Sample records for access program outcome

  1. Service system integration, access to services, and housing outcomes in a program for homeless persons with severe mental illness.

    PubMed

    Rosenheck, R; Morrissey, J; Lam, J; Calloway, M; Johnsen, M; Goldman, H; Randolph, F; Blasinsky, M; Fontana, A; Calsyn, R; Teague, G

    1998-11-01

    This study evaluated the hypothesis that greater integration and coordination between agencies within service systems is associated with greater accessibility of services and improved client housing outcomes. As part of the Access to Community Care and Effective Services and Supports program, data were obtained on baseline client characteristics, service use, and 3-month and 12-month outcomes from 1832 clients seen at 18 sites during the first year of program operation. Data on interorganizational relationships were obtained from structured interviews with key informants from relevant organizations in each community (n = 32-82 at each site). Complete follow-up data were obtained from 1340 clients (73%). After control for baseline characteristics, service system integration was associated with superior housing outcomes at 12 months, and this relationship was mediated through greater access to housing agencies. Service system integration is related to improved access to housing services and better housing outcomes among homeless people with mental illness.

  2. Expanding access to high-cost medicines through the E2 access program in Thailand: effects on utilisation, health outcomes and cost using an interrupted time-series analysis.

    PubMed

    Sruamsiri, Rosarin; Wagner, Anita K; Ross-Degnan, Dennis; Lu, Christine Y; Dhippayom, Teerapon; Ngorsuraches, Surachat; Chaiyakunapruk, Nathorn

    2016-03-17

    In 2008, the Thai government introduced the 'high-cost medicines E2 access program' as a part of the National List of Essential Medicines to increase patient access to medicines, improve clinical outcomes and make medicines more affordable. Our objective was to examine whether the 'high-cost medicines E2 access program' achieved its goals. Interrupted time-series design study. 3 tertiary hospitals in different regions of Thailand, January 2006 to December 2012. Patients with target acute and chronic disease diagnoses who newly met E2 program criteria for selected study medicines. High-cost medicines E2 access program. Level and trend changes over time in the proportions of eligible patients who received the indicated E2 medicines and who improved clinically, as well as in costs of treatment. A total of 2024 patients were included in utilisation analyses and 1375 patients with selected acute diseases contributed to analyses of clinical outcome. After 1 year of the E2 program implementation, the percentage of eligible patients receiving the indicated E2 program medicines increased significantly (relative change 12.7% (95% CI 4.4% to 21.0%), especially among those insured by the government's universal coverage scheme (relative change 19.9% (95% CI 9.5% to 30.5%)). The increase in the proportion of clinically improved patients with acute conditions was not significant (relative change 6.2% (95% CI -1.9% to 15.1%)). Quarterly healthcare costs per patient dropped significantly (relative change -13.5% (95% CI -26.9% to -1.7%)). In the study hospitals, the E2 access program seems to have facilitated patient access to specialty medicines, may have contributed to improved health outcomes, and decreased treatment costs. Routine monitoring is needed to assess effects of expanding the programme, including effects on quality of care and financial sustainability. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

  3. Evaluation of an open-access CBT-based Internet program for social anxiety: Patterns of use, retention, and outcomes.

    PubMed

    Dryman, M Taylor; McTeague, Lisa M; Olino, Thomas M; Heimberg, Richard G

    2017-10-01

    Internet-delivered cognitive-behavioral therapy (ICBT) has been established as both efficacious and effective in reducing symptoms of social anxiety. However, most research has been conducted in controlled settings, and little is known regarding the utility of such programs in an open-access format. The present study examined the use, adherence, and effectiveness of Joyable, an open-access, Internet-delivered, coach-supported CBT-based intervention for social anxiety. Participants were 3,384 registered users (Mage [SD] = 29.82 [7.89]; 54% male) that created an account between 2014 and 2016. Characteristics of use, factors related to attrition and adherence, and within-group outcomes were examined. The primary outcome measure was the Social Phobia Inventory. On average, participants remained in the program for 81.02 days (SD = 60.50), during which they completed 12.14 activities (SD = 11.09) and 1.53 exposures (SD = 3.18). About half (57%) had contact with a coach. Full adherence to the program was achieved by 16% of participants, a rate higher than previously published open-access studies of ICBT. Social anxiety symptoms were significantly reduced for participants that engaged in the program, with medium within-group effects from baseline through the cognitive restructuring module (d = 0.63-0.76) and large effects from baseline through the exposure module (d = 1.40-1.83). Response rates were high (72%). Exposures and coach contact were significant predictors of retention and outcome. This open-access online CBT-based program is effective in reducing social anxiety symptoms and has the potential to extend Internet-based mental health services to socially anxious individuals unwilling or unable to seek face-to-face evidence-based therapy. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. Long-Term Outcomes of a Dental Postbaccalaureate Program: Increasing Dental Student Diversity and Oral Health Care Access

    PubMed Central

    Wides, Cynthia D.; Brody, Harvey A.; Alexander, Charles J.; Gansky, Stuart A.; Mertz, Elizabeth A.

    2013-01-01

    The University of California, San Francisco School of Dentistry established the Dental Postbaccalaureate Program in 1998 to provide reapplication assistance to students from economically and/or educationally disadvantaged backgrounds who were previously denied admission to dental school. The goals were to increase diversity in the dental school student population and improve access to dental services for underserved populations. This article assesses the program’s short-, mid-, and long-term outcomes and is the first to examine long-term practice patterns after a dental postbaccalaureate program. Data collected on all participant (n=94) demographics, pre/post-program DAT scores, and post-program dental school admission results were used to assess short- and mid-term outcomes. Long-term outcomes and practice patterns were assessed using results of a census survey administered between 2009 and 2011 to the participants who had completed dental school and been in practice for at least two years (n=57). The survey had a response rate of 93 percent (n=53). Descriptive statistical techniques were used to examine the responses and to compare them to U.S. Census Bureau data and nationally available practice data for new dental graduates. Program participants’ DAT scores improved by an average of two points, and 98 percent were accepted to dental school. All survey respondents were practicing dentistry, and 81 percent reported serving underserved populations. These participants treat more Medicaid recipients than do most dentists, and their patient population is more diverse than the general population. The outcomes demonstrate that the program’s graduates are increasing diversity in the dental student population and that their practices are providing access to care for underserved populations. PMID:23658398

  5. Realistic expectations for public access defibrillation programs.

    PubMed

    Atkins, Dianne L

    2010-06-01

    Public access defibrillation programs have increased dramatically over the past 15 years. This review will focus on their effectiveness and operational characteristics and discuss the characteristics of successful programs, which can improve outcomes. Automated external defibrillators increase survival from cardiac arrest when used by a bystander. Recent studies show that the best outcomes are achieved when devices are placed in areas with a high frequency of cardiac arrest and there is ongoing supervision with emergency plans and cardiopulmonary resuscitation training. Programs are cost-effective under these circumstances, but become very inefficient when placed in areas of low risk. There are few adverse events related to the public access defibrillation programs and volunteers are not harmed. Unguided placement results in devices not being used and a decline in organizational structure of the program. As most cardiac arrests occur in the home, the impact on overall survival remains low. Automated external defibrillators are highly effective at reducing death from ventricular fibrillation and easy access in public areas is most effective. Placement must be prioritized based on public health impact and characteristics of the community.

  6. Project Baiterek: A Patient Access Program to Improve Clinical Outcomes and Quality of Life in Children with Type 1 Diabetes in Kazakhstan.

    PubMed

    Muratalina, Aigul; Smith-Palmer, Jayne; Nurbekova, Akmaral; Abduakhassova, Gulmira; Zhubandykova, Leila; Roze, Stéphane; Karamalis, Manolis; Shamshatova, Gulzhakhan; Demessinov, Adi; D'Agostino, Nicola Dunne; Lynch, Peter; Yedigarova, Larisa; Klots, Motty; Valentine, William; Welsh, John; Kaufman, Francine

    2015-09-01

    Diabetes is a key driver in the rise of noncommunicable diseases globally. It causes expensive and burdensome short- and long-term complications, with both an economic and social impact. In many countries, however, access to care and disease management in type 1 diabetes is suboptimal, increasing the risk for complications. In 2011, Project Baiterek was initiated as a collaborative effort between the Kazakhstan Ministry of Health, industry (Medtronic Plc), local physicians, and the Diabetes Association of the Republic of Kazakhstan to enhance patient access to continuous subcutaneous insulin infusion (CSII) therapy. It was the first countrywide project to provide equity and universal access to insulin pump therapy among children with type 1 diabetes, increasing pump use from zero to two-thirds of this population in less than 3 years. The project also involved instigating longitudinal data collection, and long-term clinical outcomes continue to be monitored. Here, we provide an overview of the clinical, quality-of-life, and economic outcomes to date associated with providing CSII therapy to children with type 1 diabetes in Kazakhstan. Initial clinical data show that CSII therapy improved clinical outcomes and quality of life for patients entered into the program and that CSII therapy was cost-effective relative to multiple daily injection therapy. The positive outcomes of Project Baiterek provide a template for similar patient access programs in other settings, and its framework could be adapted to initiatives to change health care infrastructures and standards of care for other noncommunicable diseases. Copyright © 2015. Published by Elsevier Inc.

  7. Cost-effectiveness of Access to Critical Cerebral Emergency Support Services (ACCESS): a neuro-emergent telemedicine consultation program.

    PubMed

    Whetten, Justin; van der Goes, David N; Tran, Huy; Moffett, Maurice; Semper, Colin; Yonas, Howard

    2018-04-01

    Access to Critical Cerebral Emergency Support Services (ACCESS) was developed as a low-cost solution to providing neuro-emergent consultations to rural hospitals in New Mexico that do not offer comprehensive stroke care. ACCESS is a two-way audio-visual program linking remote emergency department physicians and their patients to stroke specialists. ACCESS also has an education component in which hospitals receive training from stroke specialists on the triage and treatment of patients. This study assessed the clinical and economic outcomes of the ACCESS program in providing services to rural New Mexico from a healthcare payer perspective. A decision tree model was constructed using findings from the ACCESS program and existing literature, the likelihood that a patient will receive a tissue plasminogen activator (tPA), cost of care, and resulting quality adjusted life years (QALYs). Data from the ACCESS program includes emergency room patients in rural New Mexico from May 2015 to August 2016. Outcomes and costs have been estimated for patients who were taken to a hospital providing neurological telecare and patients who were not. The use of ACCESS decreased neuro-emergent stroke patient transfers from rural hospitals to urban settings from 85% to 5% (no tPA) and 90% to 23% (tPA), while stroke specialist reading of patient CT/MRI imaging within 3 h of onset of stroke symptoms increased from 2% to 22%. Results indicate that use of ACCESS has the potential to save $4,241 ($3,952-$4,438) per patient and increase QALYs by 0.20 (0.14-0.22). This increase in QALYs equates to ∼73 more days of life at full health. The cost savings and QALYs are expected to increase when moving from a 90-day model to a lifetime model. The analysis demonstrates potential savings and improved quality-of-life associated with the use of ACCESS for patients presenting to rural hospitals with acute ischemic stroke (AIS).

  8. ICU Telemedicine Program Financial Outcomes.

    PubMed

    Lilly, Craig M; Motzkus, Christine; Rincon, Teresa; Cody, Shawn E; Landry, Karen; Irwin, Richard S

    2017-02-01

    ICU telemedicine improves access to high-quality critical care, has substantial costs, and can change financial outcomes. Detailed information about financial outcomes and their trends over time following ICU telemedicine implementation and after the addition of logistic center function has not been published to our knowledge. Primary data were collected for consecutive adult patients of a single academic medical center. We compared clinical and financial outcomes across three groups that differed regarding telemedicine support: a group without ICU telemedicine support (pre-ICU intervention group), a group with ICU telemedicine support (ICU telemedicine group), and an ICU telemedicine group with added logistic center functions and support for quality-care standardization (logistic center group). The primary outcome was annual direct contribution margin defined as aggregated annual case revenue minus annual case direct costs (including operating costs of ICU telemedicine and its related programs). All monetary values were adjusted to 2015 US dollars using Producer Price Index for Health-Care Facilities. Annual case volume increased from 4,752 (pre-ICU telemedicine) to 5,735 (ICU telemedicine) and 6,581 (logistic center). The annual direct contribution margin improved from $7,921,584 (pre-ICU telemedicine) to $37,668,512 (ICU telemedicine) to $60,586,397 (logistic center) due to increased case volume, higher case revenue relative to direct costs, and shorter length of stay. The ability of properly modified ICU telemedicine programs to increase case volume and access to high-quality critical care with improved annual direct contribution margins suggests that there is a financial argument to encourage the wider adoption of ICU telemedicine. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  9. From Implementation to Outcomes to Impacts: Designing a Comprehensive Program Evaluation

    NASA Astrophysics Data System (ADS)

    Shebby, S.

