Sample records for access options approaches

  1. Optional anatomy and physiology e-learning resources: student access, learning approaches, and academic outcomes.

    PubMed

    Guy, Richard; Byrne, Bruce; Dobos, Marian

    2018-03-01

    Anatomy and physiology interactive video clips were introduced into a blended learning environment, as an optional resource, and were accessed by ~50% of the cohort. Student feedback indicated that clips were engaging, assisted understanding of course content, and provided lecture support. Students could also access two other optional online resources, lecture capture recordings and an interactive atlas of anatomy, and individuals were tracked with respect to their access behavior, learning approach, and subject score. Deep learning was highest among those accessing the clips or atlas or those accessing more online resources, and thus self-regulatory skill development might be a useful approach to increase student access to optional online resources. Those who accessed clips, lecture capture recordings, or atlas achieved a significantly higher subject score than those who did not. When combinations of resources used were considered, we found an approximately linear relationship between number of resources accessed and subject score, with a 16% difference in score between those who accessed none or all of the resources. However, the low resource access rate suggests that academic advantage may not be simply due to the learning support offered by the resources. As students accessing the optional resources tended to be more self-regulated, it may be that it was the extra effort made with respect to other subject resources, rather than just the access to the online resources, that contributed to higher subject score. Further studies are required to establish the relationships between academic performance, optional online resource access, and deep learning.

  2. Optional Anatomy and Physiology e-Learning Resources: Student Access, Learning Approaches, and Academic Outcomes

    ERIC Educational Resources Information Center

    Guy, Richard,; Byrne, Bruce; Dobos, Marian

    2018-01-01

    Anatomy and physiology interactive video clips were introduced into a blended learning environment, as an optional resource, and were accessed by ~50% of the cohort. Student feedback indicated that clips were engaging, assisted understanding of course content, and provided lecture support. Students could also access two other optional online…

  3. On Ramps: Options and Issues in Accessing the Internet.

    ERIC Educational Resources Information Center

    Bocher, Bob

    1995-01-01

    Outlines the basic options that schools and libraries have for accessing the Internet, focusing on four models: direct connection; dial access using SLIP/PPP (Serial Line Internet Protocol/Point-to-Point Protocol); dial-up using terminal emulation mode; and dial access through commercial online services. Discusses access option issues such as…

  4. Internet Access and Pricing: Sorting Out the Options.

    ERIC Educational Resources Information Center

    Fowler, Thomas B.

    1997-01-01

    Discusses Internet access and pricing options. Highlights include restructuring of the telecommunications industry; current methods of access; economics of high-speed access; the impact of cheap Internet access; long-term possibilities; and a table that provides a comparison of Internet access methods. (LRW)

  5. Solar Access: Issues and Policy Options | State, Local, and Tribal

    Science.gov Websites

    : approximately 2,580 megawatts (MW) of new residential solar photovoltaic (PV) capacity was brought online in home with rooftop solar Figure 1. Example of a residential solar PV system. NREL 00565 The existing Governments | NREL Solar Access: Issues and Policy Options Solar Access: Issues and Policy

  6. Both The 'Private Option' And Traditional Medicaid Expansions Improved Access To Care For Low-Income Adults.

    PubMed

    Sommers, Benjamin D; Blendon, Robert J; Orav, E John

    2016-01-01

    Under the Affordable Care Act, thirty states and the District of Columbia have expanded eligibility for Medicaid, with several states using Medicaid funds to purchase private insurance (the "private option"). Despite vigorous debate over the use of private insurance versus traditional Medicaid to provide coverage to low-income adults, there is little evidence on the relative merits of the two approaches. We compared the first-year impacts of traditional Medicaid expansion in Kentucky, the private option in Arkansas, and nonexpansion in Texas by conducting a telephone survey of two distinct waves of low-income adults (5,665 altogether) in those three states in November-December 2013 and twelve months later. Using a difference-in-differences analysis, we found that the uninsurance rate declined by 14 percentage points in the two expansion states, compared to the nonexpansion state. In the expansion states, again compared to the nonexpansion state, skipping medications because of cost and trouble paying medical bills declined significantly, and the share of individuals with chronic conditions who obtained regular care increased. Other than coverage type and trouble paying medical bills (which decreased more in Kentucky than in Arkansas), there were no significant differences between Kentucky's traditional Medicaid expansion and Arkansas's private option, which suggests that both approaches improved access among low-income adults. Project HOPE—The People-to-People Health Foundation, Inc.

  7. A hybrid modeling approach for option pricing

    NASA Astrophysics Data System (ADS)

    Hajizadeh, Ehsan; Seifi, Abbas

    2011-11-01

    The complexity of option pricing has led many researchers to develop sophisticated models for such purposes. The commonly used Black-Scholes model suffers from a number of limitations. One of these limitations is the assumption that the underlying probability distribution is lognormal and this is so controversial. We propose a couple of hybrid models to reduce these limitations and enhance the ability of option pricing. The key input to option pricing model is volatility. In this paper, we use three popular GARCH type model for estimating volatility. Then, we develop two non-parametric models based on neural networks and neuro-fuzzy networks to price call options for S&P 500 index. We compare the results with those of Black-Scholes model and show that both neural network and neuro-fuzzy network models outperform Black-Scholes model. Furthermore, comparing the neural network and neuro-fuzzy approaches, we observe that for at-the-money options, neural network model performs better and for both in-the-money and an out-of-the money option, neuro-fuzzy model provides better results.

  8. Comparing Information Access Approaches.

    ERIC Educational Resources Information Center

    Chalmers, Matthew

    1999-01-01

    Presents a broad view of information access, drawing from philosophy and semiology in constructing a framework for comparative discussion that is used to examine the information representations that underlie four approaches to information access--information retrieval, workflow, collaborative filtering, and the path model. Contains 32 references.…

  9. African Americans’ Access to Healthy Food Options in South Los Angeles Restaurants

    PubMed Central

    Lewis, LaVonna Blair; Sloane, David C.; Nascimento, Lori Miller; Diamant, Allison L.; Guinyard, Joyce Jones; Yancey, Antronette K.; Flynn, Gwendolyn

    2005-01-01

    Objectives. We examined availability and food options at restaurants in less affluent (target area) and more affluent (comparison area) areas of Los Angeles County to compare residents’ access to healthy meals prepared and purchased away from home. We also considered environmental prompts that encourage the purchase of various foods. Methods. We designed an instrument to assess the availability, quality, and preparation of food in restaurants. We also assessed advertisements and promotions, cleanliness, and service for each restaurant. We assessed 659 restaurants: 348 in the target area and 311 in the comparison area. Results. The nutritional resource environment in our target area makes it challenging for residents to eat healthy away from home. Poorer neighborhoods with a higher proportion of African American residents have fewer healthy options available, both in food selections and in food preparation; restaurants in these neighborhoods heavily promote unhealthy food options to residents. Conclusions. Environment is important in understanding health status: support for the healthy lifestyle associated with lower risks for disease is difficult in poorer communities with a higher proportion of African American residents. PMID:15798128

  10. 75 FR 47304 - Accessible Mobile Phone Options for People Who Are Blind, Deaf-Blind, or Have Low Vision

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-05

    ... FEDERAL COMMUNICATIONS COMMISSION [CG Docket No. 10-145; DA 10-1324] Accessible Mobile Phone Options for People Who Are Blind, Deaf- Blind, or Have Low Vision AGENCY: Federal Communications... wireless communication access by these populations; the cost and feasibility of technical solutions to...

  11. Pricing of swing options: A Monte Carlo simulation approach

    NASA Astrophysics Data System (ADS)

    Leow, Kai-Siong

    We study the problem of pricing swing options, a class of multiple early exercise options that are traded in energy market, particularly in the electricity and natural gas markets. These contracts permit the option holder to periodically exercise the right to trade a variable amount of energy with a counterparty, subject to local volumetric constraints. In addition, the total amount of energy traded from settlement to expiration with the counterparty is restricted by a global volumetric constraint. Violation of this global volumetric constraint is allowed but would lead to penalty settled at expiration. The pricing problem is formulated as a stochastic optimal control problem in discrete time and state space. We present a stochastic dynamic programming algorithm which is based on piecewise linear concave approximation of value functions. This algorithm yields the value of the swing option under the assumption that the optimal exercise policy is applied by the option holder. We present a proof of an almost sure convergence that the algorithm generates the optimal exercise strategy as the number of iterations approaches to infinity. Finally, we provide a numerical example for pricing a natural gas swing call option.

  12. Evidence from the Private Option: The Arkansas Experience.

    PubMed

    Maylone, Bethany; Sommers, Benjamin D

    2017-02-01

    Issue: Arkansas was the first state to receive approval to expand Medicaid under the Affordable Care Act through a Section 1115 waiver. This approach, known as the "private option," uses Medicaid funds to purchase private health plans on the state’s marketplace. It is intended to promote market competition, continuity of coverage, and greater access to care. Goal: To describe the key features of the private option and evaluate its impact on health care for low-income adults in the state after two years. Methods: Survey data from 2013–2015 that assessed health insurance coverage, access to care, utilization, and self-reported health among low-income adults in Arkansas compared to adults in two other states. Key findings and conclusions: Arkansas’s private option improved access to primary care and prescription medications, reduced reliance on the emergency department, increased use of preventive care, and improved perceptions of quality and health among low-income adults in the state, compared to Texas, which did not expand Medicaid. Arkansas’s benefits were similar to those observed in Kentucky’s traditional Medicaid expansion. Churning in coverage remained a challenge for nearly a quarter of low-income adults each year.

  13. How to Perform Transcaval Access and Closure for Transcatheter Aortic Valve Implantation

    PubMed Central

    Lederman, Robert J.; Babaliaros, Vasilis C.; Greenbaum, Adam B.

    2016-01-01

    Transcaval, or caval-aortic, access is a promising approach for fully percutaneous trans-catheter aortic valve implantation in patients without good conventional access options. This tutorial review provides step-by-step guidance to planning and executing the procedure, along with approaches to remedy complications. PMID:26356244

  14. Stock and option portfolio using fuzzy logic approach

    NASA Astrophysics Data System (ADS)

    Sumarti, Novriana; Wahyudi, Nanang

    2014-03-01

    Fuzzy Logic in decision-making process has been widely implemented in various problems in industries. It is the theory of imprecision and uncertainty that was not based on probability theory. Fuzzy Logic adds values of degree between absolute true and absolute false. It starts with and builds on a set of human language rules supplied by the user. The fuzzy systems convert these rules to their mathematical equivalents. This could simplify the job of the system designer and the computer, and results in much more accurate representations of the way systems behave in the real world. In this paper we examine the decision making process of stock and option trading by the usage of MACD (Moving Average Convergence Divergence) technical analysis and Option Pricing with Fuzzy Logic approach. MACD technical analysis is for the prediction of the trends of underlying stock prices, such as bearish (going downward), bullish (going upward), and sideways. By using Fuzzy C-Means technique and Mamdani Fuzzy Inference System, we define the decision output where the value of MACD is high then decision is "Strong Sell", and the value of MACD is Low then the decision is "Strong Buy". We also implement the fuzzification of the Black-Scholes option-pricing formula. The stock and options methods are implemented on a portfolio of one stock and its options. Even though the values of input data, such as interest rates, stock price and its volatility, cannot be obtain accurately, these fuzzy methods can give a belief degree of the calculated the Black-Scholes formula so we can make the decision on option trading. The results show the good capability of the methods in the prediction of stock price trends. The performance of the simulated portfolio for a particular period of time also shows good return.

  15. An Alternative Option to Dedicated Braille Notetakers for People with Visual Impairments: Universal Technology for Better Access

    ERIC Educational Resources Information Center

    Hong, Sunggye

    2012-01-01

    Technology provides equal access to information and helps people with visual impairments to complete tasks more independently. Among various assistive technology options for people with visual impairments, braille notetakers have been considered the most significant because of their technological innovation. Braille notetakers allow users who are…

  16. 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

  17. Listening through narratives: using a narrative approach when discussing fertility preservation options with young cancer patients

    PubMed Central

    Roher, S.I.G.; Gibson, J.; Gibson, B.E.; Gupta, A.A.

    2017-01-01

    Despite clinical practice guideline recommendations mandating that fertility preservation be discussed with young cancer patients, many providers fail to initiate such discussions with adolescents. Researchers and clinicians often focus on system-level changes to improve access to fertility preservation for adolescents and young adults in Canada. However, little of the available information considers the way in which health care providers approach those discussions. Research has shown that, even when fertility preservation options are broached with adolescents, survivors often report dissatisfaction with those conversations, thus raising additional concerns about their content and quality. Here, we consider how a narrative approach—and the Frank narrative typology in particular—could improve the quality of such conversations by helping providers to more accurately and thoughtfully respond to the needs of adolescent patients when discussing the possibility of fertility preservation. Based on findings from a qualitative research project, we provide concrete suggestions for how to more sensitively approach fertility preservation conversations with male adolescent cancer patients and survivors. PMID:28270719

  18. Stepwise Approach to Accessible MOOC Development.

    PubMed

    Draffan, E A; Wald, Mike; Dickens, Kate; Zimmermann, Gottfried; Kelle, Sebastian; Miesenberger, Klaus; Petz, Andrea

    2015-01-01

    Developing resources for online learning in its many guises and more recently for MOOCs has been discussed across the educational sector, usually by individuals working for one institution or organisation. Rarely are there discussions that highlight the issues of collaborative working on content that is delivered over a period of weeks for a wide range of abilities and skills. In particular there is a reluctance to face the issues presented by barriers to access for those with disabilities and even the issues that could arise should an academic be unable to access the development platform to present content. This paper aims to approach these issues by providing guidance in a series of practical steps that highlight an inclusive design approach.

  19. Internet Connections: Understanding Your Access Options.

    ERIC Educational Resources Information Center

    Notess, Greg R.

    1994-01-01

    Describes levels of Internet connectivity, physical connections, and connection speeds. Compares options for connecting to the Internet, including terminal accounts, dial-up terminal accounts, direct connections through a local area network, and direct connections using SLIP (Serial Line Internet Protocol) or PPP (Point-to-Point Protocol). (eight…

  20. Early cannulation prosthetic graft (Acuseal) for arteriovenous access: a useful option to provide a personal vascular access solution.

    PubMed

    Aitken, Emma L; Jackson, Andrew J; Kingsmore, David B

    2014-01-01

    Early cannulation arteriovenous grafts (ecAVGs), such as the GORE Acuseal, have "low bleed" properties permitting cannulation within 24 hours of insertion. They may provide an alternative to tunneled central venous catheters (and associated line complications) in patients requiring urgent vascular access. We present our early experience of 37 patients treated with the GORE Acuseal ecAVG. A total of 11 upper limb, 24 lower limb and 2 complex graft procedures were performed. Indications for ecAVG were as follows: bridge to transplantation (21.6%); bridge to arteriovenous fistula (AVF) maturation (8.1%); AVF salvage (8.1%); no native options (67.6%, including 17 patients with bilateral central vein stenosis); 36 AVGs (97.3%) were successfully cannulated. Mean time to first cannulation: 30.4±23.4 hours (range: 2-192). Primary and secondary patency rates at 3, 6 and 12 months were 64.9%, 48.6%, 32.4% and 70.2%, 59.4%, 40.5% respectively. The systemic bacteremia rate was 0.2 per 1,000 access days. There was one perioperative death. Other complications included hematoma at cannulation sites (n=9), pseudoaneurysm (n=3) and local infection at graft site (n=6). A total of 26 of 37 patients (70.6%) achieved a "personal vascular access solution": bridge to transplantation (n=8), bridge to functioning AVF/interposition AVG (n=5), maintenance hemodialysis via ecAVG (n=13); death with functioning AVG (n=1). Early experience with the GORE Acuseal is encouraging. Patency and bacteremia rates are at least comparable to standard polytetrafluoroethylene grafts. ecAVGs have permitted cannulation within 24 hours of insertion and line avoidance in the majority of patients. Nearly three-quarters of patients achieved a definitive "personal vascular access solution" from their ecAVG.

  1. Expensing stock options: a fair-value approach.

    PubMed

    Kaplan, Robert S; Palepu, Krishna G

    2003-12-01

    Now that companies such as General Electric and Citigroup have accepted the premise that employee stock options are an expense, the debate is shifting from whether to report options on income statements to how to report them. The authors present a new accounting mechanism that maintains the rationale underlying stock option expensing while addressing critics' concerns about measurement error and the lack of reconciliation to actual experience. A procedure they call fair-value expensing adjusts and eventually reconciles cost estimates made at grant date with subsequent changes in the value of the options, and it does so in a way that eliminates forecasting and measurement errors over time. The method captures the chief characteristic of stock option compensation--that employees receive part of their compensation in the form of a contingent claim on the value they are helping to produce. The mechanism involves creating entries on both the asset and equity sides of the balance sheet. On the asset side, companies create a prepaid-compensation account equal to the estimated cost of the options granted; on the owners'-equity side, they create a paid-in capital stock-option account for the same amount. The prepaid-compensation account is then expensed through the income statement, and the stock option account is adjusted on the balance sheet to reflect changes in the estimated fair value of the granted options. The amortization of prepaid compensation is added to the change in the option grant's value to provide the total reported expense of the options grant for the year. At the end of the vesting period, the company uses the fair value of the vested option to make a final adjustment on the income statement to reconcile any difference between that fair value and the total of the amounts already reported.

  2. Combination of real options and game-theoretic approach in investment analysis

    NASA Astrophysics Data System (ADS)

    Arasteh, Abdollah

    2016-09-01

    Investments in technology create a large amount of capital investments by major companies. Assessing such investment projects is identified as critical to the efficient assignment of resources. Viewing investment projects as real options, this paper expands a method for assessing technology investment decisions in the linkage existence of uncertainty and competition. It combines the game-theoretic models of strategic market interactions with a real options approach. Several key characteristics underlie the model. First, our study shows how investment strategies rely on competitive interactions. Under the force of competition, firms hurry to exercise their options early. The resulting "hurry equilibrium" destroys the option value of waiting and involves violent investment behavior. Second, we get best investment policies and critical investment entrances. This suggests that integrating will be unavoidable in some information product markets. The model creates some new intuitions into the forces that shape market behavior as noticed in the information technology industry. It can be used to specify best investment policies for technology innovations and adoptions, multistage R&D, and investment projects in information technology.

  3. Anatomic comparison of the endonasal and transpetrosal approaches for interpeduncular fossa access.

    PubMed

    Oyama, Kenichi; Prevedello, Daniel M; Ditzel Filho, Leo F S; Muto, Jun; Gun, Ramazan; Kerr, Edward E; Otto, Bradley A; Carrau, Ricardo L

    2014-01-01

    was 6 ml. Both approaches are valid surgical options for retrochiasmatic lesions such as craniopharyngiomas. The endoscopic endonasal approach via the dorsum sellae provides a direct and wide exposure of the interpeduncular cistern with negligible neurovascular manipulation. The transpetrosal approach also allows direct access to the interpeduncular cistern without pituitary manipulation; however, the surgical corridor is narrow due to the surrounding neurovascular structures and affords poor contralateral visibility. Conversely, in the presence of large or giant tumors in the interpeduncular cistern, which widen the spaces between neurovascular structures, the transpetrosal approach becomes a superior route, whereas the endoscopic endonasal approach may provide limited freedom of movement in the lateral extension.

  4. A Kramers-Moyal approach to the analysis of third-order noise with applications in option valuation.

    PubMed

    Popescu, Dan M; Lipan, Ovidiu

    2015-01-01

    We propose the use of the Kramers-Moyal expansion in the analysis of third-order noise. In particular, we show how the approach can be applied in the theoretical study of option valuation. Despite Pawula's theorem, which states that a truncated model may exhibit poor statistical properties, we show that for a third-order Kramers-Moyal truncation model of an option's and its underlier's price, important properties emerge: (i) the option price can be written in a closed analytical form that involves the Airy function, (ii) the price is a positive function for positive skewness in the distribution, (iii) for negative skewness, the price becomes negative only for price values that are close to zero. Moreover, using third-order noise in option valuation reveals additional properties: (iv) the inconsistencies between two popular option pricing approaches (using a "delta-hedged" portfolio and using an option replicating portfolio) that are otherwise equivalent up to the second moment, (v) the ability to develop a measure R of how accurately an option can be replicated by a mixture of the underlying stocks and cash, (vi) further limitations of second-order models revealed by introducing third-order noise.

  5. Water Resources Planning under Uncertainty: A "Real Options" Approach

    NASA Astrophysics Data System (ADS)

    Jeuland, M. A.; Whittington, D.

    2011-12-01

    This research develops a real options approach for planning new water resources developments, in infrastructure construction and system operation, under uncertainty. The approach treats the planning problem as a series of staged decisions - the selection of new projects; their scale, timing and sequencing; and finally their operating rules - each of which is characterized by varying levels of irreversibility. The performance of different configurations of the system is then assessed along the various dimensions of the decision space, using simulation methods. The methodology is then made operational using an existing hydrological simulation model that can be used to study the example of hydropower development options in the Blue Nile in Ethiopia. The model includes physical linkages between climate change and system hydrology, and allows users to test the sensitivity of the basin-wide economic consequences of dams, which consist of energy generation, changes in irrigation crop-water demand, the value of flood control, and other basin-wide impacts, to climate change or changes in runoff, as well as to other uncertainties. The analysis shows that, from an economic perspective, there is no single optimal system configuration across a range of future climate conditions deemed plausible for this basin. For example, small infrastructures perform best in scenarios with reduced runoff into the river, whereas large ones are best when runoff increases. The real options framework therefore becomes useful for helping to identify configurations that are both more robust to poor outcomes and still contain sufficient flexibility to capture high upside benefits should favorable future conditions arise. The framework could readily be extended to explore a range of features that could be usefully built into water resources projects more generally, to improve the long-term economic performance of such investments.

  6. The first 100 feet: New options for Internet and broadband access. Final report, June 1, 1996--January 31, 1998

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

    Branscomb, L.; Hurley, D.; Keller, J.

    1998-04-01

    This project was undertaken to explore new options for connecting homes and small businesses to high-speed communications networks, such as the Internet. Fundamental to this inquiry was an interest in looking at options which are newly enabled through changes in technology and regulation, and which go beyond the traditional topdown, centralized model for local access. In particular, the authors focused on opportunities for end-user and community-level investment. This project was intended to investigate the opportunities presented by the decreasing cost of computing and networking platforms, the unbundling of local exchange network elements, and the intelligent endpoints model of networking bestmore » exemplified by the Internet. Do these factors, along with communications technologies such as spread spectrum wireless, digital subscriber line services, and the ability to modulate a communications signal over the electric power line infrastructure, enable new models for end-user investment in intelligent infrastructure as a leverage point for accessing the broadband network? This question was first explored through a two-day conference held at the Freedom Forum in Arlington, Virginia, October 29 and 30, 1996. The workshop addressed issues in the consumer adoption of new communications technologies, use of the electric power line infrastructure, the role of municipalities, and the use of alternative technologies, such as XDSL, satellite, spread spectrum wireless, LMDS, and others. The best of these papers have been further developed, with editorial guidance provided by Harvard, and compiled in the form of a book (The First 100 Feet: New Options for Internet and Broadband Access, Deborah Hurley and James Keller, eds., MIT Press, 1998) to be published as part of the MIT Press Spring 1998 catalogue. A summary of topics covered by the book is given in this report.« less

  7. A Kramers-Moyal Approach to the Analysis of Third-Order Noise with Applications in Option Valuation

    PubMed Central

    Popescu, Dan M.; Lipan, Ovidiu

    2015-01-01

    We propose the use of the Kramers-Moyal expansion in the analysis of third-order noise. In particular, we show how the approach can be applied in the theoretical study of option valuation. Despite Pawula’s theorem, which states that a truncated model may exhibit poor statistical properties, we show that for a third-order Kramers-Moyal truncation model of an option’s and its underlier’s price, important properties emerge: (i) the option price can be written in a closed analytical form that involves the Airy function, (ii) the price is a positive function for positive skewness in the distribution, (iii) for negative skewness, the price becomes negative only for price values that are close to zero. Moreover, using third-order noise in option valuation reveals additional properties: (iv) the inconsistencies between two popular option pricing approaches (using a “delta-hedged” portfolio and using an option replicating portfolio) that are otherwise equivalent up to the second moment, (v) the ability to develop a measure R of how accurately an option can be replicated by a mixture of the underlying stocks and cash, (vi) further limitations of second-order models revealed by introducing third-order noise. PMID:25625856

  8. Free versus subsidised healthcare: options for fee exemptions, access to care for vulnerable groups and effects on the health system in Burkina Faso.

    PubMed

    Yaogo, Maurice

    2017-07-12

    The many forms of healthcare fee exemptions implemented in Burkina Faso since the 2000s have varied between total exemption (free) and cost subsidisation. This article examines both options, their contextual variations and the ways in which they affect access to healthcare for vulnerable people as well as the operation of the health system. This research is part of an interdisciplinary regional program on the elimination of user fees for health services in West Africa (Burkina Faso, Mali and Niger). A conceptual framework and a chronological review of policy interventions are used as references to summarise the results of the three qualitative studies presented. Historical reference points are used to describe the emergence of healthcare fee exemption policies in Burkina Faso and the events that influenced their adoption. The joint analysis of opinions on options for fee exemption focuses on the different types of repercussions on access to healthcare and the operation of the health system. In conjunction with the twists and turns of the gradual development of a national health policy and in response to international recommendations, healthcare fee exemptions have evolved since colonisation. The limitations of the changes introduced with cost recovery and the barriers to healthcare access for the poorest people led to the adoption of the current sectorial fee exemptions. The results provide information on the reasons for the changes that have occurred over time. The nuanced perspectives of different categories of people surveyed about fee exemption options show that, beyond the perceived effects on healthcare access and the health system, the issue is one of more equitable governance. In principle, the fee exemption measures are intended to provide improved healthcare access for vulnerable groups. In practice, the negative effects on the operation of the health system advocate for reforms to harmonise the changes to multifaceted fee exemptions and the actual needs

  9. Open Access Publishing in the Field of Medical Informatics.

    PubMed

    Kuballa, Stefanie

    2017-05-01

    The open access paradigm has become an important approach in today's information and communication society. Funders and governments in different countries stipulate open access publications of funded research results. Medical informatics as part of the science, technology and medicine disciplines benefits from many research funds, such as National Institutes of Health in the US, Wellcome Trust in UK, German Research Foundation in Germany and many more. In this study an overview of the current open access programs and conditions of major journals in the field of medical informatics is presented. It was investigated whether there are suitable options and how they are shaped. Therefore all journals in Thomson Reuters Web of Science that were listed in the subject category "Medical Informatics" in 2014 were examined. An Internet research was conducted by investigating the journals' websites. It was reviewed whether journals offer an open access option with a subsequent check of conditions as for example the type of open access, the fees and the licensing. As a result all journals in the field of medical informatics that had an impact factor in 2014 offer an open access option. A predominantly consistent pricing range was determined with an average fee of 2.248 € and a median fee of 2.207 €. The height of a journals' open access fee did not correlate with the height of its Impact Factor. Hence, medical informatics journals have recognized the trend of open access publishing, though the vast majority of them are working with the hybrid method. Hybrid open access may however lead to problems in questions of double dipping and the often stipulated gold open access.

  10. Expanded Access Programs

    PubMed Central

    Van Campen, Luann E.; Garnett, Timothy

    2015-01-01

    Expanded access is a regulatory mechanism by which an investigational drug can be made available outside of a clinical trial to treat patients with serious or life-threatening conditions for which there are no satisfactory treatment options. An expanded access program (EAP) is the formal plan under which preapproval access to an investigational drug can be provided to a group of patients. Although an EAP is a regulated program, the decision to authorize an EAP is the responsibility of the biopharmaceutical sponsor. Because of the significant impact an EAP can have on current patients, drug development, and future patients, we propose that a sponsor’s decision must be based not only on regulatory criteria but also on ethical and practical considerations regarding implementation of an EAP. Such an approach will help ensure that decisions and plans uphold ethical precepts such as fairness, promoting good, and minimizing risk of harm. PMID:29473010

  11. The Traveler's Guide to E-mail Access.

    ERIC Educational Resources Information Center

    Clyde, Anne

    1999-01-01

    Presents options that travelers can use to keep in e-mail contact. Discusses equipment/access issues related to traveling with a laptop; Internet cafes; free e-mail services; accessing home mail via a Web page; and new options e-mail access for travelers. Includes Internet resources on Internet access providers. (AEF)

  12. Keeping all options open: Parents' approaches to advance care planning.

    PubMed

    Beecham, Emma; Oostendorp, Linda; Crocker, Joanna; Kelly, Paula; Dinsdale, Andrew; Hemsley, June; Russell, Jessica; Jones, Louise; Bluebond-Langner, Myra

    2017-08-01

    Early engagement in advance care planning (ACP) is seen as fundamental for ensuring the highest standard of care for children and young people with a life-limiting condition (LLC). However, most families have little knowledge or experience of ACP. To investigate how parents of children and young people with LLCs approach and experience ACP. Open-ended, semi-structured interviews were conducted with parents of 18 children; nine children who were currently receiving palliative care services, and nine children who had received palliative care and died. Verbatim transcripts of audiotaped interviews were analysed following principles of grounded theory while acknowledging the use of deductive strategies, taking account of both the child's condition, and the timing and nature of decisions made. Parents reported having discussions and making decisions about the place of care, place of death and the limitation of treatment. Most decisions were made relatively late in the illness and by parents who wished to keep their options open. Parents reported different levels of involvement in a range of decisions; many wished to be involved in decision making but did not always feel able to do so. This study highlights that parents' approaches to decision making vary by the type of decision required. Their views may change over time, and it is important to allow them to keep their options open. We recommend that clinicians have regular discussions over the course of the illness in an effort to understand parents' approaches to particular decisions rather than to drive to closure prematurely. © 2016 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  13. Mapping regulatory models for medicinal cannabis: a matrix of options.

    PubMed

    Belackova, Vendula; Shanahan, Marian; Ritter, Alison

    2017-05-30

    Objective The aim of the present study was to develop a framework for assessing regulatory options for medicinal cannabis in Australia. Methods International regulatory regimes for medicinal cannabis were reviewed with a qualitative policy analysis approach and key policy features were synthesised, leading to a conceptual framework that facilitates decision making across multiple dimensions. Results Two central organising dimensions of medicinal cannabis regulation were identified: cannabis supply and patient authorisation (including patient access). A number of the different supply options can be matched with a number of different patient authorisation options, leading to a matrix of possible regulatory regimes. Conclusions The regulatory options, as used internationally, involve different forms of cannabis (synthetic and plant-based pharmaceutical preparations or herbal cannabis) and the varying extent to which patient authorisation policies and procedures are stringently or more loosely defined. The optimal combination of supply and patient authorisation options in any jurisdiction that chooses to make medicinal cannabis accessible will depend on policy goals. What is known about the topic? Internationally, regulation of medicinal cannabis has developed idiosyncratically, depending on formulations that were made available and local context. There has been no attempt to date in the scientific literature to systematically document the variety of regulatory possibilities for medicinal cannabis. What does this paper add? This paper presents a new conceptual schema for considering options for the regulation of medicinal cannabis, across both supply and patient authorisation aspects. What are the implications for practitioners? The design of regulatory systems in Australia, whether for pharmaceutical or herbal products, is a vital issue for policy makers right now as federal and state and territory governments grapple with the complexities of medicinal cannabis

  14. A rights-based approach to accessing health determinants.

    PubMed

    Perkins, Fran

    2009-03-01

    This commentary summarizes the experience and learnings from a site visit in May 2008 to a drop-in centre for vulnerable women in downtown Cairo run by El-Shehab Institution for Comprehensive Development, which provides street outreach for the prevention of Sexually Transmitted Infection (STI). The Centre successfully provides services and support for women, many of who are displaced or refugees and are from the most marginalized areas in Cairo. Through a rights-based approach to the work, the Centre helps people living in the slums fight and win the right to access clean water, sewerage and electrical power in their communities. An individual-based approach to human rights is also used. In the last year El-Shehab have helped 67 women go to court and win their marriage rights from husbands who have abandoned them. Their approach is an example of a successful way to achieve access to basic health determinants.

  15. A real options approach to biotechnology investment policy-the case of developing a Campylobacter vaccine to poultry.

    PubMed

    Lund, Mogens; Jensen, Jørgen Dejgård

    2016-06-01

    The aim of the article is to identify and analyse public-private incentives for the development and marketing of new animal vaccines within a real options methodological framework, and to investigate how real options methodology can be utilized to support economic incentives for vaccine development in a cost-effective way. The development of a vaccine against Campylobacter jejuni in poultry is applied as a case study. Employing the real options methodology, the net present value of the vaccine R&D project becomes larger than a purely probabilistic expected present value throughout the different stages of the project - and the net present value becomes larger, when more types of real options are taken into consideration. The insight from the real options analysis reveals opportunities for new policies to promote the development of animal vaccines. One such approach might be to develop schemes combining stage-by-stage optimized subsidies in the individual development stages, with proper account taken of investors'/developers' economic incentives to proceed, sell or cancel the project in the respective stages. Another way of using the real options approach to support the development of desirable animal vaccines could be to issue put options for the vaccine candidate, enabling vaccine developers to hedge against the economic risk from market volatility. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Meckel's cave access: anatomic study comparing the endoscopic transantral and endonasal approaches.

    PubMed

    Van Rompaey, Jason; Suruliraj, Anand; Carrau, Ricardo; Panizza, Benedict; Solares, C Arturo

    2014-04-01

    Recent advances in endonasal endoscopy have facilitated the surgical access to the lateral skull base including areas such as Meckel's cave. This approach has been well documented, however, few studies have outlined transantral specific access to Meckel's. A transantral approach provides a direct pathway to this region obviating the need for extensive endonasal and transsphenoidal resection. Our aim in this study is to compare the anatomical perspectives obtained in endonasal and transantral approaches. We prepared 14 cadaveric specimens with intravascular injections of colored latex. Eight cadavers underwent endoscopic endonasal transpterygoid approaches to Meckel's cave. Six additional specimens underwent an endoscopic transantral approach to the same region. Photographic evidence was obtained for review. 30 CT scans were analyzed to measure comparative distances to Meckel's cave for both approaches. The endoscopic approaches provided a direct access to the anterior and inferior portions of Meckel's cave. However, the transantral approach required shorter instrumentation, and did not require clearing of the endonasal corridor. This approach gave an anterior view of Meckel's cave making posterior dissection more difficult. A transantral approach to Meckel's cave provides access similar to the endonasal approach with minimal invasiveness. Some of the morbidity associated with extensive endonasal resection could possibly be avoided. Better understanding of the complex skull base anatomy, from different perspectives, helps to improve current endoscopic skull base surgery and to develop new alternatives, consequently, leading to improvements in safety and efficacy.

  17. Securing TCP/IP and Dial-up Access to Administrative Data.

    ERIC Educational Resources Information Center

    Conrad, L. Dean

    1992-01-01

    This article describes Arizona State University's solution to security risk inherent in general access systems such as TCP/IP (Transmission Control Protocol/INTERNET Protocol). Advantages and disadvantages of various options are compared, and the process of selecting a log-on authentication approach involving generation of a different password at…

  18. 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.

  19. Transseptal antegrade transcatheter aortic valve replacement for patients with no other access approach - a contemporary experience.

    PubMed

    Cohen, Mauricio G; Singh, Vikas; Martinez, Claudia A; O'Neill, Brian P; Alfonso, Carlos E; Martinezclark, Pedro O; Heldman, Alan W; O'Neill, William W

    2013-11-15

    To assess the feasibility and outcomes in patients undergoing transvenous transseptal (TS) transcatheter aortic valve replacement (TAVR). TS approach for TAVR was abandoned in favor of retrograde transfemoral, transaortic, or transapical approaches. TS TAVR may still be warranted in patients for whom no other approach is feasible. Observational consecutive case series at a single center, to evaluate technical outcomes in inoperable patients with aortic stenosis who had contraindications for other approaches and who underwent TAVR via a transvenous TS antegrade approach using the Edwards-Sapien (ES) valve. Over a 4-month period, 9 patients underwent TS TAVR with 26 mm (n = 4) and 23 mm (n = 5) ES valves. Mean age was 84.5 ± 6.6 years and Society of Thoracic Surgeons predicted risk of mortality was 7.8 ± 2.8%. Specific contraindications for other access included iliofemoral arterial diameter <7 mm in 9 (100%), porcelain aorta in 6 (66%) patients, multiple (≥2) sternotomies in 2 (22%) patients, severe pulmonary disease in 3 (33%), extreme frailty in 1 (11%), spinal stenosis with impaired ability to rehabilitate postsurgery in 1 (11%) and apical left ventricular thrombus in 1 (11%) patient. Antegrade deployment of the ES prosthetic valve was technically feasible in 8 patients. Major bleeding occurred in 4 patients, two patients suffered acute kidney injury without need for dialysis and one patient required a permanent pacemaker. The median (25th, 75th percentiles) fluoroscopy time was 49 (34, 81) minutes and contrast volume was 150 (120, 225) ml. No patient had hemodynamically significant post-TAVR aortic insufficiency nor damage to the mitral valve. At 6 months follow-up, there were no cerebrovascular events or rehospitalizations and mean NYHA Class improved from 3.4 to 1.7. The antegrade TS approach to TAVR is a technically feasible option for "no-access" patients. Prospective assessment of the safety and efficacy of this approach in the current era warrants

  20. Path integral approach to closed-form option pricing formulas with applications to stochastic volatility and interest rate models

    NASA Astrophysics Data System (ADS)

    Lemmens, D.; Wouters, M.; Tempere, J.; Foulon, S.

    2008-07-01

    We present a path integral method to derive closed-form solutions for option prices in a stochastic volatility model. The method is explained in detail for the pricing of a plain vanilla option. The flexibility of our approach is demonstrated by extending the realm of closed-form option price formulas to the case where both the volatility and interest rates are stochastic. This flexibility is promising for the treatment of exotic options. Our analytical formulas are tested with numerical Monte Carlo simulations.

  1. 3. APPROACH TO THE ACCESS BRIDGE AND INTAKE PIER, LOOKING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. APPROACH TO THE ACCESS BRIDGE AND INTAKE PIER, LOOKING SOUTHWEST. - Sacramento River Water Treatment Plant Intake Pier & Access Bridge, Spanning Sacramento River approximately 175 feet west of eastern levee on river; roughly .5 mile downstream from confluence of Sacramento & American Rivers, Sacramento, Sacramento County, CA

  2. Real options approach to inter-sectoral migration of U.S.farm labor

    Treesearch

    Gulcan Onel; Barry K. Goodwin

    2014-01-01

    The core of the literature on inter-sectoral labor migration is based on net present value models of investment in which individuals are assumed to migrate to take advantage of positive wage differentials. In this article, we argue that a real options approach, taken together with the adjustment costs associated with sectoral relocation, may provide a basis for...

  3. Recommendations to Facilitate Expanded Access to Investigational Therapies for Seriously Ill Patients

    PubMed Central

    Jerome, Rebecca N.; Edwards, Terri L.; Boswell, Haley C.; Bernard, Gordon R.; Harris, Paul A.; Pulley, Jill M.

    2015-01-01

    When clinical trial enrollment is not an option for seriously ill patients whose illnesses have not responded to approved treatment options, those patients and their physicians may consider gaining access to investigational therapies through a pathway established by the Food and Drug Administration (FDA) called expanded access. However, recent events have highlighted the challenging dynamics involved in accessing investigational therapies through expanded access that include a complex interplay of factors involving the patient, physician, drug company, FDA, and, increasingly, social media. The authors offer several potential strategies to streamline what is otherwise an arduous process for all involved. (1) The drug company should prospectively determine whether it will establish an expanded access program for specific drugs. (2) A central clearinghouse for companies should support registration of expanded access drugs for suitable patients. (3) The determination of whether a patient fits criteria would be made by an independent review board of clinicians. (4) An independent coordinating center is needed; academic health centers are ideally suited for that role. (5) Adequate financing of the costs of therapy need to be in place to make expanded access a reality, given frequent lack of payor coverage for therapies. (6) Further enhancement of regulatory pathways, approaches, or rules would promote expanded access. (7) Patients should explicitly acknowledge the limited data available. (8) There should be a shared, secure, technical platform to facilitate expanded access. All the authors’ strategies present important prospects for improving treatment options for the most seriously ill patients. PMID:26445080

  4. A System Dynamics Approach for the Selection of Contaminated Land Management Options

    NASA Astrophysics Data System (ADS)

    McKnight, U. S.; Kuebert, M.; Finkel, M.; Bieg, M.

    2006-12-01

    Large-scale contaminated land and groundwater is a widespread problem that can severely impact human health, the environment and the economy at many urban sites all over the world. Usually a considerable number of potential management solutions exist at each of these sites. A detailed investigation of all these options, however, is not economically feasible which makes streamlining of the planning and decision process a mandatory requirement. Decisions to be taken should be made as early as possible in order to reduce expenditures on site investigation. Therefore, a tiered decision-making procedure is required, including (i) identification and prioritization of focal areas of risks, (ii) feasibility screening of remediation targets and available management alternatives to narrow the range of possible options for (iii) subsequent detailed investigations of only a select group of preferable options. For each of these elements, tailored decision and investigation concepts are required. These concepts and applied methods should be specifically adapted to the type and scale of the particular decision to be taken- more target-oriented, cost-efficient investigation programs, as well as model-based assessment methods are needed (Ruegner et al. 2006). A gap exists within this framework with respect to preliminary assessment methodologies representing the first decision level. To fill this gap, a new system dynamics approach has been developed that represents the system of source- pathway-receptor sequences by means of a mass flux model. The dynamics are governed by the effects of possible remedial actions, which are described as mass flux change over time (Serapiglia et al. 2005). This approach has been implemented in the preliminary evaluation tool CARO-plus (Cost-efficiency Assessment of Remediation Options) that models the effects of potential remedial actions, including tackling the contaminant source and managing the groundwater plume. The model represents the causal

  5. Thermometers: Understand the Options

    MedlinePlus

    ... the options Thermometers come in a variety of styles. Understand the different types of thermometers and how ... MA. Fever in infants and children: Pathophysiology and management. http://www.uptodate.com/home. Accessed July 23, ...

  6. 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

  7. NASA's EOSDIS: options for data providers

    NASA Astrophysics Data System (ADS)

    Khalsa, Siri J.; Ujhazy, John E.

    1995-12-01

    EOSDIS, the data and information system being developed by NASA to support interdisciplinary earth science research into the 21st century, will do more than manage and distribute data from EOS-era satellites. It will also promote the exchange of data, tools, and research results across disciplinary, agency, and national boundaries. This paper describes the options that data providers will have for interacting with the EOSDIS Core System (ECS), the infrastructure of EOSDIS. The options include: using the ECS advertising service to announce the availability of data at the provider's site; submitting a candidate data set to one of the Distributed Active Archive Centers (DAACs); establishing a data server that will make the data accessible via ECS and establishing Local Information Manager (LIM) which would make the data available for multi-site searches. One additional option is through custom gateway interfaces which would provide access to existing data archives. The gateway, data server, and LIM options require the implementation of ECS code at the provider site to insure proper protocols. The advertisement and ingest options require no part of ECS design to reside at the provider site.

  8. Open Access Journal Policies: A Systematic Analysis of Radiology Journals.

    PubMed

    Narayan, Anand; Lobner, Katie; Fritz, Jan

    2018-02-01

    The open access movement has pushed for greater access to scientific knowledge by expanding access to scientific journal articles. There is limited information about the extent to which open access policies have been adopted by radiology journals. We performed a systematic analysis to ascertain the proportion of radiology journals with open access options. A search was performed with the assistance of a clinical informationist. Full and mixed English-language diagnostic and interventional radiology Web of Science journals (impact factors > 1.0) were included. Nuclear medicine, radiation oncology, physics, and solicitation-only journals were excluded. Primary outcome was open access option (yes or no) with additional outcomes including presence or absence of embargo, complete or partial copyright transfer, publication fees, and self-archiving policies. Secondary outcomes included journal citations, journal impact factors, immediacy, Eigenfactor, and article influence scores. Independent double readings were performed with differences resolved by consensus, supplemented by contacting editorial staff at each journal. In all, 125 journals were identified; review yielded 49 journals (39%, mean impact factor of 2.61). Thirty-six of the journals had open access options (73.4%), and four journals were exclusively open access (8.2%). Twelve-month embargoes were most commonly cited (90.6%) with 28.6% of journals stating that they did not require a complete transfer of copyright. Prices for open access options ranged from $750 to $4,000 (median $3,000). No statistically significant differences were found in journal impact measures comparing journals with open access options to journals without open access options. Diagnostic and interventional radiology journals have widely adopted open access options with a few radiology journals being exclusively open access. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

    PubMed

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

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

  10. One health approach to influenza: assessment of critical issues and options.

    PubMed

    Powdrill, Thomas F; Nipp, Terry L; Rinderknecht, Jennifer L

    2010-08-01

    A task force of experts on influenza, public health, and animal health met at the conference One Health Approach to Influenza: Assessment of Critical Issues and Options in Washington, DC, on December 1-2, 2009. These experts discussed the role of the One Health approach in preparing for and responding to an influenza pandemic or other emerging zoonotic disease by using pandemic (H1N1) 2009 as a case study. The meeting was convened by the US Department of Homeland Security National Center for Foreign Animal and Zoonotic Disease Defense, and the National Institute of Allergy and Infectious Diseases/National Institutes of Health Western Regional Center of Excellence for Biodefense and Emerging Infectious Diseases.

  11. 11. DETAIL VIEW OF APPROACH TO INTAKE PIER FROM ACCESS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    11. DETAIL VIEW OF APPROACH TO INTAKE PIER FROM ACCESS BRIDGE, SHOWING DOOR TO INTERIOR GATE OPERATOR ROOM, LOOKING WEST. - Sacramento River Water Treatment Plant Intake Pier & Access Bridge, Spanning Sacramento River approximately 175 feet west of eastern levee on river; roughly .5 mile downstream from confluence of Sacramento & American Rivers, Sacramento, Sacramento County, CA

  12. Efficient Trajectory Options Allocation for the Collaborative Trajectory Options Program

    NASA Technical Reports Server (NTRS)

    Rodionova, Olga; Arneson, Heather; Sridhar, Banavar; Evans, Antony

    2017-01-01

    The Collaborative Trajectory Options Program (CTOP) is a Traffic Management Initiative (TMI) intended to control the air traffic flow rates at multiple specified Flow Constrained Areas (FCAs), where demand exceeds capacity. CTOP allows flight operators to submit the desired Trajectory Options Set (TOS) for each affected flight with associated Relative Trajectory Cost (RTC) for each option. CTOP then creates a feasible schedule that complies with capacity constraints by assigning affected flights with routes and departure delays in such a way as to minimize the total cost while maintaining equity across flight operators. The current version of CTOP implements a Ration-by-Schedule (RBS) scheme, which assigns the best available options to flights based on a First-Scheduled-First-Served heuristic. In the present study, an alternative flight scheduling approach is developed based on linear optimization. Results suggest that such an approach can significantly reduce flight delays, in the deterministic case, while maintaining equity as defined using a Max-Min fairness scheme.

  13. The timing of adoption of positron emission tomography: a real options approach.

    PubMed

    Pertile, Paolo; Torri, Emanuele; Flor, Luciano; Tardivo, Stefano

    2009-09-01

    This paper presents the economic evaluation from a hospital's perspective of the investment in positron emission tomography, adopting a real options approach. The installation of this equipment requires a major capital outlay, while uncertainty on several key variables is substantial. The value of several timing strategies, including sequential investment, is determined taking into account that future decisions will be based on the information available at that time. The results show that adopting this approach may have an impact on the timing of investment, because postponing the investment may be optimal even when the Expected Net Present Value of the project is positive.

  14. 75 FR 56919 - Port Access Route Study: The Approaches to San Francisco

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-17

    ... Access Route Study: The Approaches to San Francisco AGENCY: Coast Guard, DHS. ACTION: Notice of public... the study entitled ``Port Access Route Study: Off San Francisco'' that was published in the Federal... Access Route Study (PARS) to evaluate the continued applicability of and the potential need for...

  15. Network approach for decision making under risk-How do we choose among probabilistic options with the same expected value?

    PubMed

    Pan, Wei; Chen, Yi-Shin

    2018-01-01

    Conventional decision theory suggests that under risk, people choose option(s) by maximizing the expected utility. However, theories deal ambiguously with different options that have the same expected utility. A network approach is proposed by introducing 'goal' and 'time' factors to reduce the ambiguity in strategies for calculating the time-dependent probability of reaching a goal. As such, a mathematical foundation that explains the irrational behavior of choosing an option with a lower expected utility is revealed, which could imply that humans possess rationality in foresight.

  16. Options For Development of Space Fission Propulsion Systems

    NASA Technical Reports Server (NTRS)

    Houta, Mike; VanDyke, Melissa; Godfroy, Tom; Pedersen, Kevin; Martin, James; Dickens, Ricky; Salvail, Pat; Hrbud, Ivana; Rodgers, Stephen L. (Technical Monitor)

    2001-01-01

    Fission technology can enable rapid, affordable access to any point in the solar system. Potential fission-based transportation options include high specific power continuous impulse propulsion systems and bimodal nuclear thermal rockets. Despite their tremendous potential for enhancing or enabling deep space and planetary missions, to date space fission system have only been used in Earth orbit. The first step towards utilizing advanced fission propulsion systems is development of a safe, near-term, affordable fission system that can enhance or enable near-term missions of interest. An evolutionary approach for developing space fission propulsion systems is proposed.

  17. A DG approach to the numerical solution of the Stein-Stein stochastic volatility option pricing model

    NASA Astrophysics Data System (ADS)

    Hozman, J.; Tichý, T.

    2017-12-01

    Stochastic volatility models enable to capture the real world features of the options better than the classical Black-Scholes treatment. Here we focus on pricing of European-style options under the Stein-Stein stochastic volatility model when the option value depends on the time, on the price of the underlying asset and on the volatility as a function of a mean reverting Orstein-Uhlenbeck process. A standard mathematical approach to this model leads to the non-stationary second-order degenerate partial differential equation of two spatial variables completed by the system of boundary and terminal conditions. In order to improve the numerical valuation process for a such pricing equation, we propose a numerical technique based on the discontinuous Galerkin method and the Crank-Nicolson scheme. Finally, reference numerical experiments on real market data illustrate comprehensive empirical findings on options with stochastic volatility.

  18. Network approach for decision making under risk—How do we choose among probabilistic options with the same expected value?

    PubMed Central

    Chen, Yi-Shin

    2018-01-01

    Conventional decision theory suggests that under risk, people choose option(s) by maximizing the expected utility. However, theories deal ambiguously with different options that have the same expected utility. A network approach is proposed by introducing ‘goal’ and ‘time’ factors to reduce the ambiguity in strategies for calculating the time-dependent probability of reaching a goal. As such, a mathematical foundation that explains the irrational behavior of choosing an option with a lower expected utility is revealed, which could imply that humans possess rationality in foresight. PMID:29702665

  19. Identity Options in Russian Textbooks

    ERIC Educational Resources Information Center

    Shardakova, Marya; Pavlenko, Aneta

    2004-01-01

    This article introduces a new analytical approach to the study of identity options offered in foreign and second language textbooks. This approach, grounded in poststructuralist theory and critical discourse analysis, is applied to 2 popular beginning Russian textbooks. Two sets of identity options are examined in the study: imagined learners…

  20. 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.

  1. A real options approach to clinical faculty salary structure.

    PubMed

    Kahn, Marc J; Long, Hugh W

    2012-01-01

    One can use the option theory model originally developed to price financial opportunities in security markets to analyze many other economic arrangements such as the salary structures of clinical faculty in an academic medical center practice plan. If one views the underlying asset to be the portion (labeled "salary") of the economic value of the collections made for the care provided patients by the physician, then a salary guarantee can be considered a put option provided the physician, the guarantee having value to the physician only when the actual salary earned is less than the salary guarantee. Similarly, within an incentive plan, a salary cap can be thought of as a call option provided to the practice plan since a salary cap only has value to the practice plan when a physician's earnings exceed the cap. Further, based on analysis of prior earnings, the Black-Scholes options pricing model can be used both to price each option and to determine a financially neutral balance between a salary guarantee and a salary cap by equating the prices of the implied put and call options. We suggest that such analysis is superior to empirical methods for setting clinical faculty salary structure in the academic practice plan setting.

  2. Retroperitoneal versus direct femoral artery approach for thoracic endovascular aortic repair access: a case-control study.

    PubMed

    Etezadi, Vahid; Katzen, Barry T; Benenati, James F; Alehashemi, Sara; Tsoukas, Athanassios I; Puente, Orlando A

    2011-04-01

    Many individuals who are candidates for thoracic endovascular aortic repair (TEVAR) are found to have iliac artery anatomy and/or disease that preclude transfemoral endovascular access and require retroperitoneal surgical approach through more proximal arteries. This relatively more invasive technique could potentially affect the procedural outcomes. This study compares the retroperitoneal with transfemoral access used for TEVAR in a single center. In this study, 133 consecutive patients (96 men; mean age ± SD: 69.5 ± 14.7 years) who underwent TEVAR between 1994 and 2009 in a single center were retrospectively evaluated. The type of endovascular access was identified in all the patients. The basic demographics, access method, endograft type, 30-day morbidity and mortality rates, as well as procedure recordings including fluoroscopic and procedure duration, estimated blood loss, and duration of hospitalization were compared between the TEVAR procedures performed using a surgical retroperitoneal approach and those using the standard femoral access. Retroperitoneal access was used in 19 (14.3%; 13 women; mean age ± SD: 71 ± 12.2 years) and direct femoral access in 114 (85.7%; 24 women; mean age ± SD: 69 ± 15.4 years) patients. Two of the retroperitoneal accesses were obtained after failure of femoral approach. Techniques that were used included iliac artery conduit (seven patients), aortic artery conduit (eight patients), aortobifemoral artery graft conduit (one patient), and direct sheath introduction through the distal aorta (two patients) or common iliac artery (one patient). Retroperitoneal approach was used more frequently in women (35%) as compared with men (6%) (p = 0.0001). In all, 79% of the retroperitoneal approaches were associated with use of delivery sheath sizes larger than 24F (p = 0.049). TEVAR technical success was 100% with retroperitoneal and 97.3% with femoral access (p > 0.05). Thirty-day mortality rates were 0% and 8.8% and the rates of

  3. Telecommunications Options Connect OCLC and Libraries to the Future: The Co-Evolution of OCLC Connectivity Options and the Library Computing Environment.

    ERIC Educational Resources Information Center

    Breeding, Marshall

    1998-01-01

    The Online Computer Library Center's (OCLC) access options have kept pace with the evolving trends in telecommunications and the library computing environment. As libraries deploy microcomputers and develop networks, OCLC offers access methods consistent with these environments. OCLC works toward reorienting its network paradigm through TCP/IP…

  4. Nonlinear Schrödinger approach to European option pricing

    NASA Astrophysics Data System (ADS)

    Wróblewski, Marcin

    2017-05-01

    This paper deals with numerical option pricing methods based on a Schrödinger model rather than the Black-Scholes model. Nonlinear Schrödinger boundary value problems seem to be alternatives to linear models which better reflect the complexity and behavior of real markets. Therefore, based on the nonlinear Schrödinger option pricing model proposed in the literature, in this paper a model augmented by external atomic potentials is proposed and numerically tested. In terms of statistical physics the developed model describes the option in analogy to a pair of two identical quantum particles occupying the same state. The proposed model is used to price European call options on a stock index. the model is calibrated using the Levenberg-Marquardt algorithm based on market data. A Runge-Kutta method is used to solve the discretized boundary value problem numerically. Numerical results are provided and discussed. It seems that our proposal more accurately models phenomena observed in the real market than do linear models.

  5. 1. Context view shows approach of access road to summit, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Context view shows approach of access road to summit, communication towers and NW corner of lookout tower at center right. Camera is pointed SE. - Chelan Butte Lookout, Summit of Chelan Butte, Chelan, Chelan County, WA

  6. Guaranteed Access to Campus Network Resources: Policies and Issues.

    ERIC Educational Resources Information Center

    Hassler, Ardoth A.

    1998-01-01

    Reports on a options and issues discussion at a December 1997 Orlando (Florida) meeting of CAUSE97 on providing access to campus technology resources. Options discussed included departmentally and/or university-owned modems, third-party provider contracts, and using wireless access. Issues included providing authentication, assuring network…

  7. ARCAS (ACACIA Regional Climate-data Access System) -- a Web Access System for Climate Model Data Access, Visualization and Comparison

    NASA Astrophysics Data System (ADS)

    Hakkarinen, C.; Brown, D.; Callahan, J.; hankin, S.; de Koningh, M.; Middleton-Link, D.; Wigley, T.

    2001-05-01

    A Web-based access system to climate model output data sets for intercomparison and analysis has been produced, using the NOAA-PMEL developed Live Access Server software as host server and Ferret as the data serving and visualization engine. Called ARCAS ("ACACIA Regional Climate-data Access System"), and publicly accessible at http://dataserver.ucar.edu/arcas, the site currently serves climate model outputs from runs of the NCAR Climate System Model for the 21st century, for Business as Usual and Stabilization of Greenhouse Gas Emission scenarios. Users can select, download, and graphically display single variables or comparisons of two variables from either or both of the CSM model runs, averaged for monthly, seasonal, or annual time resolutions. The time length of the averaging period, and the geographical domain for download and display, are fully selectable by the user. A variety of arithmetic operations on the data variables can be computed "on-the-fly", as defined by the user. Expansions of the user-selectable options for defining analysis options, and for accessing other DOD-compatible ("Distributed Ocean Data System-compatible") data sets, residing at locations other than the NCAR hardware server on which ARCAS operates, are planned for this year. These expansions are designed to allow users quick and easy-to-operate web-based access to the largest possible selection of climate model output data sets available throughout the world.

  8. A Personalized Approach of Patient-Health Care Provider Communication Regarding Colorectal Cancer Screening Options.

    PubMed

    Sava, M Gabriela; Dolan, James G; May, Jerrold H; Vargas, Luis G

    2018-07-01

    Current colorectal cancer screening guidelines by the US Preventive Services Task Force endorse multiple options for average-risk patients and recommend that screening choices should be guided by individual patient preferences. Implementing these recommendations in practice is challenging because they depend on accurate and efficient elicitation and assessment of preferences from patients who are facing a novel task. To present a methodology for analyzing the sensitivity and stability of a patient's preferences regarding colorectal cancer screening options and to provide a starting point for a personalized discussion between the patient and the health care provider about the selection of the appropriate screening option. This research is a secondary analysis of patient preference data collected as part of a previous study. We propose new measures of preference sensitivity and stability that can be used to determine if additional information provided would result in a change to the initially most preferred colorectal cancer screening option. Illustrative results of applying the methodology to the preferences of 2 patients, of different ages, are provided. The results show that different combinations of screening options are viable for each patient and that the health care provider should emphasize different information during the medical decision-making process. Sensitivity and stability analysis can supply health care providers with key topics to focus on when communicating with a patient and the degree of emphasis to place on each of them to accomplish specific goals. The insights provided by the analysis can be used by health care providers to approach communication with patients in a more personalized way, by taking into consideration patients' preferences before adding their own expertise to the discussion.

  9. American Thyroid Association Statement on Remote-Access Thyroid Surgery.

    PubMed

    Berber, Eren; Bernet, Victor; Fahey, Thomas J; Kebebew, Electron; Shaha, Ashok; Stack, Brendan C; Stang, Michael; Steward, David L; Terris, David J

    2016-03-01

    Remote-access techniques have been described over the recent years as a method of removing the thyroid gland without an incision in the neck. However, there is confusion related to the number of techniques available and the ideal patient selection criteria for a given technique. The aims of this review were to develop a simple classification of these approaches, describe the optimal patient selection criteria, evaluate the outcomes objectively, and define the barriers to adoption. A review of the literature was performed to identify the described techniques. A simple classification was developed. Technical details, outcomes, and the learning curve were described. Expert opinion consensus was formulated regarding recommendations for patient selection and performance of remote-access thyroid surgery. Remote-access thyroid procedures can be categorized into endoscopic or robotic breast, bilateral axillo-breast, axillary, and facelift approaches. The experience in the United States involves the latter two techniques. The limited data in the literature suggest long operative times, a steep learning curve, and higher costs with remote-access thyroid surgery compared with conventional thyroidectomy. Nevertheless, a consensus was reached that, in appropriate hands, it can be a viable option for patients with unilateral small nodules who wish to avoid a neck incision. Remote-access thyroidectomy has a role in a small group of patients who fit strict selection criteria. These approaches require an additional level of expertise, and therefore should be done by surgeons performing a high volume of thyroid and robotic surgery.

  10. Registered access: a 'Triple-A' approach.

    PubMed

    Dyke, Stephanie O M; Kirby, Emily; Shabani, Mahsa; Thorogood, Adrian; Kato, Kazuto; Knoppers, Bartha M

    2016-12-01

    We propose a standard model for a novel data access tier - registered access - to facilitate access to data that cannot be published in open access archives owing to ethical and legal risk. Based on an analysis of applicable research ethics and other legal and administrative frameworks, we discuss the general characteristics of this Registered Access Model, which would comprise a three-stage approval process: Authentication, Attestation and Authorization. We are piloting registered access with the Demonstration Projects of the Global Alliance for Genomics and Health for which it may provide a suitable mechanism for access to certain data types and to different types of data users.

  11. Scaffolding the design of accessible eLearning content: a user-centered approach and cognitive perspective.

    PubMed

    Catarci, Tiziana; De Giovanni, Loredana; Gabrielli, Silvia; Kimani, Stephen; Mirabella, Valeria

    2008-08-01

    There exist various guidelines for facilitating the design, preparation, and deployment of accessible eLearning applications and contents. However, such guidelines prevalently address accessibility in a rather technical sense, without giving sufficient consideration to the cognitive aspects and issues related to the use of eLearning materials by learners with disabilities. In this paper we describe how a user-centered design process was applied to develop a method and set of guidelines for didactical experts to scaffold their creation of accessible eLearning content, based on a more sound approach to accessibility. The paper also discusses possible design solutions for tools supporting eLearning content authors in the adoption and application of the proposed approach.

  12. Youth with cerebral palsy with differing upper limb abilities: how do they access computers?

    PubMed

    Davies, T Claire; Chau, Tom; Fehlings, Darcy L; Ameratunga, Shanthi; Stott, N Susan

    2010-12-01

    To identify the current level of awareness of different computer access technologies and the choices made regarding mode of access by youth with cerebral palsy (CP) and their families. Survey. Two tertiary-level rehabilitation centers in New Zealand and Canada. Youth (N=60) with CP, Manual Ability Classification Scale (MACS) levels I to V, age 13 to 25 years. Not applicable. Questionnaire. Fifty (83%) of the 60 youth were aware of at least 1 available assistive technology (AT), such as touch screens and joysticks. However, only 34 youth (57%) were familiar with the accessibility options currently available in the most common operating systems. Thirty-three (94%) of 35 youth who were MACS I and II used a standard mouse and keyboard, while few chose to use assistive technology or accessibility options. In contrast, 10 (40%) of 25 youth who were MACS III to V used a variety of assistive technologies such as touch screens, joysticks, trackballs, and scanning technologies. This group also had the highest use of accessibility options, although only 15 (60%) of the 25 were aware of them. Most youth with CP were aware of, and used, assistive technologies to enhance their computer access but were less knowledgeable about accessibility options. Accessibility options allow users to modify their own computer interface and can thus enhance computer access for youth with CP. Clinicians should be knowledgeable enough to give informed advice in this area of computer access, thus ensuring that all youth with CP can benefit from both AT and accessibility options, as required. Copyright © 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. The value of informal care in the context of option B+ in Malawi: a contingent valuation approach.

    PubMed

    Chiwaula, Levison Stanely; Chirwa, Gowokani Chijere; Cataldo, Fabian; Kapito-Tembo, Atupele; Hosseinipour, Mina C; van Lettow, Monique; Tweya, Hannock; Kayoyo, Virginia; Khangamwa-Kaunda, Blessings; Kasende, Florence; Trapence, Clement; Gugsa, Salem; Rosenberg, Nora E; Eliya, Michael; Phiri, Sam

    2016-04-19

    Informal care, the health care provided by the patient's social network is important in low income settings although its monetary value is rarely estimated. The lack of estimates of the value of informal care has led to its omission in economic evaluations but this can result in incorrect decisions about cost effectiveness of an intervention. We explore the use of contingent valuation methods of willingness to pay (WTP) and willingness to accept (WTA) to estimate the value of informal care provided to HIV infected women that are accessing antiretroviral therapy (ART) under the Option B+ approach to prevention of mother-to-child transmission (PMTCT) of HIV in Malawi. We collected cross sectional data from 93 caregivers of women that received ART care from six health facilities in Malawi. Caregivers of women that reported for ART care on the survey day and consented to participate in the survey were included until the targeted sample size for the facility was reached. We estimated the value of informal care by using the willingness to accept (WTA) and willingness to pay (WTP) approaches. Medians were used to summarize the values and these were compared by the Wilcoxon signed-rank test. The median WTA to provide informal care in a month was US$30 and the median WTP for informal care was US$13 and the two were statistically different (p < 0.000). Median WTP was higher in the urban areas than in the rural areas (US$21 vs. US$13, p < 0.001) and for caregivers from households from higher wealth quintile than in the lower quintile (US$15 vs. US$13, p < 0.0462). Informal caregivers place substantial value on informal care giving. In low income settings where most caregivers are not formally employed, WTP and WTA approaches can be used to value informal care. NCT02005835.

  14. Making real options really work.

    PubMed

    van Putten, Alexander B; MacMillan, Ian C

    2004-12-01

    As a way to value growth opportunities, real options have had a difficult time catching on with managers. Many CFOs believe the method ensures the overvaluation of risky projects. This concern is legitimate, but abandoning real options as a valuation model isn't the solution. Companies that rely solely on discounted cash flow (DCF) analysis underestimate the value of their projects and may fail to invest enough in uncertain but highly promising opportunities. CFOs need not--and should not--choose one approach over the other. Far from being a replacement for DCF analysis, real options are an essential complement, and a project's total value should encompass both. DCF captures a base estimate of value; real options take into account the potential for big gains. This is not to say that there aren't problems with real options. As currently applied, they focus almost exclusively on the risks associated with revenues, ignoring the risks associated with a project's costs. It's also true that option valuations almost always ignore assets that an initial investment in a subsequently abandoned project will often leave the company. In this article, the authors present a simple formula for combining DCF and option valuations that addresses these two problems. Using an integrated approach, managers will, in the long run, select better projects than their more timid competitors while keeping risk under control. Thus, they will outperform their rivals in both the product and the capital markets.

  15. American Thyroid Association Statement on Remote-Access Thyroid Surgery

    PubMed Central

    Bernet, Victor; Fahey, Thomas J.; Kebebew, Electron; Shaha, Ashok; Stack, Brendan C.; Stang, Michael; Steward, David L.; Terris, David J.

    2016-01-01

    Background: Remote-access techniques have been described over the recent years as a method of removing the thyroid gland without an incision in the neck. However, there is confusion related to the number of techniques available and the ideal patient selection criteria for a given technique. The aims of this review were to develop a simple classification of these approaches, describe the optimal patient selection criteria, evaluate the outcomes objectively, and define the barriers to adoption. Methods: A review of the literature was performed to identify the described techniques. A simple classification was developed. Technical details, outcomes, and the learning curve were described. Expert opinion consensus was formulated regarding recommendations for patient selection and performance of remote-access thyroid surgery. Results: Remote-access thyroid procedures can be categorized into endoscopic or robotic breast, bilateral axillo-breast, axillary, and facelift approaches. The experience in the United States involves the latter two techniques. The limited data in the literature suggest long operative times, a steep learning curve, and higher costs with remote-access thyroid surgery compared with conventional thyroidectomy. Nevertheless, a consensus was reached that, in appropriate hands, it can be a viable option for patients with unilateral small nodules who wish to avoid a neck incision. Conclusions: Remote-access thyroidectomy has a role in a small group of patients who fit strict selection criteria. These approaches require an additional level of expertise, and therefore should be done by surgeons performing a high volume of thyroid and robotic surgery. PMID:26858014

  16. Research into Telecommunications Options for People with Physical Disabilities

    ERIC Educational Resources Information Center

    Nguyen, Toan; Garrett, Rob; Downing, Andrew; Walker, Lloyd; Hobbs, David

    2007-01-01

    People with a disability do not have equitable access to the modern telecommunication medium. Many experience difficulty typing, handling the phone, dialing, or answering calls. For those who are unable to speak, the only option is to type messages using whatever functional control site exists on their body. The provision of accessible mobile…

  17. SEATSAT programs option analysis

    NASA Technical Reports Server (NTRS)

    Luckl, L.

    1976-01-01

    A preliminary analysis of the costs of SEASAT follow-on options is presented. All the options assume the existence of SEASAT-A as currently defined in the SEASAT Economic Assessment. It is assumed that each option will continue through the year 2000 and approach operational system status in the 1983-1986 period, depending upon the sensor package selected. The launch vehicle assumed through 1983 is the Atlas Agena. After 1983, it is assumed SEASAT-A will switch to the use of the Space Shuttle. All cost estimates are 1976 dollars for fiscal year cost accounting, with no inflation rate included.

  18. Surgical access via right thoracotomy facilitates tricuspid valve surgery in sheep

    PubMed Central

    Bothe, Wolfgang; Diab, Mahmoud; Ostermann, Romanus; Schwarzer, Michael; Woelfel, Luisa; Bischoff, Sabine; Schubert, Harald

    2017-01-01

    In quadrupeds, the three-dimensional orientation of the heart with respect to the thorax is fundamentally different from that in humans. In this study, we assessed the best surgical approach to the tricuspid valve in sheep. Firstly, different surgical access sites to the tricuspid valve were tested in sheep cadavers, the anatomy was analyzed, and the optimal surgical approach to the tricuspid valve was determined. Secondly - along with cardiopulmonary bypass and cardioplegic arrest -the chosen approach was tested in six adult sheep in vivo. Anatomical analyses revealed that a left thoracotomy provided optimal access to the aorta and left heart. However, visualization of the right heart was significantly impaired. In contrast, a right thoracotomy provided good access to the right heart, but the ascending aorta was difficult to approach. Therefore, in the in vivo studies, arterial cannulation was performed through a carotid (n = 4) or femoral (n = 2) artery. In conclusion, a right-sided thoracotomy allows good visualization of all components of the tricuspid valve complex in sheep, but not of the ascending aorta. Consequently, peripheral vessels are preferred for arterial cannulation. This work may stimulate the investigation of pathomechanisms and/or novel treatment options for tricuspid valve pathologies. PMID:27456775

  19. Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers: A "Positive Deviance" Approach.

    PubMed

    Toscos, Tammy; Carpenter, Maria; Flanagan, Mindy; Kunjan, Kislaya; Doebbeling, Bradley N

    2018-01-01

    Despite health care access challenges among underserved populations, patients, providers, and staff at community health clinics (CHCs) have developed practices to overcome limited access. These "positive deviant" practices translate into organizational policies to improve health care access and patient experience. To identify effective practices to improve access to health care for low-income, uninsured or underinsured, and minority adults and their families. Seven CHC systems, involving over 40 clinics, distributed across one midwestern state in the United States. Ninety-two key informants, comprised of CHC patients (42%) and clinic staff (53%), participated in semi-structured interviews. Interview transcripts were subjected to thematic analysis to identify patient-centered solutions for managing access challenges to primary care for underserved populations. Transcripts were coded using qualitative analytic software. Practices to improve access to care included addressing illiteracy and low health literacy, identifying cost-effective resources, expanding care offerings, enhancing the patient-provider relationship, and cultivating a culture of teamwork and customer service. Helping patients find the least expensive options for transportation, insurance, and medication was the most compelling patient-centered strategy. Appointment reminders and confirmation of patient plans for transportation to appointments reduced no-show rates. We identified nearly 35 practices for improving health care access. These were all patient-centric, uncovered by both clinic staff and patients who had successfully navigated the health care system to improve access.

  20. Doing the Right Thing: One University's Approach to Digital Accessibility

    ERIC Educational Resources Information Center

    Sieben-Schneider, Jill A.; Hamilton-Brodie, Valerie A.

    2016-01-01

    This article describes the approach employed by one university to address a complaint filed by students with disabilities with the Department of Justice (DOJ) regarding the inaccessibility of information and communication technology (ICT). Prior to the DOJ complaint, the university did not have a process in place to address ICT accessibility.…

  1. Access and Quality in Nigeria's Higher Education: Need for a Pragmatic Approach for Sustainable Transformation

    ERIC Educational Resources Information Center

    Njoku, Joy N.

    2016-01-01

    Access and quality of higher education are among the major criteria for assessing the product of any institution of higher learning. This paper discusses access and quality in Nigeria's higher education; need for a pragmatic approach for sustainable transformation. It discusses problems of access in the areas of carrying capacity of universities,…

  2. Lessons Learned From Early Implementation of Option B+: The Elizabeth Glaser Pediatric AIDS Foundation Experience in 11 African Countries

    PubMed Central

    Mattingly, Meghan; Giphart, Anja; van de Ven, Roland; Chouraya, Caspian; Walakira, Moses; Boon, Alexandre; Mikusova, Silvia; Simonds, R. J.

    2014-01-01

    Background: “Option B+” is a World Health Organization-recommended approach to prevent mother-to-child HIV transmission whereby all HIV-positive pregnant and lactating women initiate lifelong antiretroviral therapy (ART). This review of early Option B+ implementation experience is intended to inform Ministries of Health and others involved in implementing Option B+. Methods: This implementation science study analyzed data from 11 African countries supported by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) to describe early experience implementing Option B+. Data are from 4 sources: (1) national guidelines for prevention of mother-to-child HIV transmission and Option B+ implementation plans, (2) aggregated service delivery data between January 2013 and March 2014 from EGPAF-supported sites, (3) field visits to Option B+ implementation sites, and (4) relevant EGPAF research, quality improvement, and evaluation studies. Results: Rapid adoption of Option B+ led to large increases in percentage of HIV-positive pregnant women accessing ART in antenatal care. By the end of 2013, most programs reached at least 50% of HIV-positive women in antenatal care with ART, even in countries using a phased approach to implementation. Scaling up Option B+ through integrating ART in maternal and child health settings has required expansion of the workforce, and task shifting to allow nurse-led ART initiation has created staffing pressure on lower-level cadres for counseling and community follow-up. Complex data collection needs may be impairing data quality. Discussion: Early experiences with Option B+ implementation demonstrate promise. Continued program evaluation is needed, as is specific attention to counseling and support around initiation of lifetime ART in the context of pregnancy and lactation. PMID:25436817

  3. Lessons learned from early implementation of option B+: the Elizabeth Glaser Pediatric AIDS Foundation experience in 11 African countries.

    PubMed

    Kieffer, Mary Pat; Mattingly, Meghan; Giphart, Anja; van de Ven, Roland; Chouraya, Caspian; Walakira, Moses; Boon, Alexandre; Mikusova, Silvia; Simonds, R J

    2014-12-01

    "Option B+" is a World Health Organization-recommended approach to prevent mother-to-child HIV transmission whereby all HIV-positive pregnant and lactating women initiate lifelong antiretroviral therapy (ART). This review of early Option B+ implementation experience is intended to inform Ministries of Health and others involved in implementing Option B+. This implementation science study analyzed data from 11 African countries supported by the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) to describe early experience implementing Option B+. Data are from 4 sources: (1) national guidelines for prevention of mother-to-child HIV transmission and Option B+ implementation plans, (2) aggregated service delivery data between January 2013 and March 2014 from EGPAF-supported sites, (3) field visits to Option B+ implementation sites, and (4) relevant EGPAF research, quality improvement, and evaluation studies. Rapid adoption of Option B+ led to large increases in percentage of HIV-positive pregnant women accessing ART in antenatal care. By the end of 2013, most programs reached at least 50% of HIV-positive women in antenatal care with ART, even in countries using a phased approach to implementation. Scaling up Option B+ through integrating ART in maternal and child health settings has required expansion of the workforce, and task shifting to allow nurse-led ART initiation has created staffing pressure on lower-level cadres for counseling and community follow-up. Complex data collection needs may be impairing data quality. Early experiences with Option B+ implementation demonstrate promise. Continued program evaluation is needed, as is specific attention to counseling and support around initiation of lifetime ART in the context of pregnancy and lactation.

  4. Novel approach to epicardial pacemaker implantation in patients with limited venous access.

    PubMed

    Costa, Roberto; Scanavacca, Mauricio; da Silva, Kátia Regina; Martinelli Filho, Martino; Carrillo, Roger

    2013-11-01

    Limited venous access in certain patients increases the procedural risk and complexity of conventional transvenous pacemaker implantation. The purpose of this study was to determine a minimally invasive epicardial approach using pericardial reflections for dual-chamber pacemaker implantation in patients with limited venous access. Between June 2006 and November 2011, 15 patients underwent epicardial pacemaker implantation. Procedures were performed through a minimally invasive subxiphoid approach and pericardial window with subsequent fluoroscopy-assisted lead placement. Mean patient age was 46.4 ± 15.3 years (9 male [(60.0%], 6 female [40.0%]). The new surgical approach was used in patients determined to have limited venous access due to multiple abandoned leads in 5 (33.3%), venous occlusion in 3 (20.0%), intravascular retention of lead fragments from prior extraction in 3 (20.0%), tricuspid valve vegetation currently under treatment in 2 (13.3%), and unrepaired intracardiac defects in 2 (13.3%). All procedures were successful with no perioperative complications or early deaths. Mean operating time for isolated pacemaker implantation was 231.7 ± 33.5 minutes. Lead placement on the superior aspect of right atrium, through the transverse sinus, was possible in 12 patients. In the remaining 3 patients, the atrial lead was implanted on the left atrium through the oblique sinus, the postcaval recess, or the left pulmonary vein recess. None of the patients displayed pacing or sensing dysfunction, and all parameters remained stable throughout the follow-up period of 36.8 ± 25.1 months. Epicardial pacemaker implantation through pericardial reflections is an effective alternative therapy for those patients requiring physiologic pacing in whom venous access is limited. © 2013 Heart Rhythm Society. All rights reserved.

  5. Questioning the efficacy of 'gold' open access to published articles.

    PubMed

    Fredericks, Suzanne

    2015-07-01

    To question the efficacy of 'gold' open access to published articles. Open access is unrestricted access to academic, theoretical and research literature that is scholarly and peer-reviewed. Two models of open access exist: 'gold' and 'green'. Gold open access provides everyone with access to articles during all stages of publication, with processing charges paid by the author(s). Green open access involves placing an already published article into a repository to provide unrestricted access, with processing charges incurred by the publisher. This is a discussion paper. An exploration of the relative benefits and drawbacks of the 'gold' and 'green' open access systems. Green open access is a more economic and efficient means of granting open access to scholarly literature but a large number of researchers select gold open access journals as their first choices for manuscript submissions. This paper questions the efficacy of gold open access models and presents an examination of green open access models to encourage nurse researchers to consider this approach. In the current academic environment, with increased pressures to publish and low funding success rates, it is difficult to understand why gold open access still exists. Green open access enhances the visibility of an academic's work, as increased downloads of articles tend to lead to increased citations. Green open access is the cheaper option, as well as the most beneficial choice, for universities that want to provide unrestricted access to all literature at minimal risk.

  6. Space station needs, attributes and architectural options: Architectural options and selection

    NASA Technical Reports Server (NTRS)

    Nelson, W. G.

    1983-01-01

    The approach, study results, and recommendations for defining and selecting space station architectural options are described. Space station system architecture is defined as the arrangement of elements (manned and unmanned on-orbit facilities, shuttle vehicles, orbital transfer vehicles, etc.), the number of these elements, their location (orbital inclination and altitude, and their functional performance capability, power, volume, crew, etc.). Architectural options are evaluated based on the degree of mission capture versus cost and required funding rate. Mission capture refers to the number of missions accommodated by the particular architecture.

  7. Screening regional management options for their impact on climate resilience: an approach and case study in the Venen-Vechtstreek wetlands in the Netherlands.

    PubMed

    Wardekker, J A; Wildschut, D; Stemberger, S; van der Sluijs, J P

    2016-01-01

    Freshwater systems provide various resources and services. These are often vulnerable to climate change and other pressures. Therefore, enhancing resilience to climate change is important for their long term viability. This paper explores how management options can be evaluated on their resilience implications. The approach included five steps: (1) characterizing the system, (2) characterizing the impacts of climate change and other disturbances, (3) inventorying management options, (4) assessing the impacts of these on climate resilience, and (5) follow-up analysis. For the resilience assessment, we used a set of 'resilience principles': homeostasis, omnivory, high flux, flatness, buffering, and redundancy. We applied the approach in a case study in a Dutch wetlands region. Many options in the region's management plan contribute to resilience, however, the plan underutilised several principles, particularly flatness, but also redundancy and omnivory for agriculture, and high flux for nature. Co-benefits was identified as an important additional criterion to obtain support for adaptation from local stakeholders, such as farmers. The approach provided a relatively quick and participatory way to screen options. It allowed us to consider multiple impacts and sectors, multiple dimensions of resilience, and stakeholder perspectives. The results can be used to identify gaps or pitfalls, and set priorities for follow-up analyses.

  8. Medical Student Interest in Flexible Residency Training Options.

    PubMed

    Piotrowski, Madison; Stulberg, Debra; Egan, Mari

    2018-05-01

    Medical residents continue to experience high rates of burnout during residency training even after implementation of the 2003 Accreditation Council for Graduate Medical Education duty-hour restrictions. The purpose of this study is to determine medical student interest in flexible residency training options. Researchers developed an 11-question survey for second through fourth-year medical students. The populations surveyed included medical students who were: (1) attending the 2015 American Academy of Family Physicians National Conference, the 2015 Family Medicine Midwest Conference, and (2) enrolled at University of Chicago Pritzker School of Medicine, University of Illinois College of Medicine at Chicago, Drexel University College of Medicine, and Case Western Reserve University School of Medicine. The survey was completed by 789 medical students. Over half of medical students surveyed indicated that they would be interested in working part-time during some portion of their residency training (51%), and that access to part-time training options would increase their likelihood of applying to a particular residency program (52%). When given the option of three residency training schedules of varying lengths, 41% of male students and 60% of female students chose a 60-hour workweek, even when that meant extending the residency length by 33% and reducing their yearly salary to $39,000. There is considerable interest among medical students in access to part-time residency training options and reduced-hour residency programs. This level of interest indicates that offering flexible training options could be an effective recruitment tool for residency programs and could improve students' perception of their work-life balance during residency.

  9. Intraosseous access can be taught to medical students using the four-step approach.

    PubMed

    Afzali, Monika; Kvisselgaard, Ask Daffy; Lyngeraa, Tobias Stenbjerg; Viggers, Sandra

    2017-03-02

    The intraosseous (IO) access is an alternative route for vascular access when peripheral intravascular catheterization cannot be obtained. In Denmark the IO access is reported as infrequently trained and used. The aim of this pilot study was to investigate if medical students can obtain competencies in IO access when taught by a modified Walker and Peyton's four-step approach. Nineteen students attended a human cadaver course in emergency procedures. A lecture was followed by a workshop. Fifteen students were presented with a case where IO access was indicated and their performance was evaluated by an objective structured clinical examination (OSCE) and rated using a weighted checklist. To evaluate the validity of the checklist, three raters rated performance and Cohen's kappa was performed to assess inter-rater reliability (IRR). To examine the strength of the overall IRR, Randolph's free-marginal multi rater kappa was used. A maximum score of 15 points was obtained by nine (60%) of the participants and two participants (13%) scored 13 points with all three raters. Only one participant failed more than one item on the checklist. The expert rater rated lower with a mean score of 14.2 versus the non-expert raters with mean 14.6 and 14.3. The overall IRR calculated with Randolph's free-marginal multi rater kappa was 0.71. The essentials of the IO access procedure can be taught to medical students using a modified version of the Walker and Peyton's four-step approach and the checklist used was found reliable.

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

    PubMed

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

    2015-10-01

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

  11. Best surgical option for arch extension of type B aortic dissection: the open approach

    PubMed Central

    Kim, Joon Bum

    2014-01-01

    Arch extension of aortic dissection (AD) is reported to occur in 4-25% of patients presenting with acute type B AD. The DeBakey and Stanford classifications do not specifically account for this subset, however, recent studies have demonstrated that the prognosis of patients with arch extension in acute type B AD is virtually identical to that of others with type B AD. In this sense, it seems reasonable to extend the general management principles that are applied to classic acute type B AD even to patients with arch extension. This may be because even in patients with arch extension, most complications occur at locations distal to the arch, and therefore treatment of these patients is similar to that of complicated type B AD, namely thoracic endovascular aortic repair (TEVAR). Conversely, 10% of patients with acute type B AD and arch extension develop complications that are directly related to the arch pathology. This clinical scenario generally necessitates surgical arch repair through a sternotomy approach. The frozen elephant trunk technique combined with arch repair is a very reasonable option to treat this unique clinical entity that involves relatively distal locations of the aortic diseases. Combined arch and descending aorta replacement through thoracotomy is an alternative option particularly when the anatomical features of the target lesions are not suitable for a sternotomy approach or TEVAR. Nonetheless, the reported mortality associated with this approach has been exceedingly high. Hybrid arch repair is another consideration in treating these patients to reduce the treatment-related mortality and morbidity, especially when the arch pathology is limited to the distal part. Nevertheless, the safety and efficacy of this procedure in cases with more extensive arch involvement needs to be assessed in further studies in comparison with other treatment modalities. PMID:25133105

  12. Retrofacial approach to access the round window for cochlear implantation of malformed ears.

    PubMed

    Rizk, Habib; O'Connell, Brendan; Stevens, Shawn; Meyer, Ted

    2015-03-01

    To report the use of the retrofacial approach for cochlear implantation in three cases of malformed ears with inaccessible round windows through the standard facial recess. Two children with bilateral profound sensorineural hearing loss who were cochlear implant candidates. One patient had bilateral sequential cochlear implantations and the other a unilateral implant. Retrofacial approach to access the posterior mesotympanum and visualize the round window. Ability to complete the surgery with full insertion of the implant and no complications such as facial nerve injury. We implanted three ears in two patients with multiple external and middle ear malformations with an aberrant facial nerve or a posteriorly displaced round window niche. The standard facial recess approach did not allow visualization of the round window. We resorted to a retrofacial approach to access the posterior mesotympanum and proceeded with the surgery through an anterior and inferior cochleostomy or through the round window. In cases with an aberrant facial nerve or inaccessible round window through the facial recess, the retrofacial approach is a good alternative but requires a certain level of expertise and familiarity with temporal bone anatomy. The decision to use an unconventional approach should be considered before surgery, but the ultimate decision may require intraoperative assessment.

  13. A data-centric approach to understanding the pricing of financial options

    NASA Astrophysics Data System (ADS)

    Healy, J.; Dixon, M.; Read, B.; Cai, F. F.

    2002-05-01

    We investigate what can be learned from a purely phenomenological study of options prices without modelling assumptions. We fitted neural net (NN) models to LIFFE ``ESX'' European style FTSE 100 index options using daily data from 1992 to 1997. These non-parametric models reproduce the Black-Scholes (BS) analytic model in terms of fit and performance measures using just the usual five inputs (S, X, t, r, IV). We found that adding transaction costs (bid-ask spread) to these standard five parameters gives a comparable fit and performance. Tests show that the bid-ask spread can be a statistically significant explanatory variable for option prices. The difference in option prices between the models with transaction costs and those without ranges from about -3.0 to +1.5 index points, varying with maturity date. However, the difference depends on the moneyness (S/X), being greatest in-the-money. This suggests that use of a five-factor model can result in a pricing difference of up to #10 to #30 per call option contract compared with modelling under transaction costs. We found that the influence of transaction costs varied between different yearly subsets of the data. Open interest is also a significant explanatory variable, but volume is not.

  14. 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.

  15. Adjustable typography: an approach to enhancing low vision text accessibility.

    PubMed

    Arditi, Aries

    2004-04-15

    Millions of people have low vision, a disability condition caused by uncorrectable or partially correctable disorders of the eye. The primary goal of low vision rehabilitation is increasing access to printed material. This paper describes how adjustable typography, a computer graphic approach to enhancing text accessibility, can play a role in this process, by allowing visually-impaired users to customize fonts to maximize legibility according to their own visual needs. Prototype software and initial testing of the concept is described. The results show that visually-impaired users tend to produce a variety of very distinct fonts, and that the adjustment process results in greatly enhanced legibility. But this initial testing has not yet demonstrated increases in legibility over and above the legibility of highly legible standard fonts such as Times New Roman.

  16. Percutaneous Femoropopliteal Recanalization Using a Completely Transpedal/Transtibial Approach

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

    Clark, Timothy W.I., E-mail: timothy.clark@uphs.upenn.edu; Watts, Micah M.; Kwan, Tak W.

    PurposeTo report preliminary experience with femoropopliteal revascularization using a completely transpedal/transtibial approach.Materials and MethodsThree patients with Rutherford 3–4 disease underwent revascularization of TASC C/D lesions using a pedal/tibial artery as the only site of arterial access.ResultsOne patient with a chronic superficial femoral artery occlusion had continuity achieved to the common femoral artery using a dedicated reentry device and stenting; in a second patient, an occluded popliteal artery stent was successfully revised with an endograft; and in a third patient with morbid obesity, a chronic SFA occlusion was successfully stented. All patients experienced complete resolution of presenting symptoms; no puncture sitemore » complications were seen.ConclusionsUse of a pedal/tibial approach as the sole site of arterial access may become an important access technique for femoropopliteal revascularization when patients have limited femoral access options.« less

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

    PubMed Central

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

    2015-01-01

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

  18. An Imaging Calorimeter for Access-Concept Study

    NASA Technical Reports Server (NTRS)

    Parnell, T. A.; Adams, James H.; Binns, R. W.; Christl, M. J.; Derrickson, J. H.; Fountain, W. F.; Howell, L. W.; Gregory, J. C.; Hink, P. L.; Israel, M. H.; hide

    2001-01-01

    A mission concept study to define the "Advanced Cosmic-ray Composition Experiment for Space Station (ACCESS)" was sponsored by the National Aeronautics and Space Administration (NASA). The ACCESS instrument complement contains a transition radiation detector and an ionization calorimeter to measure tile spectrum of protons, helium, and heavier nuclei up to approximately 10(exp 15) eV to search for the limit of S/N shock wave acceleration, or evidence for other explanations of the spectra. Several calorimeter configurations have been studied, including the "baseline" totally active bismuth germanate instrument and sampling calorimeters utilizing various detectors. The Imaging Calorimeter for ACCESS (ICA) concept comprises a carbon target and a calorimeter using a high atomic number absorber sampled approximately each radiation length (rl) by thin scintillating fiber (SCIFI) detectors. The main features and options of the ICA instrument configuration are described in this paper. Since direct calibration is not possible over most of the energy range, the best approach must be decided from simulations of calorimeter performance extrapolated from CERN calibrations at 0.375 TeV. This paper presents results from the ICA simulations study.

  19. Research into telecommunications options for people with physical disabilities.

    PubMed

    Nguyen, Toan; Garrett, Rob; Downing, Andrew; Walker, Lloyd; Hobbs, David

    2007-01-01

    People with a disability do not have equitable access to the modern telecommunication medium. Many experience difficulty typing, handling the phone, dialing, or answering calls. For those who are unable to speak, the only option is to type messages using whatever functional control site exists on their body. The provision of accessible mobile phones for people with disabilities can significantly improve their quality of life through an increased range of accessible activities, and mobile phones can improve their independence, safety, security and self-esteem. This research was aimed at providing practical ways for people with a disability to participate in the extensive community of home and mobile phone users. The outcomes of 10 participants taking part in the evaluation and trial of off-the-shelf telecommunication options are presented. Nine out of 10 participants showed high to very high results in terms of their overall performance and satisfaction with the use of the telecommunication equipment provided. With the processes and support covering equipment matching, education, training, and delivery, current off-the-shelf solutions can help people with disabilities to effectively communicate with other members of our society and to access the same range of information systems and services enjoyed by able-bodied members of the community.

  20. Innovative Approaches to Increase Access to Medicines in Developing Countries

    PubMed Central

    Stevens, Hilde; Huys, Isabelle

    2017-01-01

    Access to essential medicines is problematic for one third of all persons worldwide. The price of many medicines (i.e., drugs, vaccines, and diagnostics) is unaffordable to the majority of the population in need, especially in least-developed countries, but also increasingly in middle-income countries. Several innovative approaches, based on partnerships, intellectual property, and pricing, are used to stimulate innovation, promote healthcare delivery, and reduce global health disparities. No single approach suffices, and therefore stakeholders need to further engage in partnerships promoting knowledge and technology transfer in assuring essential medicines to be manufactured, authorized, and distributed in low- and middle-income countries (LMICs) in an effort of making them available at affordable and acceptable conditions. PMID:29270407

  1. Corporate Social Responsibility: A Real Options Approach to the Challenge of Financial Sustainability

    PubMed Central

    2015-01-01

    Background In contemporary complex societies, social values like ethics, corporate social responsibility, and being respectful with the environment, among others, are becoming social requirements. Corporations are expected to fulfill them and, according to empirical evidence, an overwhelming majority aspires to good social valuation. At the same time, the maximization of market share value in the long run continues to be the central corporate goal. Making environmental and social expenses compatible with value creation is a central challenge for corporations since it implies the financial sustainability of Corporate Social Responsibility (CSR). Methods and Results The value creation capacity of CSR projects, mainly through innovation, is widely acknowledged in economic literature and corporate practice. This fact arouses the need of having a quantitative framework capable of summarizing the value creation capacity of the variables involved in CSR projects. With this aim we build up a sensitivity analysis of real option ratios that studies and quantifies the value creation capacity of CSR projects connected with innovation. Ratio analysis has the advantage of being scale independent. Hence, it furnishes a homogeneous framework to express the interaction of value creation variables and, thus, supports strategic thinking quantitatively. Often, CSR expenses can be regarded as preliminary projects that create the opportunity to undertake a full future project. For them, we obtain the minimum expectations scenario that makes financially sustainable a preliminary project that can be interpreted as a call option. We propose a classification of CSR projects from the decision analysis perspective following a two-fold approach: Their relationship with value creation and their links with existing corporate activities. This classification of CSR projects aims at contributing to choose the best capital budgeting method to study the financial sustainability of the project and

  2. Corporate social responsibility: a real options approach to the challenge of financial sustainability.

    PubMed

    Bosch-Badia, Maria-Teresa; Montllor-Serrats, Joan; Tarrazon-Rodon, Maria-Antonia

    2015-01-01

    In contemporary complex societies, social values like ethics, corporate social responsibility, and being respectful with the environment, among others, are becoming social requirements. Corporations are expected to fulfill them and, according to empirical evidence, an overwhelming majority aspires to good social valuation. At the same time, the maximization of market share value in the long run continues to be the central corporate goal. Making environmental and social expenses compatible with value creation is a central challenge for corporations since it implies the financial sustainability of Corporate Social Responsibility (CSR). The value creation capacity of CSR projects, mainly through innovation, is widely acknowledged in economic literature and corporate practice. This fact arouses the need of having a quantitative framework capable of summarizing the value creation capacity of the variables involved in CSR projects. With this aim we build up a sensitivity analysis of real option ratios that studies and quantifies the value creation capacity of CSR projects connected with innovation. Ratio analysis has the advantage of being scale independent. Hence, it furnishes a homogeneous framework to express the interaction of value creation variables and, thus, supports strategic thinking quantitatively. Often, CSR expenses can be regarded as preliminary projects that create the opportunity to undertake a full future project. For them, we obtain the minimum expectations scenario that makes financially sustainable a preliminary project that can be interpreted as a call option. We propose a classification of CSR projects from the decision analysis perspective following a two-fold approach: Their relationship with value creation and their links with existing corporate activities. This classification of CSR projects aims at contributing to choose the best capital budgeting method to study the financial sustainability of the project and identifying those CSR projects

  3. Effectiveness of Mutual Learning Approach in the Academic Achievement of B.Ed Students in Learning Optional II English

    ERIC Educational Resources Information Center

    Arulselvi, Evangelin

    2013-01-01

    The present study aims at finding out the effectiveness of Mutual learning approach over the conventional method in learning English optional II among B.Ed students. The randomized pre-test, post test, control group and experimental group design was employed. The B.Ed students of the same college formed the control and experimental groups. Each…

  4. Market access pathways for cell therapies in France

    PubMed Central

    Rémuzat, Cécile; Toumi, Mondher; Jørgensen, Jesper; Kefalas, Panos

    2015-01-01

    -routine basis is outside the diagnosis-related group (DRG) system through Missions of General Interest and Support to Contracting (MIGAC). For minimally manipulated cells, four different funding processes are applicable, depending on the type of activity: (1) inclusion in a DRG; (2) inclusion in the list of products and services qualifying for reimbursement (LPPR) (as a medical device); (3) an annual lump sum provided by regional health agencies; and (4) a financial allowance under Missions of General Interest (MIG). Conclusion Cell therapy is a diverse and promising category of medical interventions. Its heterogeneity and complexity mean that several funding options and market access pathways apply. The main challenges facing cell therapies relate to (1) the identification of the most appropriate path to reimbursement, and (2) price setting, whereas high manufacturing costs of these therapies will dictate a high price that could only be achieved by a product that leads to important additional patient benefits compared to available treatment options. More specific funding options could emerge as the number of cell therapies increases and the authorities face the need to structure and stabilise funding. It will be vital for manufacturers to have a clear understanding of the various temporary funding opportunities early in a product's lifecycle for the adoption of a stepwise approach to secure permanent funding. Furthermore, due to the very limited Health Technology Assessment (HTA) bodies experience for cell therapies, manufacturers should enter into dialogues with HTA agencies at an early stage to optimise market access conditions. PMID:27123176

  5. Market access pathways for cell therapies in France.

    PubMed

    Rémuzat, Cécile; Toumi, Mondher; Jørgensen, Jesper; Kefalas, Panos

    2015-01-01

    ) system through Missions of General Interest and Support to Contracting (MIGAC). For minimally manipulated cells, four different funding processes are applicable, depending on the type of activity: (1) inclusion in a DRG; (2) inclusion in the list of products and services qualifying for reimbursement (LPPR) (as a medical device); (3) an annual lump sum provided by regional health agencies; and (4) a financial allowance under Missions of General Interest (MIG). Cell therapy is a diverse and promising category of medical interventions. Its heterogeneity and complexity mean that several funding options and market access pathways apply. The main challenges facing cell therapies relate to (1) the identification of the most appropriate path to reimbursement, and (2) price setting, whereas high manufacturing costs of these therapies will dictate a high price that could only be achieved by a product that leads to important additional patient benefits compared to available treatment options. More specific funding options could emerge as the number of cell therapies increases and the authorities face the need to structure and stabilise funding. It will be vital for manufacturers to have a clear understanding of the various temporary funding opportunities early in a product's lifecycle for the adoption of a stepwise approach to secure permanent funding. Furthermore, due to the very limited Health Technology Assessment (HTA) bodies experience for cell therapies, manufacturers should enter into dialogues with HTA agencies at an early stage to optimise market access conditions.

  6. Vascular access for hemodialysis: current perspectives.

    PubMed

    Santoro, Domenico; Benedetto, Filippo; Mondello, Placido; Pipitò, Narayana; Barillà, David; Spinelli, Francesco; Ricciardi, Carlo Alberto; Cernaro, Valeria; Buemi, Michele

    2014-01-01

    A well-functioning vascular access (VA) is a mainstay to perform an efficient hemodialysis (HD) procedure. There are three main types of access: native arteriovenous fistula (AVF), arteriovenous graft, and central venous catheter (CVC). AVF, described by Brescia and Cimino, remains the first choice for chronic HD. It is the best access for longevity and has the lowest association with morbidity and mortality, and for this reason AVF use is strongly recommended by guidelines from different countries. Once autogenous options have been exhausted, prosthetic fistulae become the second option of maintenance HD access alternatives. CVCs have become an important adjunct in maintaining patients on HD. The preferable locations for insertion are the internal jugular and femoral veins. The subclavian vein is considered the third choice because of the high risk of thrombosis. Complications associated with CVC insertion range from 5% to 19%. Since an increasing number of patients have implanted pacemakers and defibrillators, usually inserted via the subclavian vein and superior vena cava into the right heart, a careful assessment of risk and benefits should be taken. Infection is responsible for the removal of about 30%-60% of HD CVCs, and hospitalization rates are higher among patients with CVCs than among AVF ones. Proper VA maintenance requires integration of different professionals to create a VA team. This team should include a nephrologist, radiologist, vascular surgeon, infectious disease consultant, and members of the dialysis staff. They should provide their experience in order to give the best options to uremic patients and the best care for their VA.

  7. Vascular access for hemodialysis: current perspectives

    PubMed Central

    Santoro, Domenico; Benedetto, Filippo; Mondello, Placido; Pipitò, Narayana; Barillà, David; Spinelli, Francesco; Ricciardi, Carlo Alberto; Cernaro, Valeria; Buemi, Michele

    2014-01-01

    A well-functioning vascular access (VA) is a mainstay to perform an efficient hemodialysis (HD) procedure. There are three main types of access: native arteriovenous fistula (AVF), arteriovenous graft, and central venous catheter (CVC). AVF, described by Brescia and Cimino, remains the first choice for chronic HD. It is the best access for longevity and has the lowest association with morbidity and mortality, and for this reason AVF use is strongly recommended by guidelines from different countries. Once autogenous options have been exhausted, prosthetic fistulae become the second option of maintenance HD access alternatives. CVCs have become an important adjunct in maintaining patients on HD. The preferable locations for insertion are the internal jugular and femoral veins. The subclavian vein is considered the third choice because of the high risk of thrombosis. Complications associated with CVC insertion range from 5% to 19%. Since an increasing number of patients have implanted pacemakers and defibrillators, usually inserted via the subclavian vein and superior vena cava into the right heart, a careful assessment of risk and benefits should be taken. Infection is responsible for the removal of about 30%–60% of HD CVCs, and hospitalization rates are higher among patients with CVCs than among AVF ones. Proper VA maintenance requires integration of different professionals to create a VA team. This team should include a nephrologist, radiologist, vascular surgeon, infectious disease consultant, and members of the dialysis staff. They should provide their experience in order to give the best options to uremic patients and the best care for their VA. PMID:25045278

  8. Generalized approach for identification and evaluation of technology-insertion options for military avionics systems

    NASA Astrophysics Data System (ADS)

    Harkness, Linda L.; Sjoberg, Eric S.

    1996-06-01

    The Georgia Tech Research Institute, sponsored by the Warner Robins Air Logistics Center, has developed an approach for efficiently postulating and evaluating methods for extending the life of radars and other avionics systems. The technique identified specific assemblies for potential replacement and evaluates the system level impact, including performance, reliability and life-cycle cost of each action. The initial impetus for this research was the increasing obsolescence of integrated circuits contained in the AN/APG-63 system. The operational life of military electronics is typically in excess of twenty years, which encompasses several generations of IC technology. GTRI has developed a systems approach to inserting modern technology components into older systems based upon identification of those functions which limit the system's performance or reliability and which are cost drivers. The presentation will discuss the above methodology and a technique for evaluating and ranking the different potential system upgrade options.

  9. Flexible Work Options within the Organisational System

    ERIC Educational Resources Information Center

    Albion, Majella J.; Chee, Munli

    2006-01-01

    The availability of flexible work options provides an opportunity for individuals to shape their careers in order to optimise their work and life goals. This study takes a systems theory approach to examine how the use of flexible work options influences relationships and interactions in the workplace. The "Flexible Work Options…

  10. Public Access Workstations in the Library: New Trends.

    ERIC Educational Resources Information Center

    Beecher, Henry

    1991-01-01

    Discusses the use of microcomputer-based workstations that are provided for public access in libraries. Criteria for workstations are discussed, including standard hardware, open-design software, scalable interface, and connectivity options for networking; systems that provide full-text access are described; and the need for standards is…

  11. Linear Time Algorithms to Restrict Insider Access using Multi-Policy Access Control Systems

    PubMed Central

    Mell, Peter; Shook, James; Harang, Richard; Gavrila, Serban

    2017-01-01

    An important way to limit malicious insiders from distributing sensitive information is to as tightly as possible limit their access to information. This has always been the goal of access control mechanisms, but individual approaches have been shown to be inadequate. Ensemble approaches of multiple methods instantiated simultaneously have been shown to more tightly restrict access, but approaches to do so have had limited scalability (resulting in exponential calculations in some cases). In this work, we take the Next Generation Access Control (NGAC) approach standardized by the American National Standards Institute (ANSI) and demonstrate its scalability. The existing publicly available reference implementations all use cubic algorithms and thus NGAC was widely viewed as not scalable. The primary NGAC reference implementation took, for example, several minutes to simply display the set of files accessible to a user on a moderately sized system. In our approach, we take these cubic algorithms and make them linear. We do this by reformulating the set theoretic approach of the NGAC standard into a graph theoretic approach and then apply standard graph algorithms. We thus can answer important access control decision questions (e.g., which files are available to a user and which users can access a file) using linear time graph algorithms. We also provide a default linear time mechanism to visualize and review user access rights for an ensemble of access control mechanisms. Our visualization appears to be a simple file directory hierarchy but in reality is an automatically generated structure abstracted from the underlying access control graph that works with any set of simultaneously instantiated access control policies. It also provide an implicit mechanism for symbolic linking that provides a powerful access capability. Our work thus provides the first efficient implementation of NGAC while enabling user privilege review through a novel visualization approach. This

  12. Visceral leishmaniasis in Somalia: A review of epidemiology and access to care.

    PubMed

    Sunyoto, Temmy; Potet, Julien; Boelaert, Marleen

    2017-03-01

    Somalia, ravaged by conflict since 1991, has areas endemic for visceral leishmaniasis (VL), a deadly parasitic disease affecting the rural poor, internally displaced, and pastoralists. Very little is known about VL burden in Somalia, where the protracted crisis hampers access to health care. We reviewed evidence about VL epidemiology in Somalia and appraised control options within the context of this fragile state's health system. VL has been reported in Somalia since 1934 and has persisted ever since in foci in the southern parts of the country. The only feasible VL control option is early diagnosis and treatment, currently mostly provided by nonstate actors. The availability of VL care in Somalia is limited and insufficient at best, both in coverage and quality. Precarious security remains a major obstacle to reach VL patients in the endemic areas, and the true VL burden and its impact remain unknown. Locally adjusted, innovative approaches in VL care provision should be explored, without undermining ongoing health system development in Somalia. Ensuring VL care is accessible is a moral imperative, and the limitations of the current VL diagnostic and treatment tools in Somalia and other endemic settings affected by conflict should be overcome.

  13. Visceral leishmaniasis in Somalia: A review of epidemiology and access to care

    PubMed Central

    Potet, Julien; Boelaert, Marleen

    2017-01-01

    Somalia, ravaged by conflict since 1991, has areas endemic for visceral leishmaniasis (VL), a deadly parasitic disease affecting the rural poor, internally displaced, and pastoralists. Very little is known about VL burden in Somalia, where the protracted crisis hampers access to health care. We reviewed evidence about VL epidemiology in Somalia and appraised control options within the context of this fragile state’s health system. VL has been reported in Somalia since 1934 and has persisted ever since in foci in the southern parts of the country. The only feasible VL control option is early diagnosis and treatment, currently mostly provided by nonstate actors. The availability of VL care in Somalia is limited and insufficient at best, both in coverage and quality. Precarious security remains a major obstacle to reach VL patients in the endemic areas, and the true VL burden and its impact remain unknown. Locally adjusted, innovative approaches in VL care provision should be explored, without undermining ongoing health system development in Somalia. Ensuring VL care is accessible is a moral imperative, and the limitations of the current VL diagnostic and treatment tools in Somalia and other endemic settings affected by conflict should be overcome. PMID:28278151

  14. Universal model for collective access patterns in the Internet traffic dynamics: A superstatistical approach

    NASA Astrophysics Data System (ADS)

    Tamazian, A.; Nguyen, V. D.; Markelov, O. A.; Bogachev, M. I.

    2016-07-01

    We suggest a universal phenomenological description for the collective access patterns in the Internet traffic dynamics both at local and wide area network levels that takes into account erratic fluctuations imposed by cooperative user behaviour. Our description is based on the superstatistical approach and leads to the q-exponential inter-session time and session size distributions that are also in perfect agreement with empirical observations. The validity of the proposed description is confirmed explicitly by the analysis of complete 10-day traffic traces from the WIDE backbone link and from the local campus area network downlink from the Internet Service Provider. Remarkably, the same functional forms have been observed in the historic access patterns from single WWW servers. The suggested approach effectively accounts for the complex interplay of both “calm” and “bursty” user access patterns within a single-model setting. It also provides average sojourn time estimates with reasonable accuracy, as indicated by the queuing system performance simulation, this way largely overcoming the failure of Poisson modelling of the Internet traffic dynamics.

  15. Bounds for Asian basket options

    NASA Astrophysics Data System (ADS)

    Deelstra, Griselda; Diallo, Ibrahima; Vanmaele, Michèle

    2008-09-01

    In this paper we propose pricing bounds for European-style discrete arithmetic Asian basket options in a Black and Scholes framework. We start from methods used for basket options and Asian options. First, we use the general approach for deriving upper and lower bounds for stop-loss premia of sums of non-independent random variables as in Kaas et al. [Upper and lower bounds for sums of random variables, Insurance Math. Econom. 27 (2000) 151-168] or Dhaene et al. [The concept of comonotonicity in actuarial science and finance: theory, Insurance Math. Econom. 31(1) (2002) 3-33]. We generalize the methods in Deelstra et al. [Pricing of arithmetic basket options by conditioning, Insurance Math. Econom. 34 (2004) 55-57] and Vanmaele et al. [Bounds for the price of discrete sampled arithmetic Asian options, J. Comput. Appl. Math. 185(1) (2006) 51-90]. Afterwards we show how to derive an analytical closed-form expression for a lower bound in the non-comonotonic case. Finally, we derive upper bounds for Asian basket options by applying techniques as in Thompson [Fast narrow bounds on the value of Asian options, Working Paper, University of Cambridge, 1999] and Lord [Partially exact and bounded approximations for arithmetic Asian options, J. Comput. Finance 10 (2) (2006) 1-52]. Numerical results are included and on the basis of our numerical tests, we explain which method we recommend depending on moneyness and time-to-maturity.

  16. Going "social" to access experimental and potentially life-saving treatment: an assessment of the policy and online patient advocacy environment for expanded access.

    PubMed

    Mackey, Tim K; Schoenfeld, Virginia J

    2016-02-02

    Social media is fundamentally altering how we access health information and make decisions about medical treatment, including for terminally ill patients. This specifically includes the growing phenomenon of patients who use online petitions and social media campaigns in an attempt to gain access to experimental drugs through expanded access pathways. Importantly, controversy surrounding expanded access and "compassionate use" involves several disparate stakeholders, including patients, manufacturers, policymakers, and regulatory agencies-all with competing interests and priorities, leading to confusion, frustration, and ultimately advocacy. In order to explore this issue in detail, this correspondence article first conducts a literature review to describe how the expanded access policy and regulatory environment in the United States has evolved over time and how it currently impacts access to experimental drugs. We then conducted structured web searches to identify patient use of online petitions and social media campaigns aimed at compelling access to experimental drugs. This was carried out in order to characterize the types of communication strategies utilized, the diseases and drugs subject to expanded access petitions, and the prevalent themes associated with this form of "digital" patient advocacy. We find that patients and their families experience mixed results, but still gravitate towards the use of online campaigns out of desperation, lack of reliable information about treatment access options, and in direct response to limitations of the current fragmented structure of expanded access regulation and policy currently in place. In response, we discuss potential policy reforms to improve expanded access processes, including advocating greater transparency for expanded access programs, exploring use of targeted economic incentives for manufacturers, and developing systems to facilitate patient information about existing treatment options. This includes

  17. Fundamental concerns of women living with HIV around the implementation of Option B+

    PubMed Central

    Matheson, Rebecca; Moses-Burton, Suzette; Hsieh, Amy C; Dilmitis, Sophie; Happy, Margaret; Sinyemu, Eunice; Brion, Sophie O; Sharma, Aditi

    2015-01-01

    Introduction In 2011, the Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping Their Mothers Alive was launched to scale up efforts to comprehensively end vertical HIV transmission and support mothers living with HIV in remaining healthy. Amidst excitement around using treatment as prevention, Malawi's Ministry of Health conceived Option B+, a strategy used to prevent vertical transmission by initiating all pregnant and breastfeeding women living with HIV on lifelong antiretroviral therapy, irrespective of CD4 count. In 2013, for programmatic and operational reasons, the WHO officially recommended Option B+ to countries with generalized epidemics, limited access to CD4 testing, limited partner testing, long breastfeeding duration or high fertility rates. Discussion While acknowledging the opportunity to increase treatment access globally and its potential, this commentary reviews the concerns of women living with HIV about human rights, community-based support and other barriers to service uptake and retention in the Option B+ context. Option B+ intensifies many of the pre-existing challenges of HIV prevention and treatment programmes. As women seek comprehensive services to prevent vertical transmission, they can experience various human rights violations, including lack of informed consent, involuntary or coercive HIV testing, limited treatment options, termination of pregnancy or coerced sterilization and pressure to start treatment. Yet, peer and community support strategies can promote treatment readiness, uptake, adherence and lifelong retention in care; reduce stigma and discrimination; and mitigate potential violence stemming from HIV disclosure. Ensuring available and accessible quality care, offering food support and improving linkages to care could increase service uptake and retention. With the heightened focus on interventions to reach pregnant and breastfeeding women living with HIV, a parallel increase in

  18. Fundamental concerns of women living with HIV around the implementation of Option B+.

    PubMed

    Matheson, Rebecca; Moses-Burton, Suzette; Hsieh, Amy C; Dilmitis, Sophie; Happy, Margaret; Sinyemu, Eunice; Brion, Sophie O; Sharma, Aditi

    2015-01-01

    In 2011, the Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping Their Mothers Alive was launched to scale up efforts to comprehensively end vertical HIV transmission and support mothers living with HIV in remaining healthy. Amidst excitement around using treatment as prevention, Malawi's Ministry of Health conceived Option B+, a strategy used to prevent vertical transmission by initiating all pregnant and breastfeeding women living with HIV on lifelong antiretroviral therapy, irrespective of CD4 count. In 2013, for programmatic and operational reasons, the WHO officially recommended Option B+ to countries with generalized epidemics, limited access to CD4 testing, limited partner testing, long breastfeeding duration or high fertility rates. While acknowledging the opportunity to increase treatment access globally and its potential, this commentary reviews the concerns of women living with HIV about human rights, community-based support and other barriers to service uptake and retention in the Option B+ context. Option B+ intensifies many of the pre-existing challenges of HIV prevention and treatment programmes. As women seek comprehensive services to prevent vertical transmission, they can experience various human rights violations, including lack of informed consent, involuntary or coercive HIV testing, limited treatment options, termination of pregnancy or coerced sterilization and pressure to start treatment. Yet, peer and community support strategies can promote treatment readiness, uptake, adherence and lifelong retention in care; reduce stigma and discrimination; and mitigate potential violence stemming from HIV disclosure. Ensuring available and accessible quality care, offering food support and improving linkages to care could increase service uptake and retention. With the heightened focus on interventions to reach pregnant and breastfeeding women living with HIV, a parallel increase in vigilance to secure their

  19. Towards an Approach for an Accessible and Inclusive Virtual Education Using ESVI-AL Project Results

    ERIC Educational Resources Information Center

    Amado-Salvatierra, Hector R.; Hilera, Jose R.

    2015-01-01

    Purpose: This paper aims to present an approach to achieve accessible and inclusive Virtual Education for all, but especially intended for students with disabilities. This work proposes main steps to take into consideration for stakeholders involved in the educational process related to an inclusive e-Learning. Design/methodology/approach: The…

  20. The Structural Algebra Option: A Discussion Paper.

    ERIC Educational Resources Information Center

    Kirshner, David

    The goal of this paper is to renew interest in the structural option to algebra instruction. Concern for the usual secondary school algebra curriculum related to simplifying expressions, solving equations, and rationalizing numerators and denominators is viewed from three pedagogical approaches: (1) structural approach, (2) empirical approach, and…

  1. 40 CFR 1602.2 - Requests for access to records.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Government Printing Office's World Wide Web site (which can be found at http://www.access.gpo.gov/su_docs... requested records, you may also, at your option, include your social security number. (e) Verification of..., date and place of birth, and, at your option, the social security number of the individual; (2) Your...

  2. 40 CFR 1602.2 - Requests for access to records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Government Printing Office's World Wide Web site (which can be found at http://www.access.gpo.gov/su_docs... requested records, you may also, at your option, include your social security number. (e) Verification of..., date and place of birth, and, at your option, the social security number of the individual; (2) Your...

  3. Statistical Approaches Used to Assess the Equity of Access to Food Outlets: A Systematic Review

    PubMed Central

    Lamb, Karen E.; Thornton, Lukar E.; Cerin, Ester; Ball, Kylie

    2015-01-01

    Background Inequalities in eating behaviours are often linked to the types of food retailers accessible in neighbourhood environments. Numerous studies have aimed to identify if access to healthy and unhealthy food retailers is socioeconomically patterned across neighbourhoods, and thus a potential risk factor for dietary inequalities. Existing reviews have examined differences between methodologies, particularly focussing on neighbourhood and food outlet access measure definitions. However, no review has informatively discussed the suitability of the statistical methodologies employed; a key issue determining the validity of study findings. Our aim was to examine the suitability of statistical approaches adopted in these analyses. Methods Searches were conducted for articles published from 2000–2014. Eligible studies included objective measures of the neighbourhood food environment and neighbourhood-level socio-economic status, with a statistical analysis of the association between food outlet access and socio-economic status. Results Fifty-four papers were included. Outlet accessibility was typically defined as the distance to the nearest outlet from the neighbourhood centroid, or as the number of food outlets within a neighbourhood (or buffer). To assess if these measures were linked to neighbourhood disadvantage, common statistical methods included ANOVA, correlation, and Poisson or negative binomial regression. Although all studies involved spatial data, few considered spatial analysis techniques or spatial autocorrelation. Conclusions With advances in GIS software, sophisticated measures of neighbourhood outlet accessibility can be considered. However, approaches to statistical analysis often appear less sophisticated. Care should be taken to consider assumptions underlying the analysis and the possibility of spatially correlated residuals which could affect the results. PMID:29546115

  4. Achieving open access to conservation science.

    PubMed

    Fuller, Richard A; Lee, Jasmine R; Watson, James E M

    2014-12-01

    Conservation science is a crisis discipline in which the results of scientific enquiry must be made available quickly to those implementing management. We assessed the extent to which scientific research published since the year 2000 in 20 conservation science journals is publicly available. Of the 19,207 papers published, 1,667 (8.68%) are freely downloadable from an official repository. Moreover, only 938 papers (4.88%) meet the standard definition of open access in which material can be freely reused providing attribution to the authors is given. This compares poorly with a comparable set of 20 evolutionary biology journals, where 31.93% of papers are freely downloadable and 7.49% are open access. Seventeen of the 20 conservation journals offer an open access option, but fewer than 5% of the papers are available through open access. The cost of accessing the full body of conservation science runs into tens of thousands of dollars per year for institutional subscribers, and many conservation practitioners cannot access pay-per-view science through their workplace. However, important initiatives such as Research4Life are making science available to organizations in developing countries. We urge authors of conservation science to pay for open access on a per-article basis or to choose publication in open access journals, taking care to ensure the license allows reuse for any purpose providing attribution is given. Currently, it would cost $51 million to make all conservation science published since 2000 freely available by paying the open access fees currently levied to authors. Publishers of conservation journals might consider more cost effective models for open access and conservation-oriented organizations running journals could consider a broader range of options for open access to nonmembers such as sponsorship of open access via membership fees. © 2014 The Authors. Conservation Biology published by Wiley Periodicals, Inc., on behalf of the Society for

  5. Advanced Stent Graft Treatment of Venous Stenosis Affecting Hemodialysis Vascular Access: Case Illustrations

    PubMed Central

    Patel, Darshan; Ray, Charles E.; Lokken, R. Peter; Bui, James T.; Lipnik, Andrew J.; Gaba, Ron C.

    2016-01-01

    Surgically placed dialysis access is an important component of dialysis replacement therapy. The vast majority of patients undergoing dialysis will have surgically placed accesses at some point in the course of their disease, and for many patients these accesses may represent their definitive renal replacement option. Most, if not all, arteriovenous fistulae and grafts will require interventions at some point in time. Percutaneous angioplasty is the typical first treatment performed for venous stenoses, with stents and stent grafts being reserved for patients in whom angioplasty and surgical options are exhausted. In some salvage situations, stent graft placement may be the only or best option for patients. This article describes, using case illustrations, placement of stent grafts in such patients; a focus will also be made on the techniques utilized in such salvage situations. PMID:27011426

  6. An innovative approach to capability-based emergency operations planning

    PubMed Central

    Keim, Mark E

    2013-01-01

    This paper describes the innovative use information technology for assisting disaster planners with an easily-accessible method for writing and improving evidence-based emergency operations plans. This process is used to identify all key objectives of the emergency response according to capabilities of the institution, community or society. The approach then uses a standardized, objective-based format, along with a consensus-based method for drafting capability-based operational-level plans. This information is then integrated within a relational database to allow for ease of access and enhanced functionality to search, sort and filter and emergency operations plan according to user need and technological capacity. This integrated approach is offered as an effective option for integrating best practices of planning with the efficiency, scalability and flexibility of modern information and communication technology. PMID:28228987

  7. An innovative approach to capability-based emergency operations planning.

    PubMed

    Keim, Mark E

    2013-01-01

    This paper describes the innovative use information technology for assisting disaster planners with an easily-accessible method for writing and improving evidence-based emergency operations plans. This process is used to identify all key objectives of the emergency response according to capabilities of the institution, community or society. The approach then uses a standardized, objective-based format, along with a consensus-based method for drafting capability-based operational-level plans. This information is then integrated within a relational database to allow for ease of access and enhanced functionality to search, sort and filter and emergency operations plan according to user need and technological capacity. This integrated approach is offered as an effective option for integrating best practices of planning with the efficiency, scalability and flexibility of modern information and communication technology.

  8. News from ESO Archive Services: Next Generation Request Handler and Data Access Delegation

    NASA Astrophysics Data System (ADS)

    Fourniol, N.; Lockhart, J.; Suchar, D.; Tacconi-Garman, L. E.; Moins, C.; Bierwirth, T.; Eglitis, P.; Vuong, M.; Micol, A.; Delmotte, N.; Vera, I.; Dobrzycki, A.; Forchì, V.; Lange, U.; Sogni, F.

    2012-09-01

    We present the new ESO Archive services which improve the electronic data access via the Download Manager and also provide PIs with the option to delegate data access to their collaborators via the Data Access Control.

  9. 36 CFR 1600.22 - Requests for access to records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Wide Web site (which can be found at http://www.access.gpo.gov/su_docs). (c) Agreement to pay fees. If..., you may also, at your option, include your social security number. (e) Verification of guardianship... place of birth, and, at your option, the social security number of the individual; (2) Your own identity...

  10. 36 CFR 1600.22 - Requests for access to records.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Wide Web site (which can be found at http://www.access.gpo.gov/su_docs). (c) Agreement to pay fees. If..., you may also, at your option, include your social security number. (e) Verification of guardianship... place of birth, and, at your option, the social security number of the individual; (2) Your own identity...

  11. Trust-based access control model from sociological approach in dynamic online social network environment.

    PubMed

    Baek, Seungsoo; Kim, Seungjoo

    2014-01-01

    There has been an explosive increase in the population of the OSN (online social network) in recent years. The OSN provides users with many opportunities to communicate among friends and family. Further, it facilitates developing new relationships with previously unknown people having similar beliefs or interests. However, the OSN can expose users to adverse effects such as privacy breaches, the disclosing of uncontrolled material, and the disseminating of false information. Traditional access control models such as MAC, DAC, and RBAC are applied to the OSN to address these problems. However, these models are not suitable for the dynamic OSN environment because user behavior in the OSN is unpredictable and static access control imposes a burden on the users to change the access control rules individually. We propose a dynamic trust-based access control for the OSN to address the problems of the traditional static access control. Moreover, we provide novel criteria to evaluate trust factors such as sociological approach and evaluate a method to calculate the dynamic trust values. The proposed method can monitor negative behavior and modify access permission levels dynamically to prevent the indiscriminate disclosure of information.

  12. Trust-Based Access Control Model from Sociological Approach in Dynamic Online Social Network Environment

    PubMed Central

    Kim, Seungjoo

    2014-01-01

    There has been an explosive increase in the population of the OSN (online social network) in recent years. The OSN provides users with many opportunities to communicate among friends and family. Further, it facilitates developing new relationships with previously unknown people having similar beliefs or interests. However, the OSN can expose users to adverse effects such as privacy breaches, the disclosing of uncontrolled material, and the disseminating of false information. Traditional access control models such as MAC, DAC, and RBAC are applied to the OSN to address these problems. However, these models are not suitable for the dynamic OSN environment because user behavior in the OSN is unpredictable and static access control imposes a burden on the users to change the access control rules individually. We propose a dynamic trust-based access control for the OSN to address the problems of the traditional static access control. Moreover, we provide novel criteria to evaluate trust factors such as sociological approach and evaluate a method to calculate the dynamic trust values. The proposed method can monitor negative behavior and modify access permission levels dynamically to prevent the indiscriminate disclosure of information. PMID:25374943

  13. Life Story Work: Optional Extra or Fundamental Entitlement?

    ERIC Educational Resources Information Center

    Atwool, Nicola

    2017-01-01

    In Aotearoa New Zealand the importance of life story books is outlined in the policy of our statutory care and protection agency Child, Youth and Family. Many children in care do not have access to such a resource, however, suggesting that social workers view this as an optional extra or "nice to have" rather than integral to good…

  14. No Special Equipment Required: The Accessibility Features Built into the Windows and Macintosh Operating Systems make Computers Accessible for Students with Special Needs

    ERIC Educational Resources Information Center

    Kimball,Walter H.; Cohen,Libby G.; Dimmick,Deb; Mills,Rick

    2003-01-01

    The proliferation of computers and other electronic learning devices has made knowledge and communication accessible to people with a wide range of abilities. Both Windows and Macintosh computers have accessibility options to help with many different special needs. This documents discusses solutions for: (1) visual impairments; (2) hearing…

  15. Dairy cow preference for different types of outdoor access.

    PubMed

    Smid, Anne-Marieke C; Weary, Daniel M; Costa, Joao H C; von Keyserlingk, Marina A G

    2018-02-01

    Dairy cows display a partial preference for being outside, but little is known about what aspects of the outdoor environment are important to cows. The primary aim of this study was to test the preference of lactating dairy cattle for pasture versus an outdoor sand pack during the night. A secondary aim was to determine whether feeding and perching behavior changed when cows were provided outdoor access. A third objective was to investigate how the lying behavior of cows changed when given access to different outdoor areas. Ninety-six lactating pregnant cows were assigned to 8 groups of 12 animals each. After a baseline phase of 2 d in which cows were kept inside the freestall barn, cows were habituated to the outdoor areas by providing them access to each of the 2 options for 24 h. Cows were then given access, in random order by group, to either the pasture (pasture phase) or the sand pack (sand phase). As we tested the 2 outdoor options using space allowances consistent with what would be practical on commercial dairy farms, the space provided on pasture was larger (21,000 m 2 ) than that provided on the sand pack (144 m 2 ). Cows were tested at night (for 2 nights in each condition), from 2000 h until morning milking at approximately 0800 h, as preference to be outdoors is strongest at this time. During the next 3 nights cows were given access to both outside options simultaneously (choice phase). Feeding and perching behaviors were recorded when cows were indoors during the day and night periods. Lying behavior was automatically recorded by HOBO data loggers (Onset, Bourne, MA). Cows spent more time outside in the pasture phase (90.0 ± 5.9%) compared with the sand phase (44.4 ± 6.3%). When provided simultaneous access to both options, cows spent more time on pasture than on the sand pack (90.5 ± 2.6% vs. 0.8 ± 0.5%, respectively). Time spent feeding indoors during the day did not change regardless of what type of outdoor access was provided, but there was a

  16. 28 CFR 16.41 - Requests for access to records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the Government Printing Office's World Wide Web site (which can be found at http://www.access.gpo.gov... accessed electronically at the Government Printing Office's World Wide Web site (which can be found at http... requested records, you may also, at your option, include your social security number. (e) Verification of...

  17. 28 CFR 16.41 - Requests for access to records.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... the Government Printing Office's World Wide Web site (which can be found at http://www.access.gpo.gov... accessed electronically at the Government Printing Office's World Wide Web site (which can be found at http... requested records, you may also, at your option, include your social security number. (e) Verification of...

  18. 48 CFR 552.217-71 - Notice Regarding Option(s).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Notice Regarding Option(s... Notice Regarding Option(s). As prescribed in 517.208(b), insert the following provision: Notice Regarding Option(s) (NOV 1992) The General Services Administration (GSA) has included an option to [Insert...

  19. Adaptive [theta]-methods for pricing American options

    NASA Astrophysics Data System (ADS)

    Khaliq, Abdul Q. M.; Voss, David A.; Kazmi, Kamran

    2008-12-01

    We develop adaptive [theta]-methods for solving the Black-Scholes PDE for American options. By adding a small, continuous term, the Black-Scholes PDE becomes an advection-diffusion-reaction equation on a fixed spatial domain. Standard implementation of [theta]-methods would require a Newton-type iterative procedure at each time step thereby increasing the computational complexity of the methods. Our linearly implicit approach avoids such complications. We establish a general framework under which [theta]-methods satisfy a discrete version of the positivity constraint characteristic of American options, and numerically demonstrate the sensitivity of the constraint. The positivity results are established for the single-asset and independent two-asset models. In addition, we have incorporated and analyzed an adaptive time-step control strategy to increase the computational efficiency. Numerical experiments are presented for one- and two-asset American options, using adaptive exponential splitting for two-asset problems. The approach is compared with an iterative solution of the two-asset problem in terms of computational efficiency.

  20. Recent Coverage of Early Childhood Education Approaches in Open Access Early Childhood Journals

    ERIC Educational Resources Information Center

    Keskin, Burhanettin

    2016-01-01

    A content analysis of the coverage of the major approaches to early childhood education in the early childhood research journals, published between 2010 and 2014, that are early childhood research oriented and have free online access were investigated. Among 21 journals in early childhood education, two journals were selected for the content…

  1. 6 CFR 5.21 - Requests for access to records.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... accessed electronically at the Government Printing Office's World Wide Web site (which can be found at http... Printing Office's World Wide Web site (which can be found at http://www.access.gpo.gov/su_docs). (c... requested records, you may also, at your option, include your social security number. (e) Verification of...

  2. 6 CFR 5.21 - Requests for access to records.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... accessed electronically at the Government Printing Office's World Wide Web site (which can be found at http... Printing Office's World Wide Web site (which can be found at http://www.access.gpo.gov/su_docs). (c... requested records, you may also, at your option, include your social security number. (e) Verification of...

  3. Dyadic OPTION: Measuring perceptions of shared decision-making in practice.

    PubMed

    Melbourne, Emma; Roberts, Stephen; Durand, Marie-Anne; Newcombe, Robert; Légaré, France; Elwyn, Glyn

    2011-04-01

    Current models of the medical consultation emphasize shared decision-making (SDM), whereby the expertise of both the doctor and the patient are recognised and seen to equally contribute to the consultation. The evidence regarding the desirability and effectiveness of the SDM approach is often conflicting. It is proposed that the conflicts are due to the nature of assessment, with current assessments from the perspective of an outside observer. To empirically assess perceived involvement in the medical consultation using the dyadic OPTION instrument. 36 simulated medical consultations were organised between general practitioners and standardized- patients, using the observer OPTION and the newly developed dyadic OPTION instruments. SDM behaviours observed in the consultations were seen to depend on both members of the doctor and patient dyad, rather than each in isolation. Thus a dyadic approach to measurement is supported. This current study highlights the necessity for a dyadic approach to assessment and introduces a novel research instrument: the dyadic OPTION instrument. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  4. Mixed waste management options

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

    Owens, C.B.; Kirner, N.P.

    1991-12-31

    Disposal fees for mixed waste at proposed commercial disposal sites have been estimated to be $15,000 to $40,000 per cubit foot. If such high disposal fees are imposed, generators may be willing to apply extraordinary treatment or regulatory approaches to properly dispose of their mixed waste. This paper explores the feasibility of several waste management scenarios and attempts to answer the question: Can mixed waste be managed out of existence? Existing data on commercially generated mixed waste streams are used to identify the realm of mixed waste known to be generated. Each waste stream is evaluated from both a regulatorymore » and technical perspective in order to convert the waste into a strictly low-level radioactive or a hazardous waste. Alternative regulatory approaches evaluated in this paper include a delisting petition, no migration petition, and a treatability variance. For each waste stream, potentially available treatment options are identified that could lead to these variances. Waste minimization methodology and storage for decay are also considered. Economic feasibility of each option is discussed broadly.« less

  5. Options for Change: A Flexible Vehicle for Curriculum Evolution and Reform

    ERIC Educational Resources Information Center

    Baldwin, Roger G.; Baumann, Melissa J.

    2005-01-01

    In this article we examine a flexible curricular approach known as the "Option." The Option enables students to supplement traditional majors with a coherent set of courses and other educational experiences in a related, often interdisciplinary field. Options can act as curricular bridges between mainstream academic fields and problems of…

  6. Health financing options for Fiji's health system.

    PubMed

    Pande, Madhukar

    2003-09-01

    Fiji is currently implementing health care reforms with the first phase of reforms focusing on decentralization of the health system. Part of this effort focuses on looking at financing options. Some options for financing health care include private health insurance, social insurance, community financing, user-pays system (out-of-pocket), health savings accounts, government taxation and subsidies, and overseas loans and aid funding. This paper addresses all these options in detail and provides an analysis into each of these options relevance to Fiji and in some instances to other nations in the South Pacific region. Given the relative small populations of Fiji and its neighbouring nations, a regional approach to financing could prove more viable in the longer-term, however political, social, economic, legal and cultural issues will need to seriously explored.

  7. Supervisory Options for Instructional Leaders in Education

    ERIC Educational Resources Information Center

    Fritz, Carrie; Miller, Greg

    2003-01-01

    The principal purpose of this article was to identify supervisory approaches available to instructional leaders in education. Selected supervisory approaches served as the basis for creating the Supervisory Options for Instructional Leaders (SOIL) Model. Instructional leaders in a variety of educational settings could use this model. The SOIL…

  8. Applying Real Options for Evaluating Investments in ERP Systems

    NASA Astrophysics Data System (ADS)

    Nakagane, Jun; Sekozawa, Teruji

    This paper intends to verify effectiveness of real options approach for evaluating investments in Enterprise Resource Planning systems (ERP) and proves how important it is to disclose shadow options potentially embedded in ERP investment. The net present value (NPV) method is principally adopted to evaluate the value of ERP. However, the NPV method assumes no uncertainties exist in the object. It doesn't satisfy the current business circumstances which are filled with dynamic issues. Since the 1990s the effectiveness of option pricing models for Information System (IS) investment to solve issues in the NPV method has been discussed in the IS literature. This paper presents 3 business cases to review the practical advantages of such techniques for IS investments, especially ERP investments. The first case is EDI development. We evaluate the project by a new approach with lighting one of shadow options, EDI implementation. In the second case we reveal an ERP investment has an “expanding option” in a case of eliminating redundancy. The third case describes an option to contract which is deliberately slotted in ERP development to prepare transferring a manufacturing facility.

  9. Open access to scientific articles: a review of benefits and challenges.

    PubMed

    Björk, Bo-Christer

    2017-03-01

    The Internet has fundamentally changed the publishing of scholarly peer reviewed journals, and the way readers find and access articles. Digital access is nowadays the norm, in particular for researchers. The Internet has enabled a totally new business model, Open Access (OA), in which an article is openly available in full text for anyone with Internet access. This article reviews the different options to achieve this, whether by journals changing their revenue structures from subscription to publishing charges, or authors utilizing a number of options for posting OA versions of article manuscripts in repositories. It also discusses the regrettable emergence of "predatory" publishers, who spam academics, and make money by promising them rapid publication with only the semblance of peer review. The situation is further discussed from the viewpoints of different stakeholders, including academics as authors and readers, practicing physicians and the general public.

  10. Guidelines and Options for Computer Access from a Reclined Position.

    PubMed

    Grott, Ray

    2015-01-01

    Many people can benefit from working in a reclined position when accessing a computer. This can be due to disabilities involving musculoskeletal weakness, or the need to offload pressure on the spine or elevate the legs. Although there are "reclining workstations" on the market that work for some people, potentially better solutions tailored to individual needs can be configured at modest cost by following some basic principles.

  11. Shungnak Energy Configuration Options.

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

    Rosewater, David Martin; Eddy, John P.

    Power systems in rural Alaska villages face a unique combination of challenges that can increase the cost of energy and lowers energy supply reliability. In the case of the remote village of Shungnak, diesel and heating fuel is either shipped in by barge or flown in by aircraft. This report presents a technical analysis of several energy infrastructure upgrade and modification options to reduce the amount of fuel consumed by the community of Shungnak. Reducing fuel usage saves money and makes the village more resilient to disruptions in fuel supply. The analysis considers demand side options, such as energy efficiency,more » alongside the installation of wind and solar power generation options. Some novel approaches are also considered including battery energy storage and the use of electrical home heating stoves powered by renewable generation that would otherwise be spilled and wasted. This report concludes with specific recommendations for Shungnak based on economic factors, and fuel price sensitivity. General conclusions are also included to support future work analyzing similar energy challenges in remote arctic regions.« less

  12. Reduced invasive and muscle-sparing operative approaches to the posterolateral chest wall provide an excellent accessibility for the operative stabilization! : Minimized approaches to the posterolateral chest wall.

    PubMed

    Langenbach, A; Oppel, Pascal; Grupp, Sina; Krinner, Sebastian; Pachowsky, Milena; Buder, Thomas; Schulz-Drost, Melanie; Hennig, Friedrich F; Schulz-Drost, Stefan

    2017-11-09

    Stabilizing techniques for flail chest injuries are described through wide surgical approaches to the chest wall, especially in the most affected posterior and lateral regions. Severe morbidity due to these invasive approaches needs to be considered due to dissection of the scapular guiding muscles and the risk of injuries to neurovascular bundles. This study discusses possibilities for minimized approaches to the posterior and lateral regions. Ten fresh-frozen cadavers in lateral decubitus position were observed on both sides. Each surgical arm was kept mobile during the procedure. Approaches were performed following a standard protocol with muscle-sparing incisions starting with 5 cm in length and extending to 10 and 15 cm. The accessible surface comparing the extensions was measured. Visible ribs were counted. In a next step, MatrixRib ® Plates were fixed to those ribs to prove the feasibility of rib stabilization through limited approaches. Combinations of the posterior and lateral minimized approaches allow surgical fixation of 6-9 and 7-11 ribs through 5 and 10 cm incisions, respectively. In the case of an extreme expansion of a rib fracture series, an access extension can be made to 15 cm to be able to adequately supply the entire hemithorax using two approaches. Extensive invasive surgical approaches to the thoracic wall can be replaced by reduced invasive and muscle-sparing access combinations. A free-moving positioning of the arm and an accurate preoperative plan for minimizing approaches are essential. Minimally invasive plate techniques are very helpful adjuncts.

  13. Medical approaches to suffering are limited, so why critique Improving Access to Psychological Therapies from the same ideology.

    PubMed

    Binnie, James

    2018-04-01

    Although the article by Scott rightly questions the dynamics of the Improving Access to Psychological Therapies system and re-examines the recovery rates, finding quite shocking results, his recommendations are ultimately flawed. There is a strong critique of the diagnostic procedures in Improving Access to Psychological Therapies services, but the answer is not to diagnose more rigorously and to adhere more strictly to a manualised approach to psychotherapy. The opposite may be required. Alternatives to the medical model of distress offer a less stigmatising and more human approach to helping people with their problems. Perhaps psychological therapists and the people they work alongside would be better served by a psychological approach rather than a psychiatric one.

  14. The pricing of European options on two underlying assets with delays

    NASA Astrophysics Data System (ADS)

    Lin, Lisha; Li, Yaqiong; Wu, Jing

    2018-04-01

    In the paper, the pricing of European options on two underlying assets with delays is discussed. By using the approach of equivalent martingale measure transformation, the market is proved to be complete. With exchange option as a particular example, we obtain the explicit pricing formula in a subinterval of option period. The robust Euler-Maruyama method is combined with the Monte Carlo simulation to compute exchange option prices within the whole option period. Numerical experiments indicate that there is an increasing possibility of the difference between the delayed and Black-Scholes option prices with the increase of delay.

  15. Avoiding pitfalls in estimating heritability with the common options approach

    PubMed Central

    Danchin, Etienne; Wajnberg, Eric; Wagner, Richard H.

    2014-01-01

    In many circumstances, heritability estimates are subject to two potentially interacting pitfalls: the spatial and the regression to the mean (RTM) fallacies. The spatial fallacy occurs when the set of potential movement options differs among individuals according to where individuals depart. The RTM fallacy occurs when extreme measurements are followed by measurements that are closer to the mean. We simulated data from the largest published heritability study of a behavioural trait, colony size choice, to examine the operation of the two fallacies. We found that spurious heritabilities are generated under a wide range of conditions both in experimental and correlative estimates of heritability. Classically designed cross-foster experiments can actually increase the frequency of spurious heritabilities. Simulations showed that experiments providing all individuals with the identical set of options, such as by fostering all offspring in the same breeding location, are immune to the two pitfalls. PMID:24865284

  16. Access to Mars from Earth-Moon Libration Point Orbits:. [Manifold and Direct Options

    NASA Technical Reports Server (NTRS)

    Kakoi, Masaki; Howell, Kathleen C.; Folta, David

    2014-01-01

    This investigation is focused specifically on transfers from Earth-Moon L(sub 1)/L(sub 2) libration point orbits to Mars. Initially, the analysis is based in the circular restricted three-body problem to utilize the framework of the invariant manifolds. Various departure scenarios are compared, including arcs that leverage manifolds associated with the Sun-Earth L(sub 2) orbits as well as non-manifold trajectories. For the manifold options, ballistic transfers from Earth-Moon L(sub 2) libration point orbits to Sun-Earth L(sub 1)/L(sub 2) halo orbits are first computed. This autonomous procedure applies to both departure and arrival between the Earth-Moon and Sun-Earth systems. Departure times in the lunar cycle, amplitudes and types of libration point orbits, manifold selection, and the orientation/location of the surface of section all contribute to produce a variety of options. As the destination planet, the ephemeris position for Mars is employed throughout the analysis. The complete transfer is transitioned to the ephemeris model after the initial design phase. Results for multiple departure/arrival scenarios are compared.

  17. Access to Care for Youth in a State Mental Health System: A Simulated Patient Approach.

    PubMed

    Olin, Su-Chin Serene; O'Connor, Briannon C; Storfer-Isser, Amy; Clark, Lisa J; Perkins, Matthew; Hudson Scholle, Sarah; Whitmyre, Emma D; Hoagwood, Kimberly; Horwitz, Sarah McCue

    2016-05-01

    To examine access to psychiatric care for adolescents with depression in outpatient specialty clinics within a state mental health system, using a simulated patient approach. Trained callers posed as the mother of a 14-year-old girl with depression, following a script. A stratified random sample (n = 264) of 340 state-licensed outpatient mental health clinics that serve youth was selected. Clinics were randomly assigned to season and insurance condition. We examined whether access varied by season, clinic characteristics, and caller insurance type. Weighted logistic and linear mixed effects regression models were fitted to examine associations with appointment availability and wait times. Among clinics at which a treatment appointment could be scheduled, appointment availability differed by season. Clinics that had participated in state-sponsored trainings targeting access were more available. Wait times for treatment appointments varied by season and region. Wait times in New York City were shorter than in some other regions. Although callers were 4.1 times more likely to be able to schedule a psychiatry appointment in the spring, wait times for psychiatry appointments were significantly longer in the spring than in the summer (49.9 vs. 36.7 days). Wait times for therapy appointments were significantly shorter in community than in hospital clinics (19.1 days vs. 35.3 days). Access to psychiatric care for youth with depression was found to be variable in a state system. State-sponsored trainings on strategies to reduce wait times appear to improve care access. The simulated patient approach has promise for monitoring the impact of health care policy reforms on care quality measures. Published by Elsevier Inc.

  18. Access to Care for Youth in a State Mental Health System: A Simulated Patient Approach

    PubMed Central

    Olin, Su-chin Serene; O'Connor, Briannon C.; Storfer-Isser, Amy; Clark, Lisa J.; Perkins, Matthew; Scholle, Sarah Hudson; Whitmyre, Emma D.; Hoagwood, Kimberly; Horwitz, Sarah McCue

    2016-01-01

    Objective To examine access to psychiatric care for adolescents with depression in outpatient specialty clinics within a state mental health system, using a simulated patient approach. Method Trained callers posed as the mother of a 14-year-old female with depression, following a script. A stratified random sample (n = 264) of 340 state-licensed outpatient mental health clinics that serve youth was selected. Clinics were randomly assigned to season and insurance condition. We examined if access varied by season, clinic characteristics, and caller insurance type. Weighted logistic and linear mixed effects regression models were fitted to examine associations with appointment availability and wait times. Results Among clinics where a treatment appointment could be scheduled, appointment availability differed by season. Clinics who had participated in state-sponsored trainings targeting access were more available. Wait times for treatment appointments varied by season and region. Wait times in New York City were shorter than in some other regions. Although callers were 4.1 times more likely to be able to schedule a psychiatry appointment in the spring, wait times for psychiatry appointments were significantly longer in the spring than in the summer (49.9 vs. 36.7 days). Wait times for therapy appointments were significantly shorter in community than hospital clinics (19.1 days vs. 35.3 days). Conclusion Access to psychiatric care for youth with depression was found to be variable in a state system. State-sponsored trainings on strategies to reduce wait times appear to improve care access. The simulated patient approach has promise for monitoring the impact of healthcare policy reforms on care quality measures. PMID:27126853

  19. Astronaut Ross Approaches Assembly Concept for Construction of Erectable Space Structure (ACCESS)

    NASA Technical Reports Server (NTRS)

    1999-01-01

    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, Virginia, and the Marshall Space Flight Center (MSFC), EASE and ACCESS were developed and demonstrated at MSFC's Neutral Buoyancy Simulator (NBS). In this STS-61B onboard photo, astronaut Ross, perched on the Manipulator Foot Restraint (MFR) approaches the erected ACCESS. The primary objective of these experiments was to test the structural assembly concepts for suitability as the framework for larger space structures and to identify ways to improve the productivity of space construction.

  20. Options Counseling for the Pregnant Adolescent Patient.

    PubMed

    Hornberger, Laurie L

    2017-09-01

    Each year, more than 500 000 girls and young women younger than 20 years become pregnant. It is important for pediatricians to have the ability and the resources in their offices to make a timely pregnancy diagnosis in their adolescent patients and provide them with nonjudgmental pregnancy options counseling. Counseling includes an unbiased discussion of the adolescent's legal options to either continue or terminate her pregnancy, supporting the adolescent in the decision-making process, and referring the adolescent to appropriate resources and services. Pediatricians who choose not to provide such discussions should promptly refer pregnant adolescent patients to a health care professional who will offer developmentally appropriate pregnancy options counseling. This approach to pregnancy options counseling has not changed since the original 1989 American Academy of Pediatrics statement on this issue. Copyright © 2017 by the American Academy of Pediatrics.

  1. Innovative options for the doctoral dissertation in nursing.

    PubMed

    Robinson, Susan; Dracup, Kathleen

    2008-01-01

    The doctoral dissertation is the capstone event of doctoral study. While developing their dissertations, graduate students discover the cutting edge of the discipline, learn the intricacies of the research process, and engage in scientific dialogue with experts in the field. Traditional dissertation formats are confined to the Dissertation Abstracts International and are not easily accessed by clinicians, administrators, and researchers who are most in need of the information. Consequently, the number of universities offering options to the traditional dissertation format is growing. This article describes and compares 2 formats: the traditional dissertation and the publication option. The benefits and challenges of each format to doctoral students and faculty are discussed. The discussion reflects changing trends in the nursing profession as an academic discipline.

  2. 39 CFR 255.8 - Access to postal facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... with the National Historic Preservation Act of 1966, 16 U.S.C. 470 et seq.; (vii) The availability of other options to foster service accessibility; and (viii) Any other factor that is relevant and...

  3. BACLOFEN-INDUCED REDUCTIONS IN OPTIONAL FOOD INTAKE DEPEND UPON FOOD COMPOSITION

    PubMed Central

    Wojnicki, F.H.E.; Charny, G.; Corwin, R.L.W

    2013-01-01

    Baclofen reduces intake of some foods but stimulates intake or has no effect on others. The reasons for these differences are not known. The present study examined effects of baclofen when composition, energy density, preference, presentation and intake of optional foods varied. Semi-solid fat emulsions and sucrose products were presented for brief periods to non-food-deprived rats. In Experiment 1, fat and sucrose composition were varied while controlling energy density. In Experiment 2A, schedule of access and the number of optional foods were varied. In Experiment 2B, the biopolymer (thickener) was examined. Baclofen reduced intake of fat and/or sugar options with different energy densities (1.28-9 kcal/g), when presented daily or intermittently, and when intakes were relatively high or low. However, the efficacy of baclofen was affected by the biopolymer used to thicken the options: baclofen had no effect when options were thickened with one biopolymer (3173), but reduced intake when options were thickened with another biopolymer (515). Baclofen failed to reduce intake of a concentrated sugar option (64% sucrose), regardless of biopolymer. Based upon these results, caution is urged when interpreting results obtained with products using different thickening agents. Systematic research is needed when designing products used in rat models of food intake. PMID:23321345

  4. Predicting Graduation Rates at 4-Year Broad Access Institutions Using a Bayesian Modeling Approach

    ERIC Educational Resources Information Center

    Crisp, Gloria; Doran, Erin; Salis Reyes, Nicole A.

    2018-01-01

    This study models graduation rates at 4-year broad access institutions (BAIs). We examine the student body, structural-demographic, and financial characteristics that best predict 6-year graduation rates across two time periods (2008-2009 and 2014-2015). A Bayesian model averaging approach is utilized to account for uncertainty in variable…

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

    PubMed Central

    Aljunid, Syed Mohamed

    2018-01-01

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

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

    PubMed

    Mahmud, Aidalina; Aljunid, Syed Mohamed

    2018-01-01

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

  7. New Author Choice for Open Access

    NASA Astrophysics Data System (ADS)

    2007-04-01

    AGU journals now offer authors the opportunity to make their articles open for others to read for free. Authors choosing this option pay a fee based on article length and number of figures; these charges are designed to offset the potential loss of subscription income. This new option, called Author Choice, provides •Unlimited access to the article for all readers from the moment of publication. • Permission to deposit the PDF version in institutional repositories so long as the repository accepts AGU copyright permissions. • Continued copyright protection to prevent unauthorized uses of the author's work.

  8. Access to space study

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This report summarizes the results of a comprehensive NASA in-house study to identify and assess alternate approaches to access to space through the year 2030, and to select and recommend a preferred cause of action. The goals of the study were to identify the best vehicles and transportation architectures to make major reductions in the cost of space transportation (at least 50%), while at the same time increasing safety for flight crews by at least an order of magnitude. In addition, vehicle reliability was to exceed 0.98 percent, and, as important, the robustness, pad time, turnaround time, and other aspects of operability were to be vastly improved. This study examined three major optional architectures: (1) retain and upgrade the Space Shuttle and expendable launch vehicles; (2) develop new expendable vehicles using conventional technologies and transition from current vehicles beginning in 2005; and (3) develop new reusable vehicles using advanced technology, and transition from current vehicles beginning in 2008. The launch-needs, mission model utilized for for the study was based upon today's projection of civil, defense, and commercial mission payload requirements.

  9. Which way in? The Necessity of Multiple Approaches to Transcatheter Valve Therapy

    PubMed Central

    Bleiziffer, S.; Krane, M.; Deutsch, M.A.; Elhmidi, Y.; Piazza, N.; Voss, B.; Lange, R.

    2013-01-01

    TAVI (transcatheter aortic valve implantation) is a less invasive treatment of the stenotic aortic valve while avoiding midline sternotomy and cardiopulmonary bypass. A crimped biological valve on a self-expanding or balloon-expandable stent is inserted antegradely or retrogradely under fluoroscopy, and deployed on the beating heart. Among the worldwide TAVI programs, many different concepts have been established for the choice of the access site. Whether retrograde or antegrade TAVI should be considered the superior approach is matter of an ongoing debate. The published literature demonstrates safety of all techniques if performed within a dedicated multidisciplinary team. Since there is no data providing evidence if one approach is superior to another, we conclude that an individualized patient-centered decision making process is most beneficial, taking advantage of the complementarity of the different access options. The aim of this article is to give an overview of the current practice of access techniques for transcatheter based valve treatment and to outline the respective special characteristics. PMID:24313647

  10. Accelerated Learning Options: A Promising Strategy for States. Policy Insights

    ERIC Educational Resources Information Center

    Michelau, Demaree

    2006-01-01

    This issue of Policy Insights draws on findings from WICHE's report Accelerated Learning Options: Moving the Needle on Access and Success, to lay out some of the important policy issues that decision makers might consider when adopting new state policy related to accelerated learning or modifying policies already in existence. The publication…

  11. Outcomes from Flexible Learning Options for Disenfranchised Youth: What Counts?

    ERIC Educational Resources Information Center

    te Riele, Kitty; Wilson, Kimberley; Wallace, Valda; McGinty, Sue; Lewthwaite, Brian

    2017-01-01

    Flexible Learning Options (FLOs) are common across many countries to enable secondary school completion by young people for whom mainstream schooling has not worked well. Access to high-quality education through FLOs is a social justice issue. In the context of an inclination among governments for accountability and evidence-based policy, as well…

  12. Electronic journal access: how does it affect the print subscription price?*

    PubMed Central

    Chen, Frances L.; Wrynn, Paul; Rieke, Judith L.

    2001-01-01

    Objective: This study examined the rates of print journal subscription price increases according to the type of available electronic access. The types of access included: electronic priced separately from the print, combination print with “free online” access, and aggregated, defined here as electronic access purchased as part of a collection. The percentages of print price increases were compared to each other and to that for titles available only in print. The authors were not aware of prior objective research in this area. Methods: The authors analyzed the percentage print price increases of 300 journals over a five-year time period. The titles were grouped according to type of available electronic access. The median and mean percentage print price increases were calculated and plotted for all titles within each group. Results: Using both the median and the mean to look at the percentage print price increases over five years, it was obvious that print prices for journals with electronic access exceeded journals that did not offer an electronic option. Electronic priced separately averaged 3% to 5% higher than print only titles using both measures. Combination print with “free online” access had higher increases from 1996 to 1999, but, in 2000, their percentage increases were about the same as print only titles. The rate of price increases for aggregated titles consistently went down over the past five years. Journals with no electronic option showed the lowest percentage rates of print price increase. Conclusions: The authors' findings reveal that the increases of print prices for their sample of titles were higher if a type of electronic access was offered. According to the results of this study, aggregated collections currently represent the electronic option whose percentage price increase for print prices was lowest. However, the uneven fluctuations in rates of subscription prices revealed that the pricing of journals with electronic access is still

  13. A Path Integral Approach to Option Pricing with Stochastic Volatility: Some Exact Results

    NASA Astrophysics Data System (ADS)

    Baaquie, Belal E.

    1997-12-01

    The Black-Scholes formula for pricing options on stocks and other securities has been generalized by Merton and Garman to the case when stock volatility is stochastic. The derivation of the price of a security derivative with stochastic volatility is reviewed starting from the first principles of finance. The equation of Merton and Garman is then recast using the path integration technique of theoretical physics. The price of the stock option is shown to be the analogue of the Schrödinger wavefunction of quantum mechanics and the exact Hamiltonian and Lagrangian of the system is obtained. The results of Hull and White are generalized to the case when stock price and volatility have non-zero correlation. Some exact results for pricing stock options for the general correlated case are derived.

  14. Suppressing ghost beams: Backlink options for LISA

    NASA Astrophysics Data System (ADS)

    Isleif, K.-S.; Gerberding, O.; Penkert, D.; Fitzsimons, E.; Ward, H.; Robertson, D.; Livas, J.; Mueller, G.; Reiche, J.; Heinzel, G.; Danzmann, K.

    2017-05-01

    In this article we discuss possible design options for the optical phase reference system, the so called backlink, between two moving optical benches in a LISA satellite. The candidates are based on two approaches: Fiber backlinks, with additional features like mode cleaning cavities and Faraday isolators, and free beam backlinks with angle compensation techniques. We will indicate dedicated ghost beam mitigation strategies for the design options and we will point out critical aspects in case of an implementation in LISA.

  15. 20 CFR 416.2035 - Optional supplementation: Additional State options.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Optional supplementation: Additional State options. 416.2035 Section 416.2035 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... § 416.2035 Optional supplementation: Additional State options. (a) Residency requirement. A State or...

  16. Mapping public policy options responding to obesity: the case of Spain.

    PubMed

    González-Zapata, L I; Ortiz-Moncada, R; Alvarez-Dardet, C

    2007-05-01

    This study assesses the opinions of the main Spanish stakeholders from food and physical exercise policy networks on public policy options for responding to obesity. We followed the multi-criteria mapping methodology in the framework of the European project 'Policy options in responding to obesity' (PorGrow), through a structured interview to 21 stakeholders. A four-step approach was taken: options, criteria, scoring and weighting, obtaining in this way a measure of the performance of each option which integrates qualitative and quantitative information. In an overall analysis, the more popular policy options where those grouped as educational initiatives: include food and health in the school curriculum, improve health education to the general public, improve the training of health professionals in obesity care and prevention, incentives to caterers to provide healthier menus and improve community sports facilities. Fiscal measures as subsidies and taxes had the lowest support. The criteria assessed as priorities were grouped as efficacy and societal benefits. Obesity in Spain can be approached through public policies, although the process will not be easy or immediate. The feasibility of changes requires concerned public policymakers developing long-term actions taking into account the map of prioritized options by the stakeholders.

  17. International Policies on Sharing Genomic Research Results with Relatives: Approaches to Balancing Privacy with Access

    PubMed Central

    Branum, Rebecca; Wolf, Susan M.

    2015-01-01

    Returning genetic research results to raises complex issues. In order to inform the U.S. debate, this paper analyzes international law and policies governing the sharing of genetic research results with relatives and identifies key themes and lessons. The laws and policies from other countries demonstrate a range of approaches to balancing individual privacy and autonomy with family access for health benefit, offering important lessons for further development of approaches in the United States. PMID:26479568

  18. A maximum (non-extensive) entropy approach to equity options bid-ask spread

    NASA Astrophysics Data System (ADS)

    Tapiero, Oren J.

    2013-07-01

    The cross-section of options bid-ask spreads with their strikes are modelled by maximising the Kaniadakis entropy. A theoretical model results with the bid-ask spread depending explicitly on the implied volatility; the probability of expiring at-the-money and an asymmetric information parameter (κ). Considering AIG as a test case for the period between January 2006 and October 2008, we find that information flows uniquely from the trading activity in the underlying asset to its derivatives. Suggesting that κ is possibly an option implied measure of the current state of trading liquidity in the underlying asset.

  19. Access to augmentative and alternative communication: new technologies and clinical decision-making.

    PubMed

    Fager, Susan; Bardach, Lisa; Russell, Susanne; Higginbotham, Jeff

    2012-01-01

    Children with severe physical impairments require a variety of access options to augmentative and alternative communication (AAC) and computer technology. Access technologies have continued to develop, allowing children with severe motor control impairments greater independence and access to communication. This article will highlight new advances in access technology, including eye and head tracking, scanning, and access to mainstream technology, as well as discuss future advances. Considerations for clinical decision-making and implementation of these technologies will be presented along with case illustrations.

  20. Retrograde Transpedal Access for Revascularization of Below-the-Knee Arteries in Patients with Critical Limb Ischemia after an Unsuccessful Antegrade Transfemoral Approach.

    PubMed

    Goltz, J P; Planert, M; Horn, M; Wiedner, M; Kleemann, M; Barkhausen, J; Stahlberg, E

    2016-10-01

    To evaluate the safety and technical and clinical success of endovascular below-the-knee (BTK) artery revascularization by a retrograde transpedal access. We retrospectively identified 16/172 patients (9.3 %) with endovascular BTK revascularization in whom a transfemoral approach had failed and transpedal access had been attempted. The dorsal pedal (n = 13) or posterior tibial (n = 3) artery was accessed using a dedicated access set and ultrasound guidance. The procedure was finished in antegrade fashion by plain old balloon angioplasty (POBA). Comorbidities, vessel diameter and calcification at the access site were recorded. The analyzed outcomes were technical success, procedural complications, procedure time, crossing (guidewire beyond lesion and intra-luminal) and procedural (residual stenosis < 30 % after POBA) success, and limb salvage. Diabetes, coronary artery disease and hypertension were present in 15 patients (93.8 %), and both renal impairment and previous amputations in 7 (43.8 %). Pedal access vessel calcification was present in 5/16 patients (31.3 %). The mean diameter was 1.75 +/-0.24 mm. The procedure time was 92.4 +/-23 min. The success rate for achieving retrograde access was 100 %. Retrograde crossing was successful in 12/16 patients (75.0 %). Procedural success was observed in 10/16 patients (68.8 %). Minor complications occurred in 2/16 patients (12.5 %). The rate of limb salvage was 72.9 %, and the overall survival was 100 % at 12 months. Major amputations after revascularization occurred in 2/16 patients (12.5 %). If an antegrade transfemoral approach to BTK lesions fails, a retrograde transpedal approach may nevertheless facilitate treatment. This approach appears to be safe and offers high technical and acceptable clinical success rates. • Retrograde approaches via transpedal or transtibial vessels are safe and offer high technical success.• One problem after technically successful puncture

  1. The Fundamental Uncertainty of Business: Real Options

    NASA Astrophysics Data System (ADS)

    Dyer, James S.

    The purpose of this paper is to discuss the manner in which uncertainty is currently evaluated in business, with an emphasis on economic measures. In recent years, the accepted approach for the valuation of capital investment decisions has become one based on the theory of real options. From the standpoint of this workshop, the interesting aspect of real options is its focus on the flexibility of management to respond to changes in the environment as a feature of an alternative that has unique value, known as "option value." While this may not be surprising to most participants in this workshop, it does represent a radical change in traditional thinking about risk in business, where efforts have primarily been focused on the elimination of risk when possible.

  2. A Real Options Approach to Valuing the Risk Transfer in a Multi-Year Procurement Contract

    DTIC Science & Technology

    2009-10-01

    asset follows a Brownian motion process where the returns have a lognormal distribution. H. BLACK-SCHOLES MODEL The value of the put option p on...risk in a firm-fixed-price contract. The government also provides interest-free financing that can greatly reduce the amount of capital a contractor...structured finance and credit default swap applications. 8 E. OPTIONS THEORY We will use closed form BS-type option pricing methods to estimate the

  3. Comparison between three option, four option and five option multiple choice question tests for quality parameters: A randomized study.

    PubMed

    Vegada, Bhavisha; Shukla, Apexa; Khilnani, Ajeetkumar; Charan, Jaykaran; Desai, Chetna

    2016-01-01

    Most of the academic teachers use four or five options per item of multiple choice question (MCQ) test as formative and summative assessment. Optimal number of options in MCQ item is a matter of considerable debate among academic teachers of various educational fields. There is a scarcity of the published literature regarding the optimum number of option in each item of MCQ in the field of medical education. To compare three options, four options, and five options MCQs test for the quality parameters - reliability, validity, item analysis, distracter analysis, and time analysis. Participants were 3 rd semester M.B.B.S. students. Students were divided randomly into three groups. Each group was given one set of MCQ test out of three options, four options, and five option randomly. Following the marking of the multiple choice tests, the participants' option selections were analyzed and comparisons were conducted of the mean marks, mean time, validity, reliability and facility value, discrimination index, point biserial value, distracter analysis of three different option formats. Students score more ( P = 0.000) and took less time ( P = 0.009) for the completion of three options as compared to four options and five options groups. Facility value was more ( P = 0.004) in three options group as compared to four and five options groups. There was no significant difference between three groups for the validity, reliability, and item discrimination. Nonfunctioning distracters were more in the four and five options group as compared to three option group. Assessment based on three option MCQs is can be preferred over four option and five option MCQs.

  4. Baclofen-induced reductions in optional food intake depend upon food composition.

    PubMed

    Wojnicki, F H E; Charny, G; Corwin, R L W

    2013-05-01

    Baclofen reduces intake of some foods but stimulates intake or has no effect on others. The reasons for these differences are not known. The present study examined effects of baclofen when composition, energy density, preference, presentation and intake of optional foods varied. Semi-solid fat emulsions and sucrose products were presented for brief periods to non-food-deprived rats. In Experiment 1, fat and sucrose composition were varied while controlling energy density. In Experiment 2A, schedule of access and the number of optional foods were varied. In Experiment 2B, the biopolymer (thickener) was examined. Baclofen reduced intake of fat and/or sugar options with different energy densities (1.28-9kcal/g), when presented daily or intermittently, and when intakes were relatively high or low. However, the efficacy of baclofen was affected by the biopolymer used to thicken the options: baclofen had no effect when options were thickened with one biopolymer (3173), but reduced intake when options were thickened with another biopolymer (515). Baclofen failed to reduce intake of a concentrated sugar option (64% sucrose), regardless of biopolymer. Based upon these results, caution is urged when interpreting results obtained with products using different thickening agents. Systematic research is needed when designing products used in rat models of food intake. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Medical adhesive-related skin injuries associated with vascular access.

    PubMed

    Hitchcock, Jan; Savine, Louise

    2017-04-27

    Establishing vascular access and preventing infection, both at insertion and during ongoing care is generally the top priority; the maintenance of optimal skin integrity is often a distant secondary consideration. Skin can react to different types of dressings or adhesives, or problems can arise relating to the securement of lines or the development of sensitivities to cleaning solutions. Clearly, these scenarios are not limited to the securement of vascular access devices; however, a patient with a long-term vascular access device may not have other options for vascular access, which makes this a very important and yet largely unrecognised area. A review of the limited literature that existed up to March 2015 showed it was typically concerned with skin tears connected with dressings and removal, and contact irritant dermatitis. The tissue viability team and vascular access team reviewed the current products associated with a typical vascular access dressing to ensure it was fit for purpose and where at all possible had good scientific literature for validation. The team worked proactively to recognise those patients at risk with the early identification of potential medical adhesive-related skin injuries (MARSI). To facilitate this an algorithm was developed that offers a step-by-step approach, clearly outlining what to do to prevent MARSI and its treatment should it develop. These reactions can result from other factors than the dressing alone, and an increase in these kinds of skin reaction in patients who are on chemotherapy regimens is being explored further. Through the implementation of an algorithm, education for both staff and patients and collaborative working between vascular access and tissue viability teams, a reduction in these phenomena has been seen despite an increasing number of at-risk patients.

  6. Dialysis Facility Transplant Philosophy and Access to Kidney Transplantation in the Southeast.

    PubMed

    Gander, Jennifer; Browne, Teri; Plantinga, Laura; Pastan, Stephen O; Sauls, Leighann; Krisher, Jenna; Patzer, Rachel E

    2015-01-01

    Little is known about the impact of dialysis facility treatment philosophy on access to transplant. The aim of our study was to determine the relationship between the dialysis facility transplant philosophy and facility-level access to kidney transplant waitlisting. A 25-item questionnaire administered to Southeastern dialysis facilities (n = 509) in 2012 captured the facility transplant philosophy (categorized as 'transplant is our first choice', 'transplant is a great option for some', and 'transplant is a good option, if the patient is interested'). Facility-level waitlisting and facility characteristics were obtained from the 2008-2011 Dialysis Facility Report. Multivariable logistic regression was used to examine the association between the dialysis facility transplant philosophy and facility waitlisting performance (dichotomized using the national median), where low performance was defined as fewer than 21.7% of dialysis patients waitlisted within a facility. Fewer than 25% (n = 124) of dialysis facilities reported 'transplant is our first option'. A total of 131 (31.4%) dialysis facilities in the Southeast were high-performing facilities with respect to waitlisting. Adjusted analysis showed that facilities who reported 'transplant is our first option' were twice (OR 2.0; 95% CI 1.0-3.9) as likely to have high waitlisting performance compared to facilities who reported that 'transplant is a good option, if the patient is interested'. Facilities with staff who had a more positive transplant philosophy were more likely to have better facility waitlisting performance. Future prospective studies are needed to further investigate if improving the kidney transplant philosophy in dialysis facilities improves access to transplantation.

  7. Transportation pricing and finance options for California.

    DOT National Transportation Integrated Search

    2006-06-01

    The objective of this research project was to conduct research on the merits, costs and application potential of various transportation pricing approaches, to better inform decision makers and the public about transportation financing/pricing option ...

  8. Expanding Discourse Options through Computer-Mediated Communication: Guiding Learners toward Autonomy

    ERIC Educational Resources Information Center

    Abraham, Lee B.; Williams, Lawrence

    2011-01-01

    This article proposes a multiliteracies-based pedagogical framework for the analysis of computer-mediated discourse (CMD) in order to give students increased access to expanded discourse options that are available in online communication environments and communities (i.e., beyond the classroom). Through the analysis of excerpts and a corpus of…

  9. Advanced multiple access concepts in mobile satellite systems

    NASA Technical Reports Server (NTRS)

    Ananasso, Fulvio

    1990-01-01

    Some multiple access strategies for Mobile Satellite Systems (MSS) are discussed. These strategies were investigated in the context of three separate studies conducted for the International Maritime Satellite Organization (INMARSAT) and the European Space Agency (ESA). Satellite-Switched Frequency Division Multiple Access (SS-FDMA), Code Division Multiple Access (CDMA), and Frequency-Addressable Beam architectures are addressed, discussing both system and technology aspects and outlining advantages and drawbacks of either solution with associated relevant hardware issues. An attempt is made to compare the considered option from the standpoint of user terminal/space segment complexity, synchronization requirements, spectral efficiency, and interference rejection.

  10. Evaluating waterpoint sustainability and access implications of revenue collection approaches in rural Kenya

    NASA Astrophysics Data System (ADS)

    Foster, T.; Hope, R.

    2017-02-01

    Water policies in many sub-Saharan African countries stipulate that rural communities are responsible for self-financing their waterpoint's operation and maintenance. In the absence of policy consensus or evidence on optimal payment models, rural communities adopt a diversity of approaches to revenue collection. This study empirically assesses waterpoint sustainability and access outcomes associated with different revenue collection approaches on the south coast of Kenya. The analysis draws on a unique data set comprising financial records spanning 27 years and 100 communities, operational performance indicators for 200 waterpoints, and water source choices for more than 2000 households. Results suggest communities collecting pay-as-you-fetch fees on a volumetric basis generate higher levels of revenue and experience better operational performance than communities charging flat fees. In both cases, financial flows mirror seasonal rainfall peaks and troughs. These outcomes are tempered by evidence that households are more likely to opt for an unimproved drinking water source when a pay-as-you-fetch system is in place. The findings illuminate a possible tension between financial sustainability and universal access. If the Sustainable Development Goal of "safe water for all" is to become a reality, policymakers and practitioners will need to address this issue and ensure rural water services are both sustainable and inclusive.

  11. From Web accessibility to Web adaptability.

    PubMed

    Kelly, Brian; Nevile, Liddy; Sloan, David; Fanou, Sotiris; Ellison, Ruth; Herrod, Lisa

    2009-07-01

    This article asserts that current approaches to enhance the accessibility of Web resources fail to provide a solid foundation for the development of a robust and future-proofed framework. In particular, they fail to take advantage of new technologies and technological practices. The article introduces a framework for Web adaptability, which encourages the development of Web-based services that can be resilient to the diversity of uses of such services, the target audience, available resources, technical innovations, organisational policies and relevant definitions of 'accessibility'. The article refers to a series of author-focussed approaches to accessibility through which the authors and others have struggled to find ways to promote accessibility for people with disabilities. These approaches depend upon the resource author's determination of the anticipated users' needs and their provision. Through approaches labelled as 1.0, 2.0 and 3.0, the authors have widened their focus to account for contexts and individual differences in target audiences. Now, the authors want to recognise the role of users in determining their engagement with resources (including services). To distinguish this new approach, the term 'adaptability' has been used to replace 'accessibility'; new definitions of accessibility have been adopted, and the authors have reviewed their previous work to clarify how it is relevant to the new approach. Accessibility 1.0 is here characterised as a technical approach in which authors are told how to construct resources for a broadly defined audience. This is known as universal design. Accessibility 2.0 was introduced to point to the need to account for the context in which resources would be used, to help overcome inadequacies identified in the purely technical approach. Accessibility 3.0 moved the focus on users from a homogenised universal definition to recognition of the idiosyncratic needs and preferences of individuals and to cater for them. All of

  12. Mental health beliefs and barriers to accessing mental health services in youth aging out of foster care.

    PubMed

    Sakai, Christina; Mackie, Thomas I; Shetgiri, Rashmi; Franzen, Sara; Partap, Anu; Flores, Glenn; Leslie, Laurel K

    2014-01-01

    To examine the perspectives of youth on factors that influence mental health service use after aging out of foster care. Focus groups were conducted with youth with a history of mental health needs and previous service use who had aged out of foster care. Questions were informed by the Health Belief Model and addressed 4 domains: youth perceptions of the "threat of mental health problems," treatment benefits versus barriers to accessing mental health services, self-efficacy, and "cues to action." Data were analyzed using a modified grounded-theory approach. Youth (N = 28) reported ongoing mental health problems affecting their functioning; however, they articulated variable levels of reliance on formal mental health treatment versus their own ability to resolve these problems without treatment. Past mental health service experiences influenced whether youth viewed treatment options as beneficial. Youth identified limited self-efficacy and insufficient psychosocial supports "cueing action" during their transition out of foster care. Barriers to accessing mental health services included difficulties obtaining health insurance, finding a mental health provider, scheduling appointments, and transportation. Youths' perceptions of their mental health needs, self-efficacy, psychosocial supports during transition, and access barriers influence mental health service use after aging out of foster care. Results suggest that strategies are needed to 1) help youth and clinicians negotiate shared understanding of mental health treatment needs and options, 2) incorporate mental health into transition planning, and 3) address insurance and other systemic barriers to accessing mental health services after aging out of foster care. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  13. Current Approaches to Improving Marine Geophysical Data Discovery and Access

    NASA Astrophysics Data System (ADS)

    Jencks, J. H.; Cartwright, J.; Varner, J. D.; Anderson, C.; Robertson, E.; McLean, S. J.

    2016-02-01

    Exploring, understanding, and managing the global oceans is a challenge when hydrographic maps are available for only 5% of the world's oceans, even less of which have been mapped geologically or to identify benthic habitats. Seafloor mapping is expensive and most government and academic budgets continue to tighten. The first step for any mapping program, before setting out to map uncharted waters, should be to identify if data currently exist in the area of interest. There are many reasons why this seemingly simple suggestion is not commonplace. While certain datasets are accessible online (e.g., NOAA's NCEI, EMODnet, IHO-DCDB), many are not. In some cases, data that are publicly available are difficult to discover and access. No single agency can successfully resolve the complex and pressing demands of ocean and coastal mapping and the associated data stewardship. NOAA partners with other federal agencies to provide an integrated approach to carry out a coordinated and comprehensive ocean and coastal mapping program. In order to maximize the return on their mapping investment, legacy and newly acquired data must be easily discoverable and readily accessible by numerous applications and formats now and well into the future. At NOAA's National Centers for Environmental Information (NCEI), resources are focused on ensuring the security and widespread availability of the Nation's scientific marine geophysical data through long-term stewardship. The public value of these data and products is maximized by streamlining data acquisition and processing operations, minimizing redundancies, facilitating discovery, and developing common standards to promote re-use. For its part, NCEI draws on a variety of software technologies and adheres to international standards to meet this challenge. The result is a geospatial framework built on spatially-enabled databases, standards-based web services, and International Standards Organization (ISO) metadata. In order to maximize

  14. Strategies for managing aortoiliac occlusions: access, treatment and outcomes

    PubMed Central

    Clair, Daniel G; Beach, Jocelyn M

    2015-01-01

    Treatment of severe aortoiliac disease has dramatically evolved from a dependence on open aortobifemoral grafting to hybrid and endovascular only approaches. Open surgery has been the gold standard treatment of severe aortoiliac disease with excellent patency rates, but with increased length of stay and major complications. In contrast, endovascular interventions can successfully treat almost any lesion with decreased risk, compared to open surgery. Although primary patency rates remain inferior, secondary endovascular interventions are often minor procedures resulting in comparable long-term outcomes. The risks of renal insufficiency, embolization and access complications are not insignificant; however, most can be prevented or managed without significant clinical consequence. Endovascular therapies should be considered a first-line treatment option for all patients with aortoiliac disease, especially those with high-risk cardiovascular comorbidities. PMID:25907618

  15. Injectable contraception. New and existing options.

    PubMed

    Kaunitz, A M

    2000-12-01

    DMPA and MPA/E2C contraception offer women safe, effective, convenient, and reversible birth control choices. The use of DMPA, a 3-month injectable, is characteristically associated with amenorrhea. Lactating women and women in whom contraceptive doses of estrogen are contraindicated can use this progestin-only birth control method. Return of fertility can be delayed in women discontinuing DMPA to become pregnant. In some cases, the use of DMPA also confers important noncontraceptive and therapeutic benefits. A monthly estrogen/progestin injectable contraceptive, MPA/E2C should appeal to women who are concerned about daily pill taking, who prefer regular cycles to amenorrhea, and who find monthly injections acceptable and accessible. As is true for oral contraceptives, MPA/E2C represents an appropriate choice for women who prefer a rapidly reversible contraceptive. Currently, the proposed contraindications for MPA/E2C parallel those for combined oral contraceptives. As MPA/E2C contraception becomes available for American women, clinicians will learn how to best include this new method among the array of contraceptive choices. By individualizing contraceptive selection, counseling, and management approaches based on the relevant behavioral and medical considerations reviewed herein, clinicians can maximize their patients' success with injectable contraceptives. The more innovative that clinicians, family planning agencies, and insurers are in facilitating access to care (including reinjections), the more women will be able to avail themselves of safe, effective, and reversible methods of contraception. In addition to the physician's office or health clinic, other sites at which women might receive contraceptive injections include employee health clinics, college health clinics, or perhaps the pharmacy where the prescription is filled. Self-administration may become an appropriate option for some users of injectable contraception.

  16. International Policies on Sharing Genomic Research Results with Relatives: Approaches to Balancing Privacy with Access.

    PubMed

    Branum, Rebecca; Wolf, Susan M

    2015-01-01

    Returning genetic research results to relatives raises complex issues. In order to inform the U.S. debate, this paper analyzes international law and policies governing the sharing of genetic research results with relatives and identifies key themes and lessons. The laws and policies from other countries demonstrate a range of approaches to balancing individual privacy and autonomy with family access for health benefit, offering important lessons for further development of approaches in the United States. © 2015 American Society of Law, Medicine & Ethics, Inc.

  17. A Comprehensive Assessment of Four Options for Financing Health Care Delivery in Oregon

    PubMed Central

    White, Chapin; Eibner, Christine; Liu, Jodi L.; Price, Carter C.; Leibowitz, Nora; Morley, Gretchen; Smith, Jeanene; Edlund, Tina; Meyer, Jack

    2017-01-01

    Abstract This article describes four options for financing health care for residents of the state of Oregon and compares the projected impacts and feasibility of each option. The Single Payer option and the Health Care Ingenuity Plan would achieve universal coverage, while the Public Option would add a state-sponsored plan to the Affordable Care Act (ACA) Marketplace. Under the Status Quo option, Oregon would maintain its expansion of Medicaid and subsidies for nongroup coverage through the ACA Marketplace. The state could cover all residents under the Single Payer option with little change in overall health care costs, but doing so would require cuts to provider payment rates that could worsen access to care, and implementation hurdles may be insurmountable. The Health Care Ingenuity Plan, a state-managed plan featuring competition among private plans, would also achieve universal coverage and would sever the employer–health insurance link, but the provider payment rates would likely be set too high, so health care costs would increase. The Public Option would be the easiest of the three options to implement, but because it would not affect many people, it would be an incremental improvement to the Status Quo. Policymakers will need to weigh these options against their desire for change to balance the benefits with the trade-offs. PMID:29057151

  18. Application of Real Options Theory to DoD Software Acquisitions

    DTIC Science & Technology

    2009-02-20

    Future Combat Systems Program. Washington, DC. U.S. Government Printing Office. Damodaran , A. (2007). Investment Valuation : The Options To Expand... valuation methodology, when enhanced and properly formulated around a proposed or existing software investment employing the spiral development approach...THIS PAGE INTENTIONALLY LEFT BLANK iii ABSTRACT The traditional real options valuation methodology, when enhanced and properly formulated

  19. Public Response to Wildfire: Is the Australian "Stay and Defend or Leave Early" Approach an Option for Wildfire Management in the United States?

    Treesearch

    Sarah M. McCaffrey; Alan Rhodes

    2009-01-01

    In the United States, the increasing costs and negative impacts of wildfires are causing fire managers and policymakers to reexamine traditional approaches to fire management including whether mass evacuation of populations threatened by wildfire is always the most appropriate option. This article examines the Australian "stay and defend or leave early" (SDLE...

  20. A Question of Justice: Disparities in Employees' Access to Flexible Schedule Arrangements

    ERIC Educational Resources Information Center

    Swanberg, Jennifer E.; Pitt-Catsouphes, Marcie; Drescher-Burke, Krista

    2005-01-01

    Within an organizational justice framework, this article investigates which group of employees are less likely to have access to flexible schedule options. Using data from the 1997 National Study of the Changing Workforce, logistical regressions were conducted to identify the employee, job, and workplace factors associated with limited access to…

  1. A new approach to the tradeoff between quality and accessibility of health care.

    PubMed

    Tanke, Marit A C; Ikkersheim, David E

    2012-05-01

    Quality of care is associated with patient volume. Regionalization of care is therefore one of the approaches that is suited to improve quality of care. A disadvantage of regionalization is that the accessibility of the facilities can decrease. By investigating the tradeoff between quality and accessibility it is possible to determine the optimal amount of treatment locations in a health care system. In this article we present a new model to quantitatively 'solve' this tradeoff. We use the condition breast cancer in the Netherlands as an example. We calculated the expected quality gains in Quality Adjusted Lifetime Years (QALY's) due to stepwise regionalization using 'volume-outcome' literature for breast cancer. Decreased accessibility was operationalized as increased (travel) costs due to regionalization by using demographic data, drive-time information, and the national median income. The total sum of the quality and accessibility function determines the optimum range of treatment locations for this particular condition, given the 'volume-quality' relationship and Dutch demographics and geography. Currently, 94 locations offer breast cancer treatment in the Netherlands. Our model estimates that the optimum range of treatment locations for this particular condition in the Netherlands varies from 15 locations to 44 locations. Our study shows that the Dutch society would benefit from regionalization of breast cancer care as possible quality gains outweigh heightened travel costs. In addition, this model can be used for other medical conditions and in other countries. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. Balancing access to health data and privacy: a review of the issues and approaches for the future.

    PubMed

    Lane, Julia; Schur, Claudia

    2010-10-01

    There has been a dramatic increase in the types of microdata, and this holds great promise for health services research. However, legislative efforts to protect individual privacy have reduced the flow of health care data for research purposes and increased costs and delays, affecting the quality of analysis. This paper provides an overview of the challenges raised by concerns about data confidentiality in the context of health services research, the current methodologies used to ensure data security, and a description of one successful approach to balancing access and privacy. Materials and Methods. We analyze the issues of access and privacy using a conceptual framework based on balancing the risk of reidentification with the utility associated with data analysis. The guiding principle should be to generate released data that are as close to the maximum acceptable risk as possible. HIPAA and other privacy measures can perhaps be seen as having had the effect of lowering the "maximum acceptable risk" level and rendering some data unreleasable. We discuss the levels of risk and utility associated with different types of data used in health services research and the ability to link data from multiple sources as well as current models of data sharing and their limitations. One particularly compelling approach is to establish a remote access "data enclave," where statistical protections are applied to the data, technical protections ensure compliance with data-sharing requirements, and operational controls limit researchers' access to the data they need for their specific research questions. We recommend reducing delays in access to data for research, increasing the use of remote access data enclaves, and disseminating knowledge and promulgating standards for best practices related to data protection. © Health Research and Educational Trust.

  3. Potential new regulatory options for e-cigarettes in New Zealand.

    PubMed

    Wilson, Nick; Edwards, Richard; Hoek, Janet; Thomson, George; Blakely, Tony; van der Deen, Frederieke Sanne; Crane, Julian

    2015-11-20

    While e-cigarette usage has grown rapidly in New Zealand and around the world, the scientific evidence base regarding the net benefits and risks of these types of products at the population level remains uncertain. The health-based policy experience is also minimal. Here, we analyse plausible future regulatory options for e-cigarettes that the New Zealand Government could explore, and that further research could help clarify. These options include: (1) a full free market (an option we doubt is desirable for multiple reasons); (2) controlled increased access through: (a) pharmacy only, (b) pharmacy only plus sales by prescription/ to licensed vapers; (c) additional controls through non-profit supply/distribution (eg, public hospital pharmacies); (3) increased restrictions compared with current (eg, adopting a complete ban on self-imports and use). In addition, we consider mechanisms to improve product quality and safety, and argue that policy makers should take great care when regulating e-cigarettes, given the scientific uncertainty and the role of commercial vested interests.

  4. Remote Access to Scientific Laboratory Equipment and Competency-Based Approach to Science and Technology Education

    ERIC Educational Resources Information Center

    Mazuritskiy, M. I.; Safontsev, S. A.; Konoplev, B. G.; Boldyreva, A. M.

    2014-01-01

    This article describes the competency-based approach to e-learning education that utilizes remote access to the laboratory equipment. The main focus of the paper is the structure and design of the e-learning system used in the Southern Federal University (Russia). The article discusses the related pedagogical strategies and presents system's…

  5. The DRIL procedure for arteriovenous access ischemic steal: a controversial approach.

    PubMed

    Davidson, Ingemar; Beathard, Gerald; Gallieni, Maurizio; Ross, John

    2017-01-18

    The DRIL procedure first described in 1988 has long been considered the preferred treatment for arteriovenous access ischemic steal (AVAIS). At the time it was a brilliant concept and breakthrough. In the last decade, the DRIL procedure has become less used. With the increasing age of the dialysis population, patients developing AVAIS are more likely to be elderly with advanced peripheral arterial disease, making the distal revascularization anastomosis difficult and risky if not impossible to perform. In addition, the distal ligation of the main artery to the arm is something most surgeons are reluctant to do. The occlusion of the arterial bypass over time is not uncommon with recurrence of hand ischemia. The multistep DRIL procedure requires general anesthesia and the need to harvest the saphenous vein for the bypass, add to the surgical risk in patients with multiple co-morbidities. For these reasons, some surgeons prefer to do only the DR (distal re-vascularization) portion of the procedure omitting the IL (interval ligation). Increasing the bypass distance from the original anastomosis, makes this modification similar to the less invasive proximal arterial inflow (PAI) procedure. Because of changes in the patient population clinical presentation, most notably forearm atherosclerosis and with new technologies, this editorial addresses the current validity of the DRIL procedure as a safe option in treating AVAIS.

  6. Options for the Development of Noninvasive Glucose Monitoring: Is Nanotechnology an Option to Break the Boundaries?

    PubMed

    Thomas, Andreas; Heinemann, Lutz; Ramírez, Araceli; Zehe, Alfred

    2016-05-01

    Nowadays nanotechnology has many applications in products used in various areas of daily life; however, this technology has also an option in modern medicine and pharmacy. Therefore, this technology is also an attractive option for the field of diagnosis and treatment of diabetes. Many people with diabetes measure their blood glucose levels regularly to determine the insulin dose. Ideally glucose values would be measured noninvasively (NI). However, none of all the NI approaches studied in the past decades enabled reliable NI measurements under all daily life conditions. Particularly an unfavorable signal-to-noise ratio turned out to be problematic. Based on the known physical possibilities for NI glucose monitoring the focus of this review is on nanotechnology approaches. Functional prototypes exist for some of these that showed promising results under defined laboratory conditions, indicating a good sensitivity and selectivity for glucose. On the second hand is to optimize the technological process of manufacturing. In view of the rapid progress in micro- and nanoelectronics hopefully NI glucose monitoring systems can be developed in the near future. © 2015 Diabetes Technology Society.

  7. Management options for cholestatic liver disease in children.

    PubMed

    Catzola, Andrea; Vajro, Pietro

    2017-11-01

    Due to a peculiar age-dependent increased susceptibility, neonatal cholestasis affects the liver of approximately 1 in every 2500 term infants. A high index of suspicion is the key to an early diagnosis, and to implement timely, often life-saving treatments. Even when specific treatment is not available or curative, prompt medical management and optimization of nutrition are of paramount importance to survival and avoidance of complications. Areas covered: The present article will prominently focus on a series of newer diagnostic and therapeutic options of cholestasis in neonates and infants blended with consolidated established paradigms. The overview of strategies for the management reported here is based on a systematic literature search published in English using accessible databases (PubMed, MEDLINE) with the keywords biliary atresia, choleretics and neonatal cholestasis. References lists from retrieved articles were also reviewed. Expert commentary: A large number of uncommon and rare hepatobiliary disorders may present with cholestasis during the neonatal and infantile period. Potentially life-saving disease-specific pharmacological and surgical therapeutic approaches are currently available. Advances in hepatobiliary transport mechanisms have started clarifying fundamental aspects of inherited and acquired cholestasis, laying the foundation for the development of possibly more effective specific therapies.

  8. [Therapeutic options for pressure ulcers].

    PubMed

    Damert, H-G; Meyer, F; Altmann, S

    2015-04-01

    The aim of this overview is based on remarks on the pathogenesis of and therapy for pressure ulcers and selected but representative cases to demonstrate current options of plastic coverage. As a consequence of the demographic developments, in particular, with regard to the increasing proportion of older patients as well as the advances in modern medicine, the number of multimorbid, geriatric and bedridden patients and of those with prolonged sickbed periods has been steadily growing. Therefore, partly severe manifestations of pressure ulcers at various exposed body regions can be observed in spite of the best preventive intention of care. While in the early stages rather conservative treatment is adequate, surgical intervention might become important and indispensable for a sufficient treatment in advanced stages. To facilitate basic care and to appropriately treat the infectious focus, the methods and procedures of plastic surgery can become relevant. Although there are several options and approaches existing to sanitise and cover defects of pressure ulcers, which are described within the article based on representative cases, preventive measures can still be considered the best approach. Georg Thieme Verlag KG Stuttgart · New York.

  9. Authorial and institutional stratification in open access publishing: the case of global health research.

    PubMed

    Siler, Kyle; Haustein, Stefanie; Smith, Elise; Larivière, Vincent; Alperin, Juan Pablo

    2018-01-01

    Using a database of recent articles published in the field of Global Health research, we examine institutional sources of stratification in publishing access outcomes. Traditionally, the focus on inequality in scientific publishing has focused on prestige hierarchies in established print journals. This project examines stratification in contemporary publishing with a particular focus on subscription vs. various Open Access (OA) publishing options. Findings show that authors working at lower-ranked universities are more likely to publish in closed/paywalled outlets, and less likely to choose outlets that involve some sort of Article Processing Charge (APCs; gold or hybrid OA). We also analyze institutional differences and stratification in the APC costs paid in various journals. Authors affiliated with higher-ranked institutions, as well as hospitals and non-profit organizations pay relatively higher APCs for gold and hybrid OA publications. Results suggest that authors affiliated with high-ranked universities and well-funded institutions tend to have more resources to choose pay options with publishing. Our research suggests new professional hierarchies developing in contemporary publishing, where various OA publishing options are becoming increasingly prominent. Just as there is stratification in institutional representation between different types of publishing access, there is also inequality within access types.

  10. Authorial and institutional stratification in open access publishing: the case of global health research

    PubMed Central

    Haustein, Stefanie; Smith, Elise; Larivière, Vincent; Alperin, Juan Pablo

    2018-01-01

    Using a database of recent articles published in the field of Global Health research, we examine institutional sources of stratification in publishing access outcomes. Traditionally, the focus on inequality in scientific publishing has focused on prestige hierarchies in established print journals. This project examines stratification in contemporary publishing with a particular focus on subscription vs. various Open Access (OA) publishing options. Findings show that authors working at lower-ranked universities are more likely to publish in closed/paywalled outlets, and less likely to choose outlets that involve some sort of Article Processing Charge (APCs; gold or hybrid OA). We also analyze institutional differences and stratification in the APC costs paid in various journals. Authors affiliated with higher-ranked institutions, as well as hospitals and non-profit organizations pay relatively higher APCs for gold and hybrid OA publications. Results suggest that authors affiliated with high-ranked universities and well-funded institutions tend to have more resources to choose pay options with publishing. Our research suggests new professional hierarchies developing in contemporary publishing, where various OA publishing options are becoming increasingly prominent. Just as there is stratification in institutional representation between different types of publishing access, there is also inequality within access types. PMID:29479492

  11. A discontinuous Galerkin method for two-dimensional PDE models of Asian options

    NASA Astrophysics Data System (ADS)

    Hozman, J.; Tichý, T.; Cvejnová, D.

    2016-06-01

    In our previous research we have focused on the problem of plain vanilla option valuation using discontinuous Galerkin method for numerical PDE solution. Here we extend a simple one-dimensional problem into two-dimensional one and design a scheme for valuation of Asian options, i.e. options with payoff depending on the average of prices collected over prespecified horizon. The algorithm is based on the approach combining the advantages of the finite element methods together with the piecewise polynomial generally discontinuous approximations. Finally, an illustrative example using DAX option market data is provided.

  12. Spectral method for pricing options in illiquid markets

    NASA Astrophysics Data System (ADS)

    Pindza, Edson; Patidar, Kailash C.

    2012-09-01

    We present a robust numerical method to solve a problem of pricing options in illiquid markets. The governing equation is described by a nonlinear Black-Scholes partial differential equation (BS-PDE) of the reaction-diffusion-advection type. To discretise this BS-PDE numerically, we use a spectral method in the asset (spatial) direction and couple it with a fifth order RADAU method for the discretisation in the time direction. Numerical experiments illustrate that our approach is very efficient for pricing financial options in illiquid markets.

  13. Options for accounting carbon sequestration in German forests.

    PubMed

    Krug, Joachim; Koehl, Michael; Riedel, Thomas; Bormann, Kristin; Rueter, Sebastian; Elsasser, Peter

    2009-08-03

    The Accra climate change talks held from 21-27 August 2008 in Accra, Ghana, were part of an ongoing series of meetings leading up to the Copenhagen meeting in December 2009. During the meeting a set of options for accounting carbon sequestration in forestry on a post-2012 framework was presented. The options include gross-net and net-net accounting and approaches for establishing baselines. This article demonstrates the embedded consequences of Accra Accounting Options for the case study of German national GHG accounting. It presents the most current assessment of sequestration rates by forest management for the period 1990 - 2007, provides an outlook of future emissions and removals (up to the year 2042) as related to three different management scenarios, and shows that implementation of some Accra options may reverse sources to sinks, or sinks to sources. The results of the study highlight the importance of elaborating an accounting system that would prioritize the climate convention goals, not national preferences.

  14. Callings in Career: A Typological Approach to Essential and Optional Components

    ERIC Educational Resources Information Center

    Hirschi, Andreas

    2011-01-01

    A sense of calling in career is supposed to have positive implications for individuals and organizations but current theoretical development is plagued with incongruent conceptualizations of what does or does not constitute a calling. The present study used cluster analysis to identify essential and optional components of a presence of calling…

  15. Management options of varicoceles

    PubMed Central

    Chan, Peter

    2011-01-01

    Varicocele is one of the most common causes of male infertility. Treatment options for varicoceles includes open varicocelectomy performed at various anatomical levels. Laparoscopic varicocelectomy has been established to be a safe and effective treatment for varicoceles. Robotic surgery has been introduced recently as an alternative surgical option for varicocelectomy. Microsurgical varicocelectomy has gained increasing popularity among experts in male reproductive medicine as the treatment of choice for varicocele because of its superior surgical outcomes. There is a growing volume of literature in the recent years on minimal invasive varicocele treatment with percutaneous retrograde and anterograde venous embolization/sclerotherapy. In this review, we will discuss the advantages and limitations associated with each treatment modality for varicoceles. Employment of these advanced techniques of varicocelectomy can provide a safe and effective approach aiming to eliminate varicocele, preserve testicular function and, in a substantial number of men, increase semen quality and the likelihood of pregnancy. PMID:21716892

  16. Direct access to the middle meningeal artery for embolization of complex dural arteriovenous fistula: a hybrid treatment approach

    PubMed Central

    Lin, Ning; Brouillard, Adam M; Mokin, Maxim; Natarajan, Sabareesh K; Snyder, Kenneth V; Levy, Elad I; Siddiqui, Adnan H

    2014-01-01

    Endovascular embolization has become increasingly favored over microsurgical resection for treatment of complex dural arteriovenous fistulas (DAVFs). However, endovascular treatment can be restricted by tortuous transarterial access and a transvenous approach is not always feasible. We present a Borden III DAVF treated by direct access to the middle meningeal artery (MMA) and Onyx embolization performed in a hybrid operating room–angiography suite. A middle-aged patient with pulsatile headaches was found to have left transverse sinus occlusion and DAVF with retrograde cortical venous drainage fed by multiple external carotid artery (ECA) feeders. Endovascular attempts via conventional transvenous and transarterial routes were unsuccessful, and the major MMA feeder was accessed directly after temporal craniotomy was performed under neuronavigation. Onyx embolization was performed; complete occlusion of the fistula was achieved. Three-month follow-up angiography showed no residual filling; the patient remains complication-free. A combined surgical–endovascular technique in a hybrid operating room–angiography suite can be an effective treatment for DAVFs complicated by inaccessible arterial and transvenous approaches. PMID:24903968

  17. 75 FR 55709 - Port Access Route Study: In the Approaches to Los Angeles-Long Beach and in the Santa Barbara...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-14

    ... Access Route Study: In the Approaches to Los Angeles-Long Beach and in the Santa Barbara Channel AGENCY...: In the Approaches to Los Angeles-Long Beach and in the Santa Barbara Channel'' that was published in... for modifications to the current vessel routing in the approaches to Los Angeles-Long Beach and in the...

  18. Predicting water consumption habits for seven arsenic-safe water options in Bangladesh.

    PubMed

    Inauen, Jennifer; Tobias, Robert; Mosler, Hans-Joachim

    2013-05-01

    In Bangladesh, 20 million people are at the risk of developing arsenicosis because of excessive arsenic intake. Despite increased awareness, many of the implemented arsenic-safe water options are not being sufficiently used by the population. This study investigated the role of social-cognitive factors in explaining the habitual use of arsenic-safe water options. Eight hundred seventy-two randomly selected households in six arsenic-affected districts of rural Bangladesh, which had access to an arsenic-safe water option, were interviewed using structured face-to-face interviews in November 2009. Habitual use of arsenic-safe water options, severity, vulnerability, affective and instrumental attitudes, injunctive and descriptive norms, self-efficacy, and coping planning were measured. The data were analyzed using multiple linear regressions. Linear regression revealed that self-efficacy (B = 0.42, SE = .03, p < .001), the instrumental attitude towards the safe water option (B = 0.24, SE = .04, p < .001), the affective attitude towards contaminated tube wells (B = -0.04, SE = .02, p = .024), vulnerability (B = -0.20, SE = .02, p < .001), as well as injunctive (B = 0.08, SE = 0.04, p = .049) and descriptive norms (B = 0.34, SE = .03, p < .001) primarily explained the habitual use of arsenic-safe water options (R2 = 0.688). This model proved highly generalizable to all seven arsenic-safe water options investigated, even though habitual use of single options were predicted on the basis of parameters estimated without these options. This general model for the habitual use of arsenic-safe water options may prove useful to predict other water consumption habits. Behavior-change interventions are derived from the model to promote the habitual use of arsenic-safe water options.

  19. Predicting water consumption habits for seven arsenic-safe water options in Bangladesh

    PubMed Central

    2013-01-01

    Background In Bangladesh, 20 million people are at the risk of developing arsenicosis because of excessive arsenic intake. Despite increased awareness, many of the implemented arsenic-safe water options are not being sufficiently used by the population. This study investigated the role of social-cognitive factors in explaining the habitual use of arsenic-safe water options. Methods Eight hundred seventy-two randomly selected households in six arsenic-affected districts of rural Bangladesh, which had access to an arsenic-safe water option, were interviewed using structured face-to-face interviews in November 2009. Habitual use of arsenic-safe water options, severity, vulnerability, affective and instrumental attitudes, injunctive and descriptive norms, self-efficacy, and coping planning were measured. The data were analyzed using multiple linear regressions. Results Linear regression revealed that self-efficacy (B = 0.42, SE = .03, p < .001), the instrumental attitude towards the safe water option (B = 0.24, SE = .04, p < .001), the affective attitude towards contaminated tube wells (B = −0.04, SE = .02, p = .024), vulnerability (B = −0.20, SE = .02, p < .001), as well as injunctive (B = 0.08, SE = 0.04, p = .049) and descriptive norms (B = 0.34, SE = .03, p < .001) primarily explained the habitual use of arsenic-safe water options (R2 = 0.688). This model proved highly generalizable to all seven arsenic-safe water options investigated, even though habitual use of single options were predicted on the basis of parameters estimated without these options. Conclusions This general model for the habitual use of arsenic-safe water options may prove useful to predict other water consumption habits. Behavior-change interventions are derived from the model to promote the habitual use of arsenic-safe water options. PMID:23634950

  20. Universal access to electricity in Burkina Faso: scaling-up renewable energy technologies

    NASA Astrophysics Data System (ADS)

    Moner-Girona, M.; Bódis, K.; Huld, T.; Kougias, I.; Szabó, S.

    2016-08-01

    This paper describes the status quo of the power sector in Burkina Faso, its limitations, and develops a new methodology that through spatial analysis processes with the aim to provide a possible pathway for universal electricity access. Following the SE4All initiative approach, it recommends the more extensive use of distributed renewable energy systems to increase access to electricity on an accelerated timeline. Less than 5% of the rural population in Burkina Faso have currently access to electricity and supply is lacking at many social structures such as schools and hospitals. Energy access achievements in Burkina Faso are still very modest. According to the latest SE4All Global Tracking Framework (2015), the access to electricity annual growth rate in Burkina Faso from 2010 to 2012 is 0%. The rural electrification strategy for Burkina Faso is scattered in several electricity sector development policies: there is a need of defining a concrete action plan. Planning and coordination between grid extension and the off-grid electrification programme is essential to reach a long-term sustainable energy model and prevent high avoidable infrastructure investments. This paper goes into details on the methodology and findings of the developed Geographic Information Systems tool. The aim of the dynamic planning tool is to provide support to the national government and development partners to define an alternative electrification plan. Burkina Faso proves to be paradigm case for the methodology as its national policy for electrification is still dominated by grid extension and the government subsidising fossil fuel electricity production. However, the results of our analysis suggest that the current grid extension is becoming inefficient and unsustainable in order to reach the national energy access targets. The results also suggest that Burkina Faso’s rural electrification strategy should be driven local renewable resources to power distributed mini-grids. We find that

  1. TRIPS, the Doha Declaration and increasing access to medicines: policy options for Ghana

    PubMed Central

    Cohen, JC; Gyansa-Lutterodt, M; Torpey, K; Esmail, LC; Kurokawa, G

    2005-01-01

    There are acute disparities in pharmaceutical access between developing and industrialized countries. Developing countries make up approximately 80% of the world's population but only represent approximately 20% of global pharmaceutical consumption. Among the many barriers to drug access are the potential consequences of the Trade Related Aspects of Intellectual Property Rights (TRIPS) Agreement. Many developing countries have recently modified their patent laws to conform to the TRIPS standards, given the 2005 deadline for developing countries. Safeguards to protect public health have been incorporated into the TRIPS Agreement; however, in practice governments may be reluctant to exercise such rights given concern about the international trade and political ramifications. The Doha Declaration and the recent Decision on the Implementation of Paragraph 6 of the Doha Declaration on the TRIPS Agreement and Public Health may provide more freedom for developing countries in using these safeguards. This paper focuses on Ghana, a developing country that recently changed its patent laws to conform to TRIPS standards. We examine Ghana's patent law changes in the context of the Doha Declaration and assess their meaning for access to drugs of its population. We discuss new and existing barriers, as well as possible solutions, to provide policy-makers with lessons learned from the Ghanaian experience. PMID:16336685

  2. Engineering Options Assessment Report. Nitrate Salt Waste Stream Processing

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

    Anast, Kurt Roy

    2015-11-13

    This report examines and assesses the available systems and facilities considered for carrying out remediation activities on remediated nitrate salt (RNS) and unremediated nitrate salt (UNS) waste containers at Los Alamos National Laboratory (LANL). The assessment includes a review of the waste streams consisting of 60 RNS, 29 above-ground UNS, and 79 candidate below-ground UNS containers that may need remediation. The waste stream characteristics were examined along with the proposed treatment options identified in the Options Assessment Report . Two primary approaches were identified in the five candidate treatment options discussed in the Options Assessment Report: zeolite blending and cementation.more » Systems that could be used at LANL were examined for housing processing operations to remediate the RNS and UNS containers and for their viability to provide repackaging support for remaining LANL legacy waste.« less

  3. Engineering Options Assessment Report: Nitrate Salt Waste Stream Processing

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

    Anast, Kurt Roy

    2015-11-18

    This report examines and assesses the available systems and facilities considered for carrying out remediation activities on remediated nitrate salt (RNS) and unremediated nitrate salt (UNS) waste containers at Los Alamos National Laboratory (LANL). The assessment includes a review of the waste streams consisting of 60 RNS, 29 aboveground UNS, and 79 candidate belowground UNS containers that may need remediation. The waste stream characteristics were examined along with the proposed treatment options identified in the Options Assessment Report . Two primary approaches were identified in the five candidate treatment options discussed in the Options Assessment Report: zeolite blending and cementation.more » Systems that could be used at LANL were examined for housing processing operations to remediate the RNS and UNS containers and for their viability to provide repackaging support for remaining LANL legacy waste.« less

  4. Asteroid Redirect Robotic Mission: Robotic Boulder Capture Option Overview

    NASA Technical Reports Server (NTRS)

    Mazanek, Daniel D.; Merrill, Raymond G.; Belbin, Scott P.; Reeves, David M.; Earle, Kevin D.; Naasz, Bo J.; Abell, Paul A.

    2014-01-01

    The National Aeronautics and Space Administration (NASA) is currently studying an option for the Asteroid Redirect Robotic Mission (ARRM) that would capture a multi-ton boulder (typically 2-4 meters in size) from the surface of a large (is approximately 100+ meter) Near-Earth Asteroid (NEA) and return it to cislunar space for subsequent human and robotic exploration. This alternative mission approach, designated the Robotic Boulder Capture Option (Option B), has been investigated to determine the mission feasibility and identify potential differences from the initial ARRM concept of capturing an entire small NEA (4-10 meters in size), which has been designated the Small Asteroid Capture Option (Option A). Compared to the initial ARRM concept, Option B allows for centimeter-level characterization over an entire large NEA, the certainty of target NEA composition type, the ability to select the boulder that is captured, numerous opportunities for mission enhancements to support science objectives, additional experience operating at a low-gravity planetary body including extended surface contact, and the ability to demonstrate future planetary defense strategies on a hazardous-size NEA. Option B can leverage precursor missions and existing Agency capabilities to help ensure mission success by targeting wellcharacterized asteroids and can accommodate uncertain programmatic schedules by tailoring the return mass.

  5. Design Evolution Study - Aging Options

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

    P. McDaniel

    The purpose of this study is to identify options and issues for aging commercial spent nuclear fuel received for disposal at the Yucca Mountain Mined Geologic Repository. Some early shipments of commercial spent nuclear fuel to the repository may be received with high-heat-output (younger) fuel assemblies that will need to be managed to meet thermal goals for emplacement. The capability to age as much as 40,000 metric tons of heavy metal of commercial spent nuclear he1 would provide more flexibility in the design to manage this younger fuel and to decouple waste receipt and waste emplacement. The following potential agingmore » location options are evaluated: (1) Surface aging at four locations near the North Portal; (2) Subsurface aging in the permanent emplacement drifts; and (3) Subsurface aging in a new subsurface area. The following aging container options are evaluated: (1) Complete Waste Package; (2) Stainless Steel inner liner of the waste package; (3) Dual Purpose Canisters; (4) Multi-Purpose Canisters; and (5) New disposable canister for uncanistered commercial spent nuclear fuel. Each option is compared to a ''Base Case,'' which is the expected normal waste packaging process without aging. A Value Engineering approach is used to score each option against nine technical criteria and rank the options. Open issues with each of the options and suggested future actions are also presented. Costs for aging containers and aging locations are evaluated separately. Capital costs are developed for direct costs and distributable field costs. To the extent practical, unit costs are presented. Indirect costs, operating costs, and total system life cycle costs will be evaluated outside of this study. Three recommendations for aging commercial spent nuclear fuel--subsurface, surface, and combined surface and subsurface are presented for further review in the overall design re-evaluation effort. Options that were evaluated but not recommended are: subsurface aging in a

  6. School Choice Options Limit Access to Higher Education for Various Groups of Students in Quebec

    ERIC Educational Resources Information Center

    Labrosse, Julie; Gaudreault, Marco; Picard, France

    2017-01-01

    The choice of selected school options by pupils in secondary school, particularly mathematics and physical sciences, have implications for future educational pathways in higher education [Felouzis, G. (1997). "L'efficacité des enseignants, Sociologie de la relation pédagogique." Paris: Presses Universitaires de France; Moreau, G. (2005).…

  7. Teaching the iPhone with Voiceover Accessibility to People with Visual Impairments

    ERIC Educational Resources Information Center

    Celusnak, Brian M.

    2016-01-01

    Moving from a conventional telephone keypad to a cellular telephone with a touchscreen can seem quite challenging for some people. When one is visually impaired, there is always the option of using VoiceOver, the iPhone's built-in access technology that is designed to allow individuals with visual impairments the ability to access the visual…

  8. Awareness and perceived fairness of option B+ in Malawi: a population-level perspective

    PubMed Central

    Yeatman, Sara; Trinitapoli, Jenny

    2017-01-01

    Abstract Introduction: Policies for rationing antiretroviral therapy (ART) have been subject to on-going ethical debates. Introduced in Malawi in 2011, Option B+ prioritized HIV-positive pregnant women for lifelong ART regardless of the underlying state of their immune system, shifting the logic of allocation away from medical eligibility. Despite the rapid expansion of this policy, we know little about how it has been understood and interpreted by the people it affects. Methods: We assessed awareness and perceived fairness of the prioritization system for ART among a population-based sample of young women (n = 1440) and their partners (n = 574) in southern Malawi. We use a card-sort technique to elicit understandings of who gets ART under Option B+ and who should be prioritized, and we compare perceptions to actual ART policy using sequence analysis and optimal matching. We then use ordered logistic regression to identify the factors associated with policy awareness. Results: In 2015, only 30.7% of women and 21.1% of male partners understood how ART was being distributed. There was widespread confusion around whether otherwise healthy HIV-positive pregnant women could access ART under Option B + . Nonetheless, more young adults thought that the fairest policy should prioritize such women than believed the actual policy did. Women who were older, more educated or had recently engaged with the health system through antenatal care or ART had more accurate understandings of Option B + . Among men, policy awareness was lower, and was patterned only by education. Conclusions: Although most respondents were unaware that Option B+ afforded ART access to healthy-pregnant women, Malawians support the prioritization of pregnant women. Countries adopting Option B+ or other new ART policies such as universal test-and-treat should communicate the policies and their rationales to the public – such transparency would be more consistent with a fair and ethical process

  9. Awareness and perceived fairness of Option B+ in Malawi: A population-level perspective

    PubMed

    Yeatman, Sara; Trinitapoli, Jenny

    2017-03-08

    Policies for rationing antiretroviral therapy (ART) have been subject to on-going ethical debates. Introduced in Malawi in 2011, Option B+ prioritized HIV-positive pregnant women for lifelong ART regardless of the underlying state of their immune system, shifting the logic of allocation away from medical eligibility. Despite the rapid expansion of this policy, we know little about how it has been understood and interpreted by the people it affects. We assessed awareness and perceived fairness of the prioritization system for ART among a population-based sample of young women (n = 1440) and their partners (n = 574) in southern Malawi. We use a card-sort technique to elicit understandings of who gets ART under Option B+ and who should be prioritized, and we compare perceptions to actual ART policy using sequence analysis and optimal matching. We then use ordered logistic regression to identify the factors associated with policy awareness. In 2015, only 30.7% of women and 21.1% of male partners understood how ART was being distributed. There was widespread confusion around whether otherwise healthy HIV-positive pregnant women could access ART under Option B + . Nonetheless, more young adults thought that the fairest policy should prioritize such women than believed the actual policy did. Women who were older, more educated or had recently engaged with the health system through antenatal care or ART had more accurate understandings of Option B + . Among men, policy awareness was lower, and was patterned only by education. Although most respondents were unaware that Option B+ afforded ART access to healthy-pregnant women, Malawians support the prioritization of pregnant women. Countries adopting Option B+ or other new ART policies such as universal test-and-treat should communicate the policies and their rationales to the public - such transparency would be more consistent with a fair and ethical process and could additionally serve to clarify confusion and

  10. European option pricing under the Student's t noise with jumps

    NASA Astrophysics Data System (ADS)

    Wang, Xiao-Tian; Li, Zhe; Zhuang, Le

    2017-03-01

    In this paper we present a new approach to price European options under the Student's t noise with jumps. Through the conditional delta hedging strategy and the minimal mean-square-error hedging, a closed-form solution of the European option value is obtained under the incomplete information case. In particular, we propose a Value-at-Risk-type procedure to estimate the volatility parameter σ such that the pricing error is in accord with the risk preferences of investors. In addition, the numerical results of us show that options are not priced in some cases in an incomplete information market.

  11. Flexible phosphor sensors: a digital supplement or option to rigid sensors.

    PubMed

    Glazer, Howard S

    2014-01-01

    An increasing number of dental practices are upgrading from film radiography to digital radiography, for reasons that include faster image processing, easier image access, better patient education, enhanced data storage, and improved office productivity. Most practices that have converted to digital technology use rigid, or direct, sensors. Another digital option is flexible phosphor sensors, also called indirect sensors or phosphor storage plates (PSPs). Flexible phosphor sensors can be advantageous for use with certain patients who may be averse to direct sensors, and they can deliver a larger image area. Additionally, sensor cost for replacement PSPs is considerably lower than for hard sensors. As such, flexible phosphor sensors appear to be a viable supplement or option to direct sensors.

  12. Browser-Based Accessibility Evaluation Tools for Beginners

    ERIC Educational Resources Information Center

    McHale, Nina

    2011-01-01

    There are hundreds of Web accessibility software options out in the world that serve many different functions. Not surprisingly, many of them are designed for users with a wide range of abilities, with the intent of making the use of computers and the Internet easier for both work and entertainment. There are, however, numerous products available…

  13. Clean subglacial access: prospects for future deep hot-water drilling

    PubMed Central

    Pearce, David; Hodgson, Dominic A.; Smith, Andrew M.; Rose, Mike; Ross, Neil; Mowlem, Matt; Parnell, John

    2016-01-01

    Accessing and sampling subglacial environments deep beneath the Antarctic Ice Sheet presents several challenges to existing drilling technologies. With over half of the ice sheet believed to be resting on a wet bed, drilling down to this environment must conform to international agreements on environmental stewardship and protection, making clean hot-water drilling the most viable option. Such a drill, and its water recovery system, must be capable of accessing significantly greater ice depths than previous hot-water drills, and remain fully operational after connecting with the basal hydrological system. The Subglacial Lake Ellsworth (SLE) project developed a comprehensive plan for deep (greater than 3000 m) subglacial lake research, involving the design and development of a clean deep-ice hot-water drill. However, during fieldwork in December 2012 drilling was halted after a succession of equipment issues culminated in a failure to link with a subsurface cavity and abandonment of the access holes. The lessons learned from this experience are presented here. Combining knowledge gained from these lessons with experience from other hot-water drilling programmes, and recent field testing, we describe the most viable technical options and operational procedures for future clean entry into SLE and other deep subglacial access targets. PMID:26667913

  14. Telecommunications access--matching available technologies to people with physical disabilities.

    PubMed

    Nguyen, Toan; Garrett, Rob; Downing, Andrew; Walker, Lloyd; Hobbs, David

    2006-03-01

    People with a disability do not have equitable access to the modern telecommunication medium. Many experience difficulty typing, handling the phone, dialling or answering calls. For those who are unable to speak, the only option is to type messages using whatever functional control site exists on their body. The provision of accessible mobile phones for people with disabilities can significantly improve their quality of life through an increased range of accessible activities, and can improve their independence, safety, security and self-esteem. This research was aimed at providing practical ways for people with a disability to participate in the extensive community of home and mobile phone users. The outcomes of ten participants taking part in the evaluation and trial of off-the-shelf telecommunication options are presented. Nine out of ten participants showed high to very high results in terms of their overall performance and satisfaction with the use of the telecommunication equipment provided. With the right policies, processes and support through equipment matching, education, training and delivery, current off-the-shelf solutions can help people with disabilities to effectively communicate with other members of our society and to access the same range of information systems and services enjoyed by able-bodied members of the community.

  15. Options to improve energy efficiency for educational building

    NASA Astrophysics Data System (ADS)

    Jahan, Mafruha

    The cost of energy is a major factor that must be considered for educational facility budget planning purpose. The analysis of energy related issues and options can be complex and requires significant time and detailed effort. One way to facilitate the inclusion of energy option planning in facility planning efforts is to utilize a tool that allows for quick appraisal of the facility energy profile. Once such an appraisal is accomplished, it is then possible to rank energy improvement options consistently with other facility needs and requirements. After an energy efficiency option has been determined to have meaningful value in comparison with other facility planning options, it is then possible to utilize the initial appraisal as the basis for an expanded consideration of additional facility and energy use detail using the same analytic system used for the initial appraisal. This thesis has developed a methodology and an associated analytic model to assist in these tasks and thereby improve the energy efficiency of educational facilities. A detailed energy efficiency and analysis tool is described that utilizes specific university building characteristics such as size, architecture, envelop, lighting, occupancy, thermal design which allows reducing the annual energy consumption. Improving the energy efficiency of various aspects of an educational building's energy performance can be complex and can require significant time and experience to make decisions. The approach developed in this thesis initially assesses the energy design for a university building. This initial appraisal is intended to assist administrators in assessing the potential value of energy efficiency options for their particular facility. Subsequently this scoping design can then be extended as another stage of the model by local facility or planning personnel to add more details and engineering aspects to the initial screening model. This approach can assist university planning efforts to

  16. EduCard. Adult Education Access Card. Policy Option Paper on Strategic Recommendation 4. First Edition.

    ERIC Educational Resources Information Center

    Porter, Dennis

    One recommendation of the 1989 California Strategic Plan for Adult Education is the use of EduCard. EduCard, the Adult Education Access Card, is a means of giving learners access to information about educational opportunities and providing administrators with machine-readable information on learners' prior education and traiing. Three models are:…

  17. POSTEROSUPERIOR SURGICAL ACCESS ROUTE FOR TREATMENT OF ACROMIOCLAVICULAR DISLOCATIONS: RESULTS FROM 84 SURGICAL CASES.

    PubMed

    Dal Molin, Danilo Canesin; Ribeiro, Fabiano Rebouças; Filho, Rômulo Brasil; Filardi, Cantídio Salvador; Tenor, Antonio Carlos; Stipp, Willian Nandi; Petros, Rodrigo Souto Borges

    2012-01-01

    To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification) operated between November 2002 and May 2010 were evaluated. The patients' mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a posterosuperior approach to the shoulder to access the top of the base of the coracoid process for placement of two anchors, which were used in reducing the dislocation. The minimum follow-up was 12 months. The postoperative clinical-radiographic evaluation was done using the modified Karlsson criteria and the University of California at Los Angeles (UCLA) score. 92.8% of the 84 patients treated presented good or excellent results, and 7.2% presented fair or poor results, using the UCLA assessment score. According to the modified Karlsson criteria, 76.2% were assessed as grade A, 17.9% as grade B and 5.9% as grade C. The posterosuperior access route to the shoulder is a new option for accessing the coracoid process and treating acromioclavicular dislocation, with clinical and radiographic results equivalent to those in the literature.

  18. Essential, Desirable or Optional? Making Distance E-Learning Courses Available to Those without Internet Access

    ERIC Educational Resources Information Center

    Hancock, Val

    2010-01-01

    The Open University, an open distance learning institution, is increasingly using a Virtual Learning Environment (VLE) that requires internet access. This paper investigates how the move to a VLE has affected one group of students who do not have internet access--offender learners studying in prison. Members of the armed forces and secure hospital…

  19. Current treatment options for the management of esophageal cancer

    PubMed Central

    Mawhinney, Mark R; Glasgow, Robert E

    2012-01-01

    In recent years, esophageal cancer characteristics and management options have evolved significantly. There has been a sharp increase in the frequency of esophageal adenocarcinoma and a decline in the frequency of squamous cell carcinoma. A more comprehensive understanding of prognostic factors influencing outcome has also been developed. This has led to more management options for esophageal cancer at all stages than ever before. A multidisciplinary, team approach to management in a high volume center is the preferred approach. Each patient should be individually assessed based on type of cancer, local or regional involvement, and his or her own functional status to determine an appropriate treatment regimen. This review will discuss management of esophageal cancer relative to disease progression and patient functional status. PMID:23152702

  20. Access to abortion: what women want from abortion services.

    PubMed

    Wiebe, Ellen R; Sandhu, Supna

    2008-04-01

    Whether Canadian physicians can refuse to refer women for abortion and whether private clinics can charge for abortions are matters of controversy. We sought to identify barriers to access for women seeking therapeutic abortion and to have them identify what they considered to be most important about access to abortion services. Women presenting for abortion over a two-month period at two free-standing abortion clinics, one publicly funded and the other private, were invited to participate in the study. Phase I of the study involved administration of a questionnaire seeking information about demographics, perceived barriers to access to abortion, and what the women wanted from abortion services. Phase II involved semi-structured interviews of a convenience sample of women to record their responses to questions about access. Responses from Phase I questionnaires were compared between the two clinics, and qualitative analysis was performed on the interview responses. Of 423 eligible women, 402 completed questionnaires, and of 45 women approached, 39 completed interviews satisfactorily. Women received information about abortion services from their physicians (60.0%), the Internet (14.8%), a telephone directory (7.8%), friends or family (5.3%), or other sources (12.3%). Many had negative experiences in gaining access. The most important issue regarding access was the long wait time; the second most important issue was difficulty in making appointments. In the private clinic, 85% of the women said they were willing to pay for shorter wait times, compared with 43.5% in the public clinic. Physicians who failed to refer patients for abortion or provide information about obtaining an abortion caused distress and impeded access for a significant minority of women requesting an abortion. Management of abortion services should be prioritized to reflect what women want: particularly decreased wait times for abortion and greater ease and convenience in booking appointments

  1. Nail Psoriasis: A Review of Treatment Options.

    PubMed

    Pasch, Marcel C

    2016-04-01

    Nail involvement affects 80-90 % of patients with plaque psoriasis, and is even more prevalent in patients with psoriatic arthritis. This review is the result of a systemic approach to the literature and covers topical, intralesional, conventional systemic, and biologic systemic treatments, as well as non-pharmacological treatment options for nail psoriasis. The available evidence suggests that all anti-tumor necrosis factor-α, anti-interleukin (IL)-17, and anti-IL-12/23 antibodies which are available for plaque psoriasis and psoriatic arthritis are highly effective treatments for nail psoriasis. Conventional systemic treatments, including methotrexate, cyclosporine, acitretin, and apremilast, as well as intralesional corticosteroids, can also be effective treatments for nail psoriasis. Topical treatments, including corticosteroids, calcipotriol, tacrolimus, and tazarotene, have also been shown to have a position in the treatment of nail psoriasis, particularly in mild cases. Finally, non-pharmacological treatment options, including phototherapy, photodynamic therapy, laser therapy, and several radiotherapeutic options, are also reviewed but cannot be advised as first-line treatment options. Another conclusion of this review is that the lack of a reliable core set of outcomes measures for trials in nail psoriasis hinders the interpretation of results, and is urgently needed.

  2. Sandy Hook : alternative access concept plan and vehicle replacement study

    DOT National Transportation Integrated Search

    2009-06-01

    This study addresses two critical issues of concern to the Sandy Hook Unit of Gateway National : Recreational Area: (1) options for alternative access to Sandy Hook during peak summer season, : particularly when the park is closed to private vehicles...

  3. Innovative approaches for increasing transportation options for people with disabilities in Florida.

    DOT National Transportation Integrated Search

    2010-04-01

    Accessible, affordable, and reliable transportation is a critical component to community inclusion. : Having access to the community is the key to many aspects of independence and self-sufficiency. : Floridas transportation delivery system is very...

  4. Access to and Accessibility of Education: An Analytic and Conceptual Approach to a Multidimensional Issue

    ERIC Educational Resources Information Center

    Stauber, Barbara; Parreira do Amaral, Marcelo

    2015-01-01

    This article presents analytical considerations for the discussion of issues of access to education and inequality. It first sharpens the concept of access and inequality by pointing to the interplay of structure and agency as well as to processes of social differentiation in which differences are constructed. This implies a critical view on…

  5. Towards an Approach of Semantic Access Control for Cloud Computing

    NASA Astrophysics Data System (ADS)

    Hu, Luokai; Ying, Shi; Jia, Xiangyang; Zhao, Kai

    With the development of cloud computing, the mutual understandability among distributed Access Control Policies (ACPs) has become an important issue in the security field of cloud computing. Semantic Web technology provides the solution to semantic interoperability of heterogeneous applications. In this paper, we analysis existing access control methods and present a new Semantic Access Control Policy Language (SACPL) for describing ACPs in cloud computing environment. Access Control Oriented Ontology System (ACOOS) is designed as the semantic basis of SACPL. Ontology-based SACPL language can effectively solve the interoperability issue of distributed ACPs. This study enriches the research that the semantic web technology is applied in the field of security, and provides a new way of thinking of access control in cloud computing.

  6. 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.

  7. Retroperitoneal access for robotic renal surgery.

    PubMed

    Anderson, Barrett G; Wright, Alec J; Potretzke, Aaron M; Figenshau, R Sherburne

    2018-01-01

    Retroperitoneal access for robotic renal surgery is an effective alternative to the commonly used transperitoneal approach. We describe our contemporary experience and technique for attaining retroperitoneal access. We outline our institutional approach to retroperitoneal access for the instruction of urologists at the beginning of the learning curve. The patient is placed in the lateral decubitus position. The first incision is made just inferior to the tip of the twelfth rib as described by Hsu, et al. After the lumbodorsal fascia is traversed, the retroperitoneal space is dilated with a round 10 millimeter AutoSutureTM (Covidien, Mansfield, MA) balloon access device. The following trocars are used: A 130 millimeter KiiR balloon trocar (Applied Medical, Rancho Santa Margarita, CA), three robotic, and one assistant. Key landmarks for the access and dissection are detailed. 177 patients underwent a retroperitoneal robotic procedure from 2007 to 2015. Procedures performed include 158 partial nephrectomies, 16 pyeloplasties, and three radical nephrectomies. The robotic fourth arm was utilized in all cases. When compared with the transperitoneal approach, the retroperitoneal approach was associated with shorter operative times and decreased length of stay (1). Selection bias and surgeon preference accounted for the higher proportion of patients who underwent partial nephrectomy off-camp via the retroperitoneal approach. Retroperitoneal robotic surgery may confer several advantages. In patients with previous abdominal surgery or intra-abdominal conditions, the retroperitoneum can be safely accessed while avoiding intraperitoneal injuries. The retroperitoneum also provides a confined space that may minimize the sequelae of potential complications including urine leak. Moreover, at our institution, retroperitoneal robotic surgery is associated with shorter operative times and a decreased length of stay when compared with the transperitoneal approach (2). In selected

  8. Towards comprehensive early abortion service delivery in high income countries: insights for improving universal access to abortion in Australia.

    PubMed

    Dawson, Angela; Bateson, Deborah; Estoesta, Jane; Sullivan, Elizabeth

    2016-10-22

    Improving access to safe abortion is an essential strategy in the provision of universal access to reproductive health care. Australians are largely supportive of the provision of abortion and its decriminalization. However, the lack of data and the complex legal and service delivery situation impacts upon access for women seeking an early termination of pregnancy. There are no systematic reviews from a health services perspective to help direct health planners and policy makers to improve access comprehensive medical and early surgical abortion in high income countries. This review therefore aims to identify quality studies of abortion services to provide insight into how access to services can be improved in Australia. We undertook a structured search of six bibliographic databases and hand-searching to ascertain peer reviewed primary research in English between 2005 and 2015. Qualitative and quantitative study designs were deemed suitable for inclusion. A deductive content analysis methodology was employed to analyse selected manuscripts based upon a framework we developed to examine access to early abortion services. This review identified the dimensions of access to surgical and medical abortion at clinic or hospital-outpatient based abortion services, as well as new service delivery approaches utilising a remote telemedicine approach. A range of factors, mostly from studies in the United Kingdom and United States of America were found to facilitate improved access to abortion, in particular, flexible service delivery approaches that provide women with cost effective options and technology based services. Standards, recommendations and targets were also identified that provided services and providers with guidance regarding the quality of abortion care. Key insights for service delivery in Australia include the: establishment of standards, provision of choice of procedure, improved provider education and training and the expansion of telemedicine for medical

  9. 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.

  10. Testing option pricing with the Edgeworth expansion

    NASA Astrophysics Data System (ADS)

    Balieiro Filho, Ruy Gabriel; Rosenfeld, Rogerio

    2004-12-01

    There is a well-developed framework, the Black-Scholes theory, for the pricing of contracts based on the future prices of certain assets, called options. This theory assumes that the probability distribution of the returns of the underlying asset is a Gaussian distribution. However, it is observed in the market that this hypothesis is flawed, leading to the introduction of a fudge factor, the so-called volatility smile. Therefore, it would be interesting to explore extensions of the Black-Scholes theory to non-Gaussian distributions. In this paper, we provide an explicit formula for the price of an option when the distributions of the returns of the underlying asset is parametrized by an Edgeworth expansion, which allows for the introduction of higher independent moments of the probability distribution, namely skewness and kurtosis. We test our formula with options in the Brazilian and American markets, showing that the volatility smile can be reduced. We also check whether our approach leads to more efficient hedging strategies of these instruments.

  11. 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

  12. Options for accounting carbon sequestration in German forests

    PubMed Central

    Krug, Joachim; Koehl, Michael; Riedel, Thomas; Bormann, Kristin; Rueter, Sebastian; Elsasser, Peter

    2009-01-01

    Background The Accra climate change talks held from 21–27 August 2008 in Accra, Ghana, were part of an ongoing series of meetings leading up to the Copenhagen meeting in December 2009. During the meeting a set of options for accounting carbon sequestration in forestry on a post-2012 framework was presented. The options include gross-net and net-net accounting and approaches for establishing baselines. Results This article demonstrates the embedded consequences of Accra Accounting Options for the case study of German national GHG accounting. It presents the most current assessment of sequestration rates by forest management for the period 1990 – 2007, provides an outlook of future emissions and removals (up to the year 2042) as related to three different management scenarios, and shows that implementation of some Accra options may reverse sources to sinks, or sinks to sources. Conclusion The results of the study highlight the importance of elaborating an accounting system that would prioritize the climate convention goals, not national preferences. PMID:19650896

  13. A population-based analysis of injury-related deaths and access to trauma care in rural-remote Northwest British Columbia.

    PubMed

    Simons, Richard; Brasher, Penelope; Taulu, Tracey; Lakha, Nasira; Molnar, Nadine; Caron, Nadine; Schuurman, Nadine; Evans, David; Hameed, Morad

    2010-07-01

    Injury rates and injury mortality rates are generally higher in rural and remote communities compared with urban jurisdictions as has been shown to be the case in the rural-remote area of Northwest (NW) British Columbia (BC). The purpose of study was to identify: (1) the place and timing of death following injury in NW BC, (2) access to and quality of local trauma services, and (3) opportunities to improve trauma outcomes. Quantitative data from demographic and geographic databases, the BC Trauma Registry, Hospital discharge abstract database, and the BC Coroner's Office, along with qualitative data from chart reviews of selected major trauma cases, and interviews with front-line trauma care providers were collated and analyzed for patients sustaining injury in NW BC from April 2001 to March 2006. The majority of trauma deaths (82%) in NW BC occur prehospital. Patients arriving alive to NW hospitals have low hospital mortality (1.0%), and patients transferring from NW BC to tertiary centers have better outcomes than matched patients achieving direct entry into the tertiary center by way of geographic proximity. Access to local trauma services was compromised by: incident discovery, limited phone service (land lines/cell), incomplete 911 emergency medical services system access, geographical and climate challenges compounded by limited transportation options, airport capabilities and paramedic training level, dysfunctional hospital no-refusal policies, lack of a hospital destination policies, and lack of system leadership and coordination. Improving trauma outcomes in this rural-remote jurisdiction requires a systems approach to address root causes of delays in access to care, focusing on improved access to emergency medical services, hospital bypass and destination protocols, improved transportation options, advanced life support transfer capability, and designated, coordinated local trauma services.

  14. Advanced software development workstation project ACCESS user's guide

    NASA Technical Reports Server (NTRS)

    1990-01-01

    ACCESS is a knowledge based software information system designed to assist the user in modifying retrieved software to satisfy user specifications. A user's guide is presented for the knowledge engineer who wishes to create for ACCESS a knowledge base consisting of representations of objects in some software system. This knowledge is accessible to an end user who wishes to use the catalogued software objects to create a new application program or an input stream for an existing system. The application specific portion of an ACCESS knowledge base consists of a taxonomy of object classes, as well as instances of these classes. All objects in the knowledge base are stored in an associative memory. ACCESS provides a standard interface for the end user to browse and modify objects. In addition, the interface can be customized by the addition of application specific data entry forms and by specification of display order for the taxonomy and object attributes. These customization options are described.

  15. Determining accessibility to dermatologists and teledermatology locations in Kentucky: demonstration of an innovative geographic information systems approach.

    PubMed

    Shannon, Gary William; Buker, Carol Marie

    2010-01-01

    Teledermatology provides a partial solution to the problem of accessibility to dermatology services in underserved areas, yet methodologies to determine the locations and geographic dimensions of these areas and the locational efficiency of remote teledermatology sites have been found wanting. This article illustrates an innovative Geographic Information Systems approach using dermatologists' addresses, U.S. Census population data, and the Topologically Integrated Geographic Encoding and Referencing System. Travel-time-based service areas were calculated and mapped for each dermatologist in the state of Kentucky and for possible locations of several remote teledermatology sites. Populations within the current and possible remote service areas were determined. These populations and associated maps permit assessment of the locational efficiency of the current distribution of dermatologists, location of underserved areas, and the potential contribution of proposed hypothetical teledermatology sites. This approach is a valuable and practical tool for evaluating access to current distributions of dermatologists as well as planning for and implementing teledermatology.

  16. Planning for airport access: An analysis of the San Francisco Bay area. Three subsystem designs

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The outcomes of three analytical studies are presented. Areas of concentration presented include: (1) Zonal Airport Transit System designed to address the problem of airport access options, (2) the issues and problems of airport parking and circulation, and (3) the problems of effectively providing airport access information.

  17. Mission options for rendezvous with the most accessible Near-Earth Asteroid - 1989 ML

    NASA Technical Reports Server (NTRS)

    Mcadams, Jim V.

    1992-01-01

    The recent discovery of the Amor-class 1989 ML, the most accessible known asteroid for minimum-energy rendezvous missions, has expedited the search for frequent, low-cost Near-Earth Asteroid rendezvous and round-trip missions. This paper identifies trajectory characteristics and assesses mass performance for low Delta V ballistic rendezvous opportunities to 1989 ML during the period 1996-2010. This asteroid also offers occasional unique extended mission opportunities, such as the lowest known Delta V requirement for any asteroid sample return mission as well as pre-rendezvous asteroid flyby and post-rendezvous comet flyby opportunities requiring less than 5.25 km/sec total Delta V. This paper also briefly comments concerning mission opportunities for asteroid 1991 JW, which recently replaced other known asteroids as the most accessible Near-Earth Asteroid for fast rendezvous and round-trip missions.

  18. Options for Vocabulary Learning Through Communication Tasks.

    ERIC Educational Resources Information Center

    Newton, Jonathan

    2001-01-01

    In a task-based approach to learning, learners will often meet new vocabulary "in passing" as they pursue communicative goals. Argues that such encounters can be turned to the learners' advantage and that rather than remove difficult words, teachers should consider a number of cooperative options for exposing learners to new words during…

  19. Future therapeutic options in food allergy.

    PubMed

    Eigenmann, P A

    2003-12-01

    Up to 5% of young children and 2% of adults suffer from food allergy. Among them many have immunoglobulin E (IgE)-mediated food allergy, a condition with potentially fatal allergic reactions. Several studies have addressed possible definite treatment options for food allergy. Immunotherapy, by the oral route or by systemic injections shows promising preliminary results, but current interpretation of these therapeutic options are mostly handicapped by studies with insufficient scientific support, or by severe side-effects. Currently, no studies can support pharmacotherapy. Finally, most promising results were recently published with anti-IgE antibodies in a human trial, or various approaches in a mouse model of food allergy (chinese herbal medicine, specific modulation of the T cell response). Rapidly evolving findings might provide hope for a cure of food allergy in the near future.

  20. Treatment options for moderate-to-very severe chronic obstructive pulmonary disease.

    PubMed

    Cazzola, Mario; Rogliani, Paola; Ora, Josuel; Matera, Maria Gabriella

    2016-01-01

    The appropriate drug management of COPD is still based on the use of bronchodilators, possibly associated with an anti-inflammatory agent. However, there are still fundamental questions that require clarification to optimise their use and major unmet clinical needs that must be addressed. The advances obtained with the pharmacological options currently consolidated and the different approaches that are often used in an attempt to respond to unmet therapeutic needs are reviewed Expert opinion: In view of the unsatisfactory status of current treatments for COPD, there is an urgent need for alternative and more effective therapeutic approaches that will help to relieve patient symptoms and affect the natural course of COPD, inhibiting chronic inflammation and reversing the disease process or preventing its progression. However, new pharmacologic options have proved difficult to develop. Therefore, it is mandatory to optimize the use of the treatment options at our disposal. However, there are still fundamental questions regarding their use, including the step-up and step-down pharmacological approach, that require clarification to optimise the use of these drugs. It is likely that phenotyping COPD patients would help in identifying the right treatment for each COPD patient and improve the effectiveness of therapies.

  1. The Mission Accessibility of Near-Earth Asteroids

    NASA Technical Reports Server (NTRS)

    Barbee, Brent W.; Abell, Paul A.; Adamo, Daniel R.; Mazanek, Daniel D.; Johnson, Lindley N.; Yeomans, Donald K.; Chodas, Paul W.; Chamberlin, Alan B.; Benner, Lance A. M.; Taylor, Patrick; hide

    2015-01-01

    Astrodynamical Earth departure dates; mission v; mission duration; stay time; etc. Physical I NEO size(?); rotation rate; dust satellites environment; chemistry; etc. Architectural Launch vehicle(s); crew vehicle(s); habitat module(s); budget; etc. Operational Operations experience; abort options profiles; etc. Astrodynamical Accessibility is the starting point for understanding the options and opportunities available to us. Here we shall focus on. Astrodynamical Accessibility.2 Earth departure date between 2015-01-01 and 2040-12-31 Earth departure C3 60 km2s2. Total mission v 12 kms. The total v includes (1) the Earth departure maneuver from a 400 km altitude circular parking orbit, (2) the maneuver to match the NEAs velocity at arrival, (3) the maneuver to depart the NEA and, (4) if necessary, a maneuver to control the atmospheric re-entry speed during Earth return. Total round trip mission duration 450 days. Stay time at the NEA 8 days Earth atmospheric entry speed 12 kms at an altitude of 125 km. A near-Earth asteroid (NEA) that offers at least one trajectory solution meeting those criteria is classified as NHATS-compliant.

  2. Comparative Analysis of Sustainable Approaches and Systems for Scientific Data Stewardship

    NASA Astrophysics Data System (ADS)

    Downs, R. R.; Chen, R. S.

    2012-12-01

    Sustainable data systems are critical components of the cyberinfrastructure needed to provide long-term stewardship of scientific data, including Earth science data, throughout their entire life cycle. A variety of approaches may help ensure the sustainability of such systems, but these approaches must be able to survive the demands of competing priorities and decreasing budgets. Analyzing and comparing alternative approaches can identify viable aspects of each approach and inform decisions for developing, managing, and supporting the cyberinfrastructure needed to facilitate discovery, access, and analysis of data by future communities of users. A typology of sustainability approaches is proposed, and example use cases are offered for comparing the approaches over time. These examples demonstrate the potential strengths and weaknesses of each approach under various conditions and with regard to different objectives, e.g., open vs. limited access. By applying the results of these analyses to their particular circumstances, systems stakeholders can assess their options for a sustainable systems approach along with other metrics and identify alternative strategies to ensure the sustainability of the scientific data and information for which they are responsible. In addition, comparing sustainability approaches should inform the design of new systems and the improvement of existing systems to meet the needs for long-term stewardship of scientific data, and support education and workforce development efforts needed to ensure that the appropriate scientific and technical skills are available to operate and further develop sustainable cyberinfrastructure.

  3. Designing flexible engineering systems utilizing embedded architecture options

    NASA Astrophysics Data System (ADS)

    Pierce, Jeff G.

    This dissertation develops and applies an integrated framework for embedding flexibility in an engineered system architecture. Systems are constantly faced with unpredictability in the operational environment, threats from competing systems, obsolescence of technology, and general uncertainty in future system demands. Current systems engineering and risk management practices have focused almost exclusively on mitigating or preventing the negative consequences of uncertainty. This research recognizes that high uncertainty also presents an opportunity to design systems that can flexibly respond to changing requirements and capture additional value throughout the design life. There does not exist however a formalized approach to designing appropriately flexible systems. This research develops a three stage integrated flexibility framework based on the concept of architecture options embedded in the system design. Stage One defines an eight step systems engineering process to identify candidate architecture options. This process encapsulates the operational uncertainty though scenario development, traces new functional requirements to the affected design variables, and clusters the variables most sensitive to change. The resulting clusters can generate insight into the most promising regions in the architecture to embed flexibility in the form of architecture options. Stage Two develops a quantitative option valuation technique, grounded in real options theory, which is able to value embedded architecture options that exhibit variable expiration behavior. Stage Three proposes a portfolio optimization algorithm, for both discrete and continuous options, to select the optimal subset of architecture options, subject to budget and risk constraints. Finally, the feasibility, extensibility and limitations of the framework are assessed by its application to a reconnaissance satellite system development problem. Detailed technical data, performance models, and cost estimates

  4. Space station needs, attributes and architectural options. Volume 1: Executive summary NASA

    NASA Technical Reports Server (NTRS)

    1983-01-01

    The uses alignment plan was implemented. The existing data bank was used to define a large number of station requirements. Ten to 20 valid mission scenarios were developed. Architectural options as they are influenced by communications operations, subsystem evolvability, and required technology growth are defined. Costing of evolutionary concepts, alternative approaches, and options, was based on minimum design details.

  5. Carotid artery stenting: current and emerging options

    PubMed Central

    Morr, Simon; Lin, Ning; Siddiqui, Adnan H

    2014-01-01

    Carotid artery stenting technologies are rapidly evolving. Options for endovascular surgeons and interventionists who treat occlusive carotid disease continue to expand. We here present an update and overview of carotid stenting devices. Evidence supporting carotid stenting includes randomized controlled trials that compare endovascular stenting to open surgical endarterectomy. Carotid technologies addressed include the carotid stents themselves as well as adjunct neuroprotective devices. Aspects of stent technology include bare-metal versus covered stents, stent tapering, and free-cell area. Drug-eluting and cutting balloon indications are described. Embolization protection options and new direct carotid access strategies are reviewed. Adjunct technologies, such as intravascular ultrasound imaging and risk stratification algorithms, are discussed. Bare-metal and covered stents provide unique advantages and disadvantages. Stent tapering may allow for a more fitted contour to the caliber decrement between the common carotid and internal carotid arteries but also introduces new technical challenges. Studies regarding free-cell area are conflicting with respect to benefits and associated risk; clinical relevance of associated adverse effects associated with either type is unclear. Embolization protection strategies include distal filter protection and flow reversal. Though flow reversal was initially met with some skepticism, it has gained wider acceptance and may provide the advantage of not crossing the carotid lesion before protection is established. New direct carotid access techniques address difficult anatomy and incorporate sophisticated flow-reversal embolization protection techniques. Carotid stenting is a new and exciting field with rapidly advancing technologies. Embolization protection, low-risk deployment, and lesion assessment and stratification are active areas of research. Ample room remains for further innovations and developments. PMID:25349483

  6. Rehabilitation Options

    MedlinePlus

    ... Speech Pathology Occupational Therapy Art Therapy Recreational therapy Neuropsychology Home Care Options Advanced Care Planning Palliative Care ... Speech Pathology Occupational Therapy Art Therapy Recreational therapy Neuropsychology Home Care Options Advanced Care Planning Palliative Care ...

  7. U.S. Physicians’ Views on Financing Options to Expand Health Insurance Coverage: A National Survey

    PubMed Central

    Woolhandler, Steffie; Bose-Kolanu, Anjali; Germann, Antonio; Bor, David H.; Himmelstein, David U.

    2009-01-01

    BACKGROUND Physician opinion can influence the prospects for health care reform, yet there are few recent data on physician views on reform proposals or access to medical care in the United States. OBJECTIVE To assess physician views on financing options for expanding health care coverage and on access to health care. DESIGN AND PARTICIPANTS Nationally representative mail survey conducted between March 2007 and October 2007 of U.S. physicians engaged in direct patient care. MEASUREMENTS Rated support for reform options including financial incentives to induce individuals to purchase health insurance and single-payer national health insurance; rated views of several dimensions of access to care. MAIN RESULTS 1,675 of 3,300 physicians responded (50.8%). Only 9% of physicians preferred the current employer-based financing system. Forty-nine percent favored either tax incentives or penalties to encourage the purchase of medical insurance, and 42% preferred a government-run, taxpayer-financed single-payer national health insurance program. The majority of respondents believed that all Americans should receive needed medical care regardless of ability to pay (89%); 33% believed that the uninsured currently have access to needed care. Nearly one fifth of respondents (19.3%) believed that even the insured lack access to needed care. Views about access were independently associated with support for single-payer national health insurance. CONCLUSIONS The vast majority of physicians surveyed supported a change in the health care financing system. While a plurality support the use of financial incentives, a substantial proportion support single payer national health insurance. These findings challenge the perception that fundamental restructuring of the U.S. health care financing system receives little acceptance by physicians. PMID:19184240

  8. 5 CFR 870.705 - Amount and election of Option B and Option C.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Amount and election of Option B and Option C. 870.705 Section 870.705 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED... Compensationers § 870.705 Amount and election of Option B and Option C. (a) The number of multiples of Option B...

  9. Remote access thyroid surgery

    PubMed Central

    Bhatia, Parisha; Mohamed, Hossam Eldin; Kadi, Abida; Walvekar, Rohan R.

    2015-01-01

    Robot assisted thyroid surgery has been the latest advance in the evolution of thyroid surgery after endoscopy assisted procedures. The advantage of a superior field vision and technical advancements of robotic technology have permitted novel remote access (trans-axillary and retro-auricular) surgical approaches. Interestingly, several remote access surgical ports using robot surgical system and endoscopic technique have been customized to avoid the social stigma of a visible scar. Current literature has displayed their various advantages in terms of post-operative outcomes; however, the associated financial burden and also additional training and expertise necessary hinder its widespread adoption into endocrine surgery practices. These approaches offer excellent cosmesis, with a shorter learning curve and reduce discomfort to surgeons operating ergonomically through a robotic console. This review aims to provide details of various remote access techniques that are being offered for thyroid resection. Though these have been reported to be safe and feasible approaches for thyroid surgery, further evaluation for their efficacy still remains. PMID:26425450

  10. Water access, water scarcity, and climate change.

    PubMed

    Mukheibir, Pierre

    2010-05-01

    This article investigates the approaches of the various discourses operating in the water sector and how they address the issues of scarcity and equitable access under projected climate change impacts. Little synergy exists between the different approaches dealing with these issues. Whilst being a sustainable development and water resources management issue, a holistic view of access, scarcity and the projected impacts of climate change is not prevalent in these discourses. The climate change discourse too does not adequately bridge the gap between these issues. The projected impacts of climate change are likely to exacerbate the problems of scarcity and equitable access unless appropriate adaptation strategies are adopted and resilience is built. The successful delivery of accessible water services under projected climate change impacts therefore lies with an extension of the adaptive water management approach to include equitable access as a key driver.

  11. Ground Vibration Testing Options for Space Launch Vehicles

    NASA Technical Reports Server (NTRS)

    Patterson, Alan; Smith, Robert K.; Goggin, David; Newsom, Jerry

    2011-01-01

    New NASA launch vehicles will require development of robust systems in a fiscally-constrained environment. NASA, Department of Defense (DoD), and commercial space companies routinely conduct ground vibration tests as an essential part of math model validation and launch vehicle certification. Although ground vibration testing must be a part of the integrated test planning process, more affordable approaches must also be considered. A study evaluated several ground vibration test options for the NASA Constellation Program flight test vehicles, Orion-1 and Orion-2, which concluded that more affordable ground vibration test options are available. The motivation for ground vibration testing is supported by historical examples from NASA and DoD. The approach used in the present study employed surveys of ground vibration test subject-matter experts that provided data to qualitatively rank six test options. Twenty-five experts from NASA, DoD, and industry provided scoring and comments for this study. The current study determined that both element-level modal tests and integrated vehicle modal tests have technical merits. Both have been successful in validating structural dynamic math models of launch vehicles. However, element-level testing has less overall cost and schedule risk as compared to integrated vehicle testing. Future NASA launch vehicle development programs should anticipate that some structural dynamics testing will be necessary. Analysis alone will be inadequate to certify a crew-capable launch vehicle. At a minimum, component and element structural dynamic tests are recommended for new vehicle elements. Three viable structural dynamic test options were identified. Modal testing of the new vehicle elements and an integrated vehicle test on the mobile launcher provided the optimal trade between technical, cost, and schedule.

  12. Publish or perish, and pay--the new paradigm of open-access journals.

    PubMed

    Tzarnas, Stephanie; Tzarnas, Chris D

    2015-01-01

    The new open-access journal business model is changing the publication landscape and residents and junior faculty should be aware of these changes. A national survey of surgery program directors and residents was performed. Open-access journals have been growing over the past decade, and many traditional printed journals are also sponsoring open-access options (the hybrid model) for accepted articles. Authors need to be aware of the new publishing paradigm and potential costs involved in publishing their work. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  13. Choice of Hemodialysis Access in Older Adults: A Cost-Effectiveness Analysis.

    PubMed

    Hall, Rasheeda K; Myers, Evan R; Rosas, Sylvia E; O'Hare, Ann M; Colón-Emeric, Cathleen S

    2017-06-07

    Although arteriovenous fistulas have been found to be the most cost-effective form of hemodialysis access, the relative benefits of placing an arteriovenous fistula versus an arteriovenous graft seem to be least certain for older adults and when placed preemptively. However, older adults' life expectancy is heterogeneous, and most patients do not undergo permanent access creation until after dialysis initiation. We evaluated cost-effectiveness of arteriovenous fistula placement after dialysis initiation in older adults as a function of age and life expectancy. Using a hypothetical cohort of patients on incident hemodialysis with central venous catheters, we constructed Markov models of three treatment options: ( 1 ) arteriovenous fistula placement, ( 2 ) arteriovenous graft placement, or ( 3 ) continued catheter use. Costs, utilities, and transitional probabilities were derived from existing literature. Probabilistic sensitivity analyses were performed by age group (65-69, 70-74, 75-79, 80-84, and 85-89 years old) and quartile of life expectancy. Costs, quality-adjusted life-months, and incremental cost-effectiveness ratios were evaluated for up to 5 years. The arteriovenous fistula option was cost effective compared with continued catheter use for all age and life expectancy groups, except for 85-89 year olds in the lowest life expectancy quartile. The arteriovenous fistula option was more cost effective than the arteriovenous graft option for all quartiles of life expectancy among the 65- to 69-year-old age group. For older age groups, differences in cost-effectiveness between the strategies were attenuated, and the arteriovenous fistula option tended to only be cost effective in patients with life expectancy >2 years. For groups for which the arteriovenous fistula option was not cost saving, the cost to gain one quality-adjusted life-month ranged from $2294 to $14,042. Among older adults, the cost-effectiveness of an arteriovenous fistula placed within the first

  14. 77 FR 71650 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-03

    ... authorizes the Exchange to restrict access to the Disaster Recovery Facility if necessitated by system... the event that it needs to operate in disaster recovery mode on account of its primary data systems on...-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and Order Granting...

  15. POSTEROSUPERIOR SURGICAL ACCESS ROUTE FOR TREATMENT OF ACROMIOCLAVICULAR DISLOCATIONS: RESULTS FROM 84 SURGICAL CASES

    PubMed Central

    Dal Molin, Danilo Canesin; Ribeiro, Fabiano Rebouças; Filho, Rômulo Brasil; Filardi, Cantídio Salvador; Tenor, Antonio Carlos; Stipp, Willian Nandi; Petros, Rodrigo Souto Borges

    2015-01-01

    Objective: To evaluate the results from surgical treatment of 84 cases of acute acromioclavicular dislocation, using a posterosuperior access route. Methods: Eighty-four cases of acute acromioclavicular dislocation (grade III in the Allman-Tossy classification) operated between November 2002 and May 2010 were evaluated. The patients’ mean age was 34 years. The diagnoses were made using clinical and radiographic evaluations. The patients were operated by the same surgical team, within three weeks of the date of the trauma, using a posterosuperior approach to the shoulder to access the top of the base of the coracoid process for placement of two anchors, which were used in reducing the dislocation. The minimum follow-up was 12 months. The postoperative clinical-radiographic evaluation was done using the modified Karlsson criteria and the University of California at Los Angeles (UCLA) score. Results: 92.8% of the 84 patients treated presented good or excellent results, and 7.2% presented fair or poor results, using the UCLA assessment score. According to the modified Karlsson criteria, 76.2% were assessed as grade A, 17.9% as grade B and 5.9% as grade C. Conclusion: The posterosuperior access route to the shoulder is a new option for accessing the coracoid process and treating acromioclavicular dislocation, with clinical and radiographic results equivalent to those in the literature. PMID:27047866

  16. Cost effectiveness of option B plus for prevention of mother-to-child transmission of HIV in resource-limited countries: evidence from Kumasi, Ghana.

    PubMed

    VanDeusen, Adam; Paintsil, Elijah; Agyarko-Poku, Thomas; Long, Elisa F

    2015-03-18

    Achieving the goal of eliminating mother-to-child HIV transmission (MTCT) necessitates increased access to antiretroviral therapy (ART) for HIV-infected pregnant women. Option B provides ART through pregnancy and breastfeeding, whereas Option B+ recommends continuous ART regardless of CD4 count, thus potentially reducing MTCT during future pregnancies. Our objective was to compare maternal and pediatric health outcomes and cost-effectiveness of Option B+ versus Option B in Ghana. A decision-analytic model was developed to simulate HIV progression in mothers and transmission (in utero, during birth, or through breastfeeding) to current and all future children. Clinical parameters, including antenatal care access and fertility rates, were estimated from a retrospective review of 817 medical records at two hospitals in Ghana. Additional parameters were obtained from published literature. Modeled outcomes include HIV infections averted among newborn children, quality-adjusted life-years (QALYs), and cost-effectiveness ratios. HIV-infected women in Ghana have a lifetime average of 2.3 children (SD 1.3). Projected maternal life expectancy under Option B+ is 16.1 years, versus 16.0 years with Option B, yielding a gain of 0.1 maternal QALYs and 3.2 additional QALYs per child. Despite higher initial ART costs, Option B+ costs $785/QALY gained, a value considered very cost-effective by World Health Organization benchmarks. Widespread implementation of Option B+ in Ghana could theoretically prevent up to 668 HIV infections among children annually. Cost-effectiveness estimates remained favorable over robust sensitivity analyses. Although more expensive than Option B, Option B+ substantially reduces MTCT in future pregnancies, increases both maternal and pediatric QALYs, and is a cost-effective use of limited resources in Ghana.

  17. A Review of Research Methods Used to Examine Employee Assistance Program Delivery Options.

    ERIC Educational Resources Information Center

    Csiernik, Rick

    1995-01-01

    This review of literature on Employee Assistance Programs (EAPs) focuses on EAP delivery options. More than half of the 48 studies reviewed used a case study approach. EAPs provided by on-staff professionals were the most frequently discussed delivery option, although this is not the most dominant form of EAP provision. (SLD)

  18. The Effects of Framing Vocational Choices on Young Adults' Sets of Career Options

    ERIC Educational Resources Information Center

    Feldman, Daniel C.; Whitcomb, Kathleen M.

    2005-01-01

    Purpose: The present paper examines the effects of two decision-framing inductions on young adults' set of career options: first, whether young adults use abilities or interests as the grounds for their vocational choices and, second, whether young adults approach the decision-making task by including all career options to which they feel…

  19. Assessment for advanced fuel cycle options in CANDU

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

    Morreale, A.C.; Luxat, J.C.; Friedlander, Y.

    2013-07-01

    The possible options for advanced fuel cycles in CANDU reactors including actinide burning options and thorium cycles were explored and are feasible options to increase the efficiency of uranium utilization and help close the fuel cycle. The actinide burning TRUMOX approach uses a mixed oxide fuel of reprocessed transuranic actinides from PWR spent fuel blended with natural uranium in the CANDU-900 reactor. This system reduced actinide content by 35% and decreased natural uranium consumption by 24% over a PWR once through cycle. The thorium cycles evaluated used two CANDU-900 units, a generator and a burner unit along with a drivermore » fuel feedstock. The driver fuels included plutonium reprocessed from PWR, from CANDU and low enriched uranium (LEU). All three cycles were effective options and reduced natural uranium consumption over a PWR once through cycle. The LEU driven system saw the largest reduction with a 94% savings while the plutonium driven cycles achieved 75% savings for PWR and 87% for CANDU. The high neutron economy, online fuelling and flexible compact fuel make the CANDU system an ideal reactor platform for many advanced fuel cycles.« less

  20. Potential of OFDM for next generation optical access

    NASA Astrophysics Data System (ADS)

    Fritzsche, Daniel; Weis, Erik; Breuer, Dirk

    2011-01-01

    This paper shows the requirements for next generation optical access (NGOA) networks and analyzes the potential of OFDM (orthogonal frequency division multiplexing) for the use in such network scenarios. First, we show the motivation for NGOA systems based on the future requirements on FTTH access systems and list the advantages of OFDM in such scenarios. In the next part, the basics of OFDM and different methods to generate and detect optical OFDM signals are explained and analyzed. At the transmitter side the options include intensity modulation and the more advanced field modulation of the optical OFDM signal. At the receiver there is the choice between direct detection and coherent detection. As the result of this discussion we show our vision of the future use of OFDM in optical access networks.

  1. Dorsal buccal mucosal graft urethroplasty by a ventral sagittal urethrotomy and minimal-access perineal approach for anterior urethral stricture.

    PubMed

    Gupta, N P; Ansari, M S; Dogra, P N; Tandon, S

    2004-06-01

    To present the technique of dorsal buccal mucosal graft urethroplasty through a ventral sagittal urethrotomy and minimal access perineal approach for anterior urethral stricture. From July 2001 to December 2002, 12 patients with a long anterior urethral stricture had the anterior urethra reconstructed, using a one-stage urethroplasty with a dorsal onlay buccal mucosal graft through a ventral sagittal urethrotomy. The urethra was approached via a small perineal incision irrespective of the site and length of the stricture. The penis was everted through the perineal wound. No urethral dissection was used on laterally or dorsally, so as not to jeopardize the blood supply. The mean (range) length of the stricture was 5 (3-16) cm and the follow-up 12 (10-16) months. The results were good in 11 of the 12 patients. One patient developed a stricture at the proximal anastomotic site and required optical internal urethrotomy. Dorsal buccal mucosal graft urethroplasty via a minimal access perineal approach is a simple technique with a good surgical outcome; it does not require urethral dissection and mobilization and hence preserves the blood supply.

  2. Analysis of Potential Alternatives to Reduce NASA's Cost of Human Access to Space

    NASA Technical Reports Server (NTRS)

    1998-01-01

    The purpose of this report is to analyze NASA's potential options for significantly reducing the cost of human access to space. The opinions expressed in this report are based on Hawthorne, Krauss & Associates' ("HKA") interaction with NASA and several of its key contractors over the past nine months. This report is not intended to be an exhaustive quantitative analysis of the various options available to NASA. Instead, its purpose is to outline key decision-related issues that the agency should consider prior to making a decision as to which option to pursue. This report attempts to bring a private-sector perspective to bear on the issue of reducing the cost of human access to space. HKA believes that the key to the NASA's success in reducing those costs over the long-term is the involvement of the private-sector incentives and disciplines--which is achieved only through the assumption of risk by the private sector, not through a traditional contractor relationship--is essential to achieve significant long-term cost reductions.

  3. Minimally invasive treatment of maxillary anterior gingival recession defects by vestibular incision subperiosteal tunnel access and platelet-derived growth factor BB.

    PubMed

    Zadeh, Homayoun H

    2011-01-01

    An array of therapeutic options are available for treatment of gingival recession defects, though many of these are better suited for treatment of isolated defects. Some of the limitations of current techniques include the need for harvesting of autogenous donor tissues and their associated morbidity, as well as scar formation at the recipient site resulting from surface incisions. Moreover, muscle pull during healing often leads to incomplete root coverage or relapse of the recession. The current case reports introduce a novel, minimally invasive approach applicable for both isolated recession defects as well as multiple contiguous defects in the maxillary anterior region. Access to the surgical site is obtained by means of an approach referred to as vestibular incision subperiosteal tunnel access (VISTA). This entails making an access incision in the maxillary anterior frenum, followed by elevation of a subperiosteal tunnel. VISTA allows for both access as well as an opportunity to coronally reposition the gingival margins of all involved teeth. In this approach, recombinant human platelet-derived growth factor BB saturated onto a matrix of beta-tricalcium phosphate is introduced using VISTA over root dehiscences to enhance periodontal healing. A novel method of stabilization of the gingival margins is also introduced, referred to as coronally anchored suturing, designed to maintain the coronal positioning during healing. The current report describes the technique and two clinical case documentations for treatment of Miller Class I and II defects, demonstrating stable, long-term outcomes. Although VISTA has been applied in other regions, its application is most advantageous in the esthetic zone.

  4. An approach for investigation of secure access processes at a combined e-learning environment

    NASA Astrophysics Data System (ADS)

    Romansky, Radi; Noninska, Irina

    2017-12-01

    The article discuses an approach to investigate processes for regulation the security and privacy control at a heterogenous e-learning environment realized as a combination of traditional and cloud means and tools. Authors' proposal for combined architecture of e-learning system is presented and main subsystems and procedures are discussed. A formalization of the processes for using different types resources (public, private internal and private external) is proposed. The apparatus of Markovian chains (MC) is used for modeling and analytical investigation of the secure access to the resources is used and some assessments are presented.

  5. Dental Care And Medicare Beneficiaries: Access Gaps, Cost Burdens, And Policy Options.

    PubMed

    Willink, Amber; Schoen, Cathy; Davis, Karen

    2016-12-01

    Despite the wealth of evidence that oral health is related to physical health, Medicare explicitly excludes dental care from coverage, leaving beneficiaries at risk for tooth decay and periodontal disease and exposed to high out-of-pocket spending. To profile these risks, we examined access to dental care across income groups and types of insurance coverage in 2012. High-income beneficiaries were almost three times as likely to have received dental care in the previous twelve months, compared to low-income beneficiaries-74 percent of whom received no dental care. We also describe two illustrative policies that would expand access, in part by providing income-related subsidies. One would offer a voluntary, premium-financed benefit similar to those offered by Part D prescription drug plans, with an estimated premium of $29 per month. The other would cover basic dental care in core Medicare Part B benefits, financed in part by premiums ($7 or $15 per month, depending on whether premiums covered 25 percent or 50 percent of the cost) and in part by general revenues. The fact that beneficiaries are forgoing dental care and are exposed to significant costs if they seek care underscores the need for action. The policies offer pathways for improving health and financial independence for older adults. Project HOPE—The People-to-People Health Foundation, Inc.

  6. Review of Systemic Treatment Options for Adult Atopic Dermatitis.

    PubMed

    Gooderham, Melinda; Lynde, Charles W; Papp, Kim; Bourcier, Marc; Guenther, Lyn; Gulliver, Wayne; Hong, Chih-Ho; Poulin, Yves; Sussman, Gordon; Vender, Ronald

    Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease resulting from defects in skin barrier and aberrant immune responses. AD significantly affects the quality of life. Not all patients respond to topical therapies, and often systemic therapy is required to control the disease. To review the treatment options for adult AD patients including those options for patients who do not respond adequately or have contraindications to oral systemic therapy. A working group of clinicians with experience managing AD was convened to review the current literature on treatment options for adult AD patients. This review is based on the best available evidence from a published systematic review and an additional literature search. Current treatments for AD are reviewed, including options for adult AD patients who do not respond or have contraindications to current systemic therapies. A new approach with targeted therapies is reviewed based on best available evidence. Many AD patients respond satisfactorily to topical or systemic treatments, but for those patients who do not respond or have contraindications, new biologic agents appear to be promising therapies.

  7. 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

  8. Shelterwood-planted northern red oaks: integrated costs and options

    Treesearch

    Martin A. Spetich; Daniel Dey; Paul Johnson

    2009-01-01

    Tree biology, environmental site conditions, relative monetary costs, management options, and the competitive struggle between planted trees and other vegetation were integrated when underplanting northern red oak (Quercus rubra L.) seedlings in Boston Mountain shelterwoods. This approach provides insight into the collective costs (...

  9. Thermal management system options for high power space platforms

    NASA Technical Reports Server (NTRS)

    Sadunas, J. A.; Lehtinen, A.; Parish, R.

    1985-01-01

    Thermal Management System (TMS) design options for a high power (75kWe), low earth orbit, multimodule space platform were investigated. The approach taken was to establish a baseline TMS representative of current technology, and to make incremental improvements through successive subsystem trades that lead to a candidate TMS. The TMS trades included centralized and decentralized transport, single-phase and two-phase transport, alternate working fluids, liquid loop and heat pipe radiators, deployed fixed, body mounted and steerable radiators, and thermal storage. The subsystem options were evaluated against criteria such as weight, TMS power requirement, reliability, system isothermality penalty, and growth potential.

  10. The origins of options.

    PubMed

    Smaldino, Paul E; Richerson, Peter J

    2012-01-01

    Most research on decision making has focused on how human or animal decision makers choose between two or more options, posed in advance by the researchers. The mechanisms by which options are generated for most decisions, however, are not well understood. Models of sequential search have examined the trade-off between continued exploration and choosing one's current best option, but still cannot explain the processes by which new options are generated. We argue that understanding the origins of options is a crucial but untapped area for decision making research. We explore a number of factors which influence the generation of options, which fall broadly into two categories: psycho-biological and socio-cultural. The former category includes factors such as perceptual biases and associative memory networks. The latter category relies on the incredible human capacity for culture and social learning, which doubtless shape not only our choices but the options available for choice. Our intention is to start a discussion that brings us closer toward understanding the origins of options.

  11. The Origins of Options

    PubMed Central

    Smaldino, Paul E.; Richerson, Peter J.

    2012-01-01

    Most research on decision making has focused on how human or animal decision makers choose between two or more options, posed in advance by the researchers. The mechanisms by which options are generated for most decisions, however, are not well understood. Models of sequential search have examined the trade-off between continued exploration and choosing one’s current best option, but still cannot explain the processes by which new options are generated. We argue that understanding the origins of options is a crucial but untapped area for decision making research. We explore a number of factors which influence the generation of options, which fall broadly into two categories: psycho-biological and socio-cultural. The former category includes factors such as perceptual biases and associative memory networks. The latter category relies on the incredible human capacity for culture and social learning, which doubtless shape not only our choices but the options available for choice. Our intention is to start a discussion that brings us closer toward understanding the origins of options. PMID:22514515

  12. Acoustic accessibility investigation for ultrasound mediated treatment of glycogen storage disease type Ia patients.

    PubMed

    Wang, Shutao; Raju, Balasundar I; Leyvi, Evgeniy; Weinstein, David A; Seip, Ralf

    2011-09-01

    Glycogen storage disease type Ia (GSDIa) is caused by an inherited defect in the glucose-6-phosphatase gene. The recent advent of targeted ultrasound-mediated delivery (USMD) of plasmid DNA (pDNA) to the liver in conjunction with microbubbles may provide an alternative treatment option. This study focuses on determining the acoustically accessible liver volume in GSDIa patients using transducer models of various geometries with an image-based geometry-driven approach. Results show that transducers with longer focal lengths and smaller apertures (up to an f/number of 2) are able to access larger liver volumes in GSDIa patients while still being capable of delivering the required ultrasound dose in situ (2.5 MPa peak negative pressure at the focus). With sufficiently large acoustic windows and the ability to use glucose to easily assess efficacy, GSD appears to be a good model for testing USMD as proof of principle as a potential therapy for liver applications in general. Copyright © 2011 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  13. Efficient Access Control in Multimedia Social Networks

    NASA Astrophysics Data System (ADS)

    Sachan, Amit; Emmanuel, Sabu

    Multimedia social networks (MMSNs) have provided a convenient way to share multimedia contents such as images, videos, blogs, etc. Contents shared by a person can be easily accessed by anybody else over the Internet. However, due to various privacy, security, and legal concerns people often want to selectively share the contents only with their friends, family, colleagues, etc. Access control mechanisms play an important role in this situation. With access control mechanisms one can decide the persons who can access a shared content and who cannot. But continuously growing content uploads and accesses, fine grained access control requirements (e.g. different access control parameters for different parts in a picture), and specific access control requirements for multimedia contents can make the time complexity of access control to be very large. So, it is important to study an efficient access control mechanism suitable for MMSNs. In this chapter we present an efficient bit-vector transform based access control mechanism for MMSNs. The proposed approach is also compatible with other requirements of MMSNs, such as access rights modification, content deletion, etc. Mathematical analysis and experimental results show the effectiveness and efficiency of our proposed approach.

  14. Accessing diabetes care in rural Uganda: Economic and social resources.

    PubMed

    Nielsen, Jannie; Bahendeka, Silver K; Bygbjerg, Ib C; Meyrowitsch, Dan W; Whyte, Susan R

    2017-07-01

    Non-communicable diseases including type 2 diabetes (T2D) are increasing rapidly in most Sub-Saharan African (SSA) countries like Uganda. Little attention has been given to how patients with T2D try to achieve treatment when the availability of public health care for their disease is limited, as is the case in most SSA countries. In this paper we focus on the landscape of availability of care and the therapeutic journeys of patients within that landscape. Based on fieldwork in south-western Uganda including 10 case studies, we explore the diabetes treatment options in the area and what it takes to access the available treatment. We analyse the resources patients need to use the available treatment options, and demonstrate that the patients' journeys to access and maintain treatment are facilitated by the knowledge and support of their therapy management groups. Patients access treatment more effectively, if they and their family have money, useful social relations, and knowledge, together with the capacity to communicate with health staff. Patients coming from households with high socio-economic status (SES) are more likely to have all of these resources, while for patients with low or medium SES, lack of economic resources increases the importance of connections within the health system.

  15. Retrieval characteristics of the Bard Denali and Argon Option inferior vena cava filters.

    PubMed

    Dowell, Joshua D; Semaan, Dominic; Makary, Mina S; Ryu, John; Khayat, Mamdouh; Pan, Xueliang

    2017-11-01

    The purpose of this study was to compare the retrieval characteristics of the Option Elite (Argon Medical, Plano, Tex) and Denali (Bard, Tempe, Ariz) retrievable inferior vena cava filters (IVCFs), two filters that share a similar conical design. A single-center, retrospective study reviewed all Option and Denali IVCF removals during a 36-month period. Attempted retrievals were classified as advanced if the routine "snare and sheath" technique was initially unsuccessful despite multiple attempts or an alternative endovascular maneuver or access site was used. Patient and filter characteristics were documented. In our study, 63 Option and 45 Denali IVCFs were retrieved, with an average dwell time of 128.73 and 99.3 days, respectively. Significantly higher median fluoroscopy times were experienced in retrieving the Option filter compared with the Denali filter (12.18 vs 6.85 minutes; P = .046). Use of adjunctive techniques was also higher in comparing the Option filter with the Denali filter (19.0% vs 8.7%; P = .079). No significant difference was noted between these groups in regard to gender, age, or history of malignant disease. Option IVCF retrieval procedures required significantly longer retrieval fluoroscopy time compared with Denali IVCFs. Although procedure time was not analyzed in this study, as a surrogate, the increased fluoroscopy time may also have an impact on procedural direct costs and throughput. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  16. 30 CFR 90.3 - Part 90 option; notice of eligibility; exercise of option.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Part 90 option; notice of eligibility; exercise of option. 90.3 Section 90.3 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF... DEVELOPMENT OF PNEUMOCONIOSIS General § 90.3 Part 90 option; notice of eligibility; exercise of option. (a...

  17. Tools for healthy tribes: improving access to healthy foods in Indian country.

    PubMed

    Fleischhacker, Sheila; Byrd, Randi R; Ramachandran, Gowri; Vu, Maihan; Ries, Amy; Bell, Ronny A; Evenson, Kelly R

    2012-09-01

    There is growing recognition that policymakers can promote access to healthy, affordable foods within neighborhoods, schools, childcare centers, and workplaces. Despite the disproportionate risk of obesity and type 2 diabetes among American Indian children and adults, comparatively little attention has been focused on the opportunities tribal policymakers have to implement policies or resolutions to promote access to healthy, affordable foods. This paper presents an approach for integrating formative research into an action-oriented strategy of developing and disseminating tribally led environmental and policy strategies to promote access to and consumption of healthy, affordable foods. This paper explains how the American Indian Healthy Eating Project evolved through five phases and discusses each phase's essential steps involved, outcomes derived, and lessons learned. Using community-based participatory research and informed by the Social Cognitive Theory and ecologic frameworks, the American Indian Healthy Eating Project was started in fall 2008 and has evolved through five phases: (1) starting the conversation; (2) conducting multidisciplinary formative research; (3) strengthening partnerships and tailoring policy options; (4) disseminating community-generated ideas; and (5) accelerating action while fostering sustainability. Collectively, these phases helped develop and disseminate Tools for Healthy Tribes-a toolkit used to raise awareness among participating tribal policymakers of their opportunities to improve access to healthy, affordable foods. Formal and informal strategies can engage tribal leaders in the development of culturally appropriate and tribe-specific sustainable strategies to improve such access, as well as empower tribal leaders to leverage their authority toward raising a healthier generation of American Indian children. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  18. Cafe Variome: general-purpose software for making genotype-phenotype data discoverable in restricted or open access contexts.

    PubMed

    Lancaster, Owen; Beck, Tim; Atlan, David; Swertz, Morris; Thangavelu, Dhiwagaran; Veal, Colin; Dalgleish, Raymond; Brookes, Anthony J

    2015-10-01

    Biomedical data sharing is desirable, but problematic. Data "discovery" approaches-which establish the existence rather than the substance of data-precisely connect data owners with data seekers, and thereby promote data sharing. Cafe Variome (http://www.cafevariome.org) was therefore designed to provide a general-purpose, Web-based, data discovery tool that can be quickly installed by any genotype-phenotype data owner, or network of data owners, to make safe or sensitive content appropriately discoverable. Data fields or content of any type can be accommodated, from simple ID and label fields through to extensive genotype and phenotype details based on ontologies. The system provides a "shop window" in front of data, with main interfaces being a simple search box and a powerful "query-builder" that enable very elaborate queries to be formulated. After a successful search, counts of records are reported grouped by "openAccess" (data may be directly accessed), "linkedAccess" (a source link is provided), and "restrictedAccess" (facilitated data requests and subsequent provision of approved records). An administrator interface provides a wide range of options for system configuration, enabling highly customized single-site or federated networks to be established. Current uses include rare disease data discovery, patient matchmaking, and a Beacon Web service. © 2015 WILEY PERIODICALS, INC.

  19. 76 FR 44633 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... position in SPY options on the same side of the market, for its own account or for the account of a customer, report certain information to the Exchange. This information would include, but would not be...-maker information can be accessed through the Exchange's market surveillance systems. In addition, the...

  20. 30 CFR 90.3 - Part 90 option; notice of eligibility; exercise of option.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Part 90 option; notice of eligibility; exercise... DEVELOPMENT OF PNEUMOCONIOSIS General § 90.3 Part 90 option; notice of eligibility; exercise of option. (a... meter of air. Each of these miners shall be notified in writing of eligibility to exercise the option...

  1. 30 CFR 90.3 - Part 90 option; notice of eligibility; exercise of option.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Part 90 option; notice of eligibility; exercise... DEVELOPMENT OF PNEUMOCONIOSIS General § 90.3 Part 90 option; notice of eligibility; exercise of option. (a... meter of air. Each of these miners shall be notified in writing of eligibility to exercise the option...

  2. 30 CFR 90.3 - Part 90 option; notice of eligibility; exercise of option.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Part 90 option; notice of eligibility; exercise... DEVELOPMENT OF PNEUMOCONIOSIS General § 90.3 Part 90 option; notice of eligibility; exercise of option. (a... meter of air. Each of these miners shall be notified in writing of eligibility to exercise the option...

  3. Some less conventional options for plutonium disposal

    NASA Astrophysics Data System (ADS)

    Stoll, Dr. Wolfgang, Prof.

    2000-07-01

    Disposition of weapons Pu (W-Pu) aims at the replacement of military access restrictions by inherent longlasting technical barriers to make the return into the weapons state difficult and not rewarding anymore. At the time of the NAS-study in 1994, two ways were perceived to be mature and selected: Fissioning of W-Pu as LWR-MOX and the disposal in a vitrified radionuclide-spiked form.1 Both options since have been questioned for equality, met different acceptance at both superpowers and showed slow progress. A criterion to measure disarmament would be the amount of W-Pu in the different proliferation resistant forms, multiplied by the effort needed for each form to return to weapons quality.

  4. Research Issues in Information Access.

    ERIC Educational Resources Information Center

    Molholt, Pat

    1989-01-01

    Discusses traditional library approaches to access to information and the possible impact of information technologies, library automation, and artificial intelligence. Access issues raised by these technologies are identified and a research agenda to explore these issues is outlined. (31 references) (CLB)

  5. Strategy Access Rods: A Hands-On Approach.

    ERIC Educational Resources Information Center

    Worthing, Bernadette; Laster, Barbara

    2002-01-01

    Describes Strategy Access Rods (SARs), balsa-wood, prism-like or rectangular rods on which a one-sentence reading strategy phrase in the first person is printed. Notes SARs serve as a visual, auditory, kinesthetic, and tactile reminder of the strategies available to developing readers. Discusses use of SARs for word recognition and comprehension.…

  6. The World's Approach toward Publishing in Springer and Elsevier's APC-Funded Open Access Journals

    ERIC Educational Resources Information Center

    Sotudeh, Hajar; Ghasempour, Zahra

    2018-01-01

    Purpose: The present study explored tendencies of the world's countries--at individual and scientific development levels--toward publishing in APC-funded open access journals. Design/Methodology/Approach: Using a bibliometric method, it studied OA and NOA articles issued in Springer and Elsevier's APC journals? during 2007-2011. The data were…

  7. Placing the power of real options analysis into the hands of natural resource managers - taking the next step.

    PubMed

    Nelson, Rohan; Howden, Mark; Hayman, Peter

    2013-07-30

    This paper explores heuristic methods with potential to place the analytical power of real options analysis into the hands of natural resource managers. The complexity of real options analysis has led to patchy or ephemeral adoption even by corporate managers familiar with the financial-market origins of valuation methods. Intuitively accessible methods for estimating the value of real options have begun to evolve, but their evaluation has mostly been limited to researcher-driven applications. In this paper we work closely with Bush Heritage Australia to evaluate the potential of real options analysis to support the intuitive judgement of conservation estate managers in covenanting land with uncertain future conservation value due to climate change. The results show that modified decision trees have potential to estimate the option value of covenanting individual properties while time and ongoing research resolves their future conservation value. Complementing this, Luehrman's option space has potential to assist managers with limited budgets to increase the portfolio value of multiple properties with different conservation attributes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Remote Access to Wireless Communications Systems Laboratory--New Technology Approach

    ERIC Educational Resources Information Center

    Kafadarova, Nadezhda; Sotirov, Sotir; Milev, Mihail

    2012-01-01

    Technology nowadays enables the remote access to laboratory equipment and instruments via Internet. This is especially useful in engineering education, where students can conduct laboratory experiment remotely. Such remote laboratory access can enable students to use expensive laboratory equipment, which is not usually available to students. In…

  9. Effective Social Media Engagement Options for Minnesota’s Diversifying Population

    DOT National Transportation Integrated Search

    2018-02-02

    Minnesota Department of Transportation (MnDOT) and Minnesota Local Road Research Board (LRRB) supported the University of Minnesota to investigate social media options for effective public engagement. A three-part approach assessed 1) the state of so...

  10. Upper limb grafts for hemodialysis access.

    PubMed

    Shemesh, David; Goldin, Ilya; Verstandig, Anthony; Berelowitz, Daniel; Zaghal, Ibrahim; Olsha, Oded

    2015-01-01

    Arteriovenous (AV) grafts are required for hemodialysis access when options for native fistulas have been fully exhausted, where they continue to play an important role in hemodialysis patients, offering a better alternative to central vein catheters. When planning autogenous accesses using Doppler ultrasound, adequate arterial inflow and venous outflow must be consciously preserved for future access creation with grafts. Efforts to improve graft patency include changing graft configuration, graft biology and hemodynamics. Industry offers early cannulation grafts to reduce central catheter use and a bioengineered graft is undergoing clinical studies. Although the outcome of AV grafts is inferior to fistulas, grafts can provide long-term hemodialysis access that is a better alternative to central venous catheters. AV grafts have significant drawbacks, mainly poor patency, infection and cost but also have some advantages: early maturation, ease of creation and needling and widespread availability. The outcome of AV graft surgery is variable from center to center. The primary patency rate for AV grafts is 58% at 6 months and the secondary patency rate is 76% at 6 months and 55% at 18 months. There are centers of excellence that report a 1 year secondary patency rate of up to 91%. In this review of the use of AV grafts for hemodialysis access in the upper extremities, technical issues involved in planning the access and performing the surgery in its different configurations are discussed and the role of surveillance and maintenance with their attendant surgical and radiological interventions is described.

  11. 21 CFR 312.305 - Requirements for all expanded access uses.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... options; (iii) The criteria for patient selection or, for an individual patient, a description of the... 21 Food and Drugs 5 2010-04-01 2010-04-01 false Requirements for all expanded access uses. 312.305 Section 312.305 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

  12. Options for the Development of Noninvasive Glucose Monitoring

    PubMed Central

    Thomas, Andreas; Heinemann, Lutz; Ramírez, Araceli; Zehe, Alfred

    2015-01-01

    Nowadays nanotechnology has many applications in products used in various areas of daily life; however, this technology has also an option in modern medicine and pharmacy. Therefore, this technology is also an attractive option for the field of diagnosis and treatment of diabetes. Many people with diabetes measure their blood glucose levels regularly to determine the insulin dose. Ideally glucose values would be measured noninvasively (NI). However, none of all the NI approaches studied in the past decades enabled reliable NI measurements under all daily life conditions. Particularly an unfavorable signal-to-noise ratio turned out to be problematic. Based on the known physical possibilities for NI glucose monitoring the focus of this review is on nanotechnology approaches. Functional prototypes exist for some of these that showed promising results under defined laboratory conditions, indicating a good sensitivity and selectivity for glucose. On the second hand is to optimize the technological process of manufacturing. In view of the rapid progress in micro- and nanoelectronics hopefully NI glucose monitoring systems can be developed in the near future. PMID:26581879

  13. A Tale of Two Cities: A Study of Access to Food, Lessons for Public Health Practice

    ERIC Educational Resources Information Center

    Caraher, Martin; Lloyd, Susan; Lawton, Julie; Singh, Gulab; Horsley, Kayt; Mussa, Fozia

    2010-01-01

    Objectives: To map food access in the city of Preston in the north-west of England in order to determine access, availability and affordability of healthy food options. Design and methodology: The research design employed a number of distinct methods including: surveys of shops; interviews with local people and shopkeepers; a cost and availability…

  14. Artificial neural network model of the hybrid EGARCH volatility of the Taiwan stock index option prices

    NASA Astrophysics Data System (ADS)

    Tseng, Chih-Hsiung; Cheng, Sheng-Tzong; Wang, Yi-Hsien; Peng, Jin-Tang

    2008-05-01

    This investigation integrates a novel hybrid asymmetric volatility approach into an Artificial Neural Networks option-pricing model to upgrade the forecasting ability of the price of derivative securities. The use of the new hybrid asymmetric volatility method can simultaneously decrease the stochastic and nonlinearity of the error term sequence, and capture the asymmetric volatility. Therefore, analytical results of the ANNS option-pricing model reveal that Grey-EGARCH volatility provides greater predictability than other volatility approaches.

  15. Surgical options for lumbosacral fusion: biomechanical stability, advantage, disadvantage and affecting factors in selecting options.

    PubMed

    Yoshihara, Hiroyuki

    2014-07-01

    Numerous surgical procedures and instrumentation techniques for lumbosacral fusion (LSF) have been developed. This is probably because of its high mechanical demand and unique anatomy. Surgical options include anterior column support (ACS) and posterior stabilization procedures. Biomechanical studies have been performed to verify the stability of those options. The options have their own advantage but also disadvantage aspects. This review article reports the surgical options for lumbosacral fusion, their biomechanical stability, advantages/disadvantages, and affecting factors in option selection. Review of literature. LSF has lots of options both for ACS and posterior stabilization procedures. Combination of posterior stabilization procedures is an option. Furthermore, combinations of ACS and posterior stabilization procedures are other options. It is difficult to make a recommendation or treatment algorithm of LSF from the current literature. However, it is important to know all aspects of the options and decision-making of surgical options for LSF needs to be tailored for each patient, considering factors such as biomechanical stress and osteoporosis.

  16. Patients' views on the use of an Option Grid for knee osteoarthritis in physiotherapy clinical encounters: An interview study.

    PubMed

    Kinsey, Katharine; Firth, Jill; Elwyn, Glyn; Edwards, Adrian; Brain, Katherine; Marrin, Katy; Nye, Alan; Wood, Fiona

    2017-12-01

    Patient decision support tools have been developed as a means of providing accurate and accessible information in order for patients to make informed decisions about their care. Option Grids ™ are a type of decision support tool specifically designed to be used during clinical encounters. To explore patients' views of the Option Grid encounter tool used in clinical consultations with physiotherapists, in comparison with usual care, within a patient population who are likely to be disadvantaged by age and low health literacy. Semi-structured interviews with 72 patients (36 who had been given an Option Grid in their consultation and 36 who had not). Thematic analysis explored patients' understanding of treatment options, perceptions of involvement, and readability and utility of the Option Grid. Interviews suggested that the Option Grid facilitated more detailed discussion about the risks and benefits of a wider range of treatment options for osteoarthritis of the knee. Participants indicated that the Option Grid was clear and aided their understanding of a structured progression of the options as their condition advanced, although it was not clear whether the Option Grid facilitated greater engagement in shared decision making. The Option Grid for osteoarthritis of the knee was well received by patient participants who reported that it helped them to understand their options, and made the notion of choice explicit. Use of Option Grids should be considered within routine consultations. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  17. Life cycle assessment of automobile/fuel options.

    PubMed

    MacLean, Heather L; Lave, Lester B

    2003-12-01

    We examine the possibilities for a "greener" car that would use less material and fuel, be less polluting, and would have a well-managed end-of-life. Light-duty vehicles are fundamental to our economy and will continue to be for the indefinite future. Any redesign to make these vehicles greener requires consumer acceptance. Consumer desires for large, powerful vehicles have been the major stumbling block in achieving a "green car". The other major barrier is inherent contradictions among social goals such as fuel economy, safety, low emissions of pollutants, and low emissions of greenhouse gases, which has led to conflicting regulations such as emissions regulations blocking sales of direct injection diesels in California, which would save fuel. In evaluating fuel/vehicle options with the potential to improve the greenness of cars [diesel (direct injection) and ethanol in internal combustion engines, battery-powered, gasoline hybrid electric, and hydrogen fuel cells], we find no option dominates the others on all dimensions. The principles of green design developed by Anastas and Zimmerman (Environ. Sci. Technol. 2003, 37, 94A-101A) and the use of a life cycle approach provide insights on the key sustainability issues associated with the various options.

  18. Leveraging community-academic partnerships to improve healthy food access in an urban, Kansas City, Kansas, community.

    PubMed

    Mabachi, Natabhona M; Kimminau, Kim S

    2012-01-01

    Americans can combat overweight (OW) and obesity by eating unprocessed, fresh foods. However, all Americans do not have equal access to these recommended foods. Low-income, minority, urban neighborhoods in particular often have limited access to healthy resources, although they are vulnerable to higher levels of OW and obesity. This project used community-based participatory research (CBPR) principles to investigate the food needs of residents and develop a business plan to improve access to healthy food options in an urban, Kansas City, Kansas, neighborhood. Partner community organizations were mobilized to conduct a Community Food Assessment survey. The surveys were accompanied by flyers that were part of the communication engagement strategy. Statistical analysis of the surveys was conducted. We engaged low-income, minority population (40% Latino, 30% African American) urban communities at the household level. Survey results provided in-depth information about residents' food needs and thoughts on how to improve food access. Results were reported to community members at a town hall style meeting. Developing a strategic plan to engage a community and develop trust is crucial to sustaining a partnership particularly when working with underserved communities. This project demonstrates that, if well managed, the benefits of academic and community partnerships outweigh the challenges thus such relationships should be encouraged and supported by communities, academic institutions, local and national government, and funders. A CBPR approach to understanding an urban community's food needs and opinions is important for comprehensive food access planning.

  19. 78 FR 25500 - Options Price Reporting Authority; Notice of Filing and Immediate Effectiveness of Proposed...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-01

    ... chain. \\4\\ The term ``quote packet'' is defined in footnote 6 to OPRA's Fee Schedule as consisting of..., bid/ask and related market data. The term ``options chain'' is also defined in footnote 6 to OPRA's... essence, an OPRA Subscriber may obtain access to OPRA data in one of two ways: Either by signing a...

  20. Operative Fixation Options for Elective and Diabetic Ankle Arthrodesis.

    PubMed

    Ramanujam, Crystal L; Stapleton, John J; Zgonis, Thomas

    2017-07-01

    Ankle arthrodesis remains one of the most definitive treatment options for end-stage arthritis, paralysis, posttraumatic and postinfectious conditions, failed total ankle arthroplasty, and severe deformities. The general aims of ankle arthrodesis are to decrease pain and instability, correct the accompanying deformity, and create a stable plantigrade foot. Several surgical approaches have been reported for ankle arthrodesis with internal fixation options. External fixation has also evolved for ankle arthrodesis in certain clinical scenarios. This article provides a comprehensive analysis of midterm to long-term outcomes for ankle arthrodesis using internal and/or external fixation each for elective and diabetic conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Personal Access Satellite System (PASS) study. Fiscal year 1989 results

    NASA Technical Reports Server (NTRS)

    Sue, Miles K. (Editor)

    1990-01-01

    The Jet Propulsion Laboratory is exploring the potential and feasibility of a personal access satellite system (PASS) that will offer the user greater freedom and mobility than existing or currently planned communications systems. Studies performed in prior years resulted in a strawman design and the identification of technologies that are critical to the successful implementation of PASS. The study efforts in FY-89 were directed towards alternative design options with the objective of either improving the system performance or alleviating the constraints on the user terminal. The various design options and system issues studied this year and the results of the study are presented.

  2. Options for Educating Students Attending Department of Defense Schools in the United States

    DTIC Science & Technology

    2016-01-01

    Middlemiss, Martha Brown, Stephen F. Hovanic, Joel Hansen, Frank O’Gara, Elaine Kanellis, Robert M. Brady, Claudia Shaw , Jessica Ray Huffman, Rita...could receive students. Chapter Three explains our methods and data sources for assessing options, including the business case analysis approach...account for these analyses. We also identify implementation issues and barriers for each option, based on work of previous studies with updates to

  3. What an option is worth for an exploration opportunity

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

    MacKay, J.A.; Lerche, I.

    1995-12-25

    The reason that a corporation might want to take an option on an opportunity is to wait until more information becomes available before committing to the decision to drill. For instance, in a situation where an opportunity is one of the first prospects in a new play trend, there is often very little known (as opposed to surmised) about the potential gain, and the chances of success are also often poorly determined. Thus, until the estimates of costs, gains, and success chances are firmed up in the future by drilling information from other operators, the corporation would prefer to holdmore » off on the decision to drill a particular prospect. Recently Dixit and Pindyck have persuasively argued qualitatively that an options approach should be taken to capital investment in any business field because, opportunities are options--rights but not obligations to take some action in the future and, as soon as you begin thinking of investment opportunities as options, the premise (that investment decisions can be reversed if conditions change or, if they cannot be reversed, that they are now-or-never propositions) changes. Irreversibility, uncertainty, and the choice of timing alter the investment decision in critical ways. From an oil industry perspective Dixit and Pindyck eloquently provide the rationale for considering an option position rather than dealing only with net present value considerations. The ability to calculate the worth of an option to a hydrocarbon exploration opportunity is what this article is about.« less

  4. Future research directions to improve fistula maturation and reduce access failure

    PubMed Central

    Hu, Haidi; Patel, Sandeep; Hanisch, Jesse J.; Santana, Jeans M.; Hashimoto, Takuya; Bai, Hualong; Kudze, Tambudzai; Foster, Trenton R.; Guo, Jianming; Yatsula, Bogdan; Tsui, Janice; Dardik, Alan

    2016-01-01

    With the increasing prevalence of end stage renal disease there is a growing need for hemodialysis. Arteriovenous fistulae (AVF) are the preferred type of vascular access for hemodialysis but maturation and failure continue to present significant barriers to successful fistula use. AVF maturation integrates outward remodeling with vessel wall thickening in response to drastic hemodynamic changes, in the setting of uremia, systemic inflammation, oxidative stress and preexistent vascular pathology. AVF can fail due to both failure to mature adequately to support hemodialysis, as well as development of neointimal hyperplasia (NIH) that narrows the AVF lumen, typically near the fistula anastomosis. Failure due to NIH involves vascular cell activation and migration and extracellular matrix remodeling with complex interactions of growth factors, adhesion molecules, inflammatory mediators, and chemokines, all of which result in maladaptive remodeling. Different strategies have been proposed to prevent and treat AVF failure, based on current understanding of the modes and pathology of access failure; these approaches range from appropriate patient selection and use of alternative surgical strategies for fistula creation, to the use of novel interventional techniques or drugs to treat failing fistulae. Effective treatments to prevent or treat AVF failure requires a multidisciplinary approach involving nephrologists, vascular surgeons and interventional radiologists, allowing careful patient selection and the use of tailored systemic or localized interventions to improve patient-specific outcomes. This review provides contemporary information on the underlying mechanisms of AVF maturation and failure and discusses the broad spectrum of options that can be tailored for specific therapy. PMID:28779782

  5. Future research directions to improve fistula maturation and reduce access failure.

    PubMed

    Hu, Haidi; Patel, Sandeep; Hanisch, Jesse J; Santana, Jeans M; Hashimoto, Takuya; Bai, Hualong; Kudze, Tambudzai; Foster, Trenton R; Guo, Jianming; Yatsula, Bogdan; Tsui, Janice; Dardik, Alan

    2016-12-01

    With the increasing prevalence of end-stage renal disease, there is a growing need for hemodialysis. Arteriovenous fistulae (AVF) are the preferred type of vascular access for hemodialysis, but maturation and failure continue to present significant barriers to successful fistula use. AVF maturation integrates outward remodeling with vessel wall thickening in response to drastic hemodynamic changes in the setting of uremia, systemic inflammation, oxidative stress, and pre-existent vascular pathology. AVF can fail due to both failure to mature adequately to support hemodialysis and development of neointimal hyperplasia that narrows the AVF lumen, typically near the fistula anastomosis. Failure due to neointimal hyperplasia involves vascular cell activation and migration and extracellular matrix remodeling with complex interactions of growth factors, adhesion molecules, inflammatory mediators, and chemokines, all of which result in maladaptive remodeling. Different strategies have been proposed to prevent and treat AVF failure based on current understanding of the modes and pathology of access failure; these approaches range from appropriate patient selection and use of alternative surgical strategies for fistula creation, to the use of novel interventional techniques or drugs to treat failing fistulae. Effective treatments to prevent or treat AVF failure require a multidisciplinary approach involving nephrologists, vascular surgeons, and interventional radiologists, careful patient selection, and the use of tailored systemic or localized interventions to improve patient-specific outcomes. This review provides contemporary information on the underlying mechanisms of AVF maturation and failure and discusses the broad spectrum of options that can be tailored for specific therapy. Published by Elsevier Inc.

  6. Radial access for cerebrovascular procedures: Case report and technical note.

    PubMed

    Satti, Sudhakar R; Vance, Ansar Z; Sivapatham, Thinesh

    2016-04-01

    Advantages of radial access over brachial/axillary or femoral access have been well described for several decades and include decreased cost, patient preference, and decreased major access site complications. Despite these advantages, radial access is rarely employed or even considered for neurointerventional procedures. This attitude should be reconsidered given several recent large, randomized, controlled trials from the cardiovascular literature proving that radial access is associated with statistically lower costs, decreased incidence of myocardial infarctions, strokes, and even decreased mortality. Radial access is now considered the standard of care for percutaneous coronary interventions in most US centers. Although radial access has been described for neurovascular procedures in the past, overall experience is limited. The two major challenges are the unique anatomy required to access the cerebral vasculature given very acute angles between the arm and craniocervical vessels and limitations in available technology. We present a simplified approach to radial access for cerebrovascular procedures and provide a concise step-by-step approach for patient selection, ultrasound-guided single-wall access, recommended catheters/wires, and review of patent hemostasis. Additionally, we present a complex cerebrovascular intervention in which standard femoral access was unsuccessful, while radial access was quickly achieved to highlight the importance of familiarity with the radial approach for all neurointerventionalists. We have found that the learning curve is not too steep and that the radial access approach can be adopted smoothly for a large percentage of diagnostic and interventional neuroradiologic procedures. Radial access should be considered in all patients undergoing a cerebrovascular procedure. © The Author(s) 2015.

  7. An approach to access control in electronic health record.

    PubMed

    Sucurovic, Snezana

    2010-08-01

    OASIS is a non-for-profit consortium that drives the development convergence and adoption of open standards for the global information society. It involves more than 600 organizations and individuals as well as IT leaders Sun, Microsoft, IBM and Oracle. One of its standards is XACML which appeared a few years ago and now there are about 150,000 hits on Google. XACML (eXtensible Access Control Markup Language) is not technology related. Sun published in 2004 open source Sun XACML which is in compliance with XACML 1.0. specification and now works to make it comply with XACML 2.0. The heart of XACML are attributes values of defined type and name that is to be attached to a subject, a resource, an action and an environment in which a subject request action on resource. In that way XACML is to replace Role Based Access Control which dominated for years. The paper examines performances in CEN 13 606 and ISO 22 600 based healthcare system which uses XACML for access control.

  8. Hemorrhoidectomy - making sense of the surgical options

    PubMed Central

    Yeo, Danson; Tan, Kok-Yang

    2014-01-01

    While debate continues as to which is the best surgical method for the treatment of hemorrhoids, none of the currently available surgical methods approach the ideal surgical option, which is one that is effective while being safe and painless. In reality, the less painful the procedure, the more likely it is to be associated with recurrence post-op. Where hemorrhoids surgery is concerned, there isn’t a “one size fits all” option. Most of the randomized controlled trials performed to date include hemorrhoids of various grades and with a focus on only comparing surgical methods while failing to stratify the outcomes according to the grade of hemorrhoid. We believe that surgery needs to be tailored not only to the grade of the hemorrhoids, but also to the size, circumferential nature of the disease, and prevailing symptomatology. PMID:25493010

  9. Hemorrhoidectomy - making sense of the surgical options.

    PubMed

    Yeo, Danson; Tan, Kok-Yang

    2014-12-07

    While debate continues as to which is the best surgical method for the treatment of hemorrhoids, none of the currently available surgical methods approach the ideal surgical option, which is one that is effective while being safe and painless. In reality, the less painful the procedure, the more likely it is to be associated with recurrence post-op. Where hemorrhoids surgery is concerned, there isn't a "one size fits all" option. Most of the randomized controlled trials performed to date include hemorrhoids of various grades and with a focus on only comparing surgical methods while failing to stratify the outcomes according to the grade of hemorrhoid. We believe that surgery needs to be tailored not only to the grade of the hemorrhoids, but also to the size, circumferential nature of the disease, and prevailing symptomatology.

  10. Percutaneous endoscopic lumbar discectomy via contralateral approach: a technical case report.

    PubMed

    Kim, Jin-Sung; Choi, Gun; Lee, Sang-Ho

    2011-08-01

    Technical case report. The authors report a new percutaneous endoscopic lumbar discectomy (PELD) technique for the treatment of lumbar disc herniation via a contralateral approach. When there are highly down-migrated lumbar disc herniation along just medial to pedicle and narrow ipsilateral intervertebral foramen, the conventional PELD is not easily accessible via ipsilateral transforaminal route. Five patients manifested gluteal and leg pain because of a soft disc herniation at the L4-L5 level. Transforaminal PELD via a contralateral approach was performed to remove the herniated fragment, achieving complete decompression of the nerve root. The symptom was relieved and the patient was discharged the next day. When a conventional transforaminal PELD is difficult because of some anatomical reasons, PELD via a contralateral route could be a good alternative option in selected cases.

  11. Predictors of round window accessibility for adult cochlear implantation based on pre-operative CT scan: a prospective observational study.

    PubMed

    Park, Edward; Amoodi, Hosam; Kuthubutheen, Jafri; Chen, Joseph M; Nedzelski, Julian M; Lin, Vincent Y W

    2015-05-28

    Cochlear implantation has become a mainstream treatment option for patients with severe to profound sensorineural hearing loss. During cochlear implant, there are key surgical steps which are influenced by anatomical variations between each patient. The aim of this study is to determine if there are potential predictors of difficulties that may be encountered during the cortical mastoidectomy, facial recess approach and round window access in cochlear implant surgery based upon pre-operative temporal bone CT scan. Fifty seven patients undergoing unilateral cochlear implantation were analyzed. Difficulty with 1) cortical mastoidectomy, 2) facial recess approach, and 3) round window access were scored intra-operatively by the surgeon in a blinded fashion (1 = "easy", 2 = "moderate", 3 = "difficult"). Pre-operative temporal bone CT scans were analyzed for 1) degree of mastoid aeration; 2) location of the sigmoid sinus; 3) height of the tegmen; 4) the presence of air cells in the facial recess, and 5) degree of round window bony overhang. Poor mastoid aeration and lower tegmen position, but not the location of sigmoid sinus, are associated with greater difficulty with the cortical mastoidectomy. Presence of an air cell around the facial nerve was predictive of easier facial recess access. However, the degree of round window bony overhang was not predictive of difficulty associated with round window access. Certain parameters on the pre-operative temporal bone CT scan may be useful in predicting potential difficulties encountered during the key steps involved in cochlear implant surgery.

  12. Zap 'Em with Assistive Technology: Notetaking, Modified Materials, Assistive Writing Tools, References, Organizational Tools, Cognitive Assistance, Adapted Access.

    ERIC Educational Resources Information Center

    Lahm, Elizabeth A.; Morrissette, Sandra K.

    This collection of materials describes different types of computer applications and software that can help students with disabilities. It contains information on: (1) Easy Access, a feature of the systems software on every Macintosh computer that allows use of the keypad instead of the mouse, options for slow keys, and options for sticky keys; (2)…

  13. Usage of Accessibility Options for the iPhone and iPad in a Visually Impaired Population.

    PubMed

    Robinson, Joshua L; Braimah Avery, Vanessa; Chun, Rob; Pusateri, Gregg; Jay, Walter M

    2017-01-01

    The iPad and iPhone have a number of low-vision accessibility features including Siri Voice Assistant, Large Text, Zoom Magnification, Invert Colors, Voice Over, and Speech Selection. We studied their usage within a low-vision population. Patients were recruited to participate in an IRB-approved survey regarding their usage of the iPad and/or iPhone. Participants met one of the following criteria: best corrected visual acuity (BCVA) of 20/60 or worse, or significant peripheral visual field defects. Thirty-three low-vision patients agreed to participate (mean age 54.3 years). There were 18 different diagnoses represented and the average visual acuity of respondents was 20/119 in the right eye and 20/133 in the left eye. The most commonly used vision accessibility features were Zoom Magnification and Large Text. Although many patients are using the low-vision accessibility features, few are receiving training or recommendations from their eye care specialist.

  14. Convergence analysis of a monotonic penalty method for American option pricing

    NASA Astrophysics Data System (ADS)

    Zhang, Kai; Yang, Xiaoqi; Teo, Kok Lay

    2008-12-01

    This paper is devoted to study the convergence analysis of a monotonic penalty method for pricing American options. A monotonic penalty method is first proposed to solve the complementarity problem arising from the valuation of American options, which produces a nonlinear degenerated parabolic PDE with Black-Scholes operator. Based on the variational theory, the solvability and convergence properties of this penalty approach are established in a proper infinite dimensional space. Moreover, the convergence rate of the combination of two power penalty functions is obtained.

  15. Charter Schools: Limited Access to Facility Financing. Report to Congressional Requesters.

    ERIC Educational Resources Information Center

    Shaul, Marnie S.

    This report determines the degree to which charter schools have access to traditional public school facility financing, and whether alternative sources of facility financing are available to charter schools. Further discussed are potential options generally available to the federal government if it were to assume a larger role in charter school…

  16. Transfemoral access when superior venous approach is not feasible equals overall success of permanent pacemaker implantation. Ten-year series.

    PubMed

    García Guerrero, Juan J; Fernández de la Concha Castañeda, Joaquín; Doblado Calatrava, Manuel; Redondo Méndez, Ángel; Lázaro Medrano, Manuel; Merchán Herrera, Antonio

    2017-06-01

    When permanent pacemaker implantation is not possible or advisable via superior venous access (i.e., axillary or subclavian veins), safe and feasible surgical alternatives are required. The femoral approach is relatively unknown and seldom studied. This single-center study analyzed 10-year outcomes of a femoral implantation approach. Data about the implantation procedure (indication, approach, lead and pacemaker models, complications), patient characteristics (age, sex, medications, comorbidities), and follow-up were analyzed for all permanent pacemaker implantations using the femoral approach between June 2001 and June 2011. A permanent pacemaker was implanted with the femoral approach in 50 patients (mean age, 76 years [range: 45-96], 31 [61%] men). The most frequent indication was atrioventricular block, associated with sinus rhythm in 30 patients and with atrial fibrillation in eight patients. Overall, 20 patients (40%) were treated with oral anticoagulants postimplantation. Mean implantation time was 64 minutes (range: 20-210) and mean fluoroscopy time was 6.7 minutes (range: 0.2-50). Minimum follow-up window was 1 year (June 2012), with a mean of 50 months [range: 1-113]). No deaths, septic episodes, or severe complications were associated with the procedure, acute or long-term. Follow-up data were available for 46 patients, of who 21 (46%) died during follow-up (mean age, 87 years [range: 73-101]). No cause of death was associated with the femoral technique. Permanent pacemaker implantation through femoral access is not difficult for an experienced implant surgeon. Outcomes were comparable to systems implanted by superior venous approach, and no severe complications were observed at 10-year follow-up. © 2017 Wiley Periodicals, Inc.

  17. Confidence limits for data mining models of options prices

    NASA Astrophysics Data System (ADS)

    Healy, J. V.; Dixon, M.; Read, B. J.; Cai, F. F.

    2004-12-01

    Non-parametric methods such as artificial neural nets can successfully model prices of financial options, out-performing the Black-Scholes analytic model (Eur. Phys. J. B 27 (2002) 219). However, the accuracy of such approaches is usually expressed only by a global fitting/error measure. This paper describes a robust method for determining prediction intervals for models derived by non-linear regression. We have demonstrated it by application to a standard synthetic example (29th Annual Conference of the IEEE Industrial Electronics Society, Special Session on Intelligent Systems, pp. 1926-1931). The method is used here to obtain prediction intervals for option prices using market data for LIFFE “ESX” FTSE 100 index options ( http://www.liffe.com/liffedata/contracts/month_onmonth.xls). We avoid special neural net architectures and use standard regression procedures to determine local error bars. The method is appropriate for target data with non constant variance (or volatility).

  18. Development of a fusion approach selection tool

    NASA Astrophysics Data System (ADS)

    Pohl, C.; Zeng, Y.

    2015-06-01

    During the last decades number and quality of available remote sensing satellite sensors for Earth observation has grown significantly. The amount of available multi-sensor images along with their increased spatial and spectral resolution provides new challenges to Earth scientists. With a Fusion Approach Selection Tool (FAST) the remote sensing community would obtain access to an optimized and improved image processing technology. Remote sensing image fusion is a mean to produce images containing information that is not inherent in the single image alone. In the meantime the user has access to sophisticated commercialized image fusion techniques plus the option to tune the parameters of each individual technique to match the anticipated application. This leaves the operator with an uncountable number of options to combine remote sensing images, not talking about the selection of the appropriate images, resolution and bands. Image fusion can be a machine and time-consuming endeavour. In addition it requires knowledge about remote sensing, image fusion, digital image processing and the application. FAST shall provide the user with a quick overview of processing flows to choose from to reach the target. FAST will ask for available images, application parameters and desired information to process this input to come out with a workflow to quickly obtain the best results. It will optimize data and image fusion techniques. It provides an overview on the possible results from which the user can choose the best. FAST will enable even inexperienced users to use advanced processing methods to maximize the benefit of multi-sensor image exploitation.

  19. Option price and market instability

    NASA Astrophysics Data System (ADS)

    Baaquie, Belal E.; Yu, Miao

    2017-04-01

    An option pricing formula, for which the price of an option depends on both the value of the underlying security as well as the velocity of the security, has been proposed in Baaquie and Yang (2014). The FX (foreign exchange) options price was empirically studied in Baaquie et al., (2014), and it was found that the model in general provides an excellent fit for all strike prices with a fixed model parameters-unlike the Black-Scholes option price Hull and White (1987) that requires the empirically determined implied volatility surface to fit the option data. The option price proposed in Baaquie and Cao Yang (2014) did not fit the data during the crisis of 2007-2008. We make a hypothesis that the failure of the option price to fit data is an indication of the market's large deviation from its near equilibrium behavior due to the market's instability. Furthermore, our indicator of market's instability is shown to be more accurate than the option's observed volatility. The market prices of the FX option for various currencies are studied in the light of our hypothesis.

  20. A discontinuous Galerkin method for numerical pricing of European options under Heston stochastic volatility

    NASA Astrophysics Data System (ADS)

    Hozman, J.; Tichý, T.

    2016-12-01

    The paper is based on the results from our recent research on multidimensional option pricing problems. We focus on European option valuation when the price movement of the underlying asset is driven by a stochastic volatility following a square root process proposed by Heston. The stochastic approach incorporates a new additional spatial variable into this model and makes it very robust, i.e. it provides a framework to price a variety of options that is closer to reality. The main topic is to present the numerical scheme arising from the concept of discontinuous Galerkin methods and applicable to the Heston option pricing model. The numerical results are presented on artificial benchmarks as well as on reference market data.

  1. Comparing the ability of OPTION(12) and OPTION(5) to assess shared decision-making in genetic counselling.

    PubMed

    Vortel, Martina A; Adam, Shelin; Port-Thompson, Ashley V; Friedman, Jan M; Grande, Stuart W; Birch, Patricia H

    2016-10-01

    OPTION(12) is the most widely used tool to measure shared decision-making (SDM) in health care. A newer scale, OPTION(5), has been proposed as a more parsimonious measure that better addresses core concepts of SDM. This study compares OPTION(5) to OPTION(12) in prenatal genetic counselling. Two raters independently used OPTION(12) and OPTION(5) to score 27 clinical encounters between genetic counsellors (GC) and women with pregnancies at increased risk for genetic conditions. Global and item scores on the two instruments were compared to test concurrent validity and to identify usability in this context. Inter-rater reliability was also assessed for both instruments. Mean scores for OPTION(12) were 43.8 (SD=9.7), and for OPTION(5) were=60.6 (SD=12.5). The correlation between OPTION(12) and OPTION(5) scores was r=0.70. Inter-rater reliability was 0.70 and 0.85 for OPTION(12) and OPTION(5) respectively, however mean inter-rater reliability for individual items was 0.31 and 0.63 for OPTION(12) and OPTION(5) respectively. GCs exhibit SDM as measured by both OPTION instruments. OPTION(5) exhibits improved psychometric performance relative to OPTION(12), and more specifically targets the core constructs of SDM. However, refinement of OPTION instruments or manuals is needed to improve reliability and validity in GC assessment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Pilot Study of a Parent Guided Website Access Package for Early Intervention Decision-Making for Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Carlon, Sarah; Carter, Mark; Stephenson, Jennifer

    2017-01-01

    A pilot study of the effectiveness of guided access to websites that provide information on intervention options for children with autism spectrum disorder (ASD) was conducted with 12 parents of preschool aged children with ASD. Guided access to reliable websites that included information about the effcacy of interventions for ASD (Raising…

  3. Implementation of power barrier option valuation

    NASA Astrophysics Data System (ADS)

    Cahyani, Agatha C. P.; Sumarti, Novriana

    2015-09-01

    Options are financial instruments that can be utilized to reduce risk in stock investment. Barrier options are one of the major types of options actively used in financial markets where its life period depends on the path of the underlying stock prices. The features of the barrier option can be used to modify other types of options. In this research, the barrier option will be implemented into power option, so it is called power barrier option. This option is an extension of the vanilla barrier options where the Call payoff being considered is defined as P C =max (STβ-Kβ,0 ) , and the Put payoff being considered is defined as P P =max (Kβ-STβ,0 ) . Here β > 0 and β ≠ 1, K is the strike price of the option, and ST is the price of the underlying stock at time maturity T. In this paper, we generate the prices of stock using binomial method which is adjusted to the power option. In the conclusion, the price of American power barrier option is more expensive than the price of European power barrier option.

  4. Integrated treatment options for male perpetrators of intimate partner violence.

    PubMed

    Crane, Cory A; Easton, Caroline J

    2017-01-01

    Male-to-female intimate partner violence remains a worldwide public health issue with adverse physical and psychological consequences for victims, perpetrators and children. Personality disorders, addiction, trauma and mood symptoms are established risk factors for intimate partner violence perpetration and factor prominently into a recovery-oriented treatment approach. We reviewed the partner violence literature for detailed reports of traditional as well as innovative, integrated treatment approaches. Empirically based recommendations for intervention programs and the policies that guide intervention efforts are offered. Nascent research suggests that integrated treatment models utilising a holistic approach to account for psychological comorbidity and interventions that involve a motivational interviewing component appear promising in terms of significantly improving intimate partner violence treatment compliance and reducing subsequent acts of physical partner violence. Further, methodologically rigorous research is required to fully assess the benefits of traditional and integrated treatment options. We have advanced several recommendations, including the development of and exclusive reliance upon empirically supported treatments, conducting a thorough risk and needs assessment of the offender and the immediate family to facilitate appropriate treatment referrals, integrating content to foster the offender's internal motivation to change maladaptive behaviours, and attempting to minimise offender treatment burdens through the strategic use of integrated treatment models. Intimate partner violence is a complicated and nuanced problem that is perpetrated by a heterogeneous population and requires greater variability in integrated treatment options. [Crane CA, Easton CJ. Integrated treatment options for male perpetrators of intimate partner violence. Drug Alcohol Rev 2017;36:24-33]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  5. Accessible Earth: Enhancing diversity in the Geosciences through accessible course design and Experiential Learning Theory

    NASA Astrophysics Data System (ADS)

    Bennett, Rick; Lamb, Diedre

    2017-04-01

    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 able bodied, we have created the capstone Accessible Earth Study Abroad Program, an alternative to geologic field camp with a focus on modern geophysical observation systems, computational thinking, and data science. In this presentation, we will report on the theoretical bases for developing the course, our experiences in teaching the course to date, and our plan for ongoing assessment, refinement, and dissemination of the effectiveness of our efforts.

  6. Selected Energy Conservation Options for Homeowners: Options, Expenses and Payoffs.

    ERIC Educational Resources Information Center

    Lengyel, Dorothy L.; And Others

    This publication is a check list for homeowners and renters to help them reduce energy costs. The list consists of 126 energy conservation options. These options range from "change clothes instead of adjusting thermostat" and "air conditioners turned off when not home" to "use sink stopper" and "weatherstripping…

  7. A participatory study of teenagers and young adults views on access and participation in cancer research.

    PubMed

    Taylor, Rachel M; Solanki, Anita; Aslam, Natasha; Whelan, Jeremy S; Fern, Lorna A

    2016-02-01

    The purpose of this study was to elicit young people's views on access and participation in cancer research. Eight young people aged 18-25 years with a previous cancer diagnosis aged 15-24 participated in a one day workshop utilising participatory methodology. The workshop consisted of four exercises: role play/scene setting; focus group examining thoughts and opinions of research access and participation; individual reflection on access to different types of research; and creative interpretation of the workshop. Further consultation with 222 young people with cancer was conducted using an electronic survey. Three themes emerged: • Patient choice: Young people thought it was their right to know all options about available research. Without knowledge of all available studies they would be unable to make an informed choice about participation. • Role of healthcare professionals as facilitators/barriers: Young people suggested non-clinical healthcare professionals such as social workers and youth support coordinators may be more suited to approaching young people about participation in psychosocial and health services research. • Value of the research: The what, when and how information was delivered was key in relaying the value of the study and assisting young people in their decision to participate. Further consultation showed approximately 70% wanted to find out about all available research. However, one third trusted healthcare professionals to decide which research studies to inform them of. Effective ways to support healthcare professionals approaching vulnerable populations about research are needed to ensure young people are empowered to make informed choices about research participation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Economic analysis of emerald ash borer (Coleoptera: Buprestidae) management options.

    PubMed

    Vannatta, A R; Hauer, R H; Schuettpelz, N M

    2012-02-01

    Emerald ash borer, Agrilus planipennis (Fairmaire) (Coleoptera: Buprestidae), plays a significant role in the health and extent of management of native North American ash species in urban forests. An economic analysis of management options was performed to aid decision makers in preparing for likely future infestations. Separate ash tree population valuations were derived from the i-Tree Streets program and the Council of Tree and Landscape Appraisers (CTLA) methodology. A relative economic analysis was used to compare a control option (do-nothing approach, only removing ash trees as they die) to three distinct management options: 1) preemptive removal of all ash trees over a 5 yr period, 2) preemptive removal of all ash trees and replacement with comparable nonash trees, or 3) treating the entire population of ash trees with insecticides to minimize mortality. For each valuation and management option, an annual analysis was performed for both the remaining ash tree population and those lost to emerald ash borer. Retention of ash trees using insecticide treatments typically retained greater urban forest value, followed by doing nothing (control), which was better than preemptive removal and replacement. Preemptive removal without tree replacement, which was the least expensive management option, also provided the lowest net urban forest value over the 20-yr simulation. A "no emerald ash borer" scenario was modeled to further serve as a benchmark for each management option and provide a level of economic justification for regulatory programs aimed at slowing the movement of emerald ash borer.

  9. A broadly applicable NHC-Cu-catalyzed approach for efficient, site-, and enantioselective coupling of readily accessible (pinacolato)alkenylboron compounds to allylic phosphates and applications to natural product synthesis.

    PubMed

    Gao, Fang; Carr, James L; Hoveyda, Amir H

    2014-02-05

    A set of protocols for catalytic enantioselective allylic substitution (EAS) reactions that allow for additions of alkenyl units to readily accessible allylic electrophiles is disclosed. Transformations afford 1,4-dienes that contain a tertiary carbon stereogenic site and are promoted by 1.0-5.0 mol % of a copper complex of an N-heterocyclic carbene (NHC). Aryl- as well as alkyl-substituted electrophiles bearing a di- or trisubstituted alkene may be employed. Reactions can involve a variety of robust alkenyl-(pinacolatoboron) [alkenyl-B(pin)] compounds that can be either purchased or prepared by various efficient, site-, and/or stereoselective catalytic reactions, such as cross-metathesis or proto-boryl additions to terminal alkynes. Vinyl-, E-, or Z-disubstituted alkenyl-, 1,1-disubstituted alkenyl-, acyclic, or heterocyclic trisubstituted alkenyl groups may be added in up to >98% yield, >98:2 SN2':SN2, and 99:1 enantiomeric ratio (er). NHC-Cu-catalyzed EAS with alkenyl-B(pin) reagents containing a conjugated carboxylic ester or aldehyde group proceed to provide the desired 1,4-diene products in good yield and with high enantioselectivity despite the presence of a sensitive stereogenic tertiary carbon center that could be considered prone to epimerization. In most instances, the alternative approach of utilizing an alkenylmetal reagent (e.g., an Al-based species) represents an incompatible option. The utility of the approach is illustrated through applications to enantioselective synthesis of natural products such as santolina alcohol, semburin, nyasol, heliespirone A, and heliannuol E.

  10. Using real options analysis to support strategic management decisions

    NASA Astrophysics Data System (ADS)

    Kabaivanov, Stanimir; Markovska, Veneta; Milev, Mariyan

    2013-12-01

    Decision making is a complex process that requires taking into consideration multiple heterogeneous sources of uncertainty. Standard valuation and financial analysis techniques often fail to properly account for all these sources of risk as well as for all sources of additional flexibility. In this paper we explore applications of a modified binomial tree method for real options analysis (ROA) in an effort to improve decision making process. Usual cases of use of real options are analyzed with elaborate study on the applications and advantages that company management can derive from their application. A numeric results based on extending simple binomial tree approach for multiple sources of uncertainty are provided to demonstrate the improvement effects on management decisions.

  11. Expensing options solves nothing.

    PubMed

    Sahlman, William A

    2002-12-01

    The use of stock options for executive compensation has become a lightning rod for public anger, and it's easy to see why. Many top executives grew hugely rich on the back of the gains they made on their options, profits they've been able to keep even as the value they were supposed to create disappeared. The supposed scam works like this: Current accounting regulations let companies ignore the cost of option grants on their income statements, so they can award valuable option packages without affecting reported earnings. Not charging the cost of the grants supposedly leads to overstated earnings, which purportedly translate into unrealistically high share prices, permitting top executives to realize big gains when they exercise their options. If an accounting anomaly is the problem, then the solution seems obvious: Write off executive share options against the current year's revenues. The trouble is, Sahlman writes, expensing option grants won't give us a more accurate view of earnings, won't add any information not already included in the financial statements, and won't even lead to equal treatment of different forms of executive pay. Far worse, expensing evades the real issue, which is whether compensation (options and other-wise) does what it's supposed to do--namely, help a company recruit, retain, and provide the right people with appropriate performance incentives. Any performance-based compensation system has the potential to encourage cheating. Only ethical management, sensible governance, adequate internal control systems, and comprehensive disclosure will save the investor from disaster. If, Sahlman warns, we pass laws that require the expensing of options, thinking that's fixed the fundamental flaws in corporate America's accounting, we will have missed a golden opportunity to focus on the much more extensive defects in the present system.

  12. Dialysis Facility Transplant Philosophy and Access to Kidney Transplantation in the Southeast

    PubMed Central

    Gander, Jennifer; Browne, Teri; Plantinga, Laura; Pastan, Stephen O; Sauls, Leighann; Krisher, Jenna; Patzer, Rachel E

    2015-01-01

    Background Little is known about the impact of dialysis facility treatment philosophy on access to transplant. The aim of our study was to determine the relationship between dialysis facility transplant philosophy and facility-level access to kidney transplant waitlisting. Methods A 25-item questionnaire administered to Southeastern dialysis facilities (n=509) in 2012 captured facility transplant philosophy (categorized as “transplant is our first choice,” “transplant is a great option for some,” and “transplant is a good option, if the patient is interested”) .. Facility-level waitlisting and facility characteristics were obtained from the 2008-2011 Dialysis Facility Report. Multivariable logistic regression was used to examinethe association between dialysis facility transplant philosophy and facility waitlisting performance (dichotomized using the national median), where low performance was defined as less than 21.7% of dialysis patients waitlisted within a facility. Results Fewer than 25% (n=124) of dialysis facilities reported “transplant is our first option.” A total of 131 (31.4%) dialysis facilities in the Southeast were high-performing with respect to waitlisting. Adjusted analysis showed that facilities who reported “transplant is our first option” were twice (OR=2.0, 95% CI 1.0, 3.9) as likely to have high waitlisting performance compared to facilities who reported “transplant is a good option, if the patient is interested.” Conclusions Facilities with staff who had a more positive transplant philosophy were more likely to have better facility waitlisting performance. Future prospective studies are needed to further transplantation. PMID:26278585

  13. Patent Pooling for Promoting Access to Antiretroviral Drugs (ARVs) - A Strategic Option for India.

    PubMed

    Satyanarayana, Kanikaram; Srivastava, Sadhana

    2010-01-19

    The current HIV/AIDS scenario in India is quite grim with an estimated 2.4 million people living with HIV/AIDS (PLHA) in 2008, just behind South Africa and Nigeria. The anti-retroviral drugs (ARVs) remain the main stay of global HIV/AIDS treatment. Over 30 ARVs (single and FDCs) available under six categories viz., NRTIs (nucleoside reverse transcriptase inhibitors), NNRTIs (non-nucleoside reverse transcriptase inhibitors), Protease inhibitors, the new Fusion inhibitors, Entry inhibitors-CCR5 co-receptor antagonists and HIV integrase strand transfer inhibitors. The major originator companies for these ARVs are: Abbott, Boehringer Ingelheim (BI), Bristol-Myers Squibb (BMS), Gilead, GlaxoSmithKline (GSK), Merck, Pfizer, Roche, and Tibotec. Beginning with zidovidine in 1987, all the drugs are available in the developed countries. In India, about 30 ARVs are available as generics manufactured by Aurobindo, Hyderabad, Andhra Pradesh; Cipla Limited, Goa; Emcure Pharmaceuticals, Pune, Maharashtra; Hetero Drugs, Hyderabad, Andhra Pradesh; Macleods Pharmaceuticals, Daman; Matrix Laboratories, Nashik, Maharashtra; Ranbaxy, Sirmour, Himachal Pradesh; and Strides Arcolab, Bangalore, Karnataka. The National AIDS Control Organization (NACO) set up in 1992 by the Govt. of India provides free ARVs to HIV positive patients in India since 2004. The drugs available in India include both single drugs and FDCs covering both first line and second line ARVs. Even while there are claims of stabilization of the disease load, there is still huge gap of those who require ARVs as only about 150,000 PLHA receive the ARVs from the Govt. and other sources. Access to ARVs therefore is still a cause of serious concern ever since India became fully Trade Related Aspects of Intellectual Property Rights (TRIPS)-complaint in 2005. Therefore, the Indian pharmaceutical companies cannot make generics for those for drugs introduced post-2005 due to product patent regime. Other concerns include heat stable

  14. A Comparison between the Kawase and Extended Retrosigmoid Approaches (Retrosigmoid Transtentorial and Retrosigmoid Intradural Suprameatal Approaches) for Accessing the Petroclival Tumors. A Cadaveric Study

    PubMed Central

    Sharma, Mayur; Ambekar, Sudheer; Guthikonda, Bharat; Nanda, Anil

    2014-01-01

    Background The aim of our study was to compare the area of exposure at the ventral brainstem and petroclival region offered by the Kawase, retrosigmoid transtentorial (RTT), and the retrosigmoid intradural suprameatal (RISA) approaches in cadaveric models. Methods We performed 15 approaches (five each of the Kawase, RISA, and RTT approaches) on silicone-injected adult cadaver heads. Ventral brainstem and petroclival areas of exposure were measured and compared. Results The mean ventral brainstem area exposed by the Kawase approach was 55.00 ± 24.1 mm2, significantly less than that exposed by RTT (441 ± 63.3 mm2) and RISA (311 ± 61 mm2) (p < 0.05). The area of ventral brainstem exposure was significantly more via RTT than through RISA (p = 0.01). The mean petroclival area of exposure through the Kawase approach was significantly smaller than that obtained through the RTT and RISA approaches (101.7 ± 545.01 mm2, 696 ± 57.7 mm2, and 716.7 ± 51.4 mm2, respectively). Conclusion Retrosigmoid approaches provide a greater exposure of the brainstem and petroclival areas. The Kawase approach is ideally suited for lesions around the Meckel cave with an extension into the middle fossa. These approaches can be used in conjunction with one another to access petroclival tumors. PMID:24967151

  15. Uncovering Barriers to Financial Capability: Underrepresented Students' Access to Financial Resources

    ERIC Educational Resources Information Center

    Eichelberger, Brenda; Mattioli, Heather; Foxhoven, Rachel

    2017-01-01

    Financial aid is designed to increase access to postsecondary education at all socioeconomic levels; however, college students are not always knowledgeable about personal finances or capable of making sound decisions regarding complex college and program choices, debt options, and long-term spending. This article reviews previous research on the…

  16. Distributed Energy Implementation Options

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

    Shah, Chandralata N

    2017-09-13

    This presentation covers the options for implementing distributed energy projects. It distinguishes between options available for distributed energy that is government owned versus privately owned, with a focus on the privately owned options including Energy Savings Performance Contract Energy Sales Agreements (ESPC ESAs). The presentation covers the new ESPC ESA Toolkit and other Federal Energy Management Program resources.

  17. Risk profile and treatment options of acute ischemic in-hospital stroke.

    PubMed

    Schürmann, Kolja; Nikoubashman, Omid; Falkenburger, Björn; Tauber, Simone C; Wiesmann, Martin; Schulz, Jörg B; Reich, Arno

    2016-03-01

    Despite the potential immediate access to diagnosis and care, in-hospital stroke (IHS) is associated with delay in diagnosis, lower rates of reperfusion treatment, and unfavorable outcome. Endovascular reperfusion therapy has shown promising results in recent trials for community-onset strokes (COS) and is limited by less contraindications than systemic thrombolysis. Thus, endovascular approaches may offer additional acute treatment options for IHS. We performed a retrospective, observational monocentric analysis of patients with acute ischemic stroke between January 2010 and December 2014. Out of 3506 acute ischemic strokes, 331 (9.4%) were IHS. In-hospital mortality (31.4 vs. 8.0%) and duration of stay after stroke (19.5 vs. 12.1 days) were higher in IHS than in COS. Most IHS occurred in cardiologic and cardiosurgical patients after catheterization or surgery. In 111 cases (33.5%) the time of onset could not be established as a result of sedation or delayed referral resulting in delayed symptom recognition. 52 IHS (15.7%) and 828 COS (26.0%, p < 0.001) patients received any kind of reperfusion therapy, of which 59.6% (IHS) and 12.1% (COS) comprised isolated endovascular interventions (p < 0.001). Intra-hospital delays (time to brain imaging, systemic thrombolysis, and angiography) were longer and outcome parameters (mRS d90, in-hospital mortality, length of stay) were worse in IHS, whereas rates of procedural complications and intracranial hemorrhages were similar in both groups. The overall rate of reperfusion treatment is lower in IHS compared to COS, as IHS patients are less likely to be eligible for systemic thrombolysis. Interventional stroke treatment is a safe and feasible therapeutic option for patients who are not eligible for systemic thrombolysis and should be anticipated whenever IHS is diagnosed.

  18. Totally implanted ports: the trapezius approach in practice.

    PubMed

    Hill, Steve

    Implanted ports (IPs) are an essential device for many patients who require long-term vascular access. IPs offer some advantages over other central venous access devices, such as lifestyle, body image benefits and lower infection rates. A typical implantation site for a port is the anterior chest wall. For some patients with breast cancer who have metastatic chest wall disease this site may lead to problems with the function of the device if disease spreads to the port site. One option for this patient group is to place the implanted port over the trapezius muscle. This article discusses six patients, all of whom had metastatic breast cancer with some degree of subcutaneous disease on the anterior chest wall. Three patients had received trapezius port placements and three had anterior chest wall placements. A retrospective review of the patients' medical records was undertaken from the time of insertion until removal or until the patient died. The anterior chest wall group of patients had their devices in for an average of 368 days vs 214 in the trapezius group. The total complications were higher in the anterior chest wall group (7 vs 2 in the trapezius group). Disease spread to two of the devices in the anterior chest wall group meaning the devices could no longer be used. The trapezius approach appears to be a safe and a reliable form of vascular access and may offer fewer complications than the traditional method of anterior chest wall placement when standard anterior chest wall approach is not suitable.

  19. Access to Medicaid and Medicare by the low-income disabled

    PubMed Central

    Ellwood, Marilyn Rymer; Burwell, Brian

    1990-01-01

    The most pervasive eligibility-related problems encountered by low-income disabled persons in gaining access to Medicaid and Medicare are reviewed in this article. A series of options for restructuring program eligibility requirements are presented, with particular attention to improving the plight of the low-income disabled worker during the 24-month waiting period for Medicare. Options for Medicaid involve nationwide income eligibility levels at 100 percent of poverty and mandatory buy-in provisions to Medicaid in all States. For Medicare, the reforms range from altering the waiting period for Medicare by the disabled who are expected to die within 24 months after benefit award to eliminating the waiting period altogether. PMID:10170682

  20. Acceptance and use of eight arsenic-safe drinking water options in Bangladesh.

    PubMed

    Inauen, Jennifer; Hossain, Mohammad Mojahidul; Johnston, Richard B; Mosler, Hans-Joachim

    2013-01-01

    Arsenic contamination of drinking water is a serious public health threat. In Bangladesh, eight major safe water options provide an alternative to contaminated shallow tubewells: piped water supply, deep tubewells, pond sand filters, community arsenic-removal, household arsenic removal, dug wells, well-sharing, and rainwater harvesting. However, it is uncertain how well these options are accepted and used by the at-risk population. Based on the RANAS model (risk, attitudes, norms, ability, and self-regulation) this study aimed to identify the acceptance and use of available safe water options. Cross-sectional face-to-face interviews were used to survey 1,268 households in Bangladesh in November 2009 (n = 872), and December 2010 (n = 396). The questionnaire assessed water consumption, acceptance factors from the RANAS model, and socioeconomic factors. Although all respondents had access to at least one arsenic-safe drinking water option, only 62.1% of participants were currently using these alternatives. The most regularly used options were household arsenic removal filters (92.9%) and piped water supply (85.6%). However, the former result may be positively biased due to high refusal rates of household filter owners. The least used option was household rainwater harvesting (36.6%). Those who reported not using an arsenic-safe source differed in terms of numerous acceptance factors from those who reported using arsenic-safe sources: non-users were characterized by greater vulnerability; showed less preference for the taste and temperature of alternative sources; found collecting safe water quite time-consuming; had lower levels of social norms, self-efficacy, and coping planning; and demonstrated lower levels of commitment to collecting safe water. Acceptance was particularly high for piped water supplies and deep tubewells, whereas dug wells and well-sharing were the least accepted sources. Intervention strategies were derived from the results in order to

  1. Acceptance and Use of Eight Arsenic-Safe Drinking Water Options in Bangladesh

    PubMed Central

    Inauen, Jennifer; Hossain, Mohammad Mojahidul; Johnston, Richard B.; Mosler, Hans-Joachim

    2013-01-01

    Arsenic contamination of drinking water is a serious public health threat. In Bangladesh, eight major safe water options provide an alternative to contaminated shallow tubewells: piped water supply, deep tubewells, pond sand filters, community arsenic-removal, household arsenic removal, dug wells, well-sharing, and rainwater harvesting. However, it is uncertain how well these options are accepted and used by the at-risk population. Based on the RANAS model (risk, attitudes, norms, ability, and self-regulation) this study aimed to identify the acceptance and use of available safe water options. Cross-sectional face-to-face interviews were used to survey 1,268 households in Bangladesh in November 2009 (n = 872), and December 2010 (n = 396). The questionnaire assessed water consumption, acceptance factors from the RANAS model, and socioeconomic factors. Although all respondents had access to at least one arsenic-safe drinking water option, only 62.1% of participants were currently using these alternatives. The most regularly used options were household arsenic removal filters (92.9%) and piped water supply (85.6%). However, the former result may be positively biased due to high refusal rates of household filter owners. The least used option was household rainwater harvesting (36.6%). Those who reported not using an arsenic-safe source differed in terms of numerous acceptance factors from those who reported using arsenic-safe sources: non-users were characterized by greater vulnerability; showed less preference for the taste and temperature of alternative sources; found collecting safe water quite time-consuming; had lower levels of social norms, self-efficacy, and coping planning; and demonstrated lower levels of commitment to collecting safe water. Acceptance was particularly high for piped water supplies and deep tubewells, whereas dug wells and well-sharing were the least accepted sources. Intervention strategies were derived from the results in order to

  2. A Multi-Level Approach to Caregiver Training Accessibility.

    ERIC Educational Resources Information Center

    Range, Diana

    This brief paper discusses how in 10 year's time a system for providing caregiver training was developed in Texas. The training accessibility system consists of five dimensions: publications, free materials, resource rooms, child development specialists, Title XX training contracts and traveling resource vans. Tips for program continuity under…

  3. Acting on uncertainty in landscape management—options forestry.

    Treesearch

    Jonathan Thompson

    2005-01-01

    In response to the highly uncertain outcomes inherent in forest management, “options forestry” has been introduced as a novel approach that includes an honest appraisal of uncertainties and learning as a specific objective. The strategy is unique in that it uses a variety of management pathways, all designed to reach the same goal, and structures them in a rigorous...

  4. Pawnee Nation Energy Option Analyses

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

    Matlock, M.; Kersey, K.; Riding In, C.

    2009-07-21

    monitor market developments in the bio-energy industry, establish contacts with research institutions with which the tribe could potentially partner in grant-funded research initiatives. In addition, a substantial effort by the Kaw and Cherokee tribes is underway to pursue wind development at the Chilocco School Site in northern Oklahoma where Pawnee is a joint landowner. Pawnee Nation representatives should become actively involved in these development discussions and should explore the potential for joint investment in wind development at the Chilocco site. Financial incentives for project development are generally structured to provide tribes with access to conventional financing mechanisms. Grant funding for project construction is currently difficult to obtain. Substantial new opportunities for bio-fuel development may exist in the next few years with passage of the 2007 Farm Bill, and through opportunities made available through Oklahoma’s new Bio-energy Center. A review of potential alternatives to Pawnee Nation’s current electricity supply scenario revealed that a range of options could be viable. These include the following scenarios: business as usual, alternative supply, negotiate lower rates with City of Pawnee, focus on reducing energy usage, develop electric utility organization. Under any circumstances, Pawnee Nation should purse strategies to reduce energy usage, as this is the simplest means of reducing electric costs and environmental impacts. The research team also recommends that Pawnee Nation initiate some focused discussions with the City of Pawnee, with GRDA, and with IEC to discuss its wholesale supply purchase options. These discussions will better inform the Pawnee Energy Team of the specific pros and cons of its wholesale power supply options, and will assist the Team’s broader decision-making on utility-related issues. The ultimate path chosen by Pawnee Nation will depend on further consideration of priorities and potential barriers by

  5. Interdisciplinary Approach to the Development of Accessible Computer-Administered Measurement Instruments.

    PubMed

    Magasi, Susan; Harniss, Mark; Heinemann, Allen W

    2018-01-01

    Principles of fairness in testing require that all test takers, including people with disabilities, have an equal opportunity to demonstrate their capacity on the construct being measured. Measurement design features and assessment protocols can pose barriers for people with disabilities. Fairness in testing is a fundamental validity issue at all phases in the design, administration, and interpretation of measurement instruments in clinical practice and research. There is limited guidance for instrument developers on how to develop and evaluate the accessibility and usability of measurement instruments. This article describes a 6-stage iterative process for developing accessible computer-administered measurement instruments grounded in the procedures implemented across several major measurement initiatives. A key component of this process is interdisciplinary teams of accessibility experts, content and measurement experts, information technology experts, and people with disabilities working together to ensure that measurement instruments are accessible and usable by a wide range of users. The development of accessible measurement instruments is not only an ethical requirement, it also ensures better science by minimizing measurement bias, missing data, and attrition due to mismatches between the target population and test administration platform and protocols. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. Retroauricular transmeatal approach to manage mandibular condylar head fractures.

    PubMed

    Benech, Arnaldo; Arcuri, Francesco; Baragiotta, Nicola; Nicolotti, Matteo; Brucoli, Matteo

    2011-03-01

    There is a multitude of reported surgical approaches and technical variants with some unresolved technical problems to gain direct access to mandibular condylar head fractures; they can be divided into 2 groups: intraoral and extraoral. In 2005, Neff et al (Mund Kiefer Gesichtschir 2005;9:80), supported by a previous experimental work, reported a successful clinical study of condylar head fractures treated by a retroauricular approach; this article is in German, and the later English-language literature does not mention about this approach to open reduction and internal fixation of mandibular condylar fractures. The retroauricular transmeatal access, selected and performed by the senior author to treat 14 patients affected by highly located condylar head fracture, is illustrated in details. We collected data of 14 consecutive adult patients who, after the discussion about all options, had consented to have 16 mandibular condylar head fractures treated with open reduction and internal fixation by miniplates and screws via a retroauricular transmeatal approach. We exposed the temporomandibular joint area easily and better by dissecting via a retroauricular route with identification, ligation, and transection of the retromandibular vein; because of the posterior access, the frontal branch of the facial nerve and the auriculotemporal nerve are located and protected within the substance of the anteriorly retracted flap, superficial to the retromandibular vein. The follow-up clinical examination showed temporary weakness of the frontal branch of the facial nerve in 1 case with a recovery to normal function of 1.6 months; no patients had permanent weakness of the facial nerve or injury of the auriculotemporal nerve. There was absence of any salivary fistula, sialocele, and Frey syndrome; hearing was preserved in all cases, without any auditory stenosis or aesthetic deformity, and there was absence of any infections, hematoma, or scarring. Retroauricular approach provides

  7. 32 CFR 48.201 - Options.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Options. 48.201 Section 48.201 National Defense...'S FAMILY PROTECTION PLAN Election of Options § 48.201 Options. As provided in § 48.203, a member may... amount equal to such 121/2 per centum. (a) Option 1 is an annuity payable to or on behalf of his widow...

  8. Monte Carlo methods for multidimensional integration for European option pricing

    NASA Astrophysics Data System (ADS)

    Todorov, V.; Dimov, I. T.

    2016-10-01

    In this paper, we illustrate examples of highly accurate Monte Carlo and quasi-Monte Carlo methods for multiple integrals related to the evaluation of European style options. The idea is that the value of the option is formulated in terms of the expectation of some random variable; then the average of independent samples of this random variable is used to estimate the value of the option. First we obtain an integral representation for the value of the option using the risk neutral valuation formula. Then with an appropriations change of the constants we obtain a multidimensional integral over the unit hypercube of the corresponding dimensionality. Then we compare a specific type of lattice rules over one of the best low discrepancy sequence of Sobol for numerical integration. Quasi-Monte Carlo methods are compared with Adaptive and Crude Monte Carlo techniques for solving the problem. The four approaches are completely different thus it is a question of interest to know which one of them outperforms the other for evaluation multidimensional integrals in finance. Some of the advantages and disadvantages of the developed algorithms are discussed.

  9. A win-win solution?: A critical analysis of tiered pricing to improve access to medicines in developing countries.

    PubMed

    Moon, Suerie; Jambert, Elodie; Childs, Michelle; von Schoen-Angerer, Tido

    2011-10-12

    Tiered pricing - the concept of selling drugs and vaccines in developing countries at prices systematically lower than in industrialized countries - has received widespread support from industry, policymakers, civil society, and academics as a way to improve access to medicines for the poor. We carried out case studies based on a review of international drug price developments for antiretrovirals, artemisinin combination therapies, drug-resistant tuberculosis medicines, liposomal amphotericin B (for visceral leishmaniasis), and pneumococcal vaccines. We found several critical shortcomings to tiered pricing: it is inferior to competition for achieving the lowest sustainable prices; it often involves arbitrary divisions between markets and/or countries, which can lead to very high prices for middle-income markets; and it leaves a disproportionate amount of decision-making power in the hands of sellers vis-à-vis consumers. In many developing countries, resources are often stretched so tight that affordability can only be approached by selling medicines at or near the cost of production. Policies that "de-link" the financing of R&D from the price of medicines merit further attention, since they can reward innovation while exploiting robust competition in production to generate the lowest sustainable prices. However, in special cases - such as when market volumes are very small or multi-source production capacity is lacking - tiered pricing may offer the only practical option to meet short-term needs for access to a product. In such cases, steps should be taken to ensure affordability and availability in the longer-term. To ensure access to medicines for populations in need, alternate strategies should be explored that harness the power of competition, avoid arbitrary market segmentation, and/or recognize government responsibilities. Competition should generally be the default option for achieving affordability, as it has proven superior to tiered pricing for reliably

  10. A win-win solution?: A critical analysis of tiered pricing to improve access to medicines in developing countries

    PubMed Central

    2011-01-01

    Background Tiered pricing - the concept of selling drugs and vaccines in developing countries at prices systematically lower than in industrialized countries - has received widespread support from industry, policymakers, civil society, and academics as a way to improve access to medicines for the poor. We carried out case studies based on a review of international drug price developments for antiretrovirals, artemisinin combination therapies, drug-resistant tuberculosis medicines, liposomal amphotericin B (for visceral leishmaniasis), and pneumococcal vaccines. Discussion We found several critical shortcomings to tiered pricing: it is inferior to competition for achieving the lowest sustainable prices; it often involves arbitrary divisions between markets and/or countries, which can lead to very high prices for middle-income markets; and it leaves a disproportionate amount of decision-making power in the hands of sellers vis-à-vis consumers. In many developing countries, resources are often stretched so tight that affordability can only be approached by selling medicines at or near the cost of production. Policies that "de-link" the financing of R&D from the price of medicines merit further attention, since they can reward innovation while exploiting robust competition in production to generate the lowest sustainable prices. However, in special cases - such as when market volumes are very small or multi-source production capacity is lacking - tiered pricing may offer the only practical option to meet short-term needs for access to a product. In such cases, steps should be taken to ensure affordability and availability in the longer-term. Summary To ensure access to medicines for populations in need, alternate strategies should be explored that harness the power of competition, avoid arbitrary market segmentation, and/or recognize government responsibilities. Competition should generally be the default option for achieving affordability, as it has proven superior

  11. Development of an integrated staircase lift for home access.

    PubMed

    Mattie, Johanne L; Borisoff, Jaimie F; Leland, Danny; Miller, William C

    2015-12-01

    Stairways into buildings present a significant environmental barrier for those with mobility impairments, including older adults. A number of home access solutions that allow users to safely enter and exit the home exist, however these all have some limitations. The purpose of this work was to develop a novel, inclusive home access solution that integrates a staircase and a lift into one device. The development of an integrated staircase lift followed a structured protocol with stakeholders providing feedback at various stages in the design process, consistent with rehabilitation engineering design methods. A novel home access device was developed. The integrated staircase-lift has the following features: inclusivity, by a universal design that provides an option for either use of stairs or a lift; constant availability, with a lift platform always ready for use on either level; and potential aesthetic advantages when integrating the device into an existing home. The potential also exists for emergency descent during a power outage, and self-powered versions. By engaging stakeholders in a user centred design process, insight on the limitations of existing home access solutions and specific feedback on our design guided development of a novel home access device.

  12. Wireless technologies and accessibility for people with disabilities: findings from a policy research instrument.

    PubMed

    Baker, Paul M A; Moon, Nathan W

    2008-01-01

    The near universal deployment in the United States of a wide variety of information and communications technologies, both wired and wireless, creates potential barriers to use for several key populations, including the poor, people with disabilities, and the aging. Equal access to wireless technologies and services can be achieved through a variety of mechanisms, including legislation and regulations, market-based solutions, and awareness and outreach-based approaches. This article discusses the results of policy research conducted by the Rehabilitation Engineering Research Center on Wireless Technologies (Wireless RERC) using policy Delphi polling methodology to probe stakeholders' opinions on key access barrier issues and to explore potential policy responses. Participants included disability advocates, disability/wireless technology policy makers, and product developers/manufacturers. Respondent input informed subsequent development of potential policy initiatives to increase access to these technologies. The findings from the Delphi suggest that awareness issues remain most important, especially manufacturer awareness of user needs and availability of consumer information for selecting the most appropriate wireless devices and services. Other key issues included the ability of people with disabilities to afford technologies and inadequacies in legislation and policy making for ensuring their general accessibility, as well as usefulness in emergencies. Technical issues, including interoperability, speech-to-text conversion, and hearing aid compatibility, were also identified by participating stakeholders as important. To address all these issues, Delphi respondents favored goals and options congruent with voluntary market-driven solutions where possible but also supported federal involvement, where necessary, to aid this process.

  13. Arterioarterial Prosthetic Loop as an Alternative Approach for Hemodialysis Access.

    PubMed

    Lei, Wenhui; Ji, Jiansong; Wang, Jian; Jin, Lie; Zou, Hai

    2015-10-01

    In the present study, we performed an arterioarterial prosthetic loop (AAPL) between the femoral artery and deep femoral artery as a new access in patients who did not have adequate vascular conditions for creating an arteriovenous fistula or graft.Between April 2005 and June 2014, 18 patients received AAPL as a vascular access. During the procedure, a polytetrafluoroethylene graft was anastomosed to the femoral artery and deep femoral artery and looped on the thigh. We assessed the reliability and safety of AAPLs by analyzing complication, primary and secondary patency rates, and postoperative blood flow.Eighteen patients (median age, 66 years; range, 43-96 years) underwent AAPL access placement under the general or local anesthesia. All patients were followed up for 3 to 38 months (mean, 24 months). Primary and secondary patency rates at 6 months were 94.5% and 88.8%, respectively, and at 3 years were 61% and 72%, respectively. After operation, one patient had infection, and another one had fat necrosis at the surgical incision site. To maintain the AAPL function, 5 surgical procedures in 4 grafts, including revision, thrombectomy, excision, and repair for bleeding were performed. More than 5000 hemodialyses were performed efficiently in our center.Our study shows that AAPL loop is an unusual but effective and safe procedure that may be a good alternative for the patients who do not allow the conventional hemodialysis access.

  14. Commentary: open access, open business, closed fairness!

    PubMed

    Moustafa, Khaled

    2015-01-01

    A strong trend to move from print to online publication is largely perceived in scientific and nonscientific fields. A growing number of publishers increasingly opt for online publication as an option or a compulsory alternative. From readers' perspective, this is a highly appreciated facility, but from the author's, things are different mainly because of excessive article processing charges (APC) that make the open access system sometimes as a hindrance for many authors but a lucrative enterprise for many shareholders, enticing the most traditional and conservative publishers.

  15. 48 CFR 570.401 - Renewal options.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Renewal options. 570.401... Requirements 570.401 Renewal options. (a) Exercise of options. Before exercising an option to renew, follow the... survey. Before exercising an option to renew a lease, review current market information to ensure the...

  16. An Accessible Approach to Understanding Entropy and Change

    ERIC Educational Resources Information Center

    Johnson, Philip

    2018-01-01

    This article challenges the notion that entropy is something to be avoided. A line of argument is presented that is accessible to those not having specialist knowledge and that offers a new perspective to those more familiar with the concept. It shows that temperature is better understood by addressing entropy. Entropy change diagrams are…

  17. Bioengineering in renal transplantation: technological advances and novel options.

    PubMed

    Yeo, Wee-Song; Zhang, Yao-Chun

    2017-06-06

    End-stage kidney disease (ESKD) is one of the most prevalent diseases in the world with significant morbidity and mortality. Current modes of renal replacement therapy include dialysis and renal transplantation. Although dialysis is an acceptable mode of renal replacement therapy, it does have its shortcomings, which include poorer life expectancy compared with renal transplantation, risk of infections and vascular thrombosis, lack of vascular access and absence of biosynthetic functions of the kidney. Renal transplantation, in contrast, is the preferred option of renal replacement therapy, with improved morbidity and mortality rates and quality of life, compared with dialysis. Renal transplantation, however, may not be available to all patients with ESKD. Some of the key factors limiting the availability and efficiency of renal transplantation include shortage of donor organs and the constant risk of rejection with complications associated with over-immunosuppression respectively. This review focuses chiefly on the potential roles of bioengineering in overcoming limitations in renal transplantation via the development of cell-based bioartificial dialysis devices as bridging options before renal transplantation, and the development of new sources of organs utilizing cell and organ engineering.

  18. Efficient option valuation of single and double barrier options

    NASA Astrophysics Data System (ADS)

    Kabaivanov, Stanimir; Milev, Mariyan; Koleva-Petkova, Dessislava; Vladev, Veselin

    2017-12-01

    In this paper we present an implementation of pricing algorithm for single and double barrier options using Mellin transformation with Maximum Entropy Inversion and its suitability for real-world applications. A detailed analysis of the applied algorithm is accompanied by implementation in C++ that is then compared to existing solutions in terms of efficiency and computational power. We then compare the applied method with existing closed-form solutions and well known methods of pricing barrier options that are based on finite differences.

  19. 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.

  20. A Comparison of Fission Power System Options for Lunar and Mars Surface Applications

    NASA Technical Reports Server (NTRS)

    Mason, Lee S.

    2006-01-01

    This paper presents a comparison of reactor and power conversion design options for 50 kWe class lunar and Mars surface power applications with scaling from 25 to 200 kWe. Design concepts and integration approaches are provided for three reactor-converter combinations: gas-cooled Brayton, liquid-metal Stirling, and liquid-metal thermoelectric. The study examines the mass and performance of low temperature, stainless steel based reactors and higher temperature refractory reactors. The preferred system implementation approach uses crew-assisted assembly and in-situ radiation shielding via installation of the reactor in an excavated hole. As an alternative, self-deployable system concepts that use earth-delivered, on-board radiation shielding are evaluated. The analyses indicate that among the 50 kWe stainless steel reactor options, the liquid-metal Stirling system provides the lowest mass at about 5300 kg followed by the gas-cooled Brayton at 5700 kg and the liquid-metal thermoelectric at 8400 kg. The use of a higher temperature, refractory reactor favors the gas-cooled Brayton option with a system mass of about 4200 kg as compared to the Stirling and thermoelectric options at 4700 and 5600 kg, respectively. The self-deployed concepts with on-board shielding result in a factor of two system mass increase as compared to the in-situ shielded concepts.

  1. Designing viable cropping options for salt-affected lands

    NASA Astrophysics Data System (ADS)

    Shabala, Sergey; Meinke, Holger

    2017-04-01

    Salinity cost agricultural sector over 27Bln pa in lost opportunities and is an issue that crosses all spatial and temporal scales - from individual fields, farms, catchments, landscapes to national and global levels. Salinity manifests itself in many forms and often leads to further soil degradation such as erosion, nutrient and soil organic matter depletion, and a loss of (soil) biodiversity. Salinity may also cause major disturbance to ecosystems due to its impact on resources (e.g. pollution of aquifers). In extreme cases it can turn previously highly productive areas into wastelands. An increasing global population and unprecedented urban sprawls are now putting additional pressures on our soil and water resources, particularly in regions where urbanisation directly competes with agriculture for access to land and water. And although everyone agrees that avoiding soil salinity in the first instance would be the most effective way of combating it, reality is that the amount of saline land and water resources is rapidly increasing, and will continue to increase, especially in developing countries. Purposefully designing our cropping systems that can cope with various levels of salinity could be one answer to this increasing problem. In this work we review some of the key cropping options that can be deployed to either avoid, reduce or remediate salt-affected lands. We argue that for these measures to be most effective an ongoing science - policy - society dialogue is required to ensure that policy frameworks that govern land and water management are conducive to reducing salinity or even assist in restoring affected areas. We first consider several case studies highlighting the extent of the problem using ongoing salinity hotspots around the globe. We then look at halophytes as a possible biological tools to remediate already saline sols, and discuss prospects of mixed (halophytes and glycophytes) cropping solutions for various agricultural systems at different

  2. Dopamine Modulates Option Generation for Behavior.

    PubMed

    Ang, Yuen-Siang; Manohar, Sanjay; Plant, Olivia; Kienast, Annika; Le Heron, Campbell; Muhammed, Kinan; Hu, Michele; Husain, Masud

    2018-05-21

    Animals make innumerable decisions every day, each of which involves evaluating potential options for action. But how are options generated? Although much is now known about decision making when a fixed set of potential options is provided, surprisingly little progress has been made on self-generated options. Some researchers have proposed that such abilities might be modulated by dopamine. Here, we used a new measure of option generation that is quantitative, objective, and culture fair to investigate how humans generate different behavioral options. Participants were asked to draw as many different paths (options) as they could between two points within a fixed time. Healthy individuals (n = 96) exhibited a trade-off between uniqueness (how individually different their options were) and fluency (number of options), generating either many similar or few unique options. To assess influence of dopamine, we first examined patients with Parkinson's disease (n = 35) ON and OFF their dopaminergic medication and compared them to elderly healthy controls (n = 34). Then we conducted a double-blind, placebo-controlled crossover study of the D2 agonist cabergoline in healthy older people (n = 29). Across both studies, dopamine increased fluency but diminished overall uniqueness of options generated, due to the effect of fluency trading off with uniqueness. Crucially, however, when this trade-off was corrected for, dopamine was found to increase uniqueness for any given fluency. Three carefully designed control studies showed that performance on our option-generation task was not related to executing movements, planning actions, or selecting between generated options. These findings show that dopamine plays an important role in modulating option generation. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  3. Educational Options for Migrant Secondary Students.

    ERIC Educational Resources Information Center

    Morales, Jeanette A.; And Others

    Designed to address the need for secondary migrant educators to have access to model secondary programs, the guide highlights some 20 state and national programs that seem to be effective in serving the migrant secondary student. The programs are representative of three types of approaches which have proven to be effective in reducing the migrant…

  4. Coupling Adaptation Tipping Points and Engineering Options: New Insights for Resilient Water Infrastructure Replacement Planning

    NASA Astrophysics Data System (ADS)

    Smet, K.; de Neufville, R.; van der Vlist, M.

    2017-12-01

    This work presents an innovative approach for replacement planning for aging water infrastructure given uncertain future conditions. We draw upon two existing methodologies to develop an integrated long-term replacement planning framework. We first expand the concept of Adaptation Tipping Points to generate long-term planning timelines that incorporate drivers of investment related to both internal structural processes as well as changes in external operating conditions. Then, we use Engineering Options to explore different actions taken at key moments in this timeline. Contrasting to the traditionally more static approach to infrastructure design, designing the next generation of infrastructure so it can be changed incrementally is a promising method to safeguard current investments given future uncertainty. This up-front inclusion of structural options in the system actively facilitates future adaptation, transforming uncertainty management in infrastructure planning from reactive to more proactive. A two-part model underpins this approach. A simulation model generates diverse future conditions, allowing development of timelines of intervention moments in the structure's life. This feeds into an economic model, evaluating the lifetime performance of different replacement strategies, making explicit the value of different designs and their flexibility. A proof of concept study demonstrates this approach for a pumping station. The strategic planning timelines for this structure demonstrate that moments when capital interventions become necessary due to reduced functionality from structural degradation or changed operating conditions are widely spread over the structure's life. The disparate timing of these necessary interventions supports an incremental, adaptive mindset when considering end-of-life and replacement decisions. The analysis then explores different replacement decisions, varying the size and specific options included in the proposed new structure

  5. 78 FR 7997 - Noncompensatory Partnership Options

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-05

    ...) accounting for noncompensatory options; (3) the characterization rule; (4) the convertible bond provision... option would necessitate adjustments to the capital accounting requirements of the regulations, as... the option. 2. Accounting for Noncompensatory Options A. Accounting for the Issuance of a...

  6. The NCAR Research Data Archive's Hybrid Approach for Data Discovery and Access

    NASA Astrophysics Data System (ADS)

    Schuster, D.; Worley, S. J.

    2013-12-01

    The NCAR Research Data Archive (RDA http://rda.ucar.edu) maintains a variety of data discovery and access capabilities for it's 600+ dataset collections to support the varying needs of a diverse user community. In-house developed and standards-based community tools offer services to more than 10,000 users annually. By number of users the largest group is external and access the RDA through web based protocols; the internal NCAR HPC users are fewer in number, but typically access more data volume. This paper will detail the data discovery and access services maintained by the RDA to support both user groups, and show metrics that illustrate how the community is using the services. The distributed search capability enabled by standards-based community tools, such as Geoportal and an OAI-PMH access point that serves multiple metadata standards, provide pathways for external users to initially discover RDA holdings. From here, in-house developed web interfaces leverage primary discovery level metadata databases that support keyword and faceted searches. Internal NCAR HPC users, or those familiar with the RDA, may go directly to the dataset collection of interest and refine their search based on rich file collection metadata. Multiple levels of metadata have proven to be invaluable for discovery within terabyte-sized archives composed of many atmospheric or oceanic levels, hundreds of parameters, and often numerous grid and time resolutions. Once users find the data they want, their access needs may vary as well. A THREDDS data server running on targeted dataset collections enables remote file access through OPENDAP and other web based protocols primarily for external users. In-house developed tools give all users the capability to submit data subset extraction and format conversion requests through scalable, HPC based delayed mode batch processing. Users can monitor their RDA-based data processing progress and receive instructions on how to access the data when it is

  7. Penalty methods for the numerical solution of American multi-asset option problems

    NASA Astrophysics Data System (ADS)

    Nielsen, Bjørn Fredrik; Skavhaug, Ola; Tveito, Aslak

    2008-12-01

    We derive and analyze a penalty method for solving American multi-asset option problems. A small, non-linear penalty term is added to the Black-Scholes equation. This approach gives a fixed solution domain, removing the free and moving boundary imposed by the early exercise feature of the contract. Explicit, implicit and semi-implicit finite difference schemes are derived, and in the case of independent assets, we prove that the approximate option prices satisfy some basic properties of the American option problem. Several numerical experiments are carried out in order to investigate the performance of the schemes. We give examples indicating that our results are sharp. Finally, the experiments indicate that in the case of correlated underlying assets, the same properties are valid as in the independent case.

  8. Hypochondriasis: treatment options for a diagnostic quagmire.

    PubMed

    Starcevic, Vladan

    2015-08-01

    This article presents the conceptual and diagnostic conundrums surrounding hypochondriasis and reviews current treatment options for this disorder. The removal of hypochondriasis from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and its replacement with two new diagnostic entities have been controversial. It appears that the Eleventh Revision of the International Classification of Diseases will take a more cautious approach and emphasise the links between hypochondriasis, obsessive-compulsive disorder and other anxiety disorders. The cornerstone of any treatment approach to hypochondriasis is establishing a good therapeutic relationship with the patient. Psychological treatments, especially cognitive-behavioural therapy, have been more useful than pharmacotherapy, but there is much room for improving treatment outcomes. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  9. Surgical options in benign parotid tumors: a proposal for classification.

    PubMed

    Quer, Miquel; Vander Poorten, Vincent; Takes, Robert P; Silver, Carl E; Boedeker, Carsten C; de Bree, Remco; Rinaldo, Alessandra; Sanabria, Alvaro; Shaha, Ashok R; Pujol, Albert; Zbären, Peter; Ferlito, Alfio

    2017-11-01

    Different surgical options are currently available for treating benign tumors of the parotid gland, and the discussion on optimal treatment continues despite several meta-analyses. These options include more limited resections (extracapsular dissection, partial lateral parotidectomy) versus more extensive and traditional options (lateral parotid lobectomy, total parotidectomy). Different schools favor one option or another based on their experience, skills and tradition. This review provides a critical analysis of the literature regarding these options. The main limitation of all the studies is the bias of selection for different surgical approaches. For this reason, we propose a staging system that could facilitate clinical decision making and the comparison of results. We propose four categories based on the size of the tumor and its location within the parotid gland. Category I includes tumors up to 3 cm, which are mobile, close to the outer surface and close to the parotid borders. Category II includes deeper tumors up to 3 cm. Category III comprises tumors greater than 3 cm involving two levels of the parotid gland, and category IV tumors are greater than 3 cm and involve more than 2 levels. For each category and for the various pathologic types, a guideline of surgical extent is proposed. The objective of this classification is to facilitate prospective multicentric studies on surgical techniques in the treatment of benign parotid tumors and to enable the comparison of results of different clinical studies.

  10. 48 CFR 17.107 - Options.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Options. 17.107 Section 17... CONTRACT TYPES SPECIAL CONTRACTING METHODS Multiyear Contracting 17.107 Options. Benefits may accrue by including options in a multiyear contract. In that event, contracting officers must follow the requirements...

  11. 48 CFR 2917.207 - Exercising options.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Exercising options. 2917... AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 2917.207 Exercising options. The contracting officer must use a standardized determination and finding before exercising an option in accordance with...

  12. A Broadly Applicable NHC–Cu-Catalyzed Approach for Efficient, Site-, and Enantioselective Coupling of Readily Accessible (Pinacolato)alkenylboron Compounds to Allylic Phosphates and Applications to Natural Product Synthesis

    PubMed Central

    2015-01-01

    A set of protocols for catalytic enantioselective allylic substitution (EAS) reactions that allow for additions of alkenyl units to readily accessible allylic electrophiles is disclosed. Transformations afford 1,4-dienes that contain a tertiary carbon stereogenic site and are promoted by 1.0–5.0 mol % of a copper complex of an N-heterocyclic carbene (NHC). Aryl- as well as alkyl-substituted electrophiles bearing a di- or trisubstituted alkene may be employed. Reactions can involve a variety of robust alkenyl–(pinacolatoboron) [alkenyl–B(pin)] compounds that can be either purchased or prepared by various efficient, site-, and/or stereoselective catalytic reactions, such as cross-metathesis or proto-boryl additions to terminal alkynes. Vinyl-, E-, or Z-disubstituted alkenyl-, 1,1-disubstituted alkenyl-, acyclic, or heterocyclic trisubstituted alkenyl groups may be added in up to >98% yield, >98:2 SN2′:SN2, and 99:1 enantiomeric ratio (er). NHC–Cu-catalyzed EAS with alkenyl–B(pin) reagents containing a conjugated carboxylic ester or aldehyde group proceed to provide the desired 1,4-diene products in good yield and with high enantioselectivity despite the presence of a sensitive stereogenic tertiary carbon center that could be considered prone to epimerization. In most instances, the alternative approach of utilizing an alkenylmetal reagent (e.g., an Al-based species) represents an incompatible option. The utility of the approach is illustrated through applications to enantioselective synthesis of natural products such as santolina alcohol, semburin, nyasol, heliespirone A, and heliannuol E. PMID:24467274

  13. The GUI OPAC: Approach with Caution.

    ERIC Educational Resources Information Center

    Hildreth, Charles R.

    1995-01-01

    Discusses the graphical user interface (GUI) online public access catalog (OPAC), a user interface that uses images to represent options. Topics include user interface design for information retrieval; designing effective bibliographic displays, including subject headings; two design principles; and what GUIs can bring to OPACs. (LRW)

  14. Bounds for the price of discrete arithmetic Asian options

    NASA Astrophysics Data System (ADS)

    Vanmaele, M.; Deelstra, G.; Liinev, J.; Dhaene, J.; Goovaerts, M. J.

    2006-01-01

    In this paper the pricing of European-style discrete arithmetic Asian options with fixed and floating strike is studied by deriving analytical lower and upper bounds. In our approach we use a general technique for deriving upper (and lower) bounds for stop-loss premiums of sums of dependent random variables, as explained in Kaas et al. (Ins. Math. Econom. 27 (2000) 151-168), and additionally, the ideas of Rogers and Shi (J. Appl. Probab. 32 (1995) 1077-1088) and of Nielsen and Sandmann (J. Financial Quant. Anal. 38(2) (2003) 449-473). We are able to create a unifying framework for European-style discrete arithmetic Asian options through these bounds, that generalizes several approaches in the literature as well as improves the existing results. We obtain analytical and easily computable bounds. The aim of the paper is to formulate an advice of the appropriate choice of the bounds given the parameters, investigate the effect of different conditioning variables and compare their efficiency numerically. Several sets of numerical results are included. We also discuss hedging using these bounds. Moreover, our methods are applicable to a wide range of (pricing) problems involving a sum of dependent random variables.

  15. Real Option Cost Vulnerability Analysis of Electrical Infrastructure

    NASA Astrophysics Data System (ADS)

    Prime, Thomas; Knight, Phil

    2015-04-01

    means that a real option can be deferred or exercised depending on the climate future that has been realised. The real option value is defined as the maximum positive NPV value that is found across the range of potential SLR "futures". Real Options add value in that flood defences may not be built when there is real value in doing so. The cost modelling output is in the form of an accessible database that has detailed real option values varying spatially across the model domain (for each critical infrastructure) and temporally up to 2100. The analysis has shown that in 2100, 8.2% of the substations analysed have a greater than a 1 in 2 chance of exercising the real option to build flood defences against coastal flooding. The cost modelling tool and flood maps that have been developed will help stakeholders in deciding where and when to invest in mitigating against coastal flooding.

  16. 38 CFR 6.10 - Options.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Options. 6.10 Section 6.10 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS UNITED STATES GOVERNMENT LIFE INSURANCE Optional Settlement § 6.10 Options. Insurance will be payable in one sum only when...

  17. Placement of Upper Extremity Arteriovenous Access in Patients with Central Venous Occlusions: A Novel Technique.

    PubMed

    Murga, Allen G; Chiriano, Jason T; Bianchi, Christian; Sheng, Neha; Patel, Sheela; Abou-Zamzam, Ahmed M; Teruya, Theodore H

    2017-07-01

    Central venous occlusion is a common occurrence in patients with end-stage renal disease. Placement of upper extremity arteriovenous access in patients with occlusion of the brachiocephalic veins is often not an option. Avoidance of lower extremity vascular access can decrease morbidity and infection. The central venous lesions were crossed centrally via femoral access. The wire was retrieved in the neck extravascularly. A Hemodialysis Reliable Outflow catheter was then placed in the right atrium and completed with an arterial anastomosis. We describe a novel technique for placing upper extremity arteriovenous access in patients with occlusion of the brachiocephalic veins. This technique was utilized in 3 patients. The technical success was 100%. The placement of upper extremity arteriovenous access in patients with central venous occlusions is technically feasible. Published by Elsevier Inc.

  18. Enrichment options for African painted dogs (Lycaon pictus).

    PubMed

    Cloutier, Tammy L; Packard, Jane M

    2014-01-01

    Best practices for carnivore enrichment encourage the diversity of species-typical behaviors, increased activity, and reduced stereotypic behavior; ideally considering the life-history and behavior of each species. African wild dogs (Lycaon pictus), or painted dogs, are social carnivores that have large home ranges and complex pack dynamics (e.g., variation in group size, relatedness, etc.). As there are relatively few studies on painted dog enrichment, the goal of this study was to compile a list of enrichment options used by institutions participating in the species survival plan (SSP). Representatives were asked to describe social groups (n = 45), enclosures (n = 21), enrichment practices (options, delivery frequency, perceived success), and overall best practices. Respondents (61%, n = 23) reported using options for all six enrichment categories recommended by the Canid Taxon Advisory Group: environmental enrichment devices, habitat, sensory, food, behavioral, and social. Perceived success was significantly higher for the food category, followed by the sensory and behavioral categories. All respondents reported delivering enrichment at least multiple times a month, and most reported multiple times per week. Enclosure size did not differ significantly for mixed-sex groups (n = 28) compared to single-sex groups (n = 17). We discuss respondents' suggestions for best practices and the need to record data to compare perceived success with actual behavioral effects, controlling for variation in group size and composition. Overall, respondents recommended a flexible approach, since not all painted dogs and groups respond in the same way to the enrichment options. © 2014 Wiley Periodicals, Inc.

  19. Basic survival needs and access to medicines--coming to grips with TRIPS: conversion + calculation.

    PubMed

    Van Puymbroeck, Rudolf V

    2010-01-01

    "Access to medicines" is a broad concept. After a review of three authoritative frameworks that help to identify its constitutive components, this essay summarizes the actual situation on the ground in low- and middle-income countries on the basis of recent empirical work. An analysis of survey data from 36 countries concluded that developing countries should promote generic medicines as a key policy option for improving access to medicines. Taking an international perspective to that recommendation, this essay reviews the World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and, particularly, how this agreement has been applied in practice. As shown by the experience of Thailand, Brazil, and the Philippines, in order to deal effectively with international pressures for an excessive application of the TRIPS Agreement, some sort of conversion experience appears to be required, which then leads to a switch from a private enterprise, supply-driven approach to a public health vision that insists on universal and affordable access. But moral conviction is not sufficient. In order to muster and sustain the political will to face down international forces, civil society and government offices must be able and ready to show the costs and other adverse consequences of the TRIPS-based model for medicines. This calculation needs to reach beyond the health sector and calls for new alliances, nationally as well as internationally. © 2010 American Society of Law, Medicine & Ethics, Inc.

  20. U.S. EPAs Geospatial Data Access Project

    EPA Pesticide Factsheets

    To improve public health and the environment, the United States Environmental Protection Agency (EPA) collects information about facilities, sites, or places subject to environmental regulation or of environmental interest. Through the Geospatial Data Download Service, the public is now able to download the EPA Geodata Shapefile, Feature Class or extensible markup language (XML) file containing facility and site information from EPA's national program systems. The files are Internet accessible from the Envirofacts Web site (https://www3.epa.gov/enviro/). The data may be used with geospatial mapping applications. (Note: The files omit facilities without latitude/longitude coordinates.) The EPA Geospatial Data contains the name, location (latitude/longitude), and EPA program information about specific facilities and sites. In addition, the files contain a Uniform Resource Locator (URL), which allows mapping applications to present an option to users to access additional EPA data resources on a specific facility or site.

  1. 48 CFR 317.107 - Options.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Options. 317.107 Section... CONTRACT TYPES SPECIAL CONTRACTING METHODS Multi-year Contracting 317.107 Options. When used as part of a multi-year contract, options shall not be used to extend the performance of the original requirement for...

  2. 38 CFR 8.25 - Options.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Options. 8.25 Section 8.25 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS NATIONAL SERVICE LIFE INSURANCE Optional Settlements § 8.25 Options. Insurance will be paid in a lump sum only when selected by...

  3. An Approach for Assessing Development and Deployment Risks in the DOE Fuel Cycle Options Evaluation and Screening Study

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

    Gehin, Jess C; Oakley, Brian; Worrall, Andrew

    2015-01-01

    Abstract One of the key objectives of the U.S. Department of Energy (DOE) Nuclear Energy R&D Roadmap is the development of sustainable nuclear fuel cycles that can improve natural resource utilization and provide solutions to the management of nuclear wastes. Recently, an evaluation and screening (E&S) of fuel cycle systems has been conducted to identify those options that provide the best opportunities for obtaining such improvements and also to identify the required research and development activities that can support the development of advanced fuel cycle options. In order to evaluate and screen the E&S study included nine criteria including Developmentmore » and Deployment Risk (D&DR). More specifically, this criterion was represented by the following metrics: Development time, development cost, deployment cost from prototypic validation to first-of-a-kind commercial, compatibility with the existing infrastructure, existence of regulations for the fuel cycle and familiarity with licensing, and existence of market incentives and/or barriers to commercial implementation of fuel cycle processes. Given the comprehensive nature of the study, a systematic approach was needed to determine metric data for the D&DR criterion, and is presented here. As would be expected, the Evaluation Group representing the once-through use of uranium in thermal reactors is always the highest ranked fuel cycle Evaluation Group for this D&DR criterion. Evaluation Groups that consist of once-through fuel cycles that use existing reactor types are consistently ranked very high. The highest ranked limited and continuous recycle fuel cycle Evaluation Groups are those that recycle Pu in thermal reactors. The lowest ranked fuel cycles are predominately continuous recycle single stage and multi-stage fuel cycles that involve TRU and/or U-233 recycle.« less

  4. OPTION(5) versus OPTION(12) instruments to appreciate the extent to which healthcare providers involve patients in decision-making.

    PubMed

    Stubenrouch, Fabienne E; Pieterse, Arwen H; Falkenberg, Rijan; Santema, T Katrien B; Stiggelbout, Anne M; van der Weijden, Trudy; Aarts, J Annemijn W M; Ubbink, Dirk T

    2016-06-01

    The 12-item "observing patient involvement" (OPTION(12))-instrument is commonly used to assess the extent to which healthcare providers involve patients in health-related decision-making. The five-item version (OPTION(5)) claims to be a more efficient measure. In this study we compared the Dutch versions of the OPTION-instruments in terms of inter-rater agreement and correlation in outpatient doctor-patient consultations in various settings, to learn if we can safely switch to the shorter OPTION(5)-instrument. Two raters coded 60 audiotaped vascular surgery and oncology patient consultations using OPTION(12) and OPTION(5). Unweighted Cohen's kappa was used to compute inter-rater agreement on item-level. The association between the total scores of the two OPTION-instruments was investigated using Pearson's correlation coefficient (r) and a Bland & Altman plot. After fine-tuning the OPTION-manuals, inter-rater agreement for OPTION(12) and OPTION(5) was good to excellent (kappa range 0.69-0.85 and 0.63-0.72, respectively). Mean total scores were 23.7 (OPTION(12); SD=7.8) and 39.3 (OPTION(5); SD=12.7). Correlation between the total scores was high (r=0.71; p=0.01). OPTION(5) scored systematically higher with a wider range than OPTION(12). Both OPTION-instruments had a good inter-rater agreement and correlated well. OPTION(5) seems to differentiate better between various levels of patient involvement. The OPTION(5)-instrument is recommended for clinical application. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. Evaluating options for balancing the water-electricity nexus in California: part 1--securing water availability.

    PubMed

    Tarroja, Brian; AghaKouchak, Amir; Sobhani, Reza; Feldman, David; Jiang, Sunny; Samuelsen, Scott

    2014-11-01

    The technical potential and effectiveness of different water supply options for securing water availability in a large-scale, interconnected water supply system under historical and climate-change augmented inflow and demand conditions were compared. Part 1 of the study focused on determining the scale of the options required to secure water availability and compared the effectiveness of different options. A spatially and temporally resolved model of California's major surface reservoirs was developed, and its sensitivity to urban water conservation, desalination, and water reuse was examined. Potential capacities of the different options were determined. Under historical (baseline) hydrology conditions, many individual options were found to be capable of securing water availability alone. Under climate change augment conditions, a portfolio approach was necessary. The water savings from many individual options other than desalination were insufficient in the latter, however, relying on seawater desalination alone requires extreme capacity installations which have energy, brine disposal, management, and cost implications. The importance of identifying and utilizing points of leverage in the system for choosing where to deploy different options is also demonstrated. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. 24 CFR 206.19 - Payment options.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Payment options. 206.19 Section 206... CONVERSION MORTGAGE INSURANCE Eligibility; Endorsement Eligible Mortgages § 206.19 Payment options. (a) Term payment option. Under the term payment option, equal monthly payments are made by the mortgagee to the...

  7. Enhancing healthcare accessibility measurements using GIS: A case study in Seoul, Korea.

    PubMed

    Kim, Yeeun; Byon, Young-Ji; Yeo, Hwasoo

    2018-01-01

    With recent aging demographic trends, the needs for enhancing geo-spatial analysis capabilities and monitoring the status of accessibilities of its citizens with healthcare services have increased. The accessibility to healthcare is determined not only by geographic distances to service locations, but also includes travel time, available modes of transportation, and departure time. Having access to the latest and accurate information regarding the healthcare accessibility allows the municipal government to plan for improvements, including expansion of healthcare infrastructure, effective labor distribution, alternative healthcare options for the regions with low accessibilities, and redesigning the public transportation routes and schedules. This paper proposes a new method named, Seoul Enhanced 2-Step Floating Catchment Area (SE2SFCA), which is customized for the city of Seoul, where population density is higher and the average distance between healthcare-service locations tends to be shorter than the typical North American or European cities. The proposed method of SE2SFCA is found to be realistic and effective in determining the weak accessibility regions. It resolves the over-estimation issues of the past, arising from the assignment of high healthcare accessibility for the regions with large hospitals and high density of population and hospitals.

  8. Making our offices universally accessible: guidelines for physicians

    PubMed Central

    Jones, K E; Tamari, I E

    1997-01-01

    OBJECTIVE: To develop recommendations for office-based physicians who wish to make their offices accessible to all patients. OPTIONS: Include taking steps to make offices more accessible, or not; offices may be accessible to varying degrees. OUTCOMES: Outcomes of accessibility involve patient-care, economic, ethical and legal issues. Stakeholders in these outcomes include patients, physicians, government and society. EVIDENCE: Data were obtained from a series of searches of MEDLINE, CINAHL and Healthstar (previously Health) databases for articles on disability and family medicine, primary (health) care and family practice, and on access and offices, and health services accessibility, and from a telephone survey of 50 stakeholders. VALUES: A high value was placed on services to persons with disabilities and on stakeholder input. Universal accessibility was valued as an overall goal; improved accessibility was also highly valued. BENEFITS, HARMS AND COSTS: Benefits to patients include improved access to care as guaranteed by the Canada Health Act and in keeping with provincial Human Rights Codes. Benefits to physicians include contact with a broader patient population and freedom from fear of litigation. Costs of improved accessibility vary depending on individual circumstances and on whether an office is being built or renovated; some improvement costs are minimal. RECOMMENDATIONS: All physicians should take measures to improve practice accessibility. Improved access should be considered in each of the following areas: transportation and entrance to the facility, entrance to the office, waiting rooms, rest rooms, examination rooms, general building features and other features. VALIDATION: No similar guidelines exist. To assess the content validity of these guidelines, the authors had a draft document reviewed by 18 stakeholders. All specific recommendations met the minimum criterion of adherence to current legislation, including national and provincial building

  9. 24 CFR 35.120 - Options.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Options. 35.120 Section 35.120... and Definitions for All Programs. § 35.120 Options. (a) Standard treatments. Where interim controls are required by this part, the designated party has the option to presume that lead-based paint or...

  10. Cost effective Internet access and video conferencing for a community cancer network.

    PubMed Central

    London, J. W.; Morton, D. E.; Marinucci, D.; Catalano, R.; Comis, R. L.

    1995-01-01

    Utilizing the ubiquitous personal computer as a platform, and Integrated Services Digital Network (ISDN) communications, cost effective medical information access and consultation can be provided for physicians at geographically remote sites. Two modes of access are provided: information retrieval via the Internet, and medical consultation video conferencing. Internet access provides general medical information such as current treatment options, literature citations, and active clinical trials. During video consultations, radiographic and pathology images, and medical text reports (e.g., history and physical, pathology, radiology, clinical laboratory reports), may be viewed and simultaneously annotated by either video conference participant. Both information access modes have been employed by physicians at community hospitals which are members of the Jefferson Cancer Network, and oncologists at Thomas Jefferson University Hospital. This project has demonstrated the potential cost effectiveness and benefits of this technology. Images Figure 1 Figure 2 Figure 3 PMID:8563397

  11. The effect of patterning options on embedded memory cells in logic technologies at iN10 and iN7

    NASA Astrophysics Data System (ADS)

    Appeltans, Raf; Weckx, Pieter; Raghavan, Praveen; Kim, Ryoung-Han; Kar, Gouri Sankar; Furnémont, Arnaud; Van der Perre, Liesbet; Dehaene, Wim

    2017-03-01

    Static Random Access Memory (SRAM) cells are used together with logic standard cells as the benchmark to develop the process flow for new logic technologies. In order to achieve successful integration of Spin-Transfer Torque Magnetic Random Access Memory (STT-MRAM) as area efficient higher level embedded cache, it also needs to be included as a benchmark. The simple cell structure of STT-MRAM brings extra patterning challenges to achieve high density. The two memory types are compared in terms of minimum area and critical design rules in both the iN10 and iN7 node, with an extra focus on patterning options in iN7. Both the use of Self-Aligned Quadruple Patterning (SAQP) mandrel and spacer engineering, as well as multi-level via's are explored. These patterning options result in large area gains for the STT-MRAM cell and moreover determine which cell variant is the smallest.

  12. Patent Pooling for Promoting Access to Antiretroviral Drugs (ARVs) – A Strategic Option for India

    PubMed Central

    Satyanarayana, Kanikaram; Srivastava, Sadhana

    2010-01-01

    The current HIV/AIDS scenario in India is quite grim with an estimated 2.4 million people living with HIV/AIDS (PLHA) in 2008, just behind South Africa and Nigeria. The anti-retroviral drugs (ARVs) remain the main stay of global HIV/AIDS treatment. Over 30 ARVs (single and FDCs) available under six categories viz., NRTIs (nucleoside reverse transcriptase inhibitors), NNRTIs (non-nucleoside reverse transcriptase inhibitors), Protease inhibitors, the new Fusion inhibitors, Entry inhibitors-CCR5 co-receptor antagonists and HIV integrase strand transfer inhibitors. The major originator companies for these ARVs are: Abbott, Boehringer Ingelheim (BI), Bristol-Myers Squibb (BMS), Gilead, GlaxoSmithKline (GSK), Merck, Pfizer, Roche, and Tibotec. Beginning with zidovidine in 1987, all the drugs are available in the developed countries. In India, about 30 ARVs are available as generics manufactured by Aurobindo, Hyderabad, Andhra Pradesh; Cipla Limited, Goa; Emcure Pharmaceuticals, Pune, Maharashtra; Hetero Drugs, Hyderabad, Andhra Pradesh; Macleods Pharmaceuticals, Daman; Matrix Laboratories, Nashik, Maharashtra; Ranbaxy, Sirmour, Himachal Pradesh; and Strides Arcolab, Bangalore, Karnataka. The National AIDS Control Organization (NACO) set up in 1992 by the Govt. of India provides free ARVs to HIV positive patients in India since 2004. The drugs available in India include both single drugs and FDCs covering both first line and second line ARVs. Even while there are claims of stabilization of the disease load, there is still huge gap of those who require ARVs as only about 150,000 PLHA receive the ARVs from the Govt. and other sources. Access to ARVs therefore is still a cause of serious concern ever since India became fully Trade Related Aspects of Intellectual Property Rights (TRIPS)-complaint in 2005. Therefore, the Indian pharmaceutical companies cannot make generics for those for drugs introduced post-2005 due to product patent regime. Other concerns include heat stable

  13. The Impacts of Using a Collaborative Evaluation Approach in Higher Education: A Case Study of Local YMCAs Providing College Access Services

    ERIC Educational Resources Information Center

    Campbell, Johnavae E.

    2013-01-01

    This dissertation offers a case study of the YMCA of the USA's pilot Higher Education Service Project (YHESP) with 61 local YMCAs on how the collaborative evaluation approach functioned to facilitate an organizational culture around evaluation and reinvention strategies of YMCAs as college access service providers. Multiple data collection sources…

  14. 17 CFR 32.3 - Trade options.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Trade options. 32.3 Section 32... OPTION TRANSACTIONS § 32.3 Trade options. (a) Subject to paragraphs (b), (c), and (d) of this section... period preceding the date on which the trade option is entered into, (iv) In connection with any non...

  15. 17 CFR 32.3 - Trade options.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 17 Commodity and Securities Exchanges 1 2013-04-01 2013-04-01 false Trade options. 32.3 Section 32... OPTION TRANSACTIONS § 32.3 Trade options. (a) Subject to paragraphs (b), (c), and (d) of this section... period preceding the date on which the trade option is entered into, (iv) In connection with any non...

  16. Detecting Inappropriate Access to Electronic Health Records Using Collaborative Filtering.

    PubMed

    Menon, Aditya Krishna; Jiang, Xiaoqian; Kim, Jihoon; Vaidya, Jaideep; Ohno-Machado, Lucila

    2014-04-01

    Many healthcare facilities enforce security on their electronic health records (EHRs) through a corrective mechanism: some staff nominally have almost unrestricted access to the records, but there is a strict ex post facto audit process for inappropriate accesses, i.e., accesses that violate the facility's security and privacy policies. This process is inefficient, as each suspicious access has to be reviewed by a security expert, and is purely retrospective, as it occurs after damage may have been incurred. This motivates automated approaches based on machine learning using historical data. Previous attempts at such a system have successfully applied supervised learning models to this end, such as SVMs and logistic regression. While providing benefits over manual auditing, these approaches ignore the identity of the users and patients involved in a record access. Therefore, they cannot exploit the fact that a patient whose record was previously involved in a violation has an increased risk of being involved in a future violation. Motivated by this, in this paper, we propose a collaborative filtering inspired approach to predicting inappropriate accesses. Our solution integrates both explicit and latent features for staff and patients, the latter acting as a personalized "finger-print" based on historical access patterns. The proposed method, when applied to real EHR access data from two tertiary hospitals and a file-access dataset from Amazon, shows not only significantly improved performance compared to existing methods, but also provides insights as to what indicates an inappropriate access.

  17. Detecting Inappropriate Access to Electronic Health Records Using Collaborative Filtering

    PubMed Central

    Menon, Aditya Krishna; Jiang, Xiaoqian; Kim, Jihoon; Vaidya, Jaideep; Ohno-Machado, Lucila

    2013-01-01

    Many healthcare facilities enforce security on their electronic health records (EHRs) through a corrective mechanism: some staff nominally have almost unrestricted access to the records, but there is a strict ex post facto audit process for inappropriate accesses, i.e., accesses that violate the facility’s security and privacy policies. This process is inefficient, as each suspicious access has to be reviewed by a security expert, and is purely retrospective, as it occurs after damage may have been incurred. This motivates automated approaches based on machine learning using historical data. Previous attempts at such a system have successfully applied supervised learning models to this end, such as SVMs and logistic regression. While providing benefits over manual auditing, these approaches ignore the identity of the users and patients involved in a record access. Therefore, they cannot exploit the fact that a patient whose record was previously involved in a violation has an increased risk of being involved in a future violation. Motivated by this, in this paper, we propose a collaborative filtering inspired approach to predicting inappropriate accesses. Our solution integrates both explicit and latent features for staff and patients, the latter acting as a personalized “finger-print” based on historical access patterns. The proposed method, when applied to real EHR access data from two tertiary hospitals and a file-access dataset from Amazon, shows not only significantly improved performance compared to existing methods, but also provides insights as to what indicates an inappropriate access. PMID:24683293

  18. Supporting Public Access to Research Results

    ERIC Educational Resources Information Center

    Lapinski, P. Scott; Osterbur, David; Parker, Joshua; McCray, Alexa T.

    2014-01-01

    We posed the question of what services an academic library can best provide to support the NIH Public Access Policy. We approached the answer to this question through education, collaboration, and tool-building. As a result, over the last four years we have engaged over 1,500 participants in discussions of public access to research results, forged…

  19. Access to investigational medicinal products for minors in Europe: ethical and regulatory issues in negotiating children's access to investigational medicines.

    PubMed

    Pinxten, Wim; Nys, Herman; Dierickx, Kris

    2010-12-01

    Patients who search for a better treatment, an increased quality of life, or even a chance to preserve life itself may claim to have an interest in accessing investigational medicinal products (IMP), particularly when no validated treatment for their disease or condition exists. For many, awaiting the uncertain and time-consuming process of converting an IMP into an approved drug may not appear a realistic option, as prognoses may be grim and a dramatic outcome may seem hard to avert. Gaining access to an IMP, however, often proves to be a difficult enterprise with a highly uncertain outcome. In addition, the process of seeking access to IMP is surrounded by various ethical issues that will be explored in this article. This paper explores the ethical concerns in two potential tracks of seeking access to IMP for minors: on an individual basis, or collectively, as a patient organisation. In this discourse, several unique ethical and regulatory concerns related to the direct negotiation of access to IMP for minor patients are identified, with a focus on product safety, the recruitment of research subjects, the unnoticed entry of market mechanisms in the recruitment of research subjects, and the sidelining of third parties in the recruitment process. The paper concludes with a concise reflection on the way forward. The quest for access to investigational drugs is particularly relevant to paediatric practice, in which a significant share of the drugs prescribed has never been tested in children or labelled for use in the paediatric population.

  20. 26 CFR 1.544-4 - Options.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Options. 1.544-4 Section 1.544-4 Internal Revenue... (CONTINUED) Personal Holding Companies § 1.544-4 Options. The shares of stock which may be acquired by reason of an option shall be considered to be constructively owned by the individual having the option to...

  1. Innovative approach for low-cost quick-access small payload missions

    NASA Astrophysics Data System (ADS)

    Friis, Jan W., Jr.

    2000-11-01

    A significant part of the burgeoning commercial space industry is placing an unprecedented number of satellites into low earth orbit for a variety of new applications and services. By some estimates the commercial space industry now exceeds that of government space activities. Yet the two markets remain largely separate, with each deploying dedicated satellites and infrastructure for their respective missions. One commercial space firm, Final Analysis, has created a new program wherein either government, scientific or new technology payloads can be integrated on a commercial spacecraft on commercial satellites for a variety of mission scenarios at a fraction of the cost of a dedicated mission. NASA has recognized the advantage of this approach, and has awarded the Quick Ride program to provide frequent, low cost flight opportunities for small independent payloads aboard the Final Analysis constellation, and investigators are rapidly developing science programs that conform to the proposed payload accommodations envelope. Missions that were not feasible using dedicated launches are now receiving approval under the lower cost Quick Ride approach. Final Analysis has dedicated ten out of its thirty-eight satellites in support of the Quick Ride efforts. The benefit of this type of space access extend beyond NASA science programs. Commercial space firms can now gain valuable flight heritage for new technology and satellite product offerings. Further, emerging international space programs can now place a payload in orbit enabling the country to allocate its resources against the payload and mission requirements rather htan increased launch costs of a dedicated spacecraft. Finally, the low cost nature provides University-based research educational opportunities previously out of the reach of most space-related budgets. This paper will describe the motivation, benefits, technical features, and program costs of the Final Analysis secondary payload program. Payloads can be

  2. Complexity associated with the optimisation of capability options in military operations

    NASA Astrophysics Data System (ADS)

    Pincombe, A.; Bender, A.; Allen, G.

    2005-12-01

    In the context of a military operation, even if the intended actions, the geographic location, and the capabilities of the opposition are known, there are still some critical uncertainties that could have a major impact on the effectiveness of a given set of capabilities. These uncertainties include unpredictable events and the response alternatives that are available to the command and control elements of the capability set. They greatly complicate any a priori mathematical description. In a forecasting approach, the most likely future might be chosen and a solution sought that is optimal for that case. With scenario analysis, futures are proposed on the basis of critical uncertainties and the option that is most robust is chosen. We use scenario analysis but our approach is different in that we focus on the complexity and use the coupling between scenarios and options to create information on ideal options. The approach makes use of both soft and hard operations research methods, with subject matter expertise being used to define plausible responses to scenarios. In each scenario, uncertainty affects only a subset of the system-inherent variables and the variables that describe system-environment interactions. It is this scenario-specific reduction of variables that makes the problem mathematically tractable. The process we define is significantly different to existing scenario analysis processes, so we have named it adversarial scenario analysis. It can be used in conjunction with other methods, including recent improvements to the scenario analysis process. To illustrate the approach, we undertake a tactical level scenario analysis for a logistics problem that is defined by a network, expected throughputs to end users, the transport capacity available, the infrastructure at the nodes and the capacities of roads, stocks etc. The throughput capacity, e.g. the effectiveness, of the system relies on all of these variables and on the couplings between them. The

  3. Acquired thrombotic thrombocytopenic purpura: new therapeutic options and their optimal use.

    PubMed

    Cataland, S R; Wu, H M

    2015-06-01

    Advances in our understanding of the pathophysiology of both congenital and acquired thrombotic thrombocytopenic purpura (TTP) have led to both an increased understanding of the disease and novel approaches to therapy. The efficacy of rituximab in acquired TTP has led to consideration of rituximab as a prophylactic therapy to prevent relapse of TTP. Novel therapies that target the A1 domain of von Willebrand factor (VWF) to block the formation of microthrombotic disease have also entered clinical study and have demonstrated promise as potential therapeutic options. Additionally, a recombinant ADAMTS13 protease has been developed which may be an important therapeutic option for both congenital and acquired TTP. The development of these new therapeutic options for patients diagnosed with TTP has increased the importance of conducting prospective, randomized studies with these agents to both confirm their efficacy and more importantly understand their most appropriate role in the treatment of patients with TTP. © 2015 International Society on Thrombosis and Haemostasis.

  4. Leveraging Globus to Support Access and Delivery of Scientific Data

    NASA Astrophysics Data System (ADS)

    Cram, T.; Schuster, D.; Ji, Z.; Worley, S. J.

    2015-12-01

    The NCAR Research Data Archive (RDA; http://rda.ucar.edu) contains a large and diverse collection of meteorological and oceanographic observations, operational and reanalysis outputs, and remote sensing datasets to support atmospheric and geoscience research. The RDA contains greater than 600 dataset collections which support the varying needs of a diverse user community. The number of RDA users is increasing annually, and the most popular method used to access the RDA data holdings is through web based protocols, such as wget and cURL based scripts. In the year 2014, 11,000 unique users downloaded greater than 1.1 petabytes of data from the RDA, and customized data products were prepared for more than 45,000 user-driven requests. In order to further support this increase in web download usage, the RDA has implemented the Globus data transfer service (www.globus.org) to provide a GridFTP data transfer option for the user community. The Globus service is broadly scalable, has an easy to install client, is sustainably supported, and provides a robust, efficient, and reliable data transfer option for the research community. This presentation will highlight the technical functionality, challenges, and usefulness of the Globus data transfer service for accessing the RDA data holdings.

  5. 45 CFR 1306.34 - Combination program option.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Combination program option. 1306.34 Section 1306... START PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.34 Combination program option. (a) Combination program option requirements: (1) Grantees implementing a...

  6. Controlled Ecological Life Support Systems (CELSS) conceptual design option study

    NASA Technical Reports Server (NTRS)

    Oleson, Melvin; Olson, Richard L.

    1986-01-01

    Results are given of a study to explore options for the development of a Controlled Ecological Life Support System (CELSS) for a future Space Station. In addition, study results will benefit the design of other facilities such as the Life Sciences Research Facility, a ground-based CELSS demonstrator, and will be useful in planning longer range missions such as a lunar base or manned Mars mission. The objectives were to develop weight and cost estimates for one CELSS module selected from a set of preliminary plant growth unit (PGU) design options. Eleven Space Station CELSS module conceptual PGU designs were reviewed, components and subsystems identified and a sensitivity analysis performed. Areas where insufficient data is available were identified and divided into the categories of biological research, engineering research, and technology development. Topics which receive significant attention are lighting systems for the PGU, the use of automation within the CELSS system, and electric power requirements. Other areas examined include plant harvesting and processing, crop mix analysis, air circulation and atmosphere contaminant flow subsystems, thermal control considerations, utility routing including accessibility and maintenance, and nutrient subsystem design.

  7. 24 CFR 982.625 - Homeownership option: General.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Homeownership option: General. 982... Types Homeownership Option § 982.625 Homeownership option: General. (a) The homeownership option is used... family assisted under the homeownership option may be a newly admitted or existing participant in the...

  8. 48 CFR 517.207 - Exercise of options.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Exercise of options. 517... METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 517.207 Exercise of options. Before exercising an option, you must: (a) Synopsize it unless you meet of the following conditions: (1) The option...

  9. 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.

  10. Endovascular Creation of an Arteriovenous Fistula (endoAVF) for Hemodialysis Access: First Results.

    PubMed

    Radosa, Christoph Georg; Radosa, Julia Caroline; Weiss, Norbert; Schmidt, Christine; Werth, Sebastian; Hofmockel, Thomas; Plodeck, Verena; Gatzweiler, Christian; Laniado, Michael; Hoffmann, Ralf-Thorsten

    2017-10-01

    Surgical creation of a radiocephalic fistula is the gold standard of vascular access for hemodialysis. Recently, an endovascular approach for upper arm fistula creation (endoAVF) has been developed, which may be an alternative to open surgery. We describe a case series of eight cases showing feasibility, early complications and outcome of this novel treatment option. Between July 2015 and February 2016, we created an endoAVF in eight patients. Indications for endoAVF were confirmed by a multidisciplinary vascular board upon the exclusion for Cimino fistula candidates. Patients were suitable for the procedure after a pre-therapeutic ultrasound showed adequate brachial and ulnar vessels and no ipsilateral central venous stenosis. Patient characteristics, technical success, total patient radiation dose, complication rates, time to maturation of endoAVF and clinical effectiveness at six months were assessed retrospectively. Creation of endoAVF using the everlinQ endoAVF system (TVA Medical Inc., Austin, TX, USA) was successful in all eight cases. There were one minor intraprocedural complication and no postoperative complications. Median time to endoAVF maturation was 63 days (range 26-137 days). One patient was lost to follow-up after the first monitoring visit. In the remaining seven patients, hemodialysis was started without problems. Patency after 6 months was 100%. The endoAVF demonstrated to be feasible and safe for the creation of arteriovenous fistula suitable for hemodialysis access. Further studies with more patients and longer follow-up periods are needed to assess long-term outcomes and comparability to surgical dialysis access creation.

  11. Contribution of Sudanese medical diaspora to the healthcare delivery system in Sudan: exploring options and barriers.

    PubMed

    Abdalla, Fayrouz Mohammed; Omar, Maye Abu; Badr, Elsheikh Elsiddig

    2016-06-30

    Medical diaspora options, including the engagement of expatriate physicians in development efforts within their home country, are being called for to reverse the effects of brain drain from developing countries. This paper presents the results of a study exploring the potential contributions for the Sudanese Medial Diaspora Options to the healthcare delivery system (HCDS) in Sudan, focusing on the options of temporal and permanent returns and the likely obstacles faced in their implementation. This was a cross-sectional study using a mixed methods design including quantitative and qualitative approaches. For the quantitative approach, the study, which focused on the possible contribution of the diaspora to healthcare delivery in Sudan, was based on an online survey using random purposive and snowballing sampling techniques involving 153 Sudanese physicians working in Saudi Arabia and other Gulf States, the United Kingdom, the Republic of Ireland, and the United States of America. The qualitative approach involved in-depth interviews with returnee physicians and key informants in Sudan, focusing on the return experiences, the barriers for return, and the options to improve future contributions. Despite contributions of the Sudanese medical diaspora being of a small scale considering the size of the phenomenon, as well as infrequent and not appropriately organized, their inputs to academia and the links built with overseas institutions and specialist clinical services were nevertheless remarkable. The main barrier to temporal return was inappropriate organization by the local counterparts, while those for permanent return of physicians were poor work environment, insufficient financial payment, unsecured accommodation, and offspring education. The study identified short-term return as a feasible option considering the country's current conditions. Proper coordination mechanisms for short-term returns and facilitation of permanent return through stakeholders

  12. Reducing the Deficit: Spending and Revenue Options

    DTIC Science & Technology

    2011-03-01

    the Conservation Reserve Program 25AgricultureOption 6 Reduce the Premium Subsidy in the Crop Insurance Program 26Option 7 Reduce by 20 Percentage...Graduate Students 31Option 11 Change the Interest Rate Structure for Student Loans 32HealthOption 12 Add a “Public Plan” to the Health Insurance Exchanges...Health Episodes Covered by Medicare 48Option 21 Reduce Medicare Costs by Changing the Cost-Sharing Structures for Medicare and Medigap Insurance 49Option

  13. Valuing options in shot noise market

    NASA Astrophysics Data System (ADS)

    Laskin, Nick

    2018-07-01

    A new exactly solvable option pricing model has been introduced and elaborated. It is assumed that a stock price follows a Geometric shot noise process. An arbitrage-free integro-differential option pricing equation has been obtained and solved. The new Greeks have been analytically calculated. It has been shown that in diffusion approximation the developed option pricing model incorporates the well-known Black-Scholes equation and its solution. The stochastic dynamic origin of the Black-Scholes volatility has been uncovered. To model the observed market stock price patterns consisting of high frequency small magnitude and low frequency large magnitude jumps, the superposition of two Geometric shot noises has been implemented. A new generalized option pricing equation has been obtained and its exact solution was found. Merton's jump-diffusion formula for option price was recovered in diffusion approximation. Despite the non-Gaussian nature of probability distributions involved, the new option pricing model has the same degree of analytical tractability as the Black-Scholes model and the Merton jump-diffusion model. This attractive feature allows one to derive exact formulas to value options and option related instruments in the market with jump-like price patterns.

  14. Management Options for Biochemically Recurrent Prostate Cancer.

    PubMed

    Fakhrejahani, Farhad; Madan, Ravi A; Dahut, William L

    2017-05-01

    Prostate cancer is the most common solid tumor malignancy in men worldwide. Treatment with surgery and radiation can be curative in organ-confined disease. Unfortunately, about one third of men develop biochemically recurrent disease based only on rising prostate-specific antigen (PSA) in the absence of visible disease on conventional imaging. For these patients with biochemical recurrent prostate cancer, there is no uniform guideline for subsequent management. Based on available data, it seems prudent that biochemical recurrent prostate cancer should initially be evaluated for salvage radiation or prostatectomy, with curative intent. In selected cases, high-intensity focused ultrasound and cryotherapy may be considered in patients that meet very narrow criteria as defined by non-randomized trials. If salvage options are not practical or unsuccessful, androgen deprivation therapy (ADT) is a standard option for disease control. While some patients prefer ADT to manage the disease immediately, others defer treatment because of the associated toxicity. In the absence of definitive randomized data, patients may be followed using PSA doubling time as a trigger to initiate ADT. Based on retrospective data, a PSA doubling time of less than 3-6 months has been associated with near-term development of metastasis and thus could be used signal to initiate ADT. Once treatment is begun, patients and their providers can choose between an intermittent and continuous ADT strategy. The intermittent approach may limit side effects but in patients with metastatic disease studies could not exclude a 20% greater risk of death. In men with biochemical recurrence, large studies have shown that intermittent therapy is non-inferior to continuous therapy, thus making this a reasonable option. Since biochemically recurrent prostate cancer is defined by technological limitations of radiographic detection, as new imaging (i.e., PSMA) strategies are developed, it may alter how the disease is

  15. An Integrated Approach for Accessing Multiple Datasets through LANCE

    NASA Astrophysics Data System (ADS)

    Murphy, K. J.; Teague, M.; Conover, H.; Regner, K.; Beaumont, B.; Masuoka, E.; Vollmer, B.; Theobald, M.; Durbin, P.; Michael, K.; Boller, R. A.; Schmaltz, J. E.; Davies, D.; Horricks, K.; Ilavajhala, S.; Thompson, C. K.; Bingham, A.

    2011-12-01

    The NASA/GSFC Land Atmospheres Near-real time Capability for EOS (LANCE) provides imagery for approximately 40 data products from MODIS, AIRS, AMSR-E and OMI to support the applications community in the study of a variety of phenomena. Thirty-six of these products are available within 2.5 hours of observation at the spacecraft. The data set includes the population density data provided by the EOSDIS Socio-Economic Data and Applications Center (SEDAC). The purpose of this paper is to describe the variety of tools that have been developed by LANCE to support user access to the imagery. The long-standing Rapid Response system has been integrated into LANCE and is a major vehicle for the distribution of the imagery to end users. There are presently approximately 10,000 anonymous users per month accessing these imagery. The products are grouped into 14 applications categories such as Smoke Plumes, Pollution, Fires, Agriculture and the selection of any category will make relevant subsets of the 40 products available as possible overlays in an interactive Web Client utilizing Web Mapping Service (WMS) to support user investigations (http://lance2.modaps.eosdis.nasa.gov/wms/). For example, selecting Severe Storms will include 6 products for MODIS, OMI, AIRS, and AMSR-E plus the SEDAC population density data. The client and WMS were developed using open-source technologies such as OpenLayers and MapServer and provides a uniform, browser-based access to data products. All overlays are downloadable in PNG, JPEG, or GeoTiff form up to 200MB per request. The WMS was beta-tested with the user community and substantial performance improvements were made through the use of such techniques as tile-caching. LANCE established a partnership with Physical Oceanography Distributed Active Archive Center (PO DAAC) to develop an alternative presentation for the 40 data products known as the State of the Earth (SOTE). This provides a Google Earth-based interface to the products grouped in

  16. Risk Assessment of Arsenic Mitigation Options in Bangladesh

    PubMed Central

    Ahmed, M. Feroze; Shamsuddin, Abu Jafar; Mahmud, Shamsul Gafur; Deere, Daniel

    2006-01-01

    The provision of alternative water sources is the principal arsenic mitigation strategy in Bangladesh, but can lead to risk substitution. A study of arsenic mitigation options was undertaken to assess water quality and sanitary condition and to estimate the burden of disease associated with each technology in disability-adjusted life years (DALYs). Dugwells and pond-sand filters showed heavy microbial contamination in both dry and monsoon seasons, and the estimated burden of disease was high. Rainwater was of good quality in the monsoon but deteriorated in the dry season. Deep tubewells showed microbial contamination in the monsoon but not in the dry season and was the only technology to approach the World Health Organization's reference level of risk of 10-6 DALYs. A few dugwells and one pond-sand filter showed arsenic in excess of 50 μg/L. The findings suggest that deep tubewells and rainwater harvesting provide safer water than dugwells and pond-sand filters and should be the preferred options. PMID:17366776

  17. Not just a drop in the bucket: expanding access to point-of-use water treatment systems.

    PubMed

    Mintz, E; Bartram, J; Lochery, P; Wegelin, M

    2001-10-01

    Since 1990, the number of people without access to safe water sources has remained constant at approximately 1.1 billion, of whom approximately 2.2 million die of waterborne disease each year. In developing countries, population growth and migrations strain existing water and sanitary infrastructure and complicate planning and construction of new infrastructure. Providing safe water for all is a long-term goal; however, relying only on time- and resource-intensive centralized solutions such as piped, treated water will leave hundreds of millions of people without safe water far into the future. Self-sustaining, decentralized approaches to making drinking water safe, including point-of-use chemical and solar disinfection, safe water storage, and behavioral change, have been widely field-tested. These options target the most affected, enhance health, contribute to development and productivity, and merit far greater priority for rapid implementation.

  18. Not Just a Drop in the Bucket: Expanding Access to Point-of-Use Water Treatment Systems

    PubMed Central

    Mintz, Eric; Bartram, Jamie; Lochery, Peter; Wegelin, Martin

    2001-01-01

    Since 1990, the number of people without access to safe water sources has remained constant at approximately 1.1 billion, of whom approximately 2.2 million die of waterborne disease each year. In developing countries, population growth and migrations strain existing water and sanitary infrastructure and complicate planning and construction of new infrastructure. Providing safe water for all is a long-term goal; however, relying only on time- and resource-intensive centralized solutions such as piped, treated water will leave hundreds of millions of people without safe water far into the future. Self-sustaining, decentralized approaches to making drinking water safe, including point-of-use chemical and solar disinfection, safe water storage, and behavioral change, have been widely field-tested. These options target the most affected, enhance health, contribute to development and productivity, and merit far greater priority for rapid implementation. PMID:11574307

  19. Collaborative Indoor Access Point Localization Using Autonomous Mobile Robot Swarm

    PubMed Central

    Awad, Fahed; Naserllah, Muhammad; Omar, Ammar; Abu-Hantash, Alaa; Al-Taj, Abrar

    2018-01-01

    Localization of access points has become an important research problem due to the wide range of applications it addresses such as dismantling critical security threats caused by rogue access points or optimizing wireless coverage of access points within a service area. Existing proposed solutions have mostly relied on theoretical hypotheses or computer simulation to demonstrate the efficiency of their methods. The techniques that rely on estimating the distance using samples of the received signal strength usually assume prior knowledge of the signal propagation characteristics of the indoor environment in hand and tend to take a relatively large number of uniformly distributed random samples. This paper presents an efficient and practical collaborative approach to detect the location of an access point in an indoor environment without any prior knowledge of the environment. The proposed approach comprises a swarm of wirelessly connected mobile robots that collaboratively and autonomously collect a relatively small number of non-uniformly distributed random samples of the access point’s received signal strength. These samples are used to efficiently and accurately estimate the location of the access point. The experimental testing verified that the proposed approach can identify the location of the access point in an accurate and efficient manner. PMID:29385042

  20. Collaborative Indoor Access Point Localization Using Autonomous Mobile Robot Swarm.

    PubMed

    Awad, Fahed; Naserllah, Muhammad; Omar, Ammar; Abu-Hantash, Alaa; Al-Taj, Abrar

    2018-01-31

    Localization of access points has become an important research problem due to the wide range of applications it addresses such as dismantling critical security threats caused by rogue access points or optimizing wireless coverage of access points within a service area. Existing proposed solutions have mostly relied on theoretical hypotheses or computer simulation to demonstrate the efficiency of their methods. The techniques that rely on estimating the distance using samples of the received signal strength usually assume prior knowledge of the signal propagation characteristics of the indoor environment in hand and tend to take a relatively large number of uniformly distributed random samples. This paper presents an efficient and practical collaborative approach to detect the location of an access point in an indoor environment without any prior knowledge of the environment. The proposed approach comprises a swarm of wirelessly connected mobile robots that collaboratively and autonomously collect a relatively small number of non-uniformly distributed random samples of the access point's received signal strength. These samples are used to efficiently and accurately estimate the location of the access point. The experimental testing verified that the proposed approach can identify the location of the access point in an accurate and efficient manner.

  1. Study of Agricultural Product Options Pricing

    NASA Astrophysics Data System (ADS)

    HONG, Qiu

    2017-09-01

    China is a large agricultural country, and the healthy development of agriculture is related to the stability of the whole society. The agricultural production and management of agricultural products are confronted with many risks, especially the market risks. Option contract is the object of option market transaction, so it is very important to study the option contract of agricultural products. Option trading separates the risk and profit, so that the trader can avoid the risk while retaining the opportunity to obtain income. The option has the characteristics of low transaction cost, simple and efficient, so it is suitable for small and medium investors.

  2. HTTP-based remote operational options for the Vacuum Tower Telescope, Tenerife

    NASA Astrophysics Data System (ADS)

    Staiger, J.

    2012-09-01

    We are currently developing network based tools for the Vacuum Tower Telescope (VTT), Tenerife which will allow to operate the telescope together with the newly developed 2D-spectrometer HELLRIDE under remote control conditions. The computational configuration can be viewed as a distributed system linking hardware components of various functionality from different locations. We have developed a communication protocol which is basically an extension of the HTTP standard. It will serve as a carrier for command- and data-transfers. The server-client software is based on Berkley-Unix sockets in a C++ programming environment. A customized CMS will allow to create browser accessible information on-the-fly. Java-based applet pages have been tested as optional user access GUI's. An access tool has been implemented to download near-realtime, web-based target information from NASA/SDO. Latency tests have been carried out at the VTT and the Swedish STT at La Palma for concept verification. Short response times indicate that under favorable network conditions remote interactive telescope handling may be possible. The scientific focus of possible future remote operations will be set on the helioseismology of the solar atmosphere, the monitoring of flares and the footpoint analysis of coronal loops and chromospheric events.

  3. A Trans-disciplinary Hydrogeological Systems Analysis Approach for Identifying and Assessing Managed Aquifer Recharge Options: Example from the Darling River Floodplain, N.S.W., Australia

    NASA Astrophysics Data System (ADS)

    Lawrie, K.; Brodie, R. S.; Tan, K. P.; Halas, L.; Magee, J.; Gow, L.; Christensen, N. B.

    2013-12-01

    Surface water availability and quality generally limits managed aquifer recharge (MAR) opportunities in inland Australia's highly salinized landscapes and groundwater systems. Economic factors also commonly limit MAR investigations to shallow freshwater groundwater systems near existing infrastructure. Aquifer opportunities lie mainly in zones of fresh groundwater in relatively thin fluvial sedimentary aquifer systems with highly variable hydraulic properties. As part of a broader strategy to identify water savings in the Murray-Darling Basin, the Broken Hill Managed Aquifer Recharge (BHMAR) project was tasked with identifying and assessing MAR and/or groundwater extraction options to reduce evaporative losses from existing surface water storages, secure Broken Hill's water supply, protect the local environment and heritage, and return water to the river system. A trans-disciplinary research approach was used to identify and assess MAR options across a broad area of the Darling River floodplain. This methodology enabled the team to recognise fundamental problems in discipline approaches, helped identify critical data gaps, led to significant innovation across discipline boundaries, was critical in the development of a new hydrogeological conceptual model, facilitated development of new models of landscape, geological and tectonic evolution of the study area, and enabled completion of pre-commissioning maximal and residual MAR risk assessments. An airborne electromagnetics (AEM) survey, acquired over a large (>7,500 sq km) area of the Darling Floodplain, enabled rapid identification of a multi-layer sequence of aquifers and aquitards, while a phased assessment methodology was developed to rapidly identify and assess over 30 potential MAR targets (largely in fresh groundwater zones within palaeochannels and at palaeochannel confluences). Hydraulic properties were confirmed by a 7.5 km drilling program (100 sonic and rotary mud holes), and complementary field

  4. University Access and Theories of Social Justice: Contributions of the Capabilities Approach

    ERIC Educational Resources Information Center

    Wilson-Strydom, Merridy

    2015-01-01

    Issues of social justice in higher education together with a focus on access or widening participation have become of increasing importance globally. Given the complex theoretical terrain of social justice and the tensions inherent in applying social justice frameworks within higher education, and particularly in the area of access, this paper…

  5. Assessing Option Grid® practicability and feasibility for facilitating shared decision making: An exploratory study.

    PubMed

    Tsulukidze, Maka; Grande, Stuart W; Gionfriddo, Michael R

    2015-07-01

    To assess the feasibility of Option Grids(®)for facilitating shared decision making (SDM) in simulated clinical consultations and explore clinicians' views on their practicability. We used mixed methods approach to analyze clinical consultations using the Observer OPTION instrument and thematic analysis for follow-up interviews with clinicians. Clinicians achieved high scores on information sharing and low scores on preference elicitation and integration. Four themes were identified: (1) Barriers affect practicability of Option Grids(®); (2) Option Grids(®) facilitate the SDM process; (3) Clinicians are aware of the gaps in their practice of SDM; (4) Training and ongoing feedback on the optimal use of Option Grids(®) are necessary. Use of Option Grids(®) by clinicians with background knowledge in SDM did not facilitate optimal levels of competency on the SDM core concepts of preference elicitation and integration. Future research must evaluate the impact of training on the use of Option Grids(®), and explore how best to help clinicians bridge the gap between knowledge and action. Clinicians proficiently imparting information in simulations struggled to elicit and integrate patient preferences - understanding this gap and developing strategies to close it are the next steps for implementing SDM into clinical practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. What Rural Women Want the Public Health Community to Know About Access to Healthful Food: A Qualitative Study, 2011.

    PubMed

    Carnahan, Leslie R; Zimmermann, Kristine; Peacock, Nadine R

    2016-04-28

    Living in a rural food desert has been linked to poor dietary habits. Understanding community perspectives about available resources and feasible solutions may inform strategies to improve food access in rural food deserts. The objective of our study was to identify resources and solutions to the food access problems of women in rural, southernmost Illinois. Fourteen focus groups with women (n = 110 participants) in 4 age groups were conducted in a 7-county region as part of a community assessment focused on women's health. We used content analysis with inductive and deductive approaches to explore food access barriers and facilitators. Similar to participants in previous studies, participants in our study reported insufficient local food sources, which they believe contributed to poor dietary habits, high food prices, and the need to travel for healthful food. Participants identified existing local activities and resources that help to increase access, such as home and community gardens, food pantries, and public transportation, as well as local solutions, such as improving nutrition education and public transportation options. Multilevel and collaborative strategies and policies are needed to address food access barriers in rural communities. At the individual level, education may help residents navigate geographic and economic barriers. Community solutions include collaborative strategies to increase availability of healthful foods through traditional and nontraditional food sources. Policy change is needed to promote local agriculture and distribution of privately grown food. Understanding needs and strengths in rural communities will ensure responsive and effective strategies to improve the rural food environment.

  7. What Rural Women Want the Public Health Community to Know About Access to Healthful Food: A Qualitative Study, 2011

    PubMed Central

    Zimmermann, Kristine; Peacock, Nadine R.

    2016-01-01

    Introduction Living in a rural food desert has been linked to poor dietary habits. Understanding community perspectives about available resources and feasible solutions may inform strategies to improve food access in rural food deserts. The objective of our study was to identify resources and solutions to the food access problems of women in rural, southernmost Illinois. Methods Fourteen focus groups with women (n = 110 participants) in 4 age groups were conducted in a 7-county region as part of a community assessment focused on women’s health. We used content analysis with inductive and deductive approaches to explore food access barriers and facilitators. Results Similar to participants in previous studies, participants in our study reported insufficient local food sources, which they believe contributed to poor dietary habits, high food prices, and the need to travel for healthful food. Participants identified existing local activities and resources that help to increase access, such as home and community gardens, food pantries, and public transportation, as well as local solutions, such as improving nutrition education and public transportation options. Conclusion Multilevel and collaborative strategies and policies are needed to address food access barriers in rural communities. At the individual level, education may help residents navigate geographic and economic barriers. Community solutions include collaborative strategies to increase availability of healthful foods through traditional and nontraditional food sources. Policy change is needed to promote local agriculture and distribution of privately grown food. Understanding needs and strengths in rural communities will ensure responsive and effective strategies to improve the rural food environment. PMID:27126555

  8. African American and Latino low income families' food shopping behaviors: promoting fruit and vegetable consumption and use of alternative healthy food options.

    PubMed

    Fish, Caitlin A; Brown, Jonisha R; Quandt, Sara A

    2015-04-01

    Minority families often reside in neighborhoods with few supermarkets or alternative healthy food options (e.g., farmers markets, community gardens), making fresh produce difficult to obtain. This qualitative study identified factors influencing fruit and vegetable shopping and use of alternative healthy food options. Forty-eight minority women with children completed interviews regarding food shopping habits and use of and attitudes toward alternative healthy food options. Interviews were subjected to thematic analysis. Produce shopping was motivated by costs and family preferences. For African American women, poor cooking skills restricted the variety of fruits and vegetables purchased. Latinas were receptive to alternative healthy food options, but did not use them because these sources were inconvenient. African American women were not receptive to them. Improving cooking skills and perceptions of acceptable foods may be as important as increased access to promote greater consumption of fruits and vegetables.

  9. African American and Latino Low Income Families’ Food Shopping Behaviors: Promoting Fruit and Vegetable Consumption and Use of Alternative Healthy Food Options

    PubMed Central

    Fish, Caitlin A.; Brown, Jonisha R.; Quandt, Sara A.

    2014-01-01

    Introduction Minority families often reside in neighborhoods with few supermarkets or alternative healthy food options (e.g., farmers markets, community gardens), making fresh produce difficult to obtain. This qualitative study identified factors influencing fruit and vegetable shopping and use of alternative healthy food options. Methods Forty-eight minority women with children completed interviews regarding food shopping habits and use of and attitudes toward alternative healthy food options. Interviews were subjected to thematic analysis. Results Produce shopping was motivated by costs and family preferences. For African American women, poor cooking skills restricted the variety of fruits and vegetables purchased. Latinas were receptive to alternative healthy food options, but did not use them because these sources were inconvenient. African American women were not receptive to them. Conclusion Improving cooking skills and perceptions of acceptable foods may be as important as increased access to promote greater consumption of fruits and vegetables. PMID:24293075

  10. Using a service sector segmented approach to identify community stakeholders who can improve access to suicide prevention services for veterans.

    PubMed

    Matthieu, Monica M; Gardiner, Giovanina; Ziegemeier, Ellen; Buxton, Miranda

    2014-04-01

    Veterans in need of social services may access many different community agencies within the public and private sectors. Each of these settings has the potential to be a pipeline for attaining needed health, mental health, and benefits services; however, many service providers lack information on how to conceptualize where Veterans go for services within their local community. This article describes a conceptual framework for outreach that uses a service sector segmented approach. This framework was developed to aid recruitment of a provider-based sample of stakeholders (N = 70) for a study on improving access to the Department of Veterans Affairs and community-based suicide prevention services. Results indicate that although there are statistically significant differences in the percent of Veterans served by the different service sectors (F(9, 55) = 2.71, p = 0.04), exposure to suicidal Veterans and providers' referral behavior is consistent across the sectors. Challenges to using this framework include isolating the appropriate sectors for targeted outreach efforts. The service sector segmented approach holds promise for identifying and referring at-risk Veterans in need of services. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  11. Current Approaches to Assessment in Self-Access Language Learning

    ERIC Educational Resources Information Center

    Reinders, Hayo; Lázaro, Noemí

    2007-01-01

    Assessment is generally seen as one of the key challenges in the field of self-access learning (Gardner & Miller, 1999; Champagne et al., 2001; Lai, 2001; Kinoshita Thomson, 1996). Many researchers and practitioners point to difficulties with assessing language gains in an environment in which variables cannot comprehensively be controlled…

  12. Availability of and ease of access to calorie information on restaurant websites.

    PubMed

    Bennett, Gary G; Steinberg, Dori M; Lanpher, Michele G; Askew, Sandy; Lane, Ilana B; Levine, Erica L; Goodman, Melody S; Foley, Perry B

    2013-01-01

    Offering calories on restaurant websites might be particularly important for consumer meal planning, but the availability of and ease of accessing this information are unknown. We assessed websites for the top 100 U.S. chain restaurants to determine the availability of and ease of access to calorie information as well as website design characteristics. We also examined potential predictors of calorie availability and ease of access. Eighty-two percent of restaurants provided calorie information on their websites; 25% presented calories on a mobile-formatted website. On average, calories could be accessed in 2.35±0.99 clicks. About half of sites (51.2%) linked to calorie information via the homepage. Fewer than half had a separate section identifying healthful options (46.3%), or utilized interactive meal planning tools (35.4%). Quick service/fast casual, larger restaurants, and those with less expensive entrées and lower revenue were more likely to make calorie information available. There were no predictors of ease of access. Calorie information is both available and largely accessible on the websites of America's leading restaurants. It is unclear whether consumer behavior is affected by the variability in the presentation of calorie information.

  13. The Road from the NASA Access to Space Study to a Reusable Launch Vehicle

    NASA Technical Reports Server (NTRS)

    Powell, Richard W.; Cook, Stephen A.; Lockwood, Mary Kae

    1998-01-01

    NASA is cooperating with the aerospace industry to develop a space transportation system that provides reliable access-to-space at a much lower cost than is possible with today's launch vehicles. While this quest has been on-going for many years it received a major impetus when the U.S. Congress mandated as part of the 1993 NASA appropriations bill that: "In view of budget difficulties, present and future..., the National Aeronautics and Space Administration shall ... recommend improvements in space transportation." NASA, working with other organizations, including the Department of Transportation, and the Department of Defense identified three major transportation architecture options that were to be evaluated in the areas of reliability, operability and cost. These architectural options were: (1) retain and upgrade the Space Shuttle and the current expendable launch vehicles; (2) develop new expendable launch vehicles using conventional technologies and transition to these new vehicles beginning in 2005; and (3) develop new reusable vehicles using advanced technology, and transition to these vehicles beginning in 2008. The launch needs mission model was based on 1993 projections of civil, defense, and commercial payload requirements. This "Access to Space" study concluded that the option that provided the greatest potential for meeting the cost, operability, and reliability goals was a rocket-powered single-stage-to-orbit fully reusable launch vehicle (RLV) fleet designed with advanced technologies.

  14. 17 CFR 32.13 - Exemption from prohibition of commodity option transactions for trade options on certain...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... trade option merchant's internal controls with respect to market risk, credit risk, and other risks... disclosure statement: This brief statement does not disclose all of the risks and other significant aspects... from sources other than the person selling you this option about the use and risks of option contracts...

  15. Risk adjustment policy options for casemix funding: international lessons in financing reform.

    PubMed

    Antioch, Kathryn M; Ellis, Randall P; Gillett, Steve; Borovnicar, Daniel; Marshall, Ric P

    2007-09-01

    This paper explores modified hospital casemix payment formulae that would refine the diagnosis-related group (DRG) system in Victoria, Australia, which already makes adjustments for teaching, severity and demographics. We estimate alternative casemix funding methods using multiple regressions for individual hospital episodes from 2001 to 2003 on 70 high-deficit DRGs, focussing on teaching hospitals where the largest deficits have occurred. Our casemix variables are diagnosis- and procedure-based severity markers, counts of diagnoses and procedures, disease types, complexity, day outliers, emergency admission and "transfers in." The results are presented for four policy options that vary according to whether all of the dollars or only some are reallocated, whether all or some hospitals are used and whether the alternatives augment or replace existing payments. While our approach identifies variables that help explain patient cost variations, hospital-level simulations suggest that the approaches explored would only reduce teaching hospital underpayment by about 10%. The implications of various policy options are discussed.

  16. Bringing patient centricity to diabetes medication access in Canada

    PubMed Central

    Glennie, Judith L; Kovacs Burns, Katharina; Oh, Paul

    2016-01-01

    Canada must become proactive in addressing type 2 diabetes. With the second highest rate of diabetes prevalence in the developed world, the number of Canadians living with diabetes will soon reach epidemic levels. Against international comparisons, Canada also performs poorly with respect to diabetes-related hospitalizations, mortality rates, and access to medications. Diabetes and its comorbidities pose a significant burden on people with diabetes (PWD) and their families, through out-of-pocket expenses for medications, devices, supplies, and the support needed to manage their illness. Rising direct and indirect costs of diabetes will become a drain on Canada’s economy and undermine the financial stability of our health care system. Canada’s approach to diabetes medication assessment and funding has created a patchwork of medication access across provinces. Access to treatments for those who rely on public programs is highly restricted compared to Canadians with private drug plans, as well in contrast with public payers in other countries. Each person living with diabetes has different needs, so a “patient-centric” approach ensures treatment focused on individual circumstances. Such tailoring is difficult to achieve, with the linear approach required by public payers. We may be undermining optimal care for PWD because of access policies that are not aligned with individualized approaches – and increasing overall health care costs in the process. The scope of Canada’s diabetes challenge demands holistic and proactive solutions. Canada needs to get out from “behind the eight ball” and get “ahead of the curve” when it comes to diabetes care. Improving access to medications is one of the tools for getting there. Canada’s “call to action” for diabetes starts with effective implementation of existing best practices. A personalized approach to medication access, to meet individual needs and optimize outcomes, is also a key enabler. PWD and

  17. Gold or green: the debate on open access policies.

    PubMed

    Abadal, Ernest

    2013-09-01

    The movement for open access to science seeks to achieve unrestricted and free access to academic publications on the Internet. To this end, two mechanisms have been established: the gold road, in which scientific journals are openly accessible, and the green road, in which publications are self-archived in repositories. The publication of the Finch Report in 2012, advocating exclusively the adoption of the gold road, generated a debate as to whether either of the two options should be prioritized. The recommendations of the Finch Report stirred controversy among academicians specialized in open access issues, who felt that the role played by repositories was not adequately considered and because the green road places the burden of publishing costs basically on authors. The Finch Report's conclusions are compatible with the characteristics of science communication in the UK and they could surely also be applied to the (few) countries with a powerful publishing industry and substantial research funding. In Spain, both the current national legislation and the existing rules at universities largely advocate the green road. This is directly related to the structure of scientific communication in Spain, where many journals have little commercial significance, the system of charging a fee to authors has not been adopted, and there is a good repository infrastructure. As for open access policies, the performance of the scientific communication system in each country should be carefully analyzed to determine the most suitable open access strategy.

  18. Incorporation of Outcome-Based Contract Requirements in a Real Options Approach for Maintenance Planning

    DTIC Science & Technology

    2016-04-30

    focus on novel onshore/offshore and small/large scale wind turbine designs for expanding their operational range and increasing their efficiency at...of maintenance options created by the implementation of PHM in wind turbines . When an RUL is predicted for a subsystem, there are multiple choices...The section titled Example— Wind Turbine With an Outcome-Based Contract presents a case study for a PHM enabled wind turbine with and without an

  19. Algorithmic Approach With Clinical Pathology Consultation Improves Access to Specialty Care for Patients With Systemic Lupus Erythematosus.

    PubMed

    Chen, Lei; Welsh, Kerry J; Chang, Brian; Kidd, Laura; Kott, Marylee; Zare, Mohammad; Carroll, Kelley; Nguyen, Andy; Wahed, Amer; Tholpady, Ashok; Pung, Norin; McKee, Donna; Risin, Semyon A; Hunter, Robert L

    2016-09-01

    Harris Health System (HHS) is a safety net system providing health care to the underserved of Harris County, Texas. There was a 6-month waiting period for a rheumatologist consult for patients with suspected systemic lupus erythematosus (SLE). The objective of the intervention was to improve access to specialty care. An algorithmic approach to testing for SLE was implemented initially through the HHS referral center. The algorithm was further offered as a "one-click" order for physicians, with automated reflex testing, interpretation, and case triaging by clinical pathology. Data review revealed that prior to the intervention, 80% of patients did not have complete laboratory workups available at the first rheumatology visit. Implementation of algorithmic testing and triaging of referrals by pathologists resulted in decreasing the waiting time for a rheumatologist by 50%. Clinical pathology intervention and case triaging can improve access to care in a county health care system. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. 17 CFR 32.13 - Exemption from prohibition of commodity option transactions for trade options on certain...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 false Exemption from prohibition of commodity option transactions for trade options on certain agricultural commodities. 32.13 Section 32.13 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION REGULATION OF COMMODITY OPTION TRANSACTIONS § 32.13 Exemption from...

  1. Task Delegation Based Access Control Models for Workflow Systems

    NASA Astrophysics Data System (ADS)

    Gaaloul, Khaled; Charoy, François

    e-Government organisations are facilitated and conducted using workflow management systems. Role-based access control (RBAC) is recognised as an efficient access control model for large organisations. The application of RBAC in workflow systems cannot, however, grant permissions to users dynamically while business processes are being executed. We currently observe a move away from predefined strict workflow modelling towards approaches supporting flexibility on the organisational level. One specific approach is that of task delegation. Task delegation is a mechanism that supports organisational flexibility, and ensures delegation of authority in access control systems. In this paper, we propose a Task-oriented Access Control (TAC) model based on RBAC to address these requirements. We aim to reason about task from organisational perspectives and resources perspectives to analyse and specify authorisation constraints. Moreover, we present a fine grained access control protocol to support delegation based on the TAC model.

  2. Semantically Enriched Data Access Policies in eHealth.

    PubMed

    Drozdowicz, Michał; Ganzha, Maria; Paprzycki, Marcin

    2016-11-01

    Internet of Things (IoT) requires novel solutions to facilitate autonomous, though controlled, resource access. Access policies have to facilitate interactions between heterogeneous entities (devices and humans). Here, we focus our attention on access control in eHealth. We propose an approach based on enriching policies, based on well-known and widely-used eXtensible Access Control Markup Language, with semantics. In the paper we describe an implementation of a Policy Information Point integrated with the HL7 Security and Privacy Ontology.

  3. Alternative Level of Care: Canada's Hospital Beds, the Evidence and Options

    PubMed Central

    Sutherland, Jason M.; Crump, R. Trafford

    2013-01-01

    Patients designated as alternative level of care (ALC) are an ongoing concern for healthcare policy makers across Canada. These patients occupy valuable hospital beds and limit access to acute care services. The objective of this paper is to present policy alternatives to address underlying factors associated with ALC bed use. Three alternatives, and their respective limitations and structural challenges, are discussed. Potential solutions may require a mix of policy options proposed here. Inadequate policy jeopardizes new acute care activity-based funding schemes in British Columbia and Ontario. Failure to address this issue could exacerbate pressures on the existing bottlenecks in the community care system in these and other provinces. PMID:23968671

  4. An objective approach to determining the weight ranges of prey preferred by and accessible to the five large African carnivores.

    PubMed

    Clements, Hayley S; Tambling, Craig J; Hayward, Matt W; Kerley, Graham I H

    2014-01-01

    Broad-scale models describing predator prey preferences serve as useful departure points for understanding predator-prey interactions at finer scales. Previous analyses used a subjective approach to identify prey weight preferences of the five large African carnivores, hence their accuracy is questionable. This study uses a segmented model of prey weight versus prey preference to objectively quantify the prey weight preferences of the five large African carnivores. Based on simulations of known predator prey preference, for prey species sample sizes above 32 the segmented model approach detects up to four known changes in prey weight preference (represented by model break-points) with high rates of detection (75% to 100% of simulations, depending on number of break-points) and accuracy (within 1.3±4.0 to 2.7±4.4 of known break-point). When applied to the five large African carnivores, using carnivore diet information from across Africa, the model detected weight ranges of prey that are preferred, killed relative to their abundance, and avoided by each carnivore. Prey in the weight ranges preferred and killed relative to their abundance are together termed "accessible prey". Accessible prey weight ranges were found to be 14-135 kg for cheetah Acinonyx jubatus, 1-45 kg for leopard Panthera pardus, 32-632 kg for lion Panthera leo, 15-1600 kg for spotted hyaena Crocuta crocuta and 10-289 kg for wild dog Lycaon pictus. An assessment of carnivore diets throughout Africa found these accessible prey weight ranges include 88±2% (cheetah), 82±3% (leopard), 81±2% (lion), 97±2% (spotted hyaena) and 96±2% (wild dog) of kills. These descriptions of prey weight preferences therefore contribute to our understanding of the diet spectrum of the five large African carnivores. Where datasets meet the minimum sample size requirements, the segmented model approach provides a means of determining, and comparing, the prey weight range preferences of any carnivore species.

  5. An Objective Approach to Determining the Weight Ranges of Prey Preferred by and Accessible to the Five Large African Carnivores

    PubMed Central

    Clements, Hayley S.; Tambling, Craig J.; Hayward, Matt W.; Kerley, Graham I. H.

    2014-01-01

    Broad-scale models describing predator prey preferences serve as useful departure points for understanding predator-prey interactions at finer scales. Previous analyses used a subjective approach to identify prey weight preferences of the five large African carnivores, hence their accuracy is questionable. This study uses a segmented model of prey weight versus prey preference to objectively quantify the prey weight preferences of the five large African carnivores. Based on simulations of known predator prey preference, for prey species sample sizes above 32 the segmented model approach detects up to four known changes in prey weight preference (represented by model break-points) with high rates of detection (75% to 100% of simulations, depending on number of break-points) and accuracy (within 1.3±4.0 to 2.7±4.4 of known break-point). When applied to the five large African carnivores, using carnivore diet information from across Africa, the model detected weight ranges of prey that are preferred, killed relative to their abundance, and avoided by each carnivore. Prey in the weight ranges preferred and killed relative to their abundance are together termed “accessible prey”. Accessible prey weight ranges were found to be 14–135 kg for cheetah Acinonyx jubatus, 1–45 kg for leopard Panthera pardus, 32–632 kg for lion Panthera leo, 15–1600 kg for spotted hyaena Crocuta crocuta and 10–289 kg for wild dog Lycaon pictus. An assessment of carnivore diets throughout Africa found these accessible prey weight ranges include 88±2% (cheetah), 82±3% (leopard), 81±2% (lion), 97±2% (spotted hyaena) and 96±2% (wild dog) of kills. These descriptions of prey weight preferences therefore contribute to our understanding of the diet spectrum of the five large African carnivores. Where datasets meet the minimum sample size requirements, the segmented model approach provides a means of determining, and comparing, the prey weight range preferences of any carnivore

  6. Enhancing healthcare accessibility measurements using GIS: A case study in Seoul, Korea

    PubMed Central

    Kim, Yeeun; Byon, Young-Ji

    2018-01-01

    With recent aging demographic trends, the needs for enhancing geo-spatial analysis capabilities and monitoring the status of accessibilities of its citizens with healthcare services have increased. The accessibility to healthcare is determined not only by geographic distances to service locations, but also includes travel time, available modes of transportation, and departure time. Having access to the latest and accurate information regarding the healthcare accessibility allows the municipal government to plan for improvements, including expansion of healthcare infrastructure, effective labor distribution, alternative healthcare options for the regions with low accessibilities, and redesigning the public transportation routes and schedules. This paper proposes a new method named, Seoul Enhanced 2-Step Floating Catchment Area (SE2SFCA), which is customized for the city of Seoul, where population density is higher and the average distance between healthcare-service locations tends to be shorter than the typical North American or European cities. The proposed method of SE2SFCA is found to be realistic and effective in determining the weak accessibility regions. It resolves the over-estimation issues of the past, arising from the assignment of high healthcare accessibility for the regions with large hospitals and high density of population and hospitals. PMID:29462194

  7. Cash and counseling: a promising option for consumer direction of home- and community-based services and supports.

    PubMed

    Mahoney, Kevin J; Simon-Rusinowitz, Lori; Simone, Kristin; Zgoda, Karen

    2006-01-01

    The Cash and Counseling Demonstration began as a 3-state social experiment to test the claims of members of the disability community that, if they had more control over their services, their lives would improve and costs would be no higher. The 2004 expansion to 12 states brings us closer to the tipping point when this option will be broadly available. The original demonstration was a controlled experiment with randomized assignment, supplemented by an ethnographic study and a process evaluation. Consumers managing flexible, individualized budgets were much more satisfied, had fewer unmet needs, and had comparable health outcomes. Access to service and supports was greatly improved. Consumer direction is increasingly accepted as a desirable option in home and community services.

  8. Decision analysis and drug development portfolio management: uncovering the real options value of your projects.

    PubMed

    Rosati, Nicoletta

    2002-04-01

    Project selection and portfolio management are particularly challenging in the pharmaceutical industry due to the high risk - high stake nature of the drug development process. In the recent years, scholars and industry experts have agreed that traditional Net-Present-Value evaluation of the projects fails to capture the value of managerial flexibility, and encouraged adopting a real options approach to recover the missed value. In this paper, we take a closer look at the drug development process and at the indices currently used to rank projects. We discuss the economic value of information and of real options arising in drug development and present decision analysis as an ideal framework for the implementation of real options valuation.

  9. Superficial Femoral Artery Intervention by Single Transpedal Arterial Access.

    PubMed

    Amoroso, Nicholas S; Shah, Sooraj; Liou, Michael; Ratcliffe, Justin; Lala, Moinakhtar; Diwan, Ravi; Huang, Yili; Rosero, Hugo; Coppola, John; Bertrand, Olivier F; Kwan, Tak W

    2015-11-01

    Atherosclerotic disease of the superficial femoral artery (SFA) is frequently seen and can be treated with percutaneous interventions, traditionally via femoral artery access. There are limited reports of transpedal artery access for peripheral artery interventions, but none to date describing routine primary transpedal artery approach for SFA stenting. In this preliminary study, we report 4 patients who underwent successful endovascular SFA stenting using a single transpedal artery access via a new ultra-low profile 6 Fr sheath (Glidesheath Slender; Terumo Corporation). All patients underwent successful SFA stenting without complication. Procedure time varied from 51 to 72 minutes. The mean contrast amount used was 56 mL; mean fluoroscopy time was 21 minutes; mean radiation dose was 91 mGy. At 1-month follow-up, duplex ultrasonography showed that all pedal arteries had remained patent. Transpedal artery approach as a primary approach to SFA stenting appears feasible and safe. Comparative trials with standard percutaneous femoral approach are warranted.

  10. Vascular access in critical limb ischemia.

    PubMed

    Kang, Won Yu; Campia, Umberto; Ota, Hideaki; Didier, Romain J; Negi, Smita I; Kiramijyan, Sarkis; Koifman, Edward; Baker, Nevin C; Magalhaes, Marco A; Lipinski, Michael J; Escarcega, Ricardo O; Torguson, Rebecca; Waksman, Ron; Bernardo, Nelson L

    2016-01-01

    Currently, percutaneous endovascular intervention is considered a first line of therapy for treating patients with critical limb ischemia. As the result of remarkable development of techniques and technologies, percutaneous endovascular intervention has led to rates of limb salvage comparable to those achieved with bypass surgery, with fewer complications, even in the presence of lower rates of long-term patency. Currently, interventionalists have a multiplicity of access routes including smaller arteries, with both antegrade and retrograde approaches. Therefore, the choice of the optimal access site has become an integral part of the success of the percutaneous intervention. By understanding the technical aspects, as well as the advantages and limitations of each approach, the interventionalists can improve clinical outcomes in patients with severe peripheral arterial disease. This article reviews the access routes in critical limb ischemia, their advantages and disadvantages, and the clinical outcomes of each. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. A Decision Support Framework for Feasibility Analysis of International Space Station (ISS) Research Capability Enhancing Options

    NASA Technical Reports Server (NTRS)

    Ortiz, James N.; Scott,Kelly; Smith, Harold

    2004-01-01

    The assembly and operation of the ISS has generated significant challenges that have ultimately impacted resources available to the program's primary mission: research. To address this, program personnel routinely perform trade-off studies on alternative options to enhance research. The approach, content level of analysis and resulting outputs of these studies vary due to many factors, however, complicating the Program Manager's job of selecting the best option. To address this, the program requested a framework be developed to evaluate multiple research-enhancing options in a thorough, disciplined and repeatable manner, and to identify the best option on the basis of cost, benefit and risk. The resulting framework consisted of a systematic methodology and a decision-support toolset. The framework provides quantifiable and repeatable means for ranking research-enhancing options for the complex and multiple-constraint domain of the space research laboratory. This paper describes the development, verification and validation of this framework and provides observations on its operational use.

  12. 48 CFR 3017.202 - Use of options.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Use of options. 3017.202... ACQUISITION REGULATION (HSAR) CONTRACT METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options. 3017.202 Use of options. (a) Contracting officers shall not use unpriced options. ...

  13. The radiative forcing potential of different climate geoengineering options

    NASA Astrophysics Data System (ADS)

    Lenton, T. M.; Vaughan, N. E.

    2009-01-01

    Climate geoengineering proposals seek to rectify the Earth's current radiative imbalance, either by reducing the absorption of incoming solar (shortwave) radiation, or by removing CO2 from the atmosphere and transferring it to long-lived reservoirs, thus increasing outgoing longwave radiation. A fundamental criterion for evaluating geoengineering options is their climate cooling effectiveness, which we quantify here in terms of radiative forcing potential. We use a simple analytical approach, based on the global energy balance and pulse response functions for the decay of CO2 perturbations. This aids transparency compared to calculations with complex numerical models, but is not intended to be definitive. Already it reveals some significant errors in existing calculations, and it allows us to compare the relative effectiveness of a range of proposals. By 2050, only stratospheric aerosol injections or sunshades in space have the potential to cool the climate back toward its pre-industrial state, but some land carbon cycle geoengineering options are of comparable magnitude to mitigation "wedges". Strong mitigation, i.e. large reductions in CO2 emissions, combined with global-scale air capture and storage, afforestation, and bio-char production, i.e. enhanced CO2 sinks, might be able to bring CO2 back to its pre-industrial level by 2100, thus removing the need for other geoengineering. Alternatively, strong mitigation stabilising CO2 at 500 ppm, combined with geoengineered increases in the albedo of marine stratiform clouds, grasslands, croplands and human settlements might achieve a patchy cancellation of radiative forcing. Ocean fertilisation options are only worthwhile if sustained on a millennial timescale and phosphorus addition probably has greater long-term potential than iron or nitrogen fertilisation. Enhancing ocean upwelling or downwelling have trivial effects on any meaningful timescale. Our approach provides a common framework for the evaluation of

  14. Management options of non-syndromic sagittal craniosynostosis.

    PubMed

    Lee, Bryan S; Hwang, Lee S; Doumit, Gaby D; Wooley, Joseph; Papay, Francis A; Luciano, Mark G; Recinos, Violette M

    2017-05-01

    There have been various effective surgical procedures for the treatment of non-syndromic sagittal craniosynostosis, but no definitive guidelines for management have been established. We conducted a study to elucidate the current state of practice and establish a warranted standard of care. An Internet-based study was sent to 180 pediatric neurosurgeons across the country and 102 craniofacial plastic surgeons in fourteen different countries, to collect data for primary indication for surgical management, preference for timing and choice of surgery, and pre-, peri-, and post-operative management options. The overall response rate from both groups was 32% (n=90/284). Skull deformity was the primary indication for surgical treatment in patients without signs of hydrocephalus for both neurosurgeons and craniofacial surgeons (80% and 63%, respectively). Open surgical management was most commonly performed at six months of age by neurosurgeons (46%) and also by craniofacial surgeons (35%). Open surgical approach was favored for patients younger than four months of age by neurosurgeons (50%), but endoscopic approach was favored by craniofacial surgeons (35%). When performing an open surgical intervention, most neurosurgeons preferred pi or reversed pi procedure (27%), whereas total cranial vault remodeling was the most commonly performed procedure by craniofacial surgeons (37%). The data demonstrated a discrepancy in the treatment options for non-syndromic sagittal craniosynostosis. By conducting/comparing a wide survey to collect consolidative data from both groups of pediatric neurosurgeons and craniofacial plastic surgeons, we can attempt to facilitate the establishment of standard of care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Maximizing value in opioid utilization: Is oxycodone immediate release a good option for pain management?

    PubMed

    Pergolizzi, Joseph V; Köknel Talu, Gül; Zmponga, Gianpetrio; Erdine, Serdar; Taylor, Robert; Ayan, Burak; Raffa, Robert B

    2015-01-01

    The modern approach to the management of pain involves optimizing all aspects of the process. This includes utilization of pharmacologic and non-pharmacologic modalities, consideration of patient characteristics, proper matching of the physiology of the pain with the analgesic's mechanism of action (pharmacodynamics, PD), and the onset and duration of action (pharmacokinetics, PK). No single agent or formulation satisfies all of the requirements for all patients. Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) are effective options for inflammatory pain and, as is acetaminophen, for mild pain. Specialized agents are helpful for particular pains, such as for migraine headache. Opioids remain the standard option for severe pain. Although they are generally a safe and effective option, opioids can produce dose-limiting adverse effects and have abuse potential. The goal of pain therapy is thus to achieve the maximum pain relief with the least amount of opioid exposure. Against this background of measured approach to the use of analgesics, an immediate release (IR) oral formulation of the established opioid oxycodone has been developed to provide rapid onset of action and rate of titration, both of which could maximize temporal matching of dose with pain level and reduce total exposure to drug. This article considers the option of an immediate release (IR) oral formulation for the management of pain.

  16. TOPEX satellite option study

    NASA Technical Reports Server (NTRS)

    1982-01-01

    The basic design of the fleet satellite communication spacecraft (FLTSATCOM) can easily accommodate any of the three payload options for the ocean dynamic topography experiment (TOPEX). The principal mission requirements as well as the payload accommodations and communications systems needed for launching this payload are reviewed. The existing FLTSATCOM satellite design is identified and the approaches for the proposed propulsion system are described in addition to subsystems for mechanical; power; attitude and velocity control; and telemetry, tracking and control are described. The compatability of FLTSATCOM with the launch vehicle is examined and its capabilities vs TOPEX requirements are summarized. Undetermined changes needed to meet data storage, thermal control, and area to mass ratio requirements are discussed. Cost estimates are included for budgetary and planning purposes. The availability of the described design is assessed based on the continuing production of FLTSATCOM spacecraft during the schedule span planned for TOPEX.

  17. 48 CFR 1517.207 - Exercise of options.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Exercise of options. 1517... CONTRACTING METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 1517.207 Exercise of options. (a) Unless otherwise approved by the Chief of the Contracting Office, contracts for services employing option...

  18. 24 CFR 982.636 - Homeownership option: Portability.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Homeownership option: Portability... Types Homeownership Option § 982.636 Homeownership option: Portability. (a) General. A family may... described in §§ 982.353 and 982.355 apply to the homeownership option and the administrative...

  19. 48 CFR 317.207 - Exercise of options.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Exercise of options. 317... METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 317.207 Exercise of options. (h) Before exercising an option for a subsequent performance period/additional quantity under a multiple-year contract...

  20. Comparative analyses of spent nuclear fuel transport modal options: Transport options under existing site constraints

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

    Brentlinger, L.A.; Hofmann, P.L.; Peterson, R.W.

    1989-08-01

    The movement of nuclear waste can be accomplished by various transport modal options involving different types of vehicles, transport casks, transport routes, and intermediate intermodal transfer facilities. A series of systems studies are required to evaluate modal/intermodal spent fuel transportation options in a consistent fashion. This report provides total life-cycle cost and life-cycle dose estimates for a series of transport modal options under existing site constraints. 14 refs., 7 figs., 28 tabs.

  1. Mandatory and Location-Aware Access Control for Relational Databases

    NASA Astrophysics Data System (ADS)

    Decker, Michael

    Access control is concerned with determining which operations a particular user is allowed to perform on a particular electronic resource. For example, an access control decision could say that user Alice is allowed to perform the operation read (but not write) on the resource research report. With conventional access control this decision is based on the user's identity whereas the basic idea of Location-Aware Access Control (LAAC) is to evaluate also a user's current location when making the decision if a particular request should be granted or denied. LAAC is an interesting approach for mobile information systems because these systems are exposed to specific security threads like the loss of a device. Some data models for LAAC can be found in literature, but almost all of them are based on RBAC and none of them is designed especially for Database Management Systems (DBMS). In this paper we therefore propose a LAAC-approach for DMBS and describe a prototypical implementation of that approach that is based on database triggers.

  2. US Instrument Options for the SPICA Observatory

    NASA Technical Reports Server (NTRS)

    Benford, Dominic; Carter, Ruth; Benner, Steve; Rossetti, Dino; Leete, Stephen; Townsend, Jackie; Keer, Beth; Davis, Chris

    2012-01-01

    NASA has engaged in studying options for a US contribution to the Japanese-led Space II Astrophysics (SPICA). This cryogenic 3m-class telescope builds on the scientific and technological legacies of Akari and Hershel. The primary portion of a US contribution would be a far-infrared spectrometer, but with a sensitivity several hundred times greater than Herschel, opening up this wavelength range for study of emission lines from galaxies up to the highest redshifts. We describe efforts to formulate an approach that fits within project and programmatic constraints and fulfills the scientific promise of the SPICA observatory.

  3. Quantum internet using code division multiple access

    PubMed Central

    Zhang, Jing; Liu, Yu-xi; Özdemir, Şahin Kaya; Wu, Re-Bing; Gao, Feifei; Wang, Xiang-Bin; Yang, Lan; Nori, Franco

    2013-01-01

    A crucial open problem inS large-scale quantum networks is how to efficiently transmit quantum data among many pairs of users via a common data-transmission medium. We propose a solution by developing a quantum code division multiple access (q-CDMA) approach in which quantum information is chaotically encoded to spread its spectral content, and then decoded via chaos synchronization to separate different sender-receiver pairs. In comparison to other existing approaches, such as frequency division multiple access (FDMA), the proposed q-CDMA can greatly increase the information rates per channel used, especially for very noisy quantum channels. PMID:23860488

  4. Vascular access site complication in transfemoral coronary angiography between uninterrupted warfarin and heparin bridging.

    PubMed

    Wongcharoen, Wanwarang; Pinyosamosorn, Kittipong; Gunaparn, Siriluck; Boonnayhun, Suchada; Thonghong, Tasalak; Suwannasom, Pannipa; Phrommintikul, Arintaya

    2017-08-01

    Warfarin discontinuation with heparin bridging is a common practice in patients receiving warfarin prior to elective coronary angiography (CAG). The uninterrupted warfarin strategy has been suggested to be alternative option for patients with high thromboembolic risk. Therefore, we aimed to assess the safety of elective transfemoral CAG during uninterrupted warfarin therapy compared to heparin bridging. This study was a randomized open-label design with blinded event evaluation. The 110 consecutive patients (age ≥ 18 years) receiving warfarin before the planned transfemoral CAG were randomly assigned to either heparin bridging or uninterrupted warfarin with targeted INR (2.0-3.0). The primary outcome was the incidence of major vascular access site complications. The baseline characteristics were comparable between two groups (mean age was 60.1 ± 7.8 years, 49 males). The mean INR on the day of CAG of heparin bridging and uninterrupted warfarin groups was 1.2 ± 0.3 and 2.2 ± 0.5 (P < 0.001). The major vascular access site complications occurred in 3 of 55 (5.5%) heparin-bridging patients and in none of 55 uninterrupted warfarin patients (P = 0.243). The total vascular access site complications occurred in 6 (10.9%) heparin-bridging and one (1.8%) uninterrupted warfarin patients (P = 0.113). No patient developed either other bleeding or thromboembolic events during 7 days after CAG. We demonstrated that an uninterrupted warfarin strategy did not increase vascular access site complications in patients undergoing transfemoral CAG compared to heparin bridging therapy. Due to the safety and the ease of uninterrupted warfarin strategy, this approach should be encouraged in patients receiving long-term warfarin who undergo elective transfemoral CAG. © 2017, Wiley Periodicals, Inc.

  5. Evaluation of Foreign Investment in Power Plants using Real Options

    NASA Astrophysics Data System (ADS)

    Kato, Moritoshi; Zhou, Yicheng

    This paper proposes new methods for evaluating foreign investment in power plants under market uncertainty using a real options approach. We suppose a thermal power plant project in a deregulated electricity market. One of our proposed methods is that we calculate the cash flow generated by the project in a reference year using actual market data to incorporate periodic characteristics of energy prices into a yearly cash flow model. We make the stochastic yearly cash flow model with the initial value which is the cash flow in the reference year, and certain trend and volatility. Then we calculate the real options value (ROV) of the project which has abandonment options using the yearly cash flow model. Another our proposed method is that we evaluate foreign currency/domestic currency exchange rate risk by representing ROV in foreign currency as yearly pay off and exchanging it to ROV in domestic currency using a stochastic exchange rate model. We analyze the effect of the heat rate and operation and maintenance costs of the power plant on ROV, and evaluate exchange rate risk through numerical examples. Our proposed method will be useful for the risk management of foreign investment in power plants.

  6. The author who wasn't there? Fairness and attribution in publications following access to population biobanks.

    PubMed

    Kleiderman, Erika; Pack, Amy; Borry, Pascal; Zawati, Ma'n

    2018-01-01

    We conducted a document analysis that explored publication ethics and authorship in the context of population biobanks from both a theoretical (e.g. normative documents) and practical (e.g. biobank-specific documentation) perspective. The aim was to provide an overview of the state of authorship attribution in population biobanks and attempt to fill the gap in discussions around the issue. Our findings demonstrate that the most common approach adopted in both the normative and biobank-specific documentation is acknowledgment. A co-authorship approach was second and highlighted concerns surrounding the fairness of imposing authorship of the scientific leadership as a condition to access data and biosamples, as well as the alignment with the International Committee of Medical Journal Editors' criteria such as what is deemed a significant contribution and how to ensure accountability. Based on these findings, we propose a three-prong approach, that may be cumulative, to address the issue of authorship attribution in the context of population biobanks, namely 1) the biobank should be appropriately acknowledged; 2) an invitation for co-authorship should be made based on the spirit of collaboration and provided a substantial contribution has been made; and 3) a citation/referencing option should be available.

  7. 48 CFR 536.270 - Exercise of options.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Exercise of options. 536... Construction 536.270 Exercise of options. (a) If exercising an option, notify the contractor, in writing, within the time period specified in the contract. (b) Exercise options only after determining that all...

  8. 48 CFR 3417.207 - Exercise of options.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Exercise of options. 3417... REGULATION CONTRACTING METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 3417.207 Exercise of options. If any provision in a contract requires that an option may only be exercised within a specified...

  9. 48 CFR 817.202 - Use of options.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Use of options. 817.202... AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 817.202 Use of options. All solicitations... four one-year renewal options as prescribed in FAR Subpart 17.2. The contracting officer must forward...

  10. 48 CFR 317.207 - Exercise of options.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 4 2012-10-01 2012-10-01 false Exercise of options. 317... METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 317.207 Exercise of options. (h) Before..., and the Section 508 Official or designee, prior to exercise of an option. The Contracting Officer...

  11. 48 CFR 17.207 - Exercise of options.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Exercise of options. 17... METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 17.207 Exercise of options. (a) When... exercise options only after determining that— (1) Funds are available; (2) The requirement covered by the...

  12. 48 CFR 317.207 - Exercise of options.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 4 2013-10-01 2013-10-01 false Exercise of options. 317... METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 317.207 Exercise of options. (h) Before..., and the Section 508 Official or designee, prior to exercise of an option. The Contracting Officer...

  13. 48 CFR 17.207 - Exercise of options.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Exercise of options. 17... METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 17.207 Exercise of options. (a) When... exercise options only after determining that— (1) Funds are available; (2) The requirement covered by the...

  14. 48 CFR 536.270 - Exercise of options.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 4 2013-10-01 2013-10-01 false Exercise of options. 536... Construction 536.270 Exercise of options. (a) If exercising an option, notify the contractor, in writing, within the time period specified in the contract. (b) Exercise options only after determining that all...

  15. 48 CFR 536.270 - Exercise of options.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Exercise of options. 536... Construction 536.270 Exercise of options. (a) If exercising an option, notify the contractor, in writing, within the time period specified in the contract. (b) Exercise options only after determining that all...

  16. 48 CFR 317.207 - Exercise of options.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Exercise of options. 317... METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 317.207 Exercise of options. (h) Before..., and the Section 508 Official or designee, prior to exercise of an option. The Contracting Officer...

  17. 48 CFR 317.207 - Exercise of options.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 4 2014-10-01 2014-10-01 false Exercise of options. 317... METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 317.207 Exercise of options. (h) Before..., and the Section 508 Official or designee, prior to exercise of an option. The Contracting Officer...

  18. 48 CFR 17.207 - Exercise of options.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Exercise of options. 17... METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 17.207 Exercise of options. (a) When... exercise options only after determining that— (1) Funds are available; (2) The requirement covered by the...

  19. 48 CFR 17.207 - Exercise of options.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Exercise of options. 17... METHODS AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 17.207 Exercise of options. (a) When... exercise options only after determining that— (1) Funds are available; (2) The requirement covered by the...

  20. 48 CFR 536.270 - Exercise of options.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 4 2012-10-01 2012-10-01 false Exercise of options. 536... Construction 536.270 Exercise of options. (a) If exercising an option, notify the contractor, in writing, within the time period specified in the contract. (b) Exercise options only after determining that all...