI implementation experiences among Florida hospitals. Methods Purposive sampling was employed to recruit diverse hospitals and multidisciplinary staff members. A semi-structured interview guide was developed based on the following constructs from the intervention characteristics domain of the Consolidated Framework for Implementation Research: evidence strength; complexity; adaptability; and packaging. Interviews were audio-recorded, transcribed and analyzed using Atlas.ti. Results Participants (n = 50) across 12 hospitals agreed that OHI is evidence-based and supported by various information sources (scientific literature, experience, and other epidemiologic or quality improvement data). Participants believed the OHI was 'average' in complexity, with variation depending on participant's role and intervention component. Participants discussed how the OHI is flexible and can be easily adapted and integrated into different hospital settings, policies and resources. The packaging was also found to be valuable in providing materials and supports (e.g., toolkit; webinars; forms; technical assistance) that assisted implementation across activities. Conclusions for Practice Participants reflected positively with regards to the evidence strength, adaptability, and packaging of the OHI. However, the complexity of the initiative adversely affected implementation experiences and required additional efforts to maximize the initiative effectiveness. Findings will inform future efforts to facilitate implementation experiences of evidence-based practices for hemorrhage prevention, ultimately decreasing maternal morbidity and

  20. Mobile Web and Accessibility

    NASA Astrophysics Data System (ADS)

    Hori, Masahiro; Kato, Takashi

    While focusing on the human-computer interaction side of the Web content delivery, this article discusses problems and prospects of the mobile Web and Web accessibility in terms of what lessons and experiences we have gained from Web accessibility and what they can say about the mobile Web. One aim is to draw particular attention to the importance of explicitly distinguishing between perceptual and cognitive aspects of the users’ interactions with the Web. Another is to emphasize the increased importance of scenario-based evaluation and remote testing for the mobile Web where the limited screen space and a variety of environmental factors of mobile use are critical design issues. A newly devised inspection type of evaluation method that focuses on the perceptual-cognitive distinction of accessibility and usability issues is presented as a viable means of scenario-based, remote testing for the Web.

  1. The experiences of working carers of older people regarding access to a web-based family care support network offered by a municipality.

    PubMed

    Andersson, Stefan; Erlingsson, Christen; Magnusson, Lennart; Hanson, Elizabeth

    2017-09-01

    Policy makers in Sweden and other European Member States pay increasing attention as to how best support working carers; carers juggling providing unpaid family care for older family members while performing paid work. Exploring perceived benefits and challenges with web-based information and communication technologies as a means of supporting working carers' in their caregiving role, this paper draws on findings from a qualitative study. The study aimed to describe working carers' experiences of having access to the web-based family care support network 'A good place' (AGP) provided by the municipality to support those caring for an older family member. Content analysis of interviews with nine working carers revealed three themes: A support hub, connections to peers, personnel and knowledge; Experiencing ICT support as relevant in changing life circumstances; and Upholding one's personal firewall. Findings indicate that the web-based family care support network AGP is an accessible, complementary means of support. Utilising support while balancing caregiving, work obligations and responsibilities was made easier with access to AGP; enabling working carers to access information, psychosocial support and learning opportunities. In particular, it provided channels for carers to share experiences with others, to be informed, and to gain insights into medical and care issues. This reinforced working carers' sense of competence, helping them meet caregiving demands and see positive aspects in their situation. Carers' low levels of digital skills and anxieties about using computer-based support were barriers to utilising web-based support and could lead to deprioritising of this support. However, to help carers overcome these barriers and to better match web-based support to working carers' preferences and situations, web-based support must be introduced in a timely manner and must more accurately meet each working carer's unique caregiving needs. © 2016 Nordic College

  2. Child-Friendly School Initiative in Jordan: A Sharing Experience

    ERIC Educational Resources Information Center

    Weshah, Hani A.; Al-Faori, Oraib; Sakal, Reham M.

    2012-01-01

    The purpose of this research was to report on a Child-Friendly School (CFS) initiative pilot project in Jordan, which aims at initiating the creation of CFS and to raise stakeholders' awareness of the importance of this project in promoting and implementing Child Rights Conviction (CRC) in Jordan. The study was conducted by a joint team selected…

  3. Tools for Local and Distributed Climate Data Access

    NASA Astrophysics Data System (ADS)

    Schweitzer, R.; O'Brien, K.; Burger, E. F.; Smith, K. M.; Manke, A. B.; Radhakrishnan, A.; Balaji, V.

    2017-12-01

    Last year we reported on our efforts to adapt existing tools to facilitate model development. During the lifecycle of a Climate Model Intercomparison Project (CMIP), data must be quality controlled before it can be published and studied. Like previous efforts, the next CMIP6 will produce an unprecedented volume of data. For an institution, modelling group or modeller the volume of data is unmanageable without tools that organize and automate as many processes as possible. Even if a modelling group has tools for data and metadata management, it often falls on individuals to do the initial quality assessment for a model run with bespoke tools. Using individually crafted tools can lead to interruptions when project personnel change and may result in inconsistencies and duplication of effort across groups. This talk will expand on our experiences using available tools (Ferret/PyFerret, the Live Access Server, the GFDL Curator, the GFDL Model Development Database Interface and the THREDDS Data Server) to seamlessly automate the data assembly process to give users "one-click" access to a rich suite of Web-based analysis and comparison tools. On the surface, it appears that this collection of tools is well suited to the task, but our experience of the last year taught us that the data volume and distributed storage adds a number of challenges in adapting the tools for this task. Quality control and initial evaluation add their own set of challenges. We will discuss how we addressed the needs of QC researchers by expanding standard tools to include specialized plots and leveraged the configurability of the tools to add specific user defined analysis operations so they are available to everyone using the system. We also report on our efforts to overcome some of the technical barriers for wide adoption of the tools by providing pre-built containers that are easily deployed in virtual machine and cloud environments. Finally, we will offer some suggestions for added features

  4. Availability and acceptability of HIV counselling and testing services. A qualitative study comparing clients' experiences of accessing HIV testing at public sector primary health care facilities or non-governmental mobile services in Cape Town, South Africa.

    PubMed

    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

  5. Civil space technology initiative

    NASA Technical Reports Server (NTRS)

    1990-01-01

    The Civil Space Technology Initiative (CSTI) is a major, focused, space technology program of the Office of Aeronautics, Exploration and Technology (OAET) of NASA. The program was initiated to advance technology beyond basic research in order to expand and enhance system and vehicle capabilities for near-term missions. CSTI takes critical technologies to the point at which a user can confidently incorporate the new or expanded capabilities into relatively near-term, high-priority NASA missions. In particular, the CSTI program emphasizes technologies necessary for reliable and efficient access to and operation in Earth orbit as well as for support of scientific missions from Earth orbit.

  6. Initial experience with laparoscopic sleeve gastrectomy by a novice bariatric team in an established bariatric center--a review of literature and initial results.

    PubMed

    Dey, Ashish; Mittal, Tarun; Malik, Vinod K

    2013-04-01

    Laparoscopic sleeve gastrectomy (LSG) is a highly successful approach to morbid obesity with low incidence of complications. The literature suggests a learning curve of 50-100 cases for attaining proficiency and reducing the complication rates for laparoscopic bariatric surgery. The aims of this paper were to review the literature of initial cases by bariatric surgeons worldwide and to report the experience of initial 50 cases of LSG by a novice bariatric team in a single center. The objective was to evaluate the outcomes for laparoscopic bariatric surgery in the first 50 patients by a novice team of bariatric surgeons in an already established bariatric surgery program with short-term follow-up. All surgeries were done by a new bariatric team who underwent laparoscopic fellowship training under a bariatric team with an experience of over 600 bariatric procedures. Fifty consecutive patients from March 2010 to January 2012 were offered LSG and followed up for a minimum of 6 months. Weight loss and comorbidity resolution were tabulated and assessed. Mean preoperative and postoperative BMIs were 46.6 and 35.7 kg/m2, respectively. There were no life threatening postoperative complications or mortality. The median percent excess weight loss was 50.3% at the end of 6 months. Comorbidity resolution values were 96% for obstructive sleep apnea, 89% for diabetes mellitus, and 87% for joint pains, among the most common comorbidities. LSG is effective in achieving weight loss and in improving comorbidities with minimal complications even at the hands of novice bariatric surgeons with good laparoscopic skills and adequate bariatric training.

  7. Design and performance of the spin asymmetries of the nucleon experiment

    DOE PAGES

    Maxwell, J. D.; Armstrong, W. R.; Choi, S.; ...

    2018-03-01

    The Spin Asymmetries of the Nucleon Experiment (SANE) performed inclusive, double-polarized electron scattering measurements of the proton at the Continuous Electron Beam Facility at Jefferson Lab. A novel detector array observed scattered electrons of four-momentum transfer 2.5 < Q 2 < 6.5 GeV 2 and Bjorken scaling 0.3 < x < 0.8 from initial beam energies of 4.7 and 5.9 GeV. Employing a polarized proton target which could be rotated with respect to the incident electron beam, both parallel and near perpendicular spin asymmetries were measured, allowing model-independent access to transverse polarization observables A 1, A 2, g 1, gmore » 2 and moment d 2 of the proton. This article summarizes the operation and performance of the polarized target, polarized electron beam, and novel detector systems used during the course of the experiment, and describes analysis techniques utilized to access the physics observables of interest.« less

  8. Design and performance of the spin asymmetries of the nucleon experiment

    NASA Astrophysics Data System (ADS)

    Maxwell, J. D.; Armstrong, W. R.; Choi, S.; Jones, M. K.; Kang, H.; Liyanage, A.; Meziani, Z.-E.; Mulholland, J.; Ndukum, L.; Rondón, O. A.; Ahmidouch, A.; Albayrak, I.; Asaturyan, A.; Ates, O.; Baghdasaryan, H.; Boeglin, W.; Bosted, P.; Brash, E.; Brock, J.; Butuceanu, C.; Bychkov, M.; Carlin, C.; Carter, P.; Chen, C.; Chen, J.-P.; Christy, M. E.; Covrig, S.; Crabb, D.; Danagoulian, S.; Daniel, A.; Davidenko, A. M.; Davis, B.; Day, D.; Deconinck, W.; Deur, A.; Dunne, J.; Dutta, D.; El Fassi, L.; Elaasar, M.; Ellis, C.; Ent, R.; Flay, D.; Frlez, E.; Gaskell, D.; Geagla, O.; German, J.; Gilman, R.; Gogami, T.; Gomez, J.; Goncharenko, Y. M.; Hashimoto, O.; Higinbotham, D. W.; Horn, T.; Huber, G. M.; Jones, M.; Kalantarians, N.; Kang, H. K.; Kawama, D.; Keith, C.; Keppel, C.; Khandaker, M.; Kim, Y.; King, P. M.; Kohl, M.; Kovacs, K.; Kubarovsky, V.; Li, Y.; Liyanage, N.; Luo, W.; Mamyan, V.; Markowitz, P.; Maruta, T.; Meekins, D.; Melnik, Y. M.; Mkrtchyan, A.; Mkrtchyan, H.; Mochalov, V. V.; Monaghan, P.; Narayan, A.; Nakamura, S. N.; Nuruzzaman; Pentchev, L.; Pocanic, D.; Posik, M.; Puckett, A.; Qiu, X.; Reinhold, J.; Riordan, S.; Roche, J.; Sawatzky, B.; Shabestari, M.; Slifer, K.; Smith, G.; Soloviev, L.; Solvignon, P.; Tadevosyan, V.; Tang, L.; Vasiliev, A. N.; Veilleux, M.; Walton, T.; Wesselmann, F.; Wood, S. A.; Yao, H.; Ye, Z.; Zhu, L.

    2018-03-01

    The Spin Asymmetries of the Nucleon Experiment (SANE) performed inclusive, double-polarized electron scattering measurements of the proton at the Continuous Electron Beam Accelerator Facility at Jefferson Lab. A novel detector array observed scattered electrons of four-momentum transfer 2 . 5 initial beam energies of 4.7 and 5.9 GeV. Employing a polarized proton target whose magnetic field direction could be rotated with respect to the incident electron beam, both parallel and near perpendicular spin asymmetries were measured, allowing model-independent access to transverse polarization observables A1, A2, g1, g2 and moment d2 of the proton. This document summarizes the operation and performance of the polarized target, polarized electron beam, and novel detector systems used during the course of the experiment, and describes analysis techniques utilized to access the physics observables of interest.

  9. Design and performance of the spin asymmetries of the nucleon experiment

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Maxwell, J. D.; Armstrong, W. R.; Choi, S.

    The Spin Asymmetries of the Nucleon Experiment (SANE) performed inclusive, double-polarized electron scattering measurements of the proton at the Continuous Electron Beam Facility at Jefferson Lab. A novel detector array observed scattered electrons of four-momentum transfer 2.5 < Q 2 < 6.5 GeV 2 and Bjorken scaling 0.3 < x < 0.8 from initial beam energies of 4.7 and 5.9 GeV. Employing a polarized proton target which could be rotated with respect to the incident electron beam, both parallel and near perpendicular spin asymmetries were measured, allowing model-independent access to transverse polarization observables A 1, A 2, g 1, gmore » 2 and moment d 2 of the proton. This article summarizes the operation and performance of the polarized target, polarized electron beam, and novel detector systems used during the course of the experiment, and describes analysis techniques utilized to access the physics observables of interest.« less

  10. Community College Selective Enrollment and the Challenge to Open Access

    ERIC Educational Resources Information Center

    Morris, David Brian

    2012-01-01

    The open access mission is central to the community college role and mission in higher education. Although initially implemented by four-year colleges and universities, adoption of formal enrollment management initiatives in community colleges is on the increase. Admission, matriculation, retention, and persistence are affected by enrollment…

  11. Meet our Neighbours - a tactile experience

    NASA Astrophysics Data System (ADS)

    Canas, L.; Lobo Correia, A.

    2013-09-01

    Planetary science is a key field in astronomy that draws lots of attention and that engages large amounts of enthusiasts. On its essence, it is a visual science and the current resources and activities for the inclusion of visually impaired children, although increasing, are still costly and somewhat scarce. Therefore there is a paramount need to develop more low cost resources in order to provide experiences that can reach all, even the more socially deprived communities. "Meet our neighbours!-a tactile experience", plans to promote and provide inclusion activities for visually impaired children and their non-visually impaired peers through the use of astronomy hands-on low cost activities. Is aimed for children from the ages of 6 to 12 years old and produce data set 13 tactile images of the main objects of the Solar System that can be used in schools, science centres and outreach associations. Accessing several common problems through tactile resources, with this project we present ways to successfully provide low cost solutions (avoiding the expensive tactile printing costs), promote inclusion and interactive hands-on activities for visually impaired children and their non-visually impaired peers and create dynamic interactions based on oral knowledge transmission between them. Here we describe the process of implementing such initiative near target communities: establishing a bridge between scientists, children and teachers. The struggles and challenges perceived during the project and the enrichment experience of engaging astronomy with these specific groups, broadening horizons in an overall experience accessible to all.

  12. Examination of Data Accession at the National Snow and Ice Data Center

    NASA Astrophysics Data System (ADS)

    Scott, D. J.; Booker, L.

    2017-12-01

    The National Snow and Ice Data Center (NSIDC) stewards nearly 750 publicly available snow and ice data sets that support research into our world's frozen realms. NSIDC data management is primarily supported by the National Aeronautics and Space Administration (NASA), the National Science Foundation (NSF) and the National Oceanic and Atmospheric Administration (NOAA), and most of the data we archive and distribute is assigned to NSIDC through the funding agency programs. In addition to these mandates, NSIDC has historically offered data stewardship to researchers wanting to properly preserve and increase visibility of their research data under our primary programs (NASA, NSF, NOAA). With publishers now requiring researchers to deliver data to a repository prior to the publication of their data-related papers, we have seen an increase in researcher-initiated data accession requests. This increase is pushing us to reexamine our process to ensure timeliness in the acquisition and release of these data. In this presentation, we will discuss the support and value a researcher receives by submitting data to a trustworthy repository. We will examine NSIDC's data accession practices, and the challenges of a consistent process across NSIDC's multiple funding sponsors. Finally, we will share recent activities related to improving our process and ideas we have for enhancing the overall data accession experience.

  13. Pore Formation and Mobility Investigation (PFMI): Concept, Hardware Development and Initial Analysis of Experiments

    NASA Technical Reports Server (NTRS)

    Grugel, Richard N.

    2004-01-01

    Porosity in the form of "bubbles and pipes" can occur during controlled directional solidification processing of metal alloys. This is a consequence that 1) precludes obtaining any meaningful scientific results and 2) is detrimental to desired material properties. Unfortunately, several Microgravity experiments have been compromised by porosity. The intent of the PFMI investigation is to conduct a systematic effort directed towards understanding porosity formation and mobility during controlled directional solidification (DS) in a microgravity environment. PFMI uses a pure transparent material, succinonitrile (SCN), as well as SCN "alloyed" with water, in conjunction with a translating temperature gradient stage so that direct observation and recording of pore generation and mobility can be made. PFMI is investigating the role of thermocapillary forces and temperature gradients in affecting bubble dynamics as well as other solidification processes in a microgravity Environment. This presentation will cover the concept, hardware development, operations, and the initial results from experiments conducted aboard the International Space Station. .

  14. Influence of operator experience and PCI volume on transfemoral access techniques: A collaboration of international cardiovascular societies.

    PubMed

    Nelson, Daniel W; Damluji, Abdulla A; Patel, Nish; Valgimigli, Marco; Windecker, Stephan; Byrne, Robert; Nolan, James; Patel, Tejas; Brilakis, Emmanouil; Banerjee, Subhash; Mayol, Jorge; Cantor, Warren J; Alfonso, Carlos E; Rao, Sunil V; Moscucci, Mauro; Cohen, Mauricio G

    2018-03-01

    Transfemoral access (TFA) is widely used for coronary angiography and percutaneous coronary intervention (PCI). The influence of operator age, gender, experience, and procedural volume on performance of femoral arterial access has not been studied. A survey instrument was developed and distributed via e-mail from professional societies to interventional cardiologists worldwide from March to December 2016. A total of 988 physicians from 88 countries responded to the survey. TFA is the preferred approach for patients with cardiogenic shock, left main or bifurcation PCI, and procedures with mechanical circulatory support. Older (<50years: 56.4%; ≥50years: 66.8%, p<0.0039) and high PCI volume operators (<100 PCI: 57.3%; 100-299 PCI: 58.7%; ≥300 PCI: 64.3%, p<0.134) preferred palpation only without imaging (fluoroscopy or ultrasound (US)) for TFA. Most respondents preferred not to use micropuncture needle to puncture the femoral artery. Older (≥50years: 64.4%; <50years: 71.5%, p<0.04) and high PCI volume operators (≥300 PCI: 64.1%; 100-299 PCI: 72.6%; <100 PCI: 67.9%, p<0.072) tended not to perform femoral angiography (FA). Of those performing FA, the majority opted to do it at the end of the procedure. Despite best practice guideline recommendations, older and high PCI volume interventional cardiologists prefer not to use imaging for femoral access or perform femoral angiography during TF procedures. These data highlight opportunities to further reduce TFA complications. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Unique Access to Learning

    ERIC Educational Resources Information Center

    Goble, Don

    2009-01-01

    This article describes the many learning opportunities that broadcast technology students at Ladue Horton Watkins High School in St. Louis, Missouri, experience because of their unique access to technology and methods of learning. Through scaffolding, stepladder techniques, and trial by fire, students learn to produce multiple television programs,…

  16. A descriptive study of the experiences of lesbian, gay and transgender parents accessing health services for their children.

    PubMed

    Chapman, Rose; Wardrop, Joan; Freeman, Phoenix; Zappia, Tess; Watkins, Rochelle; Shields, Linda

    2012-04-01

    To explore the experiences of lesbian, gay and transgender families accessing health care for their children. Although lesbian, gay and transgender families are becoming more common, little is known about their health-seeking experiences. These families may be fearful about disclosing their sexual orientation or gender identity to health professionals. As a result, lesbian, gay and transgender parents may not be receiving optimal care for their children. Descriptive qualitative study. Data were collected through semi-structured interviews with 11 lesbian, gay and transgender parents in Australia. Three themes were generated from the data: 'managing health care experiences', 'attitudes' and 'transforming bureaucracies'. Negative experiences included encountering homophobia or transphobia and being required to educate health professionals. Positive experiences occurred when both parents were acknowledged as having an equal say in their child's health care. Many health professionals lack the skill or knowledge to meet the needs of lesbian, gay and transgender families. Health services are required to ensure that all policies and procedures are inclusive of all family constellations and that staff receive relevant and up-to-date sensitivity training and create an environment that is respectful of all family groups. Adopting a philosophy of family centred care can enable health providers and health professionals to provide lesbian, gay and transgender families with inclusive non-discriminatory care. © 2012 Blackwell Publishing Ltd.

  17. The Year-Two Experiment: Exploring Teachers' Experiences of a 1:1 Technology Initiative

    ERIC Educational Resources Information Center

    Uy, Jan Michael

    2017-01-01

    This study examined the impact of 1:1 device initiatives in U.S. education K-12 school districts. Specifically, the problem addressed in this research was that studies of the second year of 1:1 technology programs in K-12 school districts had documented challenges among teachers with this change initiative leading to discontent and even…

  18. The Student Spaceflight Experiments Program: Access to the ISS for K-14 Students

    NASA Astrophysics Data System (ADS)

    Livengood, Timothy A.; Goldstein, J. J.; Vanhala, H. A. T.; Johnson, M.; Hulslander, M.

    2012-10-01

    The Student Spaceflight Experiments Program (SSEP) has flown 42 experiments to space, on behalf of students from middle school through community college, on 3 missions: each of the last 2 Space Shuttle flights, and the first SpaceX resupply flight to the International Space Station (ISS). SSEP plans 2 missions to the ISS per year for the foreseeable future, and is expanding the program to include 4-year undergraduate college students and home-schooled students. SSEP experiments have explored biological, chemical, and physical phenomena within self-contained enclosures developed by NanoRacks, currently in the form of MixStix Fluid Mixing Enclosures. Over 9000 students participated in the initial 3 missions of SSEP, directly experiencing the entire lifecycle of space science experimentation through community-wide participation in SSEP, taking research from a nascent idea through developing competitive research proposals, down-selecting to three proposals from each participating community and further selection of a single proposal for flight, actual space flight, sample recovery, analysis, and reporting. The National Air and Space Museum has hosted 2 National Conferences for SSEP student teams to report results in keeping with the model of professional research. Student teams have unflinchingly reported on success, failure, and groundbased efforts to develop proposals for future flight opportunities. Community participation extends outside the sciences and the immediate proposal efforts to include design competitions for mission patches (that also fly to space). Student experimenters have rallied around successful proposal teams to support a successful experiment on behalf of the entire community. SSEP is a project of the National Center for Earth and Space Science Education enabled through NanoRacks LLC, working in partnership with NASA under a Space Act Agreement as part of the utilization of the International Space Station as a National Laboratory.

  19. The Student Spaceflight Experiments Program: Access to the ISS for K-14 Students

    NASA Astrophysics Data System (ADS)

    Livengood, Timothy A.; Goldstein, J. J.; Hamel, S.; Manber, J.; Hulslander, M.

    2013-10-01

    The Student Spaceflight Experiments Program (SSEP) has flown 53 experiments to space, on behalf of students from middle school through community college, on 4 missions: each of the last 2 Space Shuttle flights, the first SpaceX demonstration flight to the International Space Station (ISS), and on SpaceX-1 to ISS. Two more missions to ISS have payloads flying in Fall 2013. SSEP plans 2 missions to the ISS per year for the foreseeable future, and is expanding the program to include 4-year undergraduate college students and home-schooled students. SSEP experiments have explored biological, chemical, and physical phenomena within self-contained enclosures developed by NanoRacks, currently in the form of MixStix Fluid Mixing Enclosures. 21,600 students participated in the initial 6 missions of SSEP, directly experiencing the entire lifecycle of space science experimentation through community-wide participation in SSEP, taking research from a nascent idea through developing competitive research proposals, down-selecting to three proposals from each participating community and further selection of a single proposal for flight, actual space flight, sample recovery, analysis, and reporting. The National Air and Space Museum has hosted 3 National Conferences for SSEP student teams to report results in keeping with the model of professional research. Student teams have unflinchingly reported on success, failure, and groundbased efforts to develop proposals for future flight opportunities. Community participation extends outside the sciences and the immediate proposal efforts to include design competitions for mission patches, which also fly to space. Student experimenters have rallied around successful proposal teams to support a successful experiment on behalf of the entire community. SSEP is a project of the National Center for Earth and Space Science Education enabled through NanoRacks LLC, working in partnership with NASA under a Space Act Agreement as part of the

  20. The Fabric for Frontier Experiments Project at Fermilab

    NASA Astrophysics Data System (ADS)

    Kirby, Michael

    2014-06-01

    The FabrIc for Frontier Experiments (FIFE) project is a new, far-reaching initiative within the Fermilab Scientific Computing Division to drive the future of computing services for experiments at FNAL and elsewhere. It is a collaborative effort between computing professionals and experiment scientists to produce an end-to-end, fully integrated set of services for computing on the grid and clouds, managing data, accessing databases, and collaborating within experiments. FIFE includes 1) easy to use job submission services for processing physics tasks on the Open Science Grid and elsewhere; 2) an extensive data management system for managing local and remote caches, cataloging, querying, moving, and tracking the use of data; 3) custom and generic database applications for calibrations, beam information, and other purposes; 4) collaboration tools including an electronic log book, speakers bureau database, and experiment membership database. All of these aspects will be discussed in detail. FIFE sets the direction of computing at Fermilab experiments now and in the future, and therefore is a major driver in the design of computing services worldwide.

  1. The Fabric for Frontier Experiments Project at Fermilab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kirby, Michael

    2014-01-01

    The FabrIc for Frontier Experiments (FIFE) project is a new, far-reaching initiative within the Fermilab Scientific Computing Division to drive the future of computing services for experiments at FNAL and elsewhere. It is a collaborative effort between computing professionals and experiment scientists to produce an end-to-end, fully integrated set of services for computing on the grid and clouds, managing data, accessing databases, and collaborating within experiments. FIFE includes 1) easy to use job submission services for processing physics tasks on the Open Science Grid and elsewhere, 2) an extensive data management system for managing local and remote caches, cataloging, querying,more » moving, and tracking the use of data, 3) custom and generic database applications for calibrations, beam information, and other purposes, 4) collaboration tools including an electronic log book, speakers bureau database, and experiment membership database. All of these aspects will be discussed in detail. FIFE sets the direction of computing at Fermilab experiments now and in the future, and therefore is a major driver in the design of computing services worldwide.« less

  2. Marshall Space Flight Center's role in EASE/ACCESS mission management

    NASA Technical Reports Server (NTRS)

    Hawkins, Gerald W.

    1987-01-01

    The Marshall Space Flight Center (MSFC) Spacelab Payload Project Office was responsible for the mission management and development of several successful payloads. Two recent space construction experiments, the Experimental Assembly of Structures in Extravehicular Activity (EASE) and the Assembly Concept for Construction of Erectable Space Structures (ACCESS), were combined into a payload managed by the center. The Ease/ACCESS was flown aboard the Space Shuttle Mission 61-B. The EASE/ACCESS experiments were the first structures assembled in space, and the method used to manage this successful effort will be useful for future space construction missions. The MSFC mission management responsibilities for the EASE/ACCESS mission are addressed and how the lessons learned from the mission can be applied to future space construction projects are discussed.

  3. Expanding Access to Early Head Start: State Initiatives for Infants & Toddlers at Risk

    ERIC Educational Resources Information Center

    Colvard, Jamie; Schmit, Stephanie

    2012-01-01

    The federal Early Head Start (EHS) program was created in 1994 to address the comprehensive needs of children under age 3 in low-income families and vulnerable low-income pregnant women. In addition to early learning opportunities, EHS's comprehensive early childhood development programs provide children and families with access to a range of…

  4. 16 CFR 1014.8 - Appeal of initial denial of access, correction or amendment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... a record is denied, in whole or in part, may appeal that decision within 30 working days to the... and shall: (1) Name the individual making the appeal; (2) Identify the record to which access is... decision thereon. However, for good cause shown, the Chairman of the Commission may extend the 30-day...

  5. Chronic disease patients' experiences with accessing health care in rural and remote areas: a systematic review and qualitative meta-synthesis.

    PubMed

    Brundisini, F; Giacomini, M; DeJean, D; Vanstone, M; Winsor, S; Smith, A

    2013-01-01

    Rurality can contribute to the vulnerability of people with chronic diseases. Qualitative research can identify a wide range of health care access issues faced by patients living in a remote or rural setting. To systematically review and synthesize qualitative research on the advantages and disadvantages rural patients with chronic diseases face when accessing both rural and distant care. This report synthesizes 12 primary qualitative studies on the topic of access to health care for rural patients with chronic disease. Included studies were published between 2002 and 2012 and followed adult patients in North America, Europe, Australia, and New Zealand. Qualitative meta-synthesis was used to integrate findings across primary research studies. Three major themes were identified: geography, availability of health care professionals, and rural culture. First, geographic distance from services poses access barriers, worsened by transportation problems or weather conditions. Community supports and rurally located services can help overcome these challenges. Second, the limited availability of health care professionals (coupled with low education or lack of peer support) increases the feeling of vulnerability. When care is available locally, patients appreciate long-term relationships with individual clinicians and care personalized by familiarity with the patient as a person. Finally, patients may feel culturally marginalized in the urban health care context, especially if health literacy is low. A culture of self-reliance and community belonging in rural areas may incline patients to do without distant care and may mitigate feelings of vulnerability. Qualitative research findings are not intended to generalize directly to populations, although meta-synthesis across a number of qualitative studies builds an increasingly robust understanding that is more likely to be transferable. Selected studies focused on the vulnerability experiences of rural dwellers with chronic

  6. Single port access laparoscopic surgery for large adnexal tumors: Initial 51 cases of a single institute

    PubMed Central

    Cho, Bo Ra; Han, Jae Won; Kim, Tae Hyun; Han, Ae Ra; Hur, Sung Eun; Lee, Sung Ki

    2017-01-01

    Objective Investigation of initial 51 cases of single port access (SPA) laparoscopic surgery for large adnexal tumors and evaluation of safety and feasibility of the surgical technique. Methods We retrospectively reviewed the medical records of the first 51 patients who received SPA laparoscopic surgery for large adnexal tumors greater than 10 cm, from July 2010 to February 2015. Results SPA adnexal surgeries were successfully completed in 51 patients (100%). The mean age, body mass index of the patients were 43.1 years and 22.83 kg/m2, respectively. The median operative time, median blood loss were 73.5 (range, 20 to 185) minutes, 54 (range, 5 to 500) mL, and the median tumor diameter was 13.6 (range, 10 to 30) cm. The procedures included bilateral salpingo-oophorectomy (n=18, 36.0%), unilateral salpingo-oophorectomy (n=14, 27.45%), and paratubal cystectomy (n=1, 1.96%). There were no cases of malignancy and none were insertion of additional ports or conversion to laparotomy. The cases with intraoperative spillage were 3 (5.88%) and benign cystic tumors. No other intraoperative and postoperative complications were observed during hospital days and 6-weeks follow-up period after discharge. Conclusion Our results suggest that SPA laparoscopic surgery for large adnexal tumors may be a safe and feasible alternative to conventional laparoscopic surgery. PMID:28217669

  7. Expanding access to sterile syringes through pharmacies: assessment of New York's Expanded Syringe Access Program.

    PubMed

    Tesoriero, James M; Battles, Haven B; Klein, Susan J; Kaufman, Erin; Birkhead, Guthrie S

    2009-01-01

    To investigate the evolution of pharmacist practices, attitudes, and experiences with the Expanded Syringe Access Program (ESAP), which permits over-the-counter sale of syringes by registered pharmacies in New York State. Longitudinal study. New York State in 2002 and 2006. 506 (2002) and 682 (2006) managing pharmacists (response rates approximately 70%) at ESAP-registered pharmacies (n = 346 in both years). Mailed surveys (2002 and 2006). Pharmacist practices, attitudes, and experiences with ESAP over time. Approximately 75% of pharmacists reported that ESAP had facilitated timely/emergency access to syringes, and more than 90% in each year reported no problems or very few problems administering ESAP. The practice of placing additional requirements on the sale of syringes decreased from 2002 (51.4%) to 2006 (45.1%), while a 55% increase in syringe sales was reported between 2002 (43.3/month) and 2006 (67.1/month). The sale of sharps containers also increased between 2002 (85.2%) and 2006 (92.8%). Community independent pharmacies and those located outside New York City generally expressed more favorable attitudes and experiences with ESAP, although these differences decreased over time. Pharmacy-based syringe access is a viable harm-reduction alternative in the fight against blood-borne diseases, with ESAP now equaling the number of syringes being distributed by syringe exchange programs in New York State. Continued education/training is necessary to increase participation in ESAP and to further reduce barriers to ESAP use.

  8. Accessible Earth: Enhancing diversity in the Geosciences through accessible course design

    NASA Astrophysics Data System (ADS)

    Bennett, R. A.; Lamb, D. A.

    2017-12-01

    The tradition of field-based instruction in the geoscience curriculum, which culminates in a capstone geological field camp, presents an insurmountable barrier to many disabled students who might otherwise choose to pursue geoscience careers. There is a widespread perception that success as a practicing geoscientist requires direct access to outcrops and vantage points available only to those able to traverse inaccessible terrain. Yet many modern geoscience activities are based on remotely sensed geophysical data, data analysis, and computation that take place entirely from within the laboratory. To challenge the perception of geoscience as a career option only for the non-disabled, we have created the capstone Accessible Earth Study Abroad Program, an alternative to geologic field camp for all students, with a focus on modern geophysical observation systems, computational thinking, data science, and professional development.In this presentation, we will review common pedagogical approaches in geosciences and current efforts to make the field more inclusive. We will review curricular access and inclusivity relative to a wide range of learners and provide examples of accessible course design based on our experiences in teaching a study abroad course in central Italy, and our plans for ongoing assessment, refinement, and dissemination of the effectiveness of our efforts.

  9. The impact of universal access to dental care on disparities in caries experience in children.

    PubMed

    Ismail, A I; Sohn, W

    2001-03-01

    The authors investigated the association between socioeconomic status and the severity of dental caries in 6- and 7-year-old children who had had access to dental care throughout their lives. The children had lived since birth in Nova Scotia, Canada, a province with a universal publicly financed dental care program. The authors selected a representative sample of first-grade children using a stratified multistage sampling method of primary schools (n = 1,614). The response rate was 78.8 percent. Two dentists were trained to diagnose dental caries using modified World Health Organization criteria. Intra- and interexaminer reliability was excellent (kappa > or = 0.88). Of the children who were examined (n = 1,271), 955 were lifelong residents of Nova Scotia, Canada, and so were included in this analysis. Data were weighted and adjusted for clustering (design) effects. Only 8.4 percent of the children had visited a dental office before the age of 2 years, and 88.5 percent of the children had their first dental visit between the ages of 2 and 5 years. Children whose parents had completed a university education had a significantly lower mean number of decayed, missing and filled surfaces, or dmfs, in their primary teeth than did children whose parents had a lower education level. A Poisson regression model indicated that parents' high education status, optimal fluoride concentration in schools' water supplies, daily toothbrushing and dental visits for checkup were significantly associated with low dmfs scores. Having access to a universal publicly financed dental insurance program since birth did not eliminate the disparities in caries experience. This analysis of a highly utilized universal dental insurance program suggests that disparities in oral health status cannot be reduced solely by providing universal access to dental care. Focused efforts by professional and governmental organizations should be directed toward understanding the socioeconomic, behavioral and

  10. Learning from fellow engineering students who have current professional experience

    NASA Astrophysics Data System (ADS)

    Davies, John W.; Rutherford, Ursula

    2012-08-01

    This paper presents an investigation of how experience-led content in an engineering degree can be strengthened by creating opportunities for engineering students to benefit from the knowledge, skills and resources of students with current professional experience. Students who study civil engineering part-time at Coventry University (while also working in the industry) are being used as mentors for full-time students, and careful attention is being paid to the input they can make to group project work. This paper reviews the results of evaluations of these two initiatives. The clearest enhancement to learning provided by the part-time students in these settings is the access they provide for the full-time students to real examples and the provision of actual physical artefacts such as drawings, photos, example documents and templates. Full-time students also gain an awareness of the value of the professional skills. The study confirms the value of these initiatives and points to future improvements.

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

    PubMed

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

    2017-01-01

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

  12. Overcoming Barriers to the Market Access of Biosimilars in the European Union: The Case of Biosimilar Monoclonal Antibodies.

    PubMed

    Moorkens, Evelien; Jonker-Exler, Clara; Huys, Isabelle; Declerck, Paul; Simoens, Steven; Vulto, Arnold G

    2016-01-01

    In 2014, six of the top ten blockbuster medicines were monoclonal antibodies. This multibillion-dollar market with expiring patents is the main driver for the development of biosimilar mAbs. With the ever-increasing cost of healthcare and the economic pressure to reduce or sustain healthcare expenses, biosimilars could be instrumental in reducing costs for medication and increasing patient access to treatment. The aim of this study is to identify and describe the barriers to market access of biosimilar mAbs in the European Union and to analyze how these barriers could be overcome. A narrative literature review was carried out using the databases PubMed, Embase, and EconLit. Studies were published in English or Dutch. Additionally, the reference list of the articles was checked for relevant studies. Articles and conference papers known to the authors were included as well. Articles were also identified by searching on the website of the Generics and Biosimilars Initiative (GaBI) journal. Six barriers were identified based on available literature: The manufacturing process, the regulatory process, intellectual property rights, lack of incentive, the impossibility of substitution, and the innovator's reach. These six barriers are presented as a possible framework to study the market access of biosimilar mAbs. Based on the literature search, recommendations can be made to overcome these barriers: (i) invest initially in advanced production processes with the help of single-use technology, experience or outsourcing (ii) gain experience with the regulatory process and establish alignment between stakeholders (iii) limit patent litigation, eliminate evergreening benefits, build out further the unitary patent and unified patent litigation system within the EU (iv) create demand-side policies, disseminate objective information (v) change attitude toward biosimilar switching/substitution, starting with physician, and patient education (vi) differentiate the biosimilar by

  13. Overcoming Barriers to the Market Access of Biosimilars in the European Union: The Case of Biosimilar Monoclonal Antibodies

    PubMed Central

    Moorkens, Evelien; Jonker-Exler, Clara; Huys, Isabelle; Declerck, Paul; Simoens, Steven; Vulto, Arnold G.

    2016-01-01

    Background: In 2014, six of the top ten blockbuster medicines were monoclonal antibodies. This multibillion-dollar market with expiring patents is the main driver for the development of biosimilar mAbs. With the ever-increasing cost of healthcare and the economic pressure to reduce or sustain healthcare expenses, biosimilars could be instrumental in reducing costs for medication and increasing patient access to treatment. Objectives: The aim of this study is to identify and describe the barriers to market access of biosimilar mAbs in the European Union and to analyze how these barriers could be overcome. Methods: A narrative literature review was carried out using the databases PubMed, Embase, and EconLit. Studies were published in English or Dutch. Additionally, the reference list of the articles was checked for relevant studies. Articles and conference papers known to the authors were included as well. Articles were also identified by searching on the website of the Generics and Biosimilars Initiative (GaBI) journal. Results: Six barriers were identified based on available literature: The manufacturing process, the regulatory process, intellectual property rights, lack of incentive, the impossibility of substitution, and the innovator's reach. These six barriers are presented as a possible framework to study the market access of biosimilar mAbs. Based on the literature search, recommendations can be made to overcome these barriers: (i) invest initially in advanced production processes with the help of single-use technology, experience or outsourcing (ii) gain experience with the regulatory process and establish alignment between stakeholders (iii) limit patent litigation, eliminate evergreening benefits, build out further the unitary patent and unified patent litigation system within the EU (iv) create demand-side policies, disseminate objective information (v) change attitude toward biosimilar switching/substitution, starting with physician, and patient

  14. Early results of percutaneous arteriovenous fistula creation with the Ellipsys Vascular Access System.

    PubMed

    Mallios, Alexandros; Jennings, William C; Boura, Benoit; Costanzo, Alessandro; Bourquelot, Pierre; Combes, Myriam

    2018-04-18

    We reviewed our initial experience creating a percutaneous arteriovenous fistula (pAVF) using a thermal resistance anastomosis device with proximal radial artery inflow. A retrospective review was conducted of all patients who underwent a pAVF creation procedure between May 2017 and October 2017. Primary end points of the study were technical success, patency by Doppler ultrasound examination or angiography, flow levels achieved, time to first use, and pAVF-related complications. A pAVF was attempted in 34 patients with technical success in 33 individuals (97%). Patency of the pAVF was 94%. Mean access flow was 946 mL/min (brachial artery measurement) at the latest follow-up visit (53-229 days; average, 141 days). At 6 weeks, all fistulas have been used or were ready for dialysis by clinical examination or ultrasound examination. Only one patient required superficialization of the upper arm cephalic vein by lipectomy. There were no adverse events related to the pAVF creation or use, nor was there need for further interventions. Successful pAVFs with proximal radial artery inflow were created with excellent initial results regarding technical success, patency, and safety. Advantages include avoidance of a surgical incision, short procedure times, good acceptance by patients, prompt access maturation, moderate flow, and low-pressure access, with possible reduction of risk for ischemic complications. Avoidance of vessel manipulation and side branch ligation might reduce risk of thrombosis and improve long-term patency and reduce need for further interventions. These early findings need to be confirmed in larger and longer follow-up studies. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Can Internet Access Growth Help Reduce the Global Burden Of Noncommunicable Diseases?

    PubMed Central

    Kohler, Stefan

    2013-01-01

    Noncommunicable diseases, such as cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes, are currently the leading causes of death in several regions of the world. The continuing fast increase in the global burden of noncommunicable diseases is accompanied by a speedy worldwide internet access growth. The worldwide number of internet users has doubled over the past five years. As the internet can make the access to information on a healthy lifestyle and disease prevention activities easier, internet access growth may help to promote good health. Against this background, I discuss the roles the internet and access to information can play in health promotion. I also present an open access web portal on local prevention and health promotion activities. It was initiated by two German states to link health information from disparate sources and to organize this information in a user-friendly way. The web portal focuses on reducing preventable lifestyle-related risk factors associated with noncommunicable diseases, including physical inactivity, unhealthy diet, tobacco use, and the harmful use of alcohol. This local initiative has the potential for scaling up and can serve as a blueprint for other areas that have or will acquire internet access. PMID:23923103

  16. Remote access laboratories in Australia and Europe

    NASA Astrophysics Data System (ADS)

    Ku, H.; Ahfock, T.; Yusaf, T.

    2011-06-01

    Remote access laboratories (RALs) were first developed in 1994 in Australia and Switzerland. The main purposes of developing them are to enable students to do their experiments at their own pace, time and locations and to enable students and teaching staff to get access to facilities beyond their institutions. Currently, most of the experiments carried out through RALs in Australia are heavily biased towards electrical, electronic and computer engineering disciplines. However, the experiments carried out through RALs in Europe had more variety, in addition to the traditional electrical, electronic and computer engineering disciplines, there were experiments in mechanical and mechatronic disciplines. It was found that RALs are now being developed aggressively in Australia and Europe and it can be argued that RALs will develop further and faster in the future with improving Internet technology. The rising costs of real experimental equipment will also speed up their development because by making the equipment remotely accessible, the cost can be shared by more universities or institutions and this will improve their cost-effectiveness. Their development would be particularly rapid in large countries with small populations such as Australia, Canada and Russia, because of the scale of economy. Reusability of software, interoperability in software implementation, computer supported collaborative learning and convergence with learning management systems are the required development of future RALs.

  17. Improved Maternal and Child Health Care Access in a Rural Community.

    ERIC Educational Resources Information Center

    Carcillo, Joseph A.; And Others

    1995-01-01

    Describes an underserved rural community in which health care initiatives increased access to comprehensive care. Over a 3-year period, increased accessibility to maternal and child health care also increased use of preventive services, thus decreasing emergency room visits and hospitalizations as well as low birth weight, risk of congenital…

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

    PubMed

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

    2008-12-18

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

  19. STS-61B Astronaut Ross During ACCESS Extravehicular Activity

    NASA Technical Reports Server (NTRS)

    1985-01-01

    The crew assigned to the STS-61B mission included Bryan D. O'Conner, pilot; Brewster H. Shaw, commander; Charles D. Walker, payload specialist; mission specialists Jerry L. Ross, Mary L. Cleave, and Sherwood C. Spring; and Rodolpho Neri Vela, payload specialist. Launched aboard the Space Shuttle Atlantis November 28, 1985 at 7:29:00 pm (EST), the STS-61B mission's primary payload included three communications satellites: MORELOS-B (Mexico); AUSSAT-2 (Australia); and SATCOM KU-2 (RCA Americom). Two experiments were conducted to test assembling erectable structures in space: EASE (Experimental Assembly of Structures in Extravehicular Activity), and ACCESS (Assembly Concept for Construction of Erectable Space Structure). In a joint venture between NASA/Langley Research Center in Hampton, VA and the Marshall Space Flight Center (MSFC), ACCESS and EASE were developed and demonstrated at MSFC's Neutral Buoyancy Simulator (NBS). In this STS-61B onboard photo, astronaut Ross was working on the ACCESS experiment during an Extravehicular Activity (EVA). The primary objective of this experiment was to test the ACCESS structural assembly concept for suitability as the framework for larger space structures and to identify ways to improve the productivity of space construction.

  20. HTTP as a Data Access Protocol: Trials with XrootD in CMS’s AAA Project

    NASA Astrophysics Data System (ADS)

    Balcas, J.; Bockelman, B. P.; Kcira, D.; Newman, H.; Vlimant, J.; Hendricks, T. W.; CMS Collaboration

    2017-10-01

    The main goal of the project to demonstrate the ability of using HTTP data federations in a manner analogous to the existing AAA infrastructure of the CMS experiment. An initial testbed at Caltech has been built and changes in the CMS software (CMSSW) are being implemented in order to improve HTTP support. The testbed consists of a set of machines at the Caltech Tier2 that improve the support infrastructure for data federations at CMS. As a first step, we are building systems that produce and ingest network data transfers up to 80 Gbps. In collaboration with AAA, HTTP support is enabled at the US redirector and the Caltech testbed. A plugin for CMSSW is being developed for HTTP access based on the DaviX software. It will replace the present fork/exec or curl for HTTP access. In addition, extensions to the XRootD HTTP implementation are being developed to add functionality to it, such as client-based monitoring identifiers. In the future, patches will be developed to better integrate HTTP-over-XRootD with the Open Science Grid (OSG) distribution. First results of the transfer tests using HTTP are presented in this paper together with details about the initial setup.

  1. Airborne laser topographic mapping results from initial joint NASA/US Army Corps of Engineers experiment

    NASA Technical Reports Server (NTRS)

    Krabill, W. B.; Collins, J. G.; Swift, R. N.; Butler, M. L.

    1980-01-01

    Initial results from a series of joint NASA/US Army Corps of Engineers experiments are presented. The NASA Airborne Oceanographic Lidar (AOL) was exercised over various terrain conditions, collecting both profile and scan data from which river basin cross sections are extracted. Comparisons of the laser data with both photogrammetry and ground surveys are made, with 12 to 27 cm agreement observed over open ground. Foliage penetration tests, utilizing the unique time-waveform sampling capability of the AOL, indicate 50 cm agreement with photogrammetry (known to have difficulty in foliage covered terrain).

  2. Initial experiments on the end-point control of a flexible one-link robot

    NASA Technical Reports Server (NTRS)

    Cannon, R. H., Jr.; Schmitz, E.

    1984-01-01

    The present investigation is concerned with initial experiments regarding a specific unsolved control problem which appeared to be central to advances in the art of robotics. This problem involves the control of a flexible member (one link of a robot system). The position of the end-effector, called the end point or tip, is controlled by measuring that position and using the measurement as a basis for applying control torque to the other end of the flexible member, as for instance, the robot's elbow joint. A description is presented of the features of the first experimental arm which has been made, and an outline is provided of the general strategy for controlling it using its tip sensor and shoulder torquer.

  3. Access to inpatient dermatology care in Pennsylvania hospitals.

    PubMed

    Messenger, Elizabeth; Kovarik, Carrie L; Lipoff, Jules B

    2016-01-01

    Access to care is a known issue in dermatology, and many patients may experience long waiting periods to see a physician. In this study, an anonymous online survey was sent to all 274 Pennsylvania hospitals licensed by the US Department of Health in order to evaluate current levels of access to inpatient dermatology services. Although the response rate to this survey was limited, the data suggest that access to inpatient dermatology services is limited and may be problematic in hospitals across the United States. Innovation efforts and further studies are needed to address this gap in access to care.

  4. Initial clinical experience with a video-based patient positioning system.

    PubMed

    Johnson, L S; Milliken, B D; Hadley, S W; Pelizzari, C A; Haraf, D J; Chen, G T

    1999-08-01

    To report initial clinical experience with an interactive, video-based patient positioning system that is inexpensive, quick, accurate, and easy to use. System hardware includes two black-and-white CCD cameras, zoom lenses, and a PC equipped with a frame grabber. Custom software is used to acquire and archive video images, as well as to display real-time subtraction images revealing patient misalignment in multiple views. Two studies are described. In the first study, video is used to document the daily setup histories of 5 head and neck patients. Time-lapse cine loops are generated for each patient and used to diagnose and correct common setup errors. In the second study, 6 twice-daily (BID) head and neck patients are positioned according to the following protocol: at AM setups conventional treatment room lasers are used; at PM setups lasers are used initially and then video is used for 1-2 minutes to fine-tune the patient position. Lateral video images and lateral verification films are registered off-line to compare the distribution of setup errors per patient, with and without video assistance. In the first study, video images were used to determine the accuracy of our conventional head and neck setup technique, i.e., alignment of lightcast marks and surface anatomy to treatment room lasers and the light field. For this initial cohort of patients, errors ranged from sigma = 5 to 7 mm and were patient-specific. Time-lapse cine loops of the images revealed sources of the error, and as a result, our localization techniques and immobilization device were modified to improve setup accuracy. After the improvements, conventional setup errors were reduced to sigma = 3 to 5 mm. In the second study, when a stereo pair of live subtraction images were introduced to perform daily "on-line" setup correction, errors were reduced to sigma = 1 to 3 mm. Results depended on patient health and cooperation and the length of time spent fine-tuning the position. An interactive, video

  5. The second-generation eCLIPs Endovascular Clip System: initial experience.

    PubMed

    Chiu, Albert H; De Vries, Joost; O'Kelly, Cian J; Riina, Howard; McDougall, Ian; Tippett, Jonathan; Wan, Martina; de Oliveira Manoel, Airton Leonardo; Marotta, Thomas R

    2018-02-01

    occlusion rates in this initial clinical series are comparable to the initial experience with other bifurcation support devices.

  6. Vascular access choice in incident hemodialysis patients: a decision analysis.

    PubMed

    Drew, David A; Lok, Charmaine E; Cohen, Joshua T; Wagner, Martin; Tangri, Navdeep; Weiner, Daniel E

    2015-01-01

    Hemodialysis vascular access recommendations promote arteriovenous (AV) fistulas first; however, it may not be the best approach for all hemodialysis patients, because likelihood of successful fistula placement, procedure-related and subsequent costs, and patient survival modify the optimal access choice. We performed a decision analysis evaluating AV fistula, AV graft, and central venous catheter (CVC) strategies for patients initiating hemodialysis with a CVC, a scenario occurring in over 70% of United States dialysis patients. A decision tree model was constructed to reflect progression from hemodialysis initiation. Patients were classified into one of three vascular access choices: maintain CVC, attempt fistula, or attempt graft. We explicitly modeled probabilities of primary and secondary patency for each access type, with success modified by age, sex, and diabetes. Access-specific mortality was incorporated using preexisting cohort data, including terms for age, sex, and diabetes. Costs were ascertained from the 2010 USRDS report and Medicare for procedure costs. An AV fistula attempt strategy was found to be superior to AV grafts and CVCs in regard to mortality and cost for the majority of patient characteristic combinations, especially younger men without diabetes. Women with diabetes and elderly men with diabetes had similar outcomes, regardless of access type. Overall, the advantages of an AV fistula attempt strategy lessened considerably among older patients, particularly women with diabetes, reflecting the effect of lower AV fistula success rates and lower life expectancy. These results suggest that vascular access-related outcomes may be optimized by considering individual patient characteristics. Copyright © 2015 by the American Society of Nephrology.

  7. Area-Based Partnerships in Rural Poland: The Post-Accession Experience

    ERIC Educational Resources Information Center

    Furmankiewicz, Marek; Thompson, Nicola; Zielinska, Marta

    2010-01-01

    The paper examines the characteristics of area-based partnerships in rural Poland. It is based on the study of partnerships created after the accession to the European Union in 2004. Partnership structures have been rapidly adopted in rural Poland due to opportunities provided by the LEADER+ Pilot Programme. However, the research showed that…

  8. Collaborative remembering revisited: Study context access modulates collaborative inhibition and later benefits for individual memory.

    PubMed

    Abel, Magdalena; Bäuml, Karl-Heinz T

    2017-11-01

    Collaborating groups typically show reduced recall relative to nominal groups, i.e., to the cumulated non-redundant recall of the same number of people remembering in isolation-a finding termed collaborative inhibition. Motivated by the results of several previous studies, this study examined in two experiments whether access to study context at test influences the effects of collaboration. In both experiments, subjects collaborated in triads or recalled previously studied material in isolation. Experiment 1 applied short versus prolonged retention intervals to vary access to study context at test, whereas Experiment 2 used the list-method directed forgetting task and applied remember versus forget instructions to modulate context access. In both experiments, collaborative inhibition was present when access to study context at test was intact (i.e., after the short delay and the remember instruction) but was eliminated when the access was impaired (i.e., after the prolonged delay and the forget instruction). Also, post-collaborative gains for individual recall were greater when context access was impaired and collaborative inhibition was eliminated. The findings demonstrate a critical role of access to study context at test for collaborative inhibition, indicating that impaired context access may reflect a general boundary condition for the recall impairment. The possible role of context reactivation processes for beneficial effects of social recall is discussed.

  9. Widening Access through Openness in Higher Education in the Developing World: A Bourdieusian Field Analysis of Experiences from the National Open University of Nigeria

    ERIC Educational Resources Information Center

    Olakulehin, Felix Kayode; Singh, Gurmit

    2013-01-01

    Bourdieu has argued that higher education is a field that reproduces social inequality, thus complicating how openness widens access to higher education in the developing world. Drawing on the experiences of the National Open University of Nigeria (NOUN), this paper critically analyses and evaluates the rationale, approach, difficulties,…

  10. Research at the Crossroads: How Intellectual Initiatives across Disciplines Evolve

    ERIC Educational Resources Information Center

    Frost, Susan H.; Jean, Paul M.; Teodorescu, Daniel; Brown, Amy B.

    2004-01-01

    How do intellectual initiatives across disciplines evolve? This qualitative case study of 11 interdisciplinary research initiatives at Emory University identifies key factors in their development: the passionate commitments of scholarly leaders, the presence of strong collegial networks, access to timely and multiple resources, flexible practices,…

  11. Patients report better satisfaction with part-time primary care physicians, despite less continuity of care and access.

    PubMed

    Panattoni, Laura; Stone, Ashley; Chung, Sukyung; Tai-Seale, Ming

    2015-03-01

    The growing number of primary care physicians (PCPs) reducing their clinical work hours has raised concerns about meeting the future demand for services and fulfilling the continuity and access mandates for patient-centered care. However, the patient's experience of care with part-time physicians is relatively unknown, and may be mediated by continuity and access to care outcomes. We aimed to examine the relationships between a physicians' clinical full-time equivalent (FTE), continuity of care, access to care, and patient satisfaction with the physician. We used a multi-level structural equation estimation, with continuity and access modeled as mediators, for a cross-section in 2010. The study included family medicine (n = 104) and internal medicine (n = 101) physicians in a multi-specialty group practice, along with their patient satisfaction survey responses (n = 12,688). Physician level FTE, continuity of care received by patients, continuity of care provided by physician, and a Press Ganey patient satisfaction with the physician score, on a 0-100 % scale, were measured. Access to care was measured as days to the third next-available appointment. Physician FTE was directly associated with better continuity of care received (0.172% per FTE, p < 0.001), better continuity of care provided (0.108% per FTE, p < 0.001), and better access to care (-0.033 days per FTE, p < 0.01), but worse patient satisfaction scores (-0.080% per FTE, p = 0.03). The continuity of care provided was a significant mediator (0.016% per FTE, p < 0.01) of the relationship between FTE and patient satisfaction; but overall, reduced clinical work hours were associated with better patient satisfaction (-0.053 % per FTE, p = 0.03). These results suggest that PCPs who choose to work fewer clinical hours may have worse continuity and access, but they may provide a better patient experience. Physician workforce planning should consider these care attributes when

  12. Home-based HIV counseling and testing: Client experiences and perceptions in Eastern Uganda

    PubMed Central

    2012-01-01

    Background Though prevention and treatment depend on individuals knowing their HIV status, the uptake of testing remains low in Sub-Saharan Africa. One initiative to encourage HIV testing involves delivering services at home. However, doubts have been cast about the ability of Home-Based HIV Counseling and Testing (HBHCT) to adhere to ethical practices including consent, confidentiality, and access to HIV care post-test. This study explored client experiences in relation these ethical issues. Methods We conducted 395 individual interviews in Kumi district, Uganda, where teams providing HBHCT had visited 6–12 months prior to the interviews. Semi-structured questionnaires elicited information on clients’ experiences, from initial community mobilization up to receipt of results and access to HIV services post-test. Results We found that 95% of our respondents had ever tested (average for Uganda was 38%). Among those who were approached by HBHCT providers, 98% were informed of their right to decline HIV testing. Most respondents were counseled individually, but 69% of the married/cohabiting were counseled as couples. The majority of respondents (94%) were satisfied with the information given to them and the interaction with the HBHCT providers. Most respondents considered their own homes as more private than health facilities. Twelve respondents reported that they tested positive, 11 were referred for follow-up care, seven actually went for care, and only 5 knew their CD4 counts. All HIV infected individuals who were married or cohabiting had disclosed their status to their partners. Conclusion These findings show a very high uptake of HIV testing and satisfaction with HBHCT, a large proportion of married respondents tested as couples, and high disclosure rates. HBHCT can play a major role in expanding access to testing and overcoming disclosure challenges. However, access to HIV services post-test may require attention. PMID:23146071

  13. Home-based HIV counseling and testing: client experiences and perceptions in Eastern Uganda.

    PubMed

    Kyaddondo, David; Wanyenze, Rhoda K; Kinsman, John; Hardon, Anita

    2012-11-12

    Though prevention and treatment depend on individuals knowing their HIV status, the uptake of testing remains low in Sub-Saharan Africa. One initiative to encourage HIV testing involves delivering services at home. However, doubts have been cast about the ability of Home-Based HIV Counseling and Testing (HBHCT) to adhere to ethical practices including consent, confidentiality, and access to HIV care post-test. This study explored client experiences in relation these ethical issues. We conducted 395 individual interviews in Kumi district, Uganda, where teams providing HBHCT had visited 6-12 months prior to the interviews. Semi-structured questionnaires elicited information on clients' experiences, from initial community mobilization up to receipt of results and access to HIV services post-test. We found that 95% of our respondents had ever tested (average for Uganda was 38%). Among those who were approached by HBHCT providers, 98% were informed of their right to decline HIV testing. Most respondents were counseled individually, but 69% of the married/cohabiting were counseled as couples. The majority of respondents (94%) were satisfied with the information given to them and the interaction with the HBHCT providers. Most respondents considered their own homes as more private than health facilities. Twelve respondents reported that they tested positive, 11 were referred for follow-up care, seven actually went for care, and only 5 knew their CD4 counts. All HIV infected individuals who were married or cohabiting had disclosed their status to their partners. These findings show a very high uptake of HIV testing and satisfaction with HBHCT, a large proportion of married respondents tested as couples, and high disclosure rates. HBHCT can play a major role in expanding access to testing and overcoming disclosure challenges. However, access to HIV services post-test may require attention.

  14. A quasi-experimental evaluation of parents as sexual health educators resulting in delayed sexual initiation and increased access to condoms.

    PubMed

    Campero, Lourdes; Walker, Dilys; Atienzo, Erika E; Gutierrez, Juan Pablo

    2011-04-01

    To evaluate the effectiveness of an educational intervention for parents of first year high school students in the State of Morelos, Mexico, whose aim was to impact adolescents' sexual behavior, knowledge and access to contraception. Quasi-experimental prospective study with eleven control and eleven intervention schools using self-administered questionnaires for parents and adolescents pre- and post-intervention. Parent-child dyads in the control and intervention schools were matched according to parents' propensity score; the average treatment effect (ATE) was estimated for adolescent's outcome variables. At follow-up, we found significant differences for adolescents in the intervention schools: 6.8% delayed initiation of sexual intercourse, 14.4% had correct knowledge about emergency contraception (EC), and 164% reported having received condoms from their parents, when comparing with students in control schools. Our results suggest that parent-focused interventions could be an innovative and effective strategy to promote adolescents sexual health. Copyright © 2010 The Association for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  15. Access and authorisation in a Glocal e-Health Policy context.

    PubMed

    Scott, Richard E; Jennett, Penny; Yeo, Maryann

    2004-03-31

    Challenges to the development of appropriate yet adaptable policy and tools for security of the individual patient electronic health record (EHR) are proving to be significant. Compounding this is the unique capability of e-health to transgress all existing geo-political and other barriers. Initiatives to develop and advance policy, standards, and tools in relation to EHR access control and authorisation management must address this capability. Currently policy development initiatives take place largely in an isolated manner. This jeopardises the potential of e-health because decisions made in one jurisdiction might hamper, even prevent, an e-health opportunity in another. This paper places access and authorisation issues in an overall policy context through describing current Canadian initiatives. The National Initiative for Telehealth (NIFTE) Guidelines project is developing a framework of national guidelines for telehealth. The Policy and Peer Permission (PPP) project is developing a unique tool that provides persistent protection of data. The new corporate body 'Infoway' is developing a pan-Canadian electronic health record solution. Finally, the Glocal e-Health Policy initiative is developing a tool with which to identify and describe the inter-relationships of e-health issues amongst policy levels, themes, and actors.

  16. [Transcatheter aortic valve implantation for aortic stenosis. Initial experience].

    PubMed

    Careaga-Reyna, Guillermo; Lázaro-Castillo, José Luis; Lezama-Urtecho, Carlos Alberto; Macías-Miranda, Enriqueta; Dosta-Herrera, Juan José; Galván Díaz, José

    Aortic stenosis is a frequent disease in the elderly, and is associated with other systemic pathologies that may contraindicate the surgical procedure. Another option for these patients is percutaneous aortic valve implantation, which is less invasive. We present our initial experience with this procedure. Patients with aortic stenosis were included once selection criteria were accomplished. Under general anaesthesia and echocardiographic and fluosocopic control, a transcatheter aortic valve was implanted following s valvuloplasty. Once concluded the procedure, angiographic and pressure control was realized in order to confirm the valve function. Between November 2014 and May 2015, 6 patients were treated (4 males and 2 females), with a mean age of 78.83±5.66 years-old. The preoperative transvalvular gradient was 90.16±28.53mmHg and posterior to valve implant was 3.33±2.92mmHg (P<.05). Two patients had concomitant coronary artery disease which had been treated previously. One patient presented with acute right coronary artery occlusion which was immediately treated. However due to previous renal failure, postoperative sepsis and respiratory failure, the patient died one month later. It was concluded that our preliminary results showed that in selected patients percutaneous aortic valve implantation is a safe procedure with clinical improvement for treated patients. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  17. Health care access and utilization patterns in unstably housed HIV-infected individuals in New York City.

    PubMed

    Cunningham, Chinazo O; Sohler, Nancy L; McCoy, Kate; Heller, Daliah; Selwyn, Peter A

    2005-10-01

    As part of a multisite initiative to evaluate outreach targeting underserved HIV-infected individuals, we describe baseline characteristics of unstably housed HIV-infected individuals from New York City, and their health care access and utilization patterns. Interviews with 150 HIV-infected single room occupancy (SRO) hotel residents on health care access and utilization, barriers to accessing health care, demographic characteristics, history of incarceration, severity of HIV disease, depressive symptoms, substance use, and exposure to violence were conducted. Most participants were 40 years of age or older, male, black or Latino, had public insurance, a history of substance use, depressive symptoms, and a CD4(+) count above 200 cells/mm(3). Access to and utilization of care was high with 91% reporting having a regular provider, 95% identifying a non-emergency department (ED) clinic or office as their usual location of care, 89% reporting at least one ambulatory visit, and 82% reporting optimal (>/=2) ambulatory visits during the previous 6 months. Additionally, 45% reported at least one ED visit, and 30% at least one hospitalization within the previous 6 months. Among black and Latino marginalized SRO hotel residents in New York City, this study found surprisingly high measures of access to and utilization of ambulatory care services, along with high use of acute care services. Understanding HIV-related health services access and utilization patterns among marginalized populations is essential to improve their HIV care. These patterns of high levels of access to and utilization of health care services contradict clinical experiences and other studies, and require further exploration.

  18. Utilisation of prehospital intravenous access.

    PubMed

    Bester, B H; Sobuwa, Simpiwe

    2014-07-22

    To describe the use of intravenous (IV) therapy in the South African (SA) prehopsital setting, and to determine the proportion of prehopsital cannulations considered unnecessary when graded against the South African Triage Score (SATS) chart. The study was conducted in the prehospital emergency medical care setting in the Western Cape Province, SA. Using a descriptive research design, we looked at the report forms of patients treated and transported by personnel currently employed in the public sector, serving the urban and rural areas stipulated by the municipal boundaries. All medical and trauma cases in which establishment of IV access was documented for the month of April 2013 were included. Interhospital transfers, unsuccessful attempts at IV access and intraosseous cannulation were excluded. When graded against the SATS, prophylactic IV access was not justified in 42.3% of the total number of cases (N=149) in which it was established, and therefore added no direct benefit to the continuum of patient care. It is worth noting that 18.8% (n=39) of the IV lines were utilised for fluid administration, as opposed to 9.2% (n=19) for the administration of IV medications. In view of the paucity of studies indicating a direct benefit of out-of-hospital IV intervention, the practice of precautionary, protocol-driven prophylactic establishment of IV access should be evaluated. Current data suggest that in the absence of scientific evidence, IV access should only be initiated when it will benefit the patient immediately, and precautionary IV access, especially in non-injured patients, should be re-evaluated.

  19. Public housing relocations in Atlanta, Georgia, and declines in spatial access to safety net primary care

    PubMed Central

    Cooper, Hannah LF; Wodarski, Stephanie; Cummings, Janet; Hunter-Jones, Josalin; Karnes, Conny; Ross, Zev; Druss, Ben; Bonney, Loida E

    2012-01-01

    This analysis investigates changes in spatial access to safety-net primary care in a sample of US public housing residents relocating via the HOPE VI initiative from public housing complexes to voucher-subsidized rental units; substance misusers were oversampled. We used gravity-based models to measure spatial access to care, and used mixed models to assess pre-/post-relocation changes in access. Half the sample experienced declines in spatial access of ≥79.83%; declines did not vary by substance misuse status. Results suggest that future public housing relocation initiatives should partner with relocaters, particularly those in poor health, to help them find housing near safety-net clinics. PMID:23060002

  20. Initial observations of the pioneer venus orbiter solar wind plasma experiment.

    PubMed

    Wolfe, J; Intriligator, D S; Mihalov, J; Collard, H; McKibbin, D; Whitten, R; Barnes, A

    1979-02-23

    Initial results of observations of the solar wind interaction with Venus indicate that Venus has a well-defined, strong, standing bow shock wave. Downstream from the shock, an ionosheath is observed in which the compressed and heated postshock plasma evidently interacts directly with the Venus ionosphere. Plasma ion velocity deflections observed within the ionosheath are consistent with flow around the blunt shape of the ionopause. The ionopause boundary is observed and defined by this experiment as the location where the ionosheath ion flow is first excluded. The positions of the bow shock and ionopause are variable and appear to respond to changes in the external solar wind pressure. Near the terminator the bow shock was observed at altitudes of approximately 4600 to approximately 12,000 kilometers. The ionopause altitutde ranged fromn as low as approximately 450 to approximately 1950 kilometers. Within the Venus ionosphere low-energy ions (energy per untit charge < 30 volts) were detected and have been tentatively idtentified as nonflowing ionospheric ions incident from a direction along the spacecraft velocity vector.