    2015-12-01

    Funders are often interested in learning about the impact of program activities, yet before the impacts are determined, educational evaluations should first examine program implementation and outcomes. Implementation evaluation examines how and the extent to which program activities are delivered as intended, including the extent to which activities reached the targeted participants. Outcome evaluation is comprised of a systematic examination of the effects that a program has on program participants, such as changes in knowledge, attitudes, beliefs, values, and behaviors. In this presentation, presenters will share insights on evaluating the implementation, outcomes, and impacts associated with an online science curriculum for K-2 students. The science curriculum was designed to provide students with access to science concepts and skills in an interactive and innovative environment, and teachers with embedded, aligned, and on-demand professional development. One of the most important—and challenging—steps in this evaluation was to select outcomes that were well-defined, measurable, and aligned to program activities, as well as relevant to program stakeholders. An additional challenge was to measure implementation given limited access to the classroom environment. This presentation will include a discussion of the process evaluators used to select appropriate implementation indicators and outcomes (teacher and student), design an evaluation approach, and craft data collection instruments. Although examples provided are specific to the K-2 science intervention, the best practices discussed are pertinent to all program and event evaluations. Impact evaluation goes beyond implementation and outcome evaluation to inform whether a program is working or not. It requires a comparison group to inform what outcomes would have been in the absence of the intervention. As such, this presentation will also include a discussion of impacts, including how impacts are defined

  10. A National Long-term Outcomes Evaluation of U. S. Premedical Postbaccalaureate Programs Designed to Promote Healthcare Access and Workforce Diversity

    PubMed Central

    McDougle, Leon; Way, David P.; Lee, Winona K.; Morfin, Jose A.; Mavis, Brian E.; Wiggins, De’Andrea; Latham-Sadler, Brenda A.; Clinchot, Daniel M.

    2016-01-01

    The National Postbaccalaureate Collaborative (NPBC) is a partnership of Postbaccalaureate Programs (PBPs) dedicated to helping promising college graduates from disadvantaged and underrepresented backgrounds get into and succeed in medical school. This study aims to determine long-term program outcomes by looking at PBP graduates, who are now practicing physicians, in terms of healthcare service to the poor and underserved and contribution to healthcare workforce diversity. Methods We surveyed the PBP graduates and a randomly drawn sample of non-PBP graduates from the affiliated 10 medical schools stratified by the year of medical school graduation (1996-2002). Results The PBP graduates were more likely to be providing care in federally designated underserved areas and practicing in institutional settings that enable access to care for vulnerable populations. Conclusion The NPBC graduates serve a critical role in providing access to care for underserved populations and serve as a source for healthcare workforce diversity. PMID:26320900

  11. Factors associated with health care access and outcome.

    PubMed

    Paek, Min-So; Lim, Jung-Won

    2012-01-01

    This study aims to (1) assess ethnic differences in health care access and health outcome between Asian Americans and whites and between Asian American subgroups, (2) examine effects of cultural factors, and (3) investigate moderating effects of health risk behaviors between cultural characteristics and health care access and outcome. Data were derived from the 2007 California Health Interview Survey. Asian Americans (n = 4,462) and whites (n = 4,470) were included. There were significant ethnic differences in health care access and health perception between Asian Americans and Whites and across Asian American subgroups. Health risk behaviors moderated relationships between cultural factors and health care access and outcome. Findings reveal that ethnicity affects an individual's health care access and health perception, and their health behaviors are an important factor that may improve or worsen outcomes. This study may increase our knowledge base of research and interventions to enhance ethnic minority populations' health care accessibility and perceptions.

  12. A National Long-term Outcomes Evaluation of U.S. Premedical Postbaccalaureate Programs Designed to Promote Health care Access and Workforce Diversity.

    PubMed

    McDougle, Leon; Way, David P; Lee, Winona K; Morfin, Jose A; Mavis, Brian E; Matthews, De'Andrea; Latham-Sadler, Brenda A; Clinchot, Daniel M

    2015-08-01

    The National Postbaccalaureate Collaborative (NPBC) is a partnership of Postbaccalaureate Programs (PBPs) dedicated to helping promising college graduates from disadvantaged and underrepresented backgrounds get into and succeed in medical school. This study aims to determine long-term program outcomes by looking at PBP graduates, who are now practicing physicians, in terms of health care service to the poor and underserved and contribution to health care workforce diversity. We surveyed the PBP graduates and a randomly drawn sample of non-PBP graduates from the affiliated 10 medical schools stratified by the year of medical school graduation (1996-2002). The PBP graduates were more likely to be providing care in federally designated underserved areas and practicing in institutional settings that enable access to care for vulnerable populations. The NPBC graduates serve a critical role in providing access to care for underserved populations and serve as a source for health care workforce diversity.

  13. An Outcome Evaluation of the Success for Kids Program

    PubMed Central

    Maestas, Nicole; Gaillot, Sarah J.

    2012-01-01

    Abstract This article presents results from a multisite, quantitative evaluation of the international Success for Kids (SFK) after-school program. The program seeks to build resilience in children by teaching them to access inner resources and build positive connections with others. The SFK program is unlike most after-school programs both in its focus on spiritual development and in its emphasis on outcomes related to resilience rather than academics. The authors found that the program had beneficial effects on adaptive skills, behavioral problems, overexternalization of problems, and school problems, and the effects persisted at 12-week follow-up. Interestingly, the program positively affected school-related outcomes, even though SFK is not an academic intervention. Specifically, it improved reported study skills and reduced reported learning problems and attention problems. Overall, a major strength of the program appears to be its careful attention to uniformity of program delivery—in particular, its standardized curriculum, use of experienced teachers, and formal teacher-training program. PMID:28083226

  14. An Outcome Evaluation of the Success for Kids Program.

    PubMed

    Maestas, Nicole; Gaillot, Sarah J

    2012-01-01

    This article presents results from a multisite, quantitative evaluation of the international Success for Kids (SFK) after-school program. The program seeks to build resilience in children by teaching them to access inner resources and build positive connections with others. The SFK program is unlike most after-school programs both in its focus on spiritual development and in its emphasis on outcomes related to resilience rather than academics. The authors found that the program had beneficial effects on adaptive skills, behavioral problems, overexternalization of problems, and school problems, and the effects persisted at 12-week follow-up. Interestingly, the program positively affected school-related outcomes, even though SFK is not an academic intervention. Specifically, it improved reported study skills and reduced reported learning problems and attention problems. Overall, a major strength of the program appears to be its careful attention to uniformity of program delivery-in particular, its standardized curriculum, use of experienced teachers, and formal teacher-training program.

  15. Access to health programs at the workplace and the reduction of work presenteeism: a population-based cross-sectional study.

    PubMed

    Bustillos, Arnaldo Sanchez; Trigoso, Oswaldo Ortiz

    2013-11-01

    To examine access to health programs at workplace as a determinant of presenteeism among adults. Data source was a subsample of the 2009-2010 Canadian Community Health Survey. The outcome was self-reported reduced activities at work (presenteeism). The explanatory variable was self-reported access to a health program at workplace. Logistic regression was used to measure the association between outcome and explanatory variables adjusting for potential confounders. Adjusting for sex, age, education, income, work stress, and chronic conditions, presenteeism was not associated with having access to a health program at workplace (adjusted odds ratio, 1.23; 95% confidence interval, 0.91 to 1.65). The odds of presenteeism were higher in workers who reported high work stress and those with chronic medical conditions. This study found that access to health programs at workplace is not significantly associated with a decline in presenteeism.

  16. Vascular Access Outcomes Reported in Maintenance Hemodialysis Trials: A Systematic Review.

    PubMed

    Viecelli, Andrea K; O'Lone, Emma; Sautenet, Benedicte; Craig, Jonathan C; Tong, Allison; Chemla, Eric; Hooi, Lai-Seong; Lee, Timmy; Lok, Charmaine; Polkinghorne, Kevan R; Quinn, Robert R; Vachharajani, Tushar; Vanholder, Raymond; Zuo, Li; Irish, Ashley B; Mori, Trevor A; Pascoe, Elaine M; Johnson, David W; Hawley, Carmel M

    2018-03-01

    Many randomized controlled trials have been performed with the goal of improving outcomes related to hemodialysis vascular access. If the reported outcomes are relevant and measured consistently to allow comparison of interventions across trials, such trials can inform decision making. This study aimed to assess the scope and consistency of vascular access outcomes reported in contemporary hemodialysis trials. Systematic review. Adults requiring maintenance hemodialysis. All randomized controlled trials and trial protocols reporting vascular access outcomes identified from ClinicalTrials.gov, Embase, MEDLINE, and the Cochrane Kidney and Transplant Specialized Register from January 2011 to June 2016. Any hemodialysis-related intervention. The frequency and characteristics of vascular access outcome measures were analyzed and classified. From 168 relevant trials, 1,426 access-related outcome measures were extracted and classified into 23 different outcomes. The 3 most common outcomes were function (136 [81%] trials), infection (63 [38%]), and maturation (31 [18%]). Function was measured in 489 different ways, but most frequently reported as "mean access blood flow (mL/min)" (37 [27%] trials) and "number of thromboses" (30 [22%]). Infection was assessed in 136 different ways, with "number of access-related infections" being the most common measure. Maturation was assessed in 44 different ways at 15 different time points and most commonly characterized by vein diameter and blood flow. Patient-reported outcomes, including pain (19 [11%]) and quality of life (5 [3%]), were reported infrequently. Only a minority of trials used previously standardized outcome definitions. Restricted sampling frame for feasibility and focus on contemporary trials. The reporting of access outcomes in hemodialysis trials is very heterogeneous, with limited patient-reported outcomes and infrequent use of standardized outcome measures. Efforts to standardize outcome reporting for vascular

  17. 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

  18. SSI/SSDI Outreach, Access, and Recovery (SOAR): Disability Application Outcomes Among Homeless Adults.

    PubMed

    Lowder, Evan M; Desmarais, Sarah L; Neupert, Shevaun D; Truelove, Melissa A

    2017-11-01

    The SSI/SSDI Outreach, Access, and Recovery (SOAR) program has been shown to increase access to Supplemental Security Income and Social Security Disability Insurance benefits among homeless adults. However, little empirical data exist on how or for whom SOAR achieves successful application outcomes. This study investigated applicant and application characteristics associated with disability application outcomes among homeless adults. Secondary data on 6,361 SOAR-assisted applications were obtained. Multilevel models investigated between-applicant differences in application processing time and decision as a function of applicant and application characteristics. Older age and living in an institution were associated with greater odds of application approval. Female gender and receipt of public assistance were associated with longer processing time and lower odds of approval. Except for quality review, SOAR critical components were associated with greater odds of approval. Women and adults receiving public assistance appear disadvantaged in the SOAR application process. SOAR critical components promote successful disability application outcomes.

  19. The educational impact of the Specialty Care Access Network-Extension of Community Healthcare Outcomes program.

    PubMed

    Salgia, Reena J; Mullan, Patricia B; McCurdy, Heather; Sales, Anne; Moseley, Richard H; Su, Grace L

    2014-11-01

    With the aging hepatitis C cohort and increasing prevalence of fatty liver disease, the burden on primary care providers (PCPs) to care for patients with liver disease is growing. In response, the Veterans Administration implemented initiatives for primary care-specialty referral to increase PCP competency in complex disease management. The Specialty Care Access Network-Extension of Community Healthcare Outcomes (SCAN-ECHO) program initiative was designed to transfer subspecialty knowledge to PCPs through case-based distance learning combined with real-time consultation. There is limited information regarding the initiative's ability to engage PCPs to learn and influence their practice. We surveyed PCPs to determine the factors that led to their participation in this program and the educational impact of participation. Of 51 potential participants, 24 responded to an anonymous survey. More than 75% of respondents participated more than one time in a SCAN-ECHO clinic. Providers were motivated to participate by a desire to learn more about liver disease, to apply the knowledge gained to future patients, and to save their patients time traveling to another center for specialty consultation. Seventy-one percent responded that the didactic component and case-based discussion were equally important. It is important that participation changed clinical practice: 75% of providers indicated they had personally discussed the information they learned from the case presentations with their colleague(s), and 42% indicated they helped a colleague care for their patient with the knowledge learned during discussions of other participants' cases. This study shows that the SCAN-ECHO videoconferencing program between PCPs and specialists can educate providers in the delivery of specialty care from a distance and potentially improve healthcare delivery.

  20. 47 CFR 76.1003 - Program access proceedings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1003 Program access proceedings. (a) Complaints. Any multichannel video programming distributor aggrieved by conduct... multichannel video programming distributor intending to file a complaint under this section must first notify...

  1. 47 CFR 76.1003 - Program access proceedings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1003 Program access proceedings. (a) Complaints. Any multichannel video programming distributor aggrieved by conduct... multichannel video programming distributor intending to file a complaint under this section must first notify...

  2. 47 CFR 76.1003 - Program access proceedings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1003 Program access proceedings. (a) Complaints. Any multichannel video programming distributor aggrieved by conduct... multichannel video programming distributor intending to file a complaint under this section must first notify...

  3. 47 CFR 76.1003 - Program access proceedings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1003 Program access proceedings. (a) Complaints. Any multichannel video programming distributor aggrieved by conduct... multichannel video programming distributor intending to file a complaint under this section must first notify...

  4. 47 CFR 76.1003 - Program access proceedings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive Access to Cable Programming § 76.1003 Program access proceedings. (a) Complaints. Any multichannel video programming distributor aggrieved by conduct... multichannel video programming distributor intending to file a complaint under this section must first notify...

  5. The Case for Evaluating Student Outcomes and Equity Gaps to Improve Pathways and Programs of Study

    ERIC Educational Resources Information Center

    Bragg, Debra D.

    2017-01-01

    When linked to program review and improvement, program evaluation can help practitioners to ensure that career-technical education (CTE) and science, technology, engineering, and mathematics (STEM) programs offer equitable access and outcomes for underserved student groups.

  6. String Music Educators' Perceptions of the Impact of New String Programs on Student Outcomes, School Music Programs, and Communities

    ERIC Educational Resources Information Center

    Gillespie, Robert; Russell, Joshua A.; Hamann, Donald L.

    2014-01-01

    The purpose of this study was to examine the impact of newly initiated string programs on teachers, schools, districts, communities, and existing music program administration and students. Research questions pertained to (a) locations, student access, and instructional offerings; (b) educators; and (c) perceived impact on student outcomes. Data…

  7. Relationship between Learning Outcomes and Online Accesses

    ERIC Educational Resources Information Center

    Suanpang, Pannee; Petocz, Peter; Reid, Anna

    2004-01-01

    This paper reports on a study carried out in Thailand investigating the relationship between students' use of an e-learning system and their learning outcomes in a course on Business Statistics. The results show a clear relationship between accesses to the e-learning system, as measured by number of "hits", and outcomes, as measured by…

  8. 43 CFR 17.550 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Program accessibility: Existing facilities....550 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or... its existing facilities or every part of a facility accessible to and usable by handicapped persons...

  9. 49 CFR 28.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false Program accessibility: Existing facilities. 28.150....150 Program accessibility: Existing facilities. (a) General. The Department shall operate each program... Department to make each of its existing facilities accessible to and usable by individuals with handicaps; (2...

  10. Outcomes of out-of-hospital cardiac arrest by public location in the public-access defibrillation era.

    PubMed

    Murakami, Yukiko; Iwami, Taku; Kitamura, Tetsuhisa; Nishiyama, Chika; Nishiuchi, Tatsuya; Hayashi, Yasuyuki; Kawamura, Takashi

    2014-04-22

    The strategy to place public-access automated external defibrillators (AEDs) has not yet been established in real settings. This, prospective, population-based observational study in Osaka, Japan, included consecutive out-of-hospital cardiac arrest (OHCA) patients with resuscitation attempts during 7 years, from January 2005 through December 2011. The trends in the proportion of public-access AED use and 1-month survival with neurologically favorable outcome were evaluated by location. Factors associated with neurologically favorable outcome (defined as cerebral performance category 1 or 2) after ventricular fibrillation were also assessed using multiple logistic regression analysis. A total of 9453 bystander-witnessed OHCAs of cardiac origin were documented and 894 (9.5%) of them occurred at public places. The proportion of public-access AED use significantly increased from 0.0% (0/20) in 2005 to 41.2% (7/17) in 2011 at railway stations and from 0.0% (0/7) to 56.5% (13/23) at sports facilities. Mean time from collapse to shock was 5.0 minutes among those who received shocks with public-access AEDs. The proportion of neurologically favorable outcome was 28.0% (33/118) at railway stations, 51.6% (48/93) at sports facilities, 23.3% (20/86) in public buildings, and 41.9% (13/31) in schools. In multivariate analysis, early defibrillation, irrespective of bystander or emergency medical service (EMS) personnel, was significantly associated with neurologically favorable outcome (adjusted odds ratio for 1-minute increment, 0.89; 95% confidence interval, 0.87 to 0.92). This large, population-based OHCA registry demonstrated that earlier shock, irrespective the shock provider (bystander or EMS personnel), contributed to improving outcome, and a public-access defibrillation program was successfully implemented so that shocks with public-access AEDs were delivered to over 40% of bystander-witnessed OHCAs and time to shock was shortened in some kinds of public places.

  11. 45 CFR 1214.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false Program accessibility: Discrimination prohibited... PROGRAMS OR ACTIVITIES CONDUCTED BY ACTION § 1214.149 Program accessibility: Discrimination prohibited... of, be excluded from participation in, or otherwise be subjected to discrimination under any program...

  12. 29 CFR 4907.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE PENSION BENEFIT GUARANTY CORPORATION § 4907.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by handicapped...

  13. Predicting Employment Outcomes for Consumers in Community College Short-Term Training Programs

    ERIC Educational Resources Information Center

    Flannery, K. Brigid; Benz, Michael R.; Yovanoff, Paul; Kato, Mary McGrath; Lindstrom, Lauren

    2011-01-01

    Postsecondary education has been linked to improved access to employment opportunities for individuals with and without disabilities. The purpose of this study was to determine factors associated with increased employment outcomes for Vocational Rehabilitation consumers enrolled in community college short term occupational skill training programs.…

  14. 22 CFR 1005.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE INTER-AMERICAN FOUNDATION § 1005.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by...

  15. 12 CFR 794.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL CREDIT UNION ADMINISTRATION § 794.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by handicapped...

  16. 49 CFR 807.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 807... CONDUCTED BY THE NATIONAL TRANSPORTATION SAFETY BOARD § 807.150 Program accessibility: Existing facilities... not— (1) Necessarily require the agency to make each of its existing facilities accessible to and...

  17. 50 CFR 550.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 11 2012-10-01 2012-10-01 false Program accessibility: Discrimination... Program accessibility: Discrimination prohibited. Except as otherwise provided in § 550.150, no qualified... discrimination under any program or activity conducted by the agency. ...

  18. 50 CFR 550.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY MARINE MAMMAL COMMISSION § 550.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by...

  19. 28 CFR 39.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF JUSTICE § 39.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by...

  20. 32 CFR 1699.149 - Program accessibility: discrimination prohibited.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 6 2012-07-01 2012-07-01 false Program accessibility: discrimination prohibited... SERVICE SYSTEM ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY SELECTIVE SERVICE SYSTEM § 1699.149 Program accessibility: discrimination prohibited. Except as...

  1. 45 CFR 606.50 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Program accessibility: Discrimination prohibited... SCIENCE FOUNDATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL SCIENCE FOUNDATION § 606.50 Program accessibility: Discrimination prohibited...

  2. 46 CFR 507.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 9 2012-10-01 2012-10-01 false Program accessibility: Discrimination prohibited. 507... MARITIME COMMISSION § 507.149 Program accessibility: Discrimination prohibited. Except as otherwise... in, or otherwise be subjected to discrimination under any program or activity conducted by the agency. ...

  3. 45 CFR 2104.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

  4. 45 CFR 2104.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

  5. 45 CFR 2104.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

  6. 45 CFR 2104.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

  7. 45 CFR 2104.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... FINE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE COMMISSION OF FINE ARTS § 2104.150 Program accessibility: Existing facilities. (a) General... of achieving program accessibility include— (i) Using audio-visual materials and devices to depict...

  8. 49 CFR 28.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 1 2014-10-01 2014-10-01 false Program accessibility: Discrimination prohibited... § 28.149 Program accessibility: Discrimination prohibited. Except as otherwise provided in § 28.150, no... otherwise be subjected to discrimination under any program or activity conducted by the Department. ...

  9. 32 CFR 1699.149 - Program accessibility: discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Program accessibility: discrimination prohibited... CONDUCTED BY SELECTIVE SERVICE SYSTEM § 1699.149 Program accessibility: discrimination prohibited. Except as... participation in, or otherwise be subject to discrimination under any program or activity conducted by the...

  10. 49 CFR 28.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Program accessibility: Discrimination prohibited... § 28.149 Program accessibility: Discrimination prohibited. Except as otherwise provided in § 28.150, no... otherwise be subjected to discrimination under any program or activity conducted by the Department. ...

  11. 34 CFR 1200.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 4 2011-07-01 2011-07-01 false Program accessibility: Discrimination prohibited. 1200...) NATIONAL COUNCIL ON DISABILITY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL COUNCIL ON DISABILITY § 1200.149 Program accessibility: Discrimination...

  12. 36 CFR 1208.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... OR ACTIVITIES CONDUCTED BY THE NATIONAL ARCHIVES AND RECORDS ADMINISTRATION § 1208.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by individuals with...

  13. 45 CFR 2490.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps...

  14. 31 CFR 17.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Program accessibility: Discrimination... DEPARTMENT OF THE TREASURY § 17.149 Program accessibility: Discrimination prohibited. Except as otherwise... participation in, or otherwise be subjected to discrimination under any program or activity conducted by the...

  15. The effects of New York's bypass surgery provider profiling on access to care and patient outcomes in the elderly.

    PubMed

    Peterson, E D; DeLong, E R; Jollis, J G; Muhlbaier, L H; Mark, D B

    1998-10-01

    The aim of this study was to examine the effects of provider profiling on bypass surgery access and outcomes in elderly patients in New York. Since 1989, New York (NY) has compiled provider-specific bypass surgery mortality reports. While some have proposed that "provider profiling" has led to lower surgical mortality rates, critics have suggested that such programs lower in-state procedural access (increasing out-of-state transfers) without improving patient outcomes. Using national Medicare data, we examined trends in the percentages of NY residents aged 65 years or older receiving out-of-state bypass surgery between 1987 and 1992 (before and after program initiation). We also examined in-state procedure use among elderly myocardial infarction patients during this period. Finally, we compared trends in surgical outcomes in NY Medicare patients with those for the rest of the nation. Between 1987 and 1992, the percentage of NY residents receiving bypass out-of-state actually declined (from 12.5% to 11.3%, p < 0.01 for trend). An elderly patient's likelihood for bypass following myocardial infarction in NY increased significantly since the program's initiation. Between 1987 and 1992, unadjusted 30-day mortality rates following bypass declined by 33% in NY Medicare patients compared with a 19% decline nationwide (p < 0.001). As a result of this improvement, NY had the lowest risk-adjusted bypass mortality rate of any state in 1992. We found no evidence that NY's provider profiling limited procedure access in NY's elderly or increased out-of-state transfers. Despite an increasing preoperative risk profile, procedural outcomes in NY improved significantly faster than the national average.

  16. Bridging the Gap between Access and Success: A Study of the Impact of an Access and Success Program on Academic Outcomes of Low-Income College Freshmen

    ERIC Educational Resources Information Center

    Collins, Sarah R.

    2012-01-01

    In response to the increasing cost of college, colleges and universities are leveraging financial aid and academic support services to implement access and success programs intended to help financially disadvantaged students afford and persist through a baccalaureate degree program. This research is a study of the efficacy of one such program at a…

  17. "Utstein style" spreadsheet and database programs based on Microsoft Excel and Microsoft Access software for CPR data management of in-hospital resuscitation.

    PubMed

    Adams, Bruce D; Whitlock, Warren L

    2004-04-01

    In 1997, The American Heart Association in association with representatives of the International Committee on Resuscitation (ILCOR) published recommended guidelines for reviewing, reporting and conducting in-hospital cardiopulmonary resuscitation (CPR) outcomes using the "Utstein style". Using these guidelines, we developed two Microsoft Office based database management programs that may be useful to the resuscitation community. We developed a user-friendly spreadsheet based on MS Office Excel. The user enters patient variables such as name, age, and diagnosis. Then, event resuscitation variables such as time of collapse and CPR team arrival are entered from a "code flow sheet". Finally, outcome variables such as patient condition at different time points are recorded. The program then makes automatic calculations of average response times, survival rates and other important outcome measurements. Also using the Utstein style, we developed a database program based on MS Office Access. To promote free public access to these programs, we established at a website. These programs will help hospitals track, analyze, and present their CPR outcomes data. Clinical CPR researchers might also find the programs useful because they are easily modified and have statistical functions.

  18. 22 CFR 1600.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Program accessibility: Discrimination prohibited. 1600.149 Section 1600.149 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT... STATES FRIENDSHIP COMMISSION § 1600.149 Program accessibility: Discrimination prohibited. Except as...

  19. 47 CFR 1.1849 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Program accessibility: Discrimination... the Federal Communications Commission § 1.1849 Program accessibility: Discrimination prohibited. (a... benefits of, be excluded from participation in, or otherwise be subjected to discrimination under any...

  20. Outcomes from a university-based low-cost in vitro fertilization program providing access to care for a low-resource socioculturally diverse urban community.

    PubMed

    Herndon, Christopher N; Anaya, Yanett; Noel, Martha; Cakmak, Hakan; Cedars, Marcelle I

    2017-10-01

    To report on outcomes from a university-based low-cost and low-complexity IVF program using mild stimulation approaches and simplified protocols to provide basic access to ART to a socioculturally diverse low-income urban population. Retrospective cohort study. Academic infertility center. Sixty-five infertile couples were enrolled from a county hospital serving a low-resource largely immigrant population. Patients were nonrandomly allocated to one of four mild stimulation protocols: clomiphene/letrozole alone, two clomiphene/letrozole-based protocols involving sequential or flare addition of low-dose gonadotropins, and low-dose gonadotropins alone. Clinical fellows managed all aspects of cycle preparation, monitoring, oocyte retrieval, and embryo transfer under an attending preceptor. Retrieval was undertaken without administration of deep anesthesia, and laboratory interventions were minimized. All embryo transfers were performed at the cleavage stage. Sociomedical demographics, treatment response, and pregnancy outcomes were recorded. From August 2010 to June 2016, 65 patients initiated 161 stimulation IVF cycles, which resulted in 107 retrievals, 91 fresh embryo transfers, and 40 frozen embryo transfer cycles. The mean age of patients was 33.3 years, and mean reported duration of infertility was 5.3 years; 33.5% (54/161) of cycles were cancelled before oocyte retrieval, with 13% due to premature ovulation. Overall, cumulative live birth rates per retrieval including subsequent use of frozen embryos was 29.0%; 44.6% (29/65) of patients enrolled in the program achieved pregnancy. Use of mild stimulation protocols, simplified monitoring, and minimized laboratory handling procedures enabled access to care in a low-resource socioculturally diverse infertile population. Copyright © 2017. Published by Elsevier Inc.

  1. 36 CFR 909.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Program accessibility: Discrimination prohibited. 909.149 Section 909.149 Parks, Forests, and Public Property PENNSYLVANIA AVENUE... CONDUCTED BY THE PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION § 909.149 Program accessibility: Discrimination...

  2. 45 CFR 2301.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Program accessibility: Discrimination prohibited. 2301.149 Section 2301.149 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC... CONDUCTED BY THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.149 Program accessibility: Discrimination...

  3. 45 CFR 2301.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Program accessibility: Discrimination prohibited. 2301.149 Section 2301.149 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC... CONDUCTED BY THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.149 Program accessibility: Discrimination...

  4. 28 CFR 41.56 - General requirement concerning program accessibility.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false General requirement concerning program accessibility. 41.56 Section 41.56 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE... Determining Discriminatory Practices Program Accessibility § 41.56 General requirement concerning program...

  5. 19 CFR 201.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Program accessibility: Discrimination prohibited. 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination...

  6. 19 CFR 201.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

  7. 19 CFR 201.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 3 2012-04-01 2012-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

  8. 19 CFR 201.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 3 2014-04-01 2014-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

  9. 19 CFR 201.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 3 2012-04-01 2012-04-01 false Program accessibility: Discrimination prohibited. 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination...

  10. 19 CFR 201.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 3 2013-04-01 2013-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

  11. 19 CFR 201.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 3 2014-04-01 2014-04-01 false Program accessibility: Discrimination prohibited. 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination...

  12. 19 CFR 201.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 3 2011-04-01 2011-04-01 false Program accessibility: Discrimination prohibited. 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination...

  13. 19 CFR 201.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 3 2013-04-01 2013-04-01 false Program accessibility: Discrimination prohibited. 201.149 Section 201.149 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.149 Program accessibility: Discrimination...

  14. 19 CFR 201.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 3 2011-04-01 2011-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

  15. 45 CFR 2490.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

  16. 45 CFR 2490.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

  17. 45 CFR 2490.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

  18. 45 CFR 2490.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Program accessibility: Existing facilities. 2490.150 Section 2490.150 Public Welfare Regulations Relating to Public Welfare (Continued) JAMES MADISON... ACTIVITIES CONDUCTED BY THE JAMES MADISON MEMORIAL FELLOWSHIP FOUNDATION § 2490.150 Program accessibility...

  19. 45 CFR 2301.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 2301.150 Section 2301.150 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC RESEARCH... THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.150 Program accessibility: Existing facilities. (a...

  20. 45 CFR 2301.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Program accessibility: Existing facilities. 2301.150 Section 2301.150 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC RESEARCH... THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.150 Program accessibility: Existing facilities. (a...

  1. 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.

  2. 14 CFR 1251.550 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps... accessible to and usable by individuals with handicaps; (2) In the case of historic preservation programs...

  3. 14 CFR 1251.550 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps... accessible to and usable by individuals with handicaps; (2) In the case of historic preservation programs...

  4. 14 CFR 1251.550 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps... accessible to and usable by individuals with handicaps; (2) In the case of historic preservation programs...

  5. 14 CFR 1251.550 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps... accessible to and usable by individuals with handicaps; (2) In the case of historic preservation programs...

  6. 24 CFR 9.152 - Program accessibility: alterations of Property Disposition Program multifamily housing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of Property Disposition Program multifamily housing facilities. 9.152 Section 9.152 Housing and Urban... URBAN DEVELOPMENT § 9.152 Program accessibility: alterations of Property Disposition Program multifamily...) in such a project shall be accessible for persons with hearing or vision impairments. If state or...

  7. 24 CFR 9.152 - Program accessibility: alterations of Property Disposition Program multifamily housing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... of Property Disposition Program multifamily housing facilities. 9.152 Section 9.152 Housing and Urban... URBAN DEVELOPMENT § 9.152 Program accessibility: alterations of Property Disposition Program multifamily...) in such a project shall be accessible for persons with hearing or vision impairments. If state or...

  8. Outcomes of Elderly Patients after Predialysis Vascular Access Creation

    PubMed Central

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

    2015-01-01

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

  9. 50 CFR 648.60 - Sea scallop access area program requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Sea scallop access area program... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop access area program requirements. (a) A limited access scallop vessel may only fish in the Sea Scallop Access Areas specified in...

  10. 50 CFR 648.60 - Sea scallop access area program requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Sea scallop access area program... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop access area program requirements. (a) A limited access scallop vessel may only fish in the Sea Scallop Access Areas specified in...

  11. 50 CFR 648.60 - Sea scallop area access program requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 10 2011-10-01 2011-10-01 false Sea scallop area access program... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop area access program requirements. (a) A limited access scallop vessel may only fish in the Sea Scallop Access Areas specified in...

  12. 50 CFR 648.60 - Sea scallop access area program requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Sea scallop access area program... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop access area program requirements. (a) A limited access scallop vessel may only fish in the Sea Scallop Access Areas specified in...

  13. 50 CFR 648.60 - Sea scallop area access program requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Sea scallop area access program... Management Measures for the Atlantic Sea Scallop Fishery § 648.60 Sea scallop area access program requirements. (a) A limited access scallop vessel may only fish in the Sea Scallop Access Areas specified in...

  14. Increasing access and support for emergency management higher education programs.

    PubMed

    Cwiak, Carol L

    2014-01-01

    The number of emergency management higher education programs has grown dramatically since 1994 when the FEMA Higher Education Program was created to propagate and support such growth. Data collected annually since 2007 from emergency management higher education programs shows that these programs face some consistent challenges. These challenges were coupled with annual data on program access and support indicators via dimensional analysis to answer the questions: To what extent are the challenges linked to a lack of access or support? If there is linkage, what can be gleaned from these linkages that can help address the challenges through improving access and support? The analysis showed that lack of access to funding and resources, and lack of support from partner organizations, has an impact on emergency management higher education. Discussion of that impact is followed with detailed recommendations that are focused on strengthening both internal and external access and support relationships for emergency management higher education programs.

  15. Outcomes Assessment in Dental Hygiene Programs.

    ERIC Educational Resources Information Center

    Grimes, Ellen B.

    1999-01-01

    A survey of 22 dental-hygiene-program directors found that programs routinely and effectively assess student outcomes and use the information for program improvements and to demonstrate accountability. Both policy and faculty/administrative support were deemed important to implementation. Time constraints were a major barrier. Outcomes-assessment…

  16. 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

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

    PubMed

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

    2015-12-01

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

  18. Welfare, Work, and Health Care Access Predictors of Low-Income Children’s Physical Health Outcomes

    PubMed Central

    Slack, Kristen Shook; Holl, Jane L.; Yoo, Joan; Amsden, Laura B.; Collins, Emily; Bolger, Kerry

    2009-01-01

    This analysis examines whether young children’s (N= 494) general physical health is associated with parental employment, welfare receipt, and health care access within a low-income population transitioning from welfare to work. A latent physical health measure derived from survey and medical chart data is used to capture children’s poor health, and parental ratings of child health are used to identify excellent health. Controlling for a host of factors associated with children’s health outcomes, results show that children of caregivers who are unemployed and off welfare have better health than children of caregivers who are working and off welfare. Children whose caregivers are unemployed and on welfare, or combining work and welfare, have health outcomes similar to children of caregivers who are working and off welfare. Health care access characteristics, such as gaps in health insurance coverage, source of primary care setting, and type of health insurance are associated with children’s general physical health. Implications of these results for state TANF programs are discussed. PMID:25505809

  19. Pediatric Diabetes Telemedicine Program Improves Access to Care for Rural Families: Role of APRNs.

    PubMed

    Smith, Nancy Marie; Satyshur, Rosemarie DiMauro

    2016-01-01

    Type 1 diabetes mellitus has increased in children by 23% from 2001 to 2009. Rural communities additionally have increased disparities related to access barriers and a large minority population with poorer overall health. Research evidence supports telemedicine as an effective alternative to bring preventive diabetes care to remote areas. This article presents an overview of the leadership role of advanced practice registered nurses (APRNs) with the implementation and evaluation of a pediatric diabetes telemedicine program at a rural pediatric outpatient specialty clinic in partnership with a tertiary center telemedicine network. The telemedicine program quality improvement (QI) project explored caregiver satisfaction with a convenience sample of caregivers (N = 14) using a nine-item Telemedicine Diabetes Caregiver Satisfaction Survey (TDCSS), with responses ranging from 1 = strongly disagree to 5 = strongly agree. Findings indicate caregivers were highly satisfied with communication/ privacy (M = 4.8), access to care (M = 4.1), and quality of services (M = 5.0). The multidisciplinary collaborative teamwork, continuous QI, and dependable technology were integral to the quality of the telemedicine clinical initiative. APRNs provided technology expertise, interdisciplinary collaboration leadership, care coordination, and advocacy for policy changes. Results demonstrate that telemedicine and APRN leadership can help implement innovative programs into rural communities to improve access to care, healthcare cost, and outcomes.

  20. Stellar Atmospheric Modelling for the ACCESS Program

    NASA Astrophysics Data System (ADS)

    Morris, Matthew; Kaiser, Mary Elizabeth; Bohlin, Ralph; Kurucz, Robert; ACCESS Team

    2018-01-01

    A goal of the ACCESS program (Absolute Color Calibration Experiment for Standard Stars) is to enable greater discrimination between theoretical astrophysical models and observations, where the comparison is limited by systematic errors associated with the relative flux calibration of the targets. To achieve these goals, ACCESS has been designed as a sub-orbital rocket borne payload and ground calibration program, to establish absolute flux calibration of stellar targets at <1 % precision, with a resolving power of 500 across the 0.35 to 1.7 micron bandpass.In order to obtain higher resolution spectroscopy in the optical and near-infrared range than either the ACCESS payload or CALSPEC observations provide, the ACCESS team has conducted a multi-instrument observing program at Apache Point Observatory. Using these calibrated high resolution spectra in addition to the HST/CALSPEC data, we have generated stellar atmosphere models for ACCESS flight candidates, as well as a selection of A and G stars from the CALSPEC database. Stellar atmosphere models were generated using Atlas 9 and Atlas 12 Kurucz stellar atmosphere software. The effective temperature, log(g), metallicity, and redenning were varied and the chi-squared statistic was minimized to obtain a best-fit model. A comparison of these models and the results from interpolation between grids of existing models will be presented. The impact of the flexibility of the Atlas 12 input parameters (e.g. solar metallicity fraction, abundances, microturbulent velocity) is being explored.

  1. 14 CFR § 1251.550 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... activity, when viewed in its entirety, is readily accessible to and usable by individuals with handicaps... accessible to and usable by individuals with handicaps; (2) In the case of historic preservation programs...

  2. Program Capacity to Eliminate Outcome Disparities in Addiction Health Services

    PubMed Central

    Guerrero, Erick G.; Aarons, Gregory; Grella, Christine; Garner, Bryan R.; Cook, Benjamin; Vega, William A.

    2014-01-01

    We evaluated program capacity factors associated with client outcomes in publicly funded substance abuse treatment organizations in one of the most populous and diverse regions of the United States. Using multilevel cross-sectional analyses of program data (n = 97) merged with client data from 2010–2011 for adults (n = 8,599), we examined the relationships between program capacity (leadership, readiness for change, and Medi-Cal payment acceptance) and client wait time and treatment duration. Acceptance of Medi-Cal was associated with shorter wait times, whereas organizational readiness for change was positively related to treatment duration. Staff attributes were negatively related to treatment duration. Overall, compared to low program capacity, high program capacity was negatively associated with wait time and positively related to treatment duration. In conclusion, program capacity, an organizational indicator of performance, plays a significant role in access to and duration of treatment. Implications for health care reform implementation in relation to expansion of public health insurance and capacity building to promote health equities are discussed. PMID:25450596

  3. Program Capacity to Eliminate Outcome Disparities in Addiction Health Services.

    PubMed

    Guerrero, Erick G; Aarons, Gregory A; Grella, Christine E; Garner, Bryan R; Cook, Benjamin; Vega, William A

    2016-01-01

    We evaluated program capacity factors associated with client outcomes in publicly funded substance abuse treatment organizations in one of the most populous and diverse regions of the United States. Using multilevel cross-sectional analyses of program data (n = 97) merged with client data from 2010 to 2011 for adults (n = 8,599), we examined the relationships between program capacity (leadership, readiness for change, and Medi-Cal payment acceptance) and client wait time and treatment duration. Acceptance of Medi-Cal was associated with shorter wait times, whereas organizational readiness for change was positively related to treatment duration. Staff attributes were negatively related to treatment duration. Overall, compared to low program capacity, high program capacity was negatively associated with wait time and positively related to treatment duration. In conclusion, program capacity, an organizational indicator of performance, plays a significant role in access to and duration of treatment. Implications for health care reform implementation in relation to expansion of public health insurance and capacity building to promote health equities are discussed.

  4. Impact of pharmacy worker training and deployment on access to essential medicines and health outcomes in Malawi: protocol for a cluster quasi-experimental evaluation.

    PubMed

    Lubinga, Solomon J; Jenny, Alisa M; Larsen-Cooper, Erin; Crawford, Jessica; Matemba, Charles; Stergachis, Andy; Babigumira, Joseph B

    2014-10-11

    Access to essential medicines is core to saving lives and improving health outcomes of people worldwide, particularly in the low- and middle-income countries. Having a trained pharmacy workforce to manage the supply chain and safely dispense medicines is critical to ensuring timely access to quality pharmaceuticals and improving child health outcomes. This study measures the impact of an innovative pharmacy assistant training program in the low-income country of Malawi on access to medicines and health outcomes. We employ a cluster quasi-experimental design with pre-and post-samples and decision analytic modeling to examine access to and the use of medicines for malaria, pneumonia, and diarrhea for children less than 5 years of age. Two intervention districts, with newly trained and deployed pharmacy assistants, and two usual care comparison districts, matched on socio-economic, geographic, and health-care utilization indicators, were selected for the study. A baseline household survey was conducted in March 2014, prior to the deployment of pharmacy assistants to the intervention district health centers. Follow-up surveys are planned at 12- and 24-months post-deployment. In addition, interviews are planned with caregivers, and time-motion studies will be conducted with health-care providers at the health centers to estimate costs and resources use. This impact evaluation is designed to provide data on the effects of a novel pharmacy assistant program on pharmaceutical systems performance, and morbidity and mortality for the most common causes of death for children under five. The results of this study should contribute to policy decisions about whether and how to scale up the health systems strengthening workforce development program to have the greatest impact on the supply chain and health outcomes in Malawi.

  5. 12 CFR 268.707 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Programs and Activities Because of Physical or Mental Disability § 268.707 Program accessibility: Existing facilities. (a) General. The Board shall operate each program or activity so that the program or activity... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...

  6. 12 CFR 268.707 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Programs and Activities Because of Physical or Mental Disability § 268.707 Program accessibility: Existing facilities. (a) General. The Board shall operate each program or activity so that the program or activity... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...

  7. 75 FR 34941 - Review of the Commission's Program Access Rules and Examination of Programming Tying Arrangements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-21

    ... Commission's Program Access Rules and Examination of Programming Tying Arrangements AGENCY: Federal... Program Access Rules and Examination of Programming Tying Arrangements, MB Docket No. 07-198, FCC 10-17... information collection is contained in Sections 4(i), 303(r), and 628 of the Communications Act of 1934, as...

  8. 32 CFR 1699.150 - Program accessibility: existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... SYSTEM ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY SELECTIVE SERVICE SYSTEM § 1699.150 Program accessibility: existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is...

  9. 24 CFR 8.20 - General requirement concerning program accessibility.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false General requirement concerning program accessibility. 8.20 Section 8.20 Housing and Urban Development Office of the Secretary, Department... requirement concerning program accessibility. Except as otherwise provided in §§ 8.21(c)(1), 8.24(a), 8.25...

  10. 32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

  11. 32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

  12. 32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

  13. 32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

  14. 32 CFR 1906.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.149 Program accessibility: Discrimination prohibited...

  15. 31 CFR 17.150 - Program accessibility; Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...'s facilities that limit the physical accessibility of its programs or activities to individuals with... ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE... operate each program or activity so that the program or activity, when viewed in its entirety, is readily...

  16. 24 CFR 9.150 - Program accessibility: existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... ACTIVITIES CONDUCTED BY THE DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT § 9.150 Program accessibility... shall operate each program or activity so that the program or activity, when viewed in its entirety, is... nature of a program or activity or in undue financial and administrative burdens. In those circumstances...

  17. 40 CFR 12.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE ENVIRONMENTAL PROTECTION... program or activity so that the program or activity, when viewed in its entirety, is readily accessible to... the nature of a program or activity or in undue financial and administrative burdens. In those...

  18. 47 CFR 1.1849 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... prohibited. 1.1849 Section 1.1849 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND... the Federal Communications Commission § 1.1849 Program accessibility: Discrimination prohibited. (a... interpreters, communication access realtime translation (CART) providers, transcribers, captioners, and readers...

  19. 32 CFR 1906.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

  20. 32 CFR 1906.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

  1. 32 CFR 1906.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

  2. 32 CFR 1906.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

  3. 32 CFR 1906.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.150 Program accessibility: Existing facilities. (a...

  4. 45 CFR 1175.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE... program or activity so that the program or activity, when viewed in its entirety, is readily accessible to... of a program or activity or in undue financial and administrative burdens. In those circumstances...

  5. 12 CFR 606.650 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FARM CREDIT... program or activity so that the program or activity, when viewed in its entirety, is readily accessible to... the nature of a program or activity or in undue financial and administrative burdens. In those...

  6. 45 CFR 1214.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ACTIVITIES CONDUCTED BY ACTION § 1214.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in its entirety, is... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens...

  7. 22 CFR 1701.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE UNITED STATES INSTITUTE OF... program or activity so that the program or activity, when viewed in its entirety, is readily accessible to... the nature of a program or activity or in undue financial and administrative burdens. In those...

  8. Access, treatment and outcomes of care: a study of ethnic minorities in Europe.

    PubMed

    Hanssens, Lise G M; Detollenaere, Jens; Hardyns, Wim; Willems, Sara J T

    2016-05-01

    Recent research has shown that ethnic minorities still have less access to medical care and are less satisfied with the treatment they receive and the outcomes of the health care process. This article assesses how migrants in Europe experience access, treatment and outcomes in the European health care systems. Data were obtained from the QUALICOPC study (Quality and Costs of Primary Care in Europe). Regression analyses were used to estimate the access, treatment and outcomes of care for ethnic minorities. In several countries, migrants experience that the opening hours of their GP practice were too limited and indicate that the practice was too far away from their work or home (lower access). They are more likely to report negative patient-doctor communication and less continuity of care than native patients (worse treatment). In addition, they are less satisfied with the care they received and are more likely to postpone care (worse outcomes). In general, migrants are still disadvantaged during the health care process. However, our results also indicate that satisfaction with the health care process improves for second-generation migrants in comparison with first-generation migrants.

  9. 45 CFR 85.42 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF HEALTH AND HUMAN... program or activity so that the program or activity, when viewed in its entirety, is readily accessible to... the nature of a program or activity or in undue financial and administrative burdens. In those...

  10. 44 CFR 16.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL EMERGENCY MANAGEMENT AGENCY § 16.150 Program...

  11. 10 CFR 4.550 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE FROM THE COMMISSION Enforcement of Nondiscrimination on the Basis of Handicap in Programs or Activities Conducted by the U.S. Nuclear Regulatory Commission § 4.550 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity...

  12. 36 CFR 1154.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD § 1154.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the...

  13. 10 CFR 4.550 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Program accessibility: Existing facilities. 4.550 Section 4.550 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION IN FEDERALLY ASSISTED PROGRAMS OR...) Transition plan. In the event that structural changes to facilities will be undertaken to achieve program...

  14. 10 CFR 4.550 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Program accessibility: Existing facilities. 4.550 Section 4.550 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION IN FEDERALLY ASSISTED PROGRAMS OR...) Transition plan. In the event that structural changes to facilities will be undertaken to achieve program...

  15. Programming and Technology for Accessibility in Geoscience

    NASA Astrophysics Data System (ADS)

    Sevre, E.; Lee, S.

    2013-12-01

    Many people, students and professors alike, shy away from learning to program because it is often believed to be something scary or unattainable. However, integration of programming into geoscience education can be a valuable tool for increasing the accessibility of content for all who are interested. It is my goal to dispel these myths and convince people that: 1) Students with disabilities can use programming to increase their role in the classroom, 2) Everyone can learn to write programs to simplify daily tasks, 3) With a deep understanding of the task, anyone can write a program to do a complex task, 4) Technology can be combined with programming to create an inclusive environment for all students of geoscience, and 5) More advanced knowledge of programming and technology can lead geoscientists to create software to serve as assistive technology in the classroom. It is my goal to share my experiences using technology to enhance the classroom experience as a way of addressing the aforementioned issues. Through my experience, I have found that programming skills can be included and learned by all to enhance the content of courses without detracting from curriculum. I hope that, through this knowledge, geoscience courses can become more accessible for people with disabilities by including programming and technology to the benefit of all involved.

  16. JASPAR RESTful API: accessing JASPAR data from any programming language.

    PubMed

    Khan, Aziz; Mathelier, Anthony

    2018-05-01

    JASPAR is a widely used open-access database of curated, non-redundant transcription factor binding profiles. Currently, data from JASPAR can be retrieved as flat files or by using programming language-specific interfaces. Here, we present a programming language-independent application programming interface (API) to access JASPAR data using the Representational State Transfer (REST) architecture. The REST API enables programmatic access to JASPAR by most programming languages and returns data in eight widely used formats. Several endpoints are available to access the data and an endpoint is available to infer the TF binding profile(s) likely bound by a given DNA binding domain protein sequence. Additionally, it provides an interactive browsable interface for bioinformatics tool developers. This REST API is implemented in Python using the Django REST Framework. It is accessible at http://jaspar.genereg.net/api/ and the source code is freely available at https://bitbucket.org/CBGR/jaspar under GPL v3 license. aziz.khan@ncmm.uio.no or anthony.mathelier@ncmm.uio.no. Supplementary data are available at Bioinformatics online.

  17. 22 CFR 1600.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Program accessibility: New construction and alterations. 1600.151 Section 1600.151 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT... STATES FRIENDSHIP COMMISSION § 1600.151 Program accessibility: New construction and alterations. Each...

  18. 22 CFR 1600.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Program accessibility: New construction and alterations. 1600.151 Section 1600.151 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT... STATES FRIENDSHIP COMMISSION § 1600.151 Program accessibility: New construction and alterations. Each...

  19. 22 CFR 1600.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Program accessibility: New construction and alterations. 1600.151 Section 1600.151 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT... STATES FRIENDSHIP COMMISSION § 1600.151 Program accessibility: New construction and alterations. Each...

  20. 22 CFR 1600.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Program accessibility: New construction and alterations. 1600.151 Section 1600.151 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT... STATES FRIENDSHIP COMMISSION § 1600.151 Program accessibility: New construction and alterations. Each...

  1. 76 FR 66089 - Access Authorization Program for Nuclear Power Plants

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-25

    ... NUCLEAR REGULATORY COMMISSION [NRC-2011-0245] Access Authorization Program for Nuclear Power... Program for Nuclear Power Plants.'' This guide describes a method that NRC staff considers acceptable to... Regulations (10 CFR), section 73.56, ``Personnel Access Authorization Requirements for Nuclear Power Plants...

  2. 10 CFR 1041.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Program accessibility: Existing facilities. 1041.150 Section 1041.150 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF ENERGY § 1041.150 Program...

  3. 10 CFR 1041.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Program accessibility: Existing facilities. 1041.150 Section 1041.150 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF ENERGY § 1041.150 Program...

  4. 10 CFR 1041.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Program accessibility: Existing facilities. 1041.150 Section 1041.150 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF ENERGY § 1041.150 Program...

  5. 10 CFR 1041.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Program accessibility: Existing facilities. 1041.150 Section 1041.150 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF ENERGY § 1041.150 Program...

  6. 10 CFR 1041.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Program accessibility: Existing facilities. 1041.150 Section 1041.150 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF ENERGY § 1041.150 Program...

  7. 5 CFR 1207.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... facilities. 1207.150 Section 1207.150 Administrative Personnel MERIT SYSTEMS PROTECTION BOARD ORGANIZATION... CONDUCTED BY THE MERIT SYSTEMS PROTECTION BOARD § 1207.150 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the program or activity, when viewed in...

  8. Characteristics, Access, Utilization, Satisfaction, and Outcomes of Healthy Start Participants in Eight Sites

    PubMed Central

    O’Neil, So; Cook, Benjamin; Trebino, Lisa; Walker, Deborah Klein

    2009-01-01

    To describe the characteristics, access, utilization, satisfaction, and outcomes of Healthy Start participants in eight selected sites, a survey of Healthy Start participants with infants ages 6–12-months-old at time of interview was conducted between October 2006 and January 2007. The response rate was 66% (n = 646), ranging from 37% in one site to >70% in seven sites. Healthy Start participants’ outcomes were compared to two national benchmarks. Healthy Start participants reported that they were satisfied with the program (>90% on five measures). Level of unmet need was 6% or less for most services, except for dental appointments (11%), housing (13%), and child care (11%). Infants had significantly better access to medical care than did their mothers, with higher rates of insurance coverage, medical homes, and checkups, and fewer unmet needs for health care. Healthy Start participants’ rates of ever breastfeeding (72%) and putting infants to sleep on their backs (70%) were at or near the Healthy People 2010 objectives, and considerably higher than rates among low-income mothers in the ECLS. The high rate of health education (>90%) may have contributed to these outcomes. Elimination of smoking among Healthy Start participants (46%) fell short of the Healthy People 2010 objective (99%). The low-birth weight (LBW) rate among Black Healthy Start participants (14%) was three times higher than the rate for Whites and Hispanics (5% each). Overall, the LBW rate in the eight sites (7.5%) was similar to the rate for low-income mothers in the ECLS, but both rates were above the Healthy People 2010 objective (5%). Challenges remain in reducing disparities in maternal and child health outcomes. Further attention to risk factors associated with LBW (especially smoking) may help close the gaps. The life course theory suggests that improved outcomes may require longer-term investments. Healthy Start’s emerging focus on interconception care has the potential to address

  9. 36 CFR 909.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Program accessibility: New construction and alterations. 909.151 Section 909.151 Parks, Forests, and Public Property PENNSYLVANIA AVENUE... CONDUCTED BY THE PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION § 909.151 Program accessibility: New...

  10. 17 CFR 200.650 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the Basis of Handicap in Programs or Activities Conducted by the Securities and Exchange Commission... or activity so that the program or activity, when viewed in its entirety, is readily accessible to... the nature of a program or activity or in undue financial and administrative burdens. In those...

  11. 25 CFR 720.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NAVAJO AND HOPI INDIAN RELOCATION... program or activity so that the program or activity, when viewed in its entirety, is readily accessible to... activity or in undue financial and administrative burdens. In those circumstances where agency personnel...

  12. 22 CFR 1510.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE AFRICAN DEVELOPMENT FOUNDATION... or activity so that the program or activity, when viewed in its entirety, is readily accessible to... the nature of a program or activity or in undue financial and administrative burdens. In those...

  13. 22 CFR 144.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE UNITED STATES DEPARTMENT OF... program or activity so that the program or activity, when viewed in its entirety, is readily accessible to... activity or in undue financial and administrative burdens. In those circumstances where agency personnel...

  14. Cognitive-communication disorder following right hemisphere stroke: exploring rehabilitation access and outcomes.

    PubMed

    Hewetson, Ronelle; Cornwell, Petrea; Shum, David

    2017-07-01

    Rehabilitation positively influences return to activities and social roles in people with aphasia. The cognitive-communication disorder (CCD) found following a right hemisphere stroke has been less extensively researched with rehabilitation access and outcomes yet to be determined. To document rehabilitation access and outcomes for people with CCD post-stroke; and compare outcomes based on presence (viz CCD; aphasia) or absence of communication impairment. A retrospective chart audit was completed for patients with first onset unilateral stroke, with a hospital length of stay (LOS) of at least two days and a communication assessment by a speech pathologist. Data extracted included presence and severity of communication impairment, access to and LOS in a rehabilitation unit, and functional outcome measures recorded at rehabilitation discharge. The majority of the 115 patients who met inclusion criteria were living independently (n = 112, 97.4%) at the time of stroke. CCD (66%) was diagnosed with similar frequency to aphasia (68%). The presence of communication impairment did not result in significant differences in rehabilitation LOS and discharge destination when compared to hemispheric strokes without communication impairment. Severity of CCD was an independent predictor of functional gain by rehabilitation discharge. People with CCD require comparable access to rehabilitation as people with aphasia, and severity of CCD should be considered in determining rehabilitation LOS. A large number of people are discharged with ongoing CCD which warrants exploration of potential participation restrictions created by the communication impairment.

  15. 19 CFR 201.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Program accessibility: New construction and alterations. 201.151 Section 201.151 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES... Activities Conducted by the U.S. International Trade Commission § 201.151 Program accessibility: New...

  16. 19 CFR 201.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 3 2011-04-01 2011-04-01 false Program accessibility: New construction and alterations. 201.151 Section 201.151 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES... Activities Conducted by the U.S. International Trade Commission § 201.151 Program accessibility: New...

  17. 19 CFR 201.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 3 2014-04-01 2014-04-01 false Program accessibility: New construction and alterations. 201.151 Section 201.151 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES... Activities Conducted by the U.S. International Trade Commission § 201.151 Program accessibility: New...

  18. 19 CFR 201.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 3 2012-04-01 2012-04-01 false Program accessibility: New construction and alterations. 201.151 Section 201.151 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES... Activities Conducted by the U.S. International Trade Commission § 201.151 Program accessibility: New...

  19. 19 CFR 201.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 3 2013-04-01 2013-04-01 false Program accessibility: New construction and alterations. 201.151 Section 201.151 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES... Activities Conducted by the U.S. International Trade Commission § 201.151 Program accessibility: New...

  20. The Medical Devices Special Access Program in Canada: A Scoping Study

    PubMed Central

    Menon, Devidas; Stafinski, Tania

    2018-01-01

    New health technologies enter Canadian healthcare organizations in various ways, and understanding them is essential to the development of a pan-Canadian Health Technology Management (HTM) Strategy, now a priority of governments across Canada. One way is through Health Canada's Medical Devices Special Access Program (MDSAP), which permits unlicensed devices to be obtained by healthcare professionals. However, the circumstances around and implications of the current use of this program are not clear. A scoping literature review was conducted to clarify these and identify important roles and issues related to the MDSAP. Limited information was found on the MDSAP. Nevertheless, three themes demonstrating the roles of the MDSAP in HTM emerged: arbiter in technology selection, a route to technology procurement and facilitator of health technology innovation. No information suggesting that MDSAP is used to circumvent licensing was found. Rather, it enables desired patient outcomes and product commercialization. PMID:29595436

  1. 5 CFR 1850.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE OFFICE OF SPECIAL COUNSEL... or activity so that the program or activity, when viewed in its entirety, is readily accessible to... the nature of a program or activity or in undue financial and administrative burdens. In those...

  2. 49 CFR 28.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION § 28... or activity so that the program or activity, when viewed in its entirety, is readily accessible to... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens...

  3. 3 CFR 102.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE EXECUTIVE OFFICE OF THE PRESIDENT... or activity so that the program or activity, when viewed in its entirety, is readily accessible to... the nature of a program or activity or in undue financial and administrative burdens. In those...

  4. 44 CFR 16.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the... facilities accessible to and usable by individuals with handicaps; (2) In the case of historic preservation...

  5. 34 CFR 395.12 - Access to program and financial information.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... arrange a convenient time to assist in the interpretation of such financial data. ... 34 Education 2 2010-07-01 2010-07-01 false Access to program and financial information. 395.12... BLIND ON FEDERAL AND OTHER PROPERTY The State Licensing Agency § 395.12 Access to program and financial...

  6. 75 FR 2583 - Over-the-Road Bus Accessibility Program Grants

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ... Transportation Equity Act for the 21st Century (TEA-21). The OTRB Accessibility Program makes funds available to... (TEA-21), Public Law 105-85 as amended by the Safe, Accountable, Flexible, Efficient, Transportation.... transportation system. TEA-21 authorized FTA's OTRB Accessibility Program to assist OTRB operators in complying...

  7. 43 CFR 17.550 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... on the Basis of Handicap in Programs or Activities Conducted by the Department of the Interior § 17... activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable... the nature of a program or activity or in undue financial and administrative burdens. In those...

  8. 1 CFR 457.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL CAPITAL PLANNING COMMISSION § 457... activity so that the program or activity, when viewed in its entirety, is readily accessible to and usable... can demonstrate would result in a fundamental alteration in the nature of a program or activity or in...

  9. Socioieconomic outcomes of restricted access to abortion.

    PubMed

    Muller, C

    1971-06-01

    Such questions as the extent to which greater accessibility to abortion services affects poverty and its problems are analyzed, and proposals for identifying the socioeconomic impact of liberalized abortion laws and accessible services are developed. The number of unwanted children born is directly affected by the barriers to legal abortion. In countries that have improved access to legal abortion, the demand for the service has risen among all socioeconomic groups. Long-time family earning potential is severely effected by the defects in the timing and spacing of the birth of children, which often leads to young men and pregnant teen-agers leaving school because of the burdens of pregnancy and child support. Large family size was found in 35% of families in 1965 where the head of the household was a fully employed worker. Children born and living as psychologically rejected or unwanted children risk impaired learning and development which in turn limits future economic achievments. Research into the access of and financing of abortion services should deal with the financial needs of patient groups. The effects of nonhospital service programs, manpower needs, and the surveillance of gaps and coverage of the service needs should be prime research targets.

  10. A responsive evaluation of an Aboriginal nursing education access program.

    PubMed

    Curran, Vernon; Solberg, Shirley; LeFort, Sandra; Fleet, Lisa; Hollett, Ann

    2008-01-01

    Nursing education access programs have been introduced in a number of countries to address the shortage of healthcare providers of Aboriginal descent. An evaluation study of a nursing education access program in Labrador, Canada, was undertaken using a Responsive Evaluation approach. Interviews and focus groups with program stakeholders were conducted. Program effectiveness was influenced by culturally relevant curriculum, experiential and authentic learning opportunities, academic and social support, and the need for partnership building between stakeholders. The authors report key findings resulting from the Responsive Evaluation.

  11. Economic Impact of the Critical Access Hospital Program on Kentucky's Communities

    ERIC Educational Resources Information Center

    Ona, Lucia; Davis, Alison

    2011-01-01

    Context: In 1997, the Medicare Rural Hospital Flexibility Grant Program created the Critical Access Hospital (CAH) Program as a response to the financial distress of rural hospitals. It was believed that this program would reduce the rate of rural hospital closures and improve access to health care services in rural communities. Objective: The…

  12. Outcomes associated with a structured prenatal counseling program for shoulder dystocia with brachial plexus injury.

    PubMed

    Daly, Mary Veronica; Bender, Christina; Townsend, Kathryn E; Hamilton, Emily F

    2012-08-01

    We examined outcomes that were associated with a novel program to identify patients who are at high risk for shoulder dystocia with brachial plexus injury. The program included a checklist of key risk factors and a multifactorial algorithm to estimate risk of shoulder dystocia with brachial plexus injury. We examined rates of cesarean delivery and shoulder dystocia in 8767 deliveries by clinicians who were enrolled in the program and in 11,958 patients of clinicians with no access to the program. Key risk factors were identified in 1071 of 8767 mothers (12.2%), of whom 40 of 8767 women (0.46%) had results in the high-risk category. The rate of primary cesarean delivery rate was stable (21.2-20.8%; P = .57). Shoulder dystocia rates fell by 56.8% (1.74-0.75%; P = .002). The rates of shoulder dystocia and cesarean birth showed no changes in the group with no access to the program. With the introduction of this program, overall shoulder dystocia rates fell by more than one-half with no increase in the primary cesarean delivery rate. Copyright © 2012 Mosby, Inc. All rights reserved.

  13. Contexts, Mechanisms, and Outcomes That Matter in Dutch Community-Based Physical Activity Programs Targeting Socially Vulnerable Groups.

    PubMed

    Herens, Marion; Wagemakers, Annemarie; Vaandrager, Lenneke; van Ophem, Johan; Koelen, Maria

    2017-09-01

    This article presents a practitioner-based approach to identify key combinations of contextual factors (C) and mechanisms (M) that trigger outcomes (O) in Dutch community-based health-enhancing physical activity (CBHEPA) programs targeting socially vulnerable groups. Data were collected in six programs using semi-structured interviews and focus groups using a timeline technique. Sessions were recorded, anonymized, and transcribed. A realist synthesis protocol was used for data-driven and thematic analysis of CMO configurations. CMO configurations related to community outreach, program sustainability, intersectoral collaboration, and enhancing participants' active lifestyles. We have refined the CBHEPA program theory by showing that actors' passion for, and past experiences with, physical activity programs trigger outcomes, alongside their commitment to socially vulnerable target groups. Project discontinuity, limited access to resources, and a trainer's stand-alone position were negative configurations. The authors conclude that local governance structures appear often to lack adaptive capacity to accommodate multilevel processes to sustain programs.

  14. Doula Services Within a Healthy Start Program: Increasing Access for an Underserved Population.

    PubMed

    Thomas, Mary-Powel; Ammann, Gabriela; Brazier, Ellen; Noyes, Philip; Maybank, Aletha

    2017-12-01

    Women of color in the United States, particularly in high-poverty neighborhoods, experience high rates of poor birth outcomes, including cesarean section, preterm birth, low birthweight, and infant mortality. Doula care has been linked to improvements in many perinatal outcomes, but women of color and low-income women often face barriers in accessing doula support. To address this issue, the New York City Department of Health and Mental Hygiene's Healthy Start Brooklyn introduced the By My Side Birth Support Program in 2010. The goal was to complement other maternal home-visiting programs by providing doula support during labor and birth, along with prenatal and postpartum visits. Between 2010 and 2015, 489 infants were born to women enrolled in the program. Data indicate that By My Side is a promising model of support for Healthy Start projects nationwide. Compared to the project area, program participants had lower rates of preterm birth (6.3 vs. 12.4%, p < 0.001) and low birthweight (6.5 vs. 11.1%, p = 0.001); however, rates of cesarean birth did not differ significantly (33.5 vs. 36.9%, p = 0.122). Further research is needed to explore possible reasons for this finding, and to examine the influence of doula support on birth outcomes among populations with high rates of chronic disease and stressors such as poverty, racism, and exposure to violence. However, feedback from participants indicates that doula support is highly valued and helps give women a voice in consequential childbirth decisions. Available evidence suggests that doula services may be an important component of an effort to address birth inequities.

  15. 11 CFR 6.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 11 Federal Elections 1 2011-01-01 2011-01-01 false Program accessibility: Discrimination prohibited. 6.149 Section 6.149 Federal Elections FEDERAL ELECTION COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL ELECTION COMMISSION...

  16. 22 CFR 711.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....150 Section 711.150 Foreign Relations OVERSEAS PRIVATE INVESTMENT CORPORATION ADMINISTRATIVE... THE OVERSEAS PRIVATE INVESTMENT CORPORATION § 711.150 Program accessibility: Existing facilities. (a... result in a fundamental alteration in the nature of a program or activity or in undue financial and...

  17. 47 CFR 1.1849 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Program accessibility: Discrimination...: Discrimination prohibited. (a) Except as otherwise provided in § 1.1850, no qualified individual with a... discrimination under any program or activity conducted by the Commission. (b) Individuals shall request...

  18. 47 CFR 1.1849 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Program accessibility: Discrimination...: Discrimination prohibited. (a) Except as otherwise provided in § 1.1850, no qualified individual with a... discrimination under any program or activity conducted by the Commission. (b) Individuals shall request...

  19. 49 CFR 807.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: Discrimination prohibited. Except as otherwise provided in § 807.150, no qualified handicapped person shall... 49 Transportation 7 2011-10-01 2011-10-01 false Program accessibility: Discrimination prohibited...) NATIONAL TRANSPORTATION SAFETY BOARD ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS...

  20. 38 CFR 15.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...: Discrimination prohibited. 15.149 Section 15.149 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF VETERANS AFFAIRS § 15.149 Program accessibility: Discrimination prohibited. Except...

  1. 36 CFR 406.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...: Discrimination prohibited. 406.149 Section 406.149 Parks, Forests, and Public Property AMERICAN BATTLE MONUMENTS COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY AMERICAN BATTLE MONUMENTS COMMISSION § 406.149 Program accessibility: Discrimination prohibited. Except as...

  2. 36 CFR 812.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...: Discrimination prohibited. 812.149 Section 812.149 Parks, Forests, and Public Property ADVISORY COUNCIL ON HISTORIC PRESERVATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE ADVISORY COUNCIL ON HISTORIC PRESERVATION § 812.149 Program accessibility: Discrimination...

  3. Assessing Education Program Learning Outcomes

    ERIC Educational Resources Information Center

    Bahous, Rima; Nabhani, Mona

    2011-01-01

    Teacher education programs help teachers gain knowledge and skills, develop "new" attitudes, and impact their beliefs about teaching, thereby favorably affecting teaching outcomes. In the absence of national standards and formal studies in Lebanon of existing teacher preparation programs, findings of this study could greatly contribute…

  4. 11 CFR 9420.4 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 11 Federal Elections 1 2011-01-01 2011-01-01 false Program accessibility: Discrimination prohibited. 9420.4 Section 9420.4 Federal Elections ELECTION ASSISTANCE COMMISSION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE U.S. ELECTION ASSISTANCE COMMISSION § 9420...

  5. 11 CFR 9420.4 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Program accessibility: Discrimination prohibited. 9420.4 Section 9420.4 Federal Elections ELECTION ASSISTANCE COMMISSION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE U.S. ELECTION ASSISTANCE COMMISSION § 9420...

  6. 5 CFR 1636.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... facilities. 1636.150 Section 1636.150 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD... RETIREMENT THRIFT INVESTMENT BOARD § 1636.150 Program accessibility: Existing facilities. (a) General. The... fundamental alteration in the nature of a program or activity or in undue financial and administrative burdens...

  7. 22 CFR 1005.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Program accessibility: Discrimination prohibited. 1005.149 Section 1005.149 Foreign Relations INTER-AMERICAN FOUNDATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE INTER-AMERICAN FOUNDATION § 1005...

  8. 34 CFR 1200.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Program accessibility: Discrimination prohibited. 1200.149 Section 1200.149 Education Regulations of the Offices of the Department of Education (Continued) NATIONAL COUNCIL ON DISABILITY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR...

  9. 47 CFR 79.2 - Accessibility of programming providing emergency information.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) BROADCAST RADIO SERVICES ACCESSIBILITY OF VIDEO PROGRAMMING Video Programming Owners, Providers, and... of programming providing emergency information. (1) Video programming distributors must make... or by using a method of visual presentation, as described in § 79.1. (2) Video programming...

  10. 5 CFR 723.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... facilities. 723.150 Section 723.150 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL... ACTIVITIES CONDUCTED BY THE OFFICE OF PERSONNEL MANAGEMENT § 723.150 Program accessibility: Existing... would result in a fundamental alteration in the nature of a program or activity or in undue financial...

  11. 22 CFR 1600.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Program accessibility: Discrimination prohibited. 1600.149 Section 1600.149 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP...

  12. 22 CFR 1600.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Program accessibility: Discrimination prohibited. 1600.149 Section 1600.149 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP...

  13. 22 CFR 1600.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Program accessibility: Existing facilities. 1600.150 Section 1600.150 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP...

  14. 22 CFR 1600.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Program accessibility: Discrimination prohibited. 1600.149 Section 1600.149 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP...

  15. 22 CFR 1600.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Program accessibility: Existing facilities. 1600.150 Section 1600.150 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP...

  16. 22 CFR 1600.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Program accessibility: Existing facilities. 1600.150 Section 1600.150 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP...

  17. 22 CFR 1600.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Program accessibility: Existing facilities. 1600.150 Section 1600.150 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP...

  18. 50 CFR 550.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Program accessibility: Discrimination prohibited. 550.149 Section 550.149 Wildlife and Fisheries MARINE MAMMAL COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY MARINE MAMMAL COMMISSION § 550.149...

  19. 45 CFR 1153.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

  20. 45 CFR 1153.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

  1. 45 CFR 1153.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

  2. 45 CFR 1153.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

  3. 45 CFR 1153.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL ENDOWMENT FOR THE ARTS...), alternative methods of achieving program accessibility include— (i) Using audio-visual materials and devices...

  4. 22 CFR 530.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE BROADCASTING BOARD OF GOVERNORS... or activity so that the program or activity, when viewed in its entirety, is readily accessible to... activity or in undue financial and administrative burdens. In those circumstances where Board personnel...

  5. 46 CFR 507.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL MARITIME COMMISSION... or activity so that the program or activity, when viewed in its entirety, is readily accessible to... activity or in undue financial and administrative burdens. In those circumstances where agency personnel...

  6. 1 CFR 500.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL COMMISSION FOR EMPLOYMENT POLICY... or activity so that the program or activity, when viewed in its entirety, is readily accessible to... activity or in undue financial and administrative burdens. In those circumstances where agency personnel...

  7. 49 CFR 1014.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE SURFACE TRANSPORTATION BOARD... or activity so that the program or activity, when viewed in its entirety, is readily accessible to... activity or in undue financial and administrative burdens. In those circumstances where agency personnel...

  8. 10 CFR 4.550 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Program accessibility: Existing facilities. 4.550 Section 4.550 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION IN FEDERALLY ASSISTED PROGRAMS OR... changes shall be made by August 22, 1989, but in any event as expeditiously as possible. (d) Transition...

  9. 10 CFR 4.550 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Program accessibility: Existing facilities. 4.550 Section 4.550 Energy NUCLEAR REGULATORY COMMISSION NONDISCRIMINATION IN FEDERALLY ASSISTED PROGRAMS OR... changes shall be made by August 22, 1989, but in any event as expeditiously as possible. (d) Transition...

  10. 22 CFR 1600.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Program accessibility: Discrimination prohibited. 1600.149 Section 1600.149 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP...

  11. 22 CFR 1600.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Program accessibility: Existing facilities. 1600.150 Section 1600.150 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED STATES FRIENDSHIP...

  12. 24 CFR 9.152 - Program accessibility: alterations of Property Disposition Program multifamily housing facilities.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... of Property Disposition Program multifamily housing facilities. 9.152 Section 9.152 Housing and Urban... URBAN DEVELOPMENT § 9.152 Program accessibility: alterations of Property Disposition Program multifamily housing facilities. (a) Substantial alteration. If the agency undertakes alterations to a PDP multifamily...

  13. 24 CFR 9.152 - Program accessibility: alterations of Property Disposition Program multifamily housing facilities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... of Property Disposition Program multifamily housing facilities. 9.152 Section 9.152 Housing and Urban... URBAN DEVELOPMENT § 9.152 Program accessibility: alterations of Property Disposition Program multifamily housing facilities. (a) Substantial alteration. If the agency undertakes alterations to a PDP multifamily...

  14. 34 CFR 105.32 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Program accessibility: Existing facilities. 105.32 Section 105.32 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES...

  15. Technological Innovation and Cooperation for Foreign Information Access Program

    ERIC Educational Resources Information Center

    Office of Postsecondary Education, US Department of Education, 2012

    2012-01-01

    The Technological Innovation and Cooperation for Foreign Information Access (TICFIA) Program supports projects focused on developing innovative technologies for accessing, collecting, organizing, preserving, and disseminating information from foreign sources to address the U.S.' teaching and research needs in international education and foreign…

  16. 76 FR 2686 - Video Programming and Emergency Access Advisory Committee; Announcement of Establishment and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-14

    ... FEDERAL COMMUNICATIONS COMMISSION [DA 10-2320] Video Programming and Emergency Access Advisory... appointment of members of the Video Programming and Emergency Access Advisory Committee (``Committee'' or... change of the Committee's popular name to the Video Programming Accessibility Advisory Committee (``VPAAC...

  17. Associations between Motivational Orientations and Chronically Accessible Outcomes in Leisure-Time Physical Activity: Are Appearance-Related Outcomes Controlling in Nature?

    ERIC Educational Resources Information Center

    McLachlan, Sarah; Hagger, Martin S.

    2010-01-01

    This study aimed to explore relations between chronically accessible outcomes in physical activity and scaled measures of motivational orientations from a self-determination perspective. Methods from construct and attitude accessibility research and the Levesque and Pelletier (2003) study were used to identify participants' chronically accessible…

  18. 7 CFR 15e.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE UNITED STATES DEPARTMENT OF AGRICULTURE... or activity so that the program or activity, when viewed in its entirety, is readily accessible to... the nature of a program or activity or in undue financial and administrative burdens. In those...

  19. 41 CFR 105-8.154 - Program accessibility: Exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Program accessibility: Exceptions. 105-8.154 Section 105-8.154 Public Contracts and Property Management Federal Property Management... any action that it can demonstrate would result in a fundamental alteration in the nature of a program...

  20. 12 CFR 410.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Program accessibility: Existing facilities. 410.150 Section 410.150 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY EXPORT-IMPORT BANK OF THE UNITED...

  1. 12 CFR 410.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Program accessibility: Discrimination prohibited. 410.149 Section 410.149 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY EXPORT-IMPORT BANK OF THE UNITED...

  2. 77 FR 6113 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-07

    ... FEDERAL COMMUNICATIONS COMMISSION [DA 12-15] Video Programming and Accessibility Advisory.... SUMMARY: This document announces the next meeting of the Video Programming Accessibility Advisory... Commission regarding the provision of video description, access to emergency programming, and access to user...

  3. Student and community outcomes in service-learning: part 2--community outcomes.

    PubMed

    Reising, Deanna L; Allen, Patricia N; Hall, Susan G

    2006-12-01

    This article is the second of a two-part series reporting outcomes from a service-learning program implemented in a bachelor of science in nursing program. Part 1 (on pages 512-515) described students' perceptions of outcomes realized from the program, and Part 2 describes the community outcomes. The purposes of the program were to provide students with history-taking, blood pressure, and heart rate assessment skills, and beginning counseling skills, as well as to provide the university community with blood pressure screening and counseling in a convenient and accessible location. Data on community outcomes were collected on a continual basis during the hypertension screening and counseling program implementation. Clients were anonymously surveyed on health behavior actions taken after their screening and on the screening process. More than 700 client screenings were performed over 2 years, with positive health behavior changes being reported by clients.

  4. Commerical Crew Program (CCP) Access Arm Installation

    NASA Image and Video Library

    2016-08-15

    The Crew Access Arm and White Room for Boeing's CST-100 Starliner are attached to the Crew Access Tower at Cape Canaveral Air Force Station’s Space Launch Complex 41. The arm will serve as the connection that astronauts will walk through prior to boarding the Starliner spacecraft when stacked atop a United Launch Alliance Atlas V rocket. This installation completes the major construction of the first new Crew Access Tower to be built at the Cape since the Apollo era. Under a Commercial Crew Transportation Capability contract with NASA, Boeing’s Starliner system will be certified by NASA's Commercial Crew Program to fly crews to and from the International Space Station.

  5. 7 CFR 62.206 - Access to program documents and activities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... (CONTINUED) LIVESTOCK, MEAT, AND OTHER AGRICULTURAL COMMODITIES (QUALITY SYSTEMS VERIFICATION PROGRAMS) Quality Systems Verification Programs Definitions Service § 62.206 Access to program documents and... SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS...

  6. 47 CFR 79.2 - Accessibility of programming providing emergency information.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) BROADCAST RADIO SERVICES CLOSED CAPTIONING AND VIDEO DESCRIPTION OF VIDEO PROGRAMMING § 79.2 Accessibility... information. (1) Video programming distributors must make emergency information, as defined in paragraph (a..., as described in § 79.1. (2) Video programming distributors and video programming providers must make...

  7. Ranking Surgical Residency Programs: Reputation Survey or Outcomes Measures?

    PubMed

    Wilson, Adam B; Torbeck, Laura J; Dunnington, Gary L

    2015-01-01

    The release of general surgery residency program rankings by Doximity and U.S. News & World Report accentuates the need to define and establish measurable standards of program quality. This study evaluated the extent to which program rankings based solely on peer nominations correlated with familiar program outcomes measures. Publicly available data were collected for all 254 general surgery residency programs. To generate a rudimentary outcomes-based program ranking, surgery programs were rank-ordered according to an average percentile rank that was calculated using board pass rates and the prevalence of alumni publications. A Kendall τ-b rank correlation computed the linear association between program rankings based on reputation alone and those derived from outcomes measures to validate whether reputation was a reasonable surrogate for globally judging program quality. For the 218 programs with complete data eligible for analysis, the mean board pass rate was 72% with a standard deviation of 14%. A total of 60 programs were placed in the 75th percentile or above for the number of publications authored by program alumni. The correlational analysis reported a significant correlation of 0.428, indicating only a moderate association between programs ranked by outcomes measures and those ranked according to reputation. Seventeen programs that were ranked in the top 30 according to reputation were also ranked in the top 30 based on outcomes measures. This study suggests that reputation alone does not fully capture a representative snapshot of a program's quality. Rather, the use of multiple quantifiable indicators and attributes unique to programs ought to be given more consideration when assigning ranks to denote program quality. It is advised that the interpretation and subsequent use of program rankings be met with caution until further studies can rigorously demonstrate best practices for awarding program standings. Copyright © 2015 Association of Program

  8. Decreasing dialysis catheter rates by creating a multidisciplinary dialysis access program.

    PubMed

    Rosenberry, Patricia M; Niederhaus, Silke V; Schweitzer, Eugene J; Leeser, David B

    2018-03-01

    Centers for Medicare and Medicaid Services have determined that chronic dialysis units should have <12% of their patients utilizing central venous catheters for hemodialysis treatments. On the Eastern Shore of Maryland, the central venous catheter rates in the dialysis units averaged >45%. A multidisciplinary program was established with goals of decreasing catheter rates in order to decrease central line-associated bloodstream infections, decrease mortality associated with central line-associated bloodstream infection, decrease hospital days, and provide savings to the healthcare system. We collected the catheter rates within three dialysis centers served over a 5-year period. Using published data surrounding the incidence and related costs of central line-associated bloodstream infection and mortality per catheter day, the number of central line-associated bloodstream infection events, the costs, and the related mortality could be determined prior to and after the initiation of the dialysis access program. An organized dialysis access program resulted in a 82% decrease in the number of central venous catheter days which lead to a concurrent reduction in central line-associated bloodstream infection and deaths. As a result of creating an access program, central venous catheter rates decreased from an average rate of 45% to 8%. The cost savings related to the program was calculated to be over US$5 million. The decrease in the number of mortalities is estimated to be between 13 and 27 patients. We conclude that a formalized access program decreases catheter rates, central line-associated bloodstream infection, and the resultant hospitalizations, mortality, and costs. Areas with high hemodialysis catheter rates should develop access programs to better serve their patient population.

  9. New Graduate Transition Programs: Relationships With Access to Support and Bullying.

    PubMed

    Rush, Kathy L; Adamack, Monica; Gordon, Jason; Janke, Robert

    2014-02-03

    Abstract New graduate nurses are often targets of bullying and horizontal violence. The support offered by new graduate nurse transition programs may moderate the effects of bullying and limit its negative impact on new graduate nurse transition. This study examined the relationships between access to support, workplace bullying and new graduate nurse transition within the context of New Graduate Transition programs. As part of a mixed methods study, an online survey was administered to new graduates (n=245) approximately a year from starting employment. Bullied new graduate nurses were less able to access support when needed and had poorer transition experiences than their non-bullied peers. Participation in a formal transition program improved access to support and transition for bullied new graduate nurses. People supports within transition programs positively influenced the new graduate nurse transition experience. Formal transition programs provide support that attenuates the impact of bullying on new graduate nurses and improves transition.

  10. 32 CFR 1906.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.151 Program accessibility: New construction and...

  11. 32 CFR 1906.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.151 Program accessibility: New construction and...

  12. 32 CFR 1906.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.151 Program accessibility: New construction and...

  13. 32 CFR 1906.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.151 Program accessibility: New construction and...

  14. 32 CFR 1906.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... INTELLIGENCE AGENCY ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE CENTRAL INTELLIGENCE AGENCY § 1906.151 Program accessibility: New construction and...

  15. 75 FR 20034 - Over-the-Road Bus Accessibility Program Grants: Corrections

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-16

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Over-the-Road Bus Accessibility... ``Over-the-Road Bus Accessibility Program Grants,'' extends the application deadline, and allows... comply with the terms and conditions of the Special Warranty for the Over-the-Road Bus Accessibility...

  16. 28 CFR 41.56 - General requirement concerning program accessibility.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false General requirement concerning program accessibility. 41.56 Section 41.56 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE ORDER 12250, NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY ASSISTED PROGRAMS Guidelines for...

  17. 28 CFR 41.56 - General requirement concerning program accessibility.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 1 2012-07-01 2012-07-01 false General requirement concerning program accessibility. 41.56 Section 41.56 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE ORDER 12250, NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY ASSISTED PROGRAMS Guidelines for...

  18. 28 CFR 41.56 - General requirement concerning program accessibility.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 1 2014-07-01 2014-07-01 false General requirement concerning program accessibility. 41.56 Section 41.56 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE ORDER 12250, NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY ASSISTED PROGRAMS Guidelines for...

  19. 28 CFR 41.56 - General requirement concerning program accessibility.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 1 2013-07-01 2013-07-01 false General requirement concerning program accessibility. 41.56 Section 41.56 Judicial Administration DEPARTMENT OF JUSTICE IMPLEMENTATION OF EXECUTIVE ORDER 12250, NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY ASSISTED PROGRAMS Guidelines for...

  20. Retransplantation in Late Hepatic Artery Thrombosis: Graft Access and Transplant Outcome.

    PubMed

    Buchholz, Bettina M; Khan, Shakeeb; David, Miruna D; Gunson, Bridget K; Isaac, John R; Roberts, Keith J; Muiesan, Paolo; Mirza, Darius F; Tripathi, Dhiraj; Perera, M Thamara P R

    2017-08-01

    Definitive treatment for late hepatic artery thrombosis (L-HAT) is retransplantation (re-LT); however, the L-HAT-associated disease burden is poorly represented in allocation models. Graft access and transplant outcome of the re-LT experience between 2005 and 2016 was reviewed with specific focus on the L-HAT cohort in this single-center retrospective study. Ninety-nine (5.7%) of 1725 liver transplantations were re-LT with HAT as the main indication (n = 43; 43%) distributed into early (n = 25) and late (n = 18) episodes. Model for end-stage liver disease as well as United Kingdom model for end-stage liver disease did not accurately reflect high disease burden of graft failure associated infections such as hepatic abscesses and biliary sepsis in L-HAT. Hence, re-LT candidates with L-HAT received low prioritization and waited longest until the allocation of an acceptable graft (median, 103 days; interquartile range, 28-291 days), allowing for progression of biliary sepsis. Balance of risk score and 3-month mortality score prognosticated good transplant outcome in L-HAT but, contrary to the prediction, the factual 1-year patient survival after re-LT was significantly inferior in L-HAT compared to early HAT, early non-HAT and late non-HAT (65% vs 82%, 92% and 95%) which was mainly caused by sepsis and multiorgan failure driving 3-month mortality (28% vs 11%, 16% and 0%). Access to a second graft after a median waitlist time of 6 weeks achieved the best short- and long-term outcome in re-LT for L-HAT (3-month mortality, 13%; 1-year survival, 77%). Inequity in graft access and peritransplant sepsis are fundamental obstacles for successful re-LT in L-HAT. Offering a graft for those in need at the best window of opportunity could facilitate earlier engrafting with improved outcomes.

  1. 45 CFR 2301.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) ARCTIC RESEARCH COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.151 Program accessibility: New...

  2. 45 CFR 2301.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) ARCTIC RESEARCH COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.151 Program accessibility: New...

  3. Association of Hospital Critical Access Status With Surgical Outcomes and Expenditures Among Medicare Beneficiaries.

    PubMed

    Ibrahim, Andrew M; Hughes, Tyler G; Thumma, Jyothi R; Dimick, Justin B

    2016-05-17

    Critical access hospitals are a predominant source of care for many rural populations. Previous reports suggest these centers provide lower quality of care for common medical admissions. Little is known about the outcomes and costs of patients admitted for surgical procedures. To compare the surgical outcomes and associated Medicare payments at critical access hospitals vs non-critical access hospitals. Cross-sectional retrospective review of 1,631,904 Medicare beneficiary admissions to critical access hospitals (n = 828) and non-critical access hospitals (n = 3676) for 1 of 4 common types of surgical procedures-appendectomy, 3467 for critical access and 151,867 for non-critical access; cholecystectomy, 10,556 for critical access and 573,435 for non-critical access; colectomy, 10,198 for critical access and 577,680 for non-critical access; hernia repair, 4291 for critical access and 300,410 for non-critical access-between 2009 and 2013. We compared risk-adjusted outcomes using a multivariable logistical regression that adjusted for patient factors (age, sex, race, Elixhauser comorbidities), admission type (elective, urgent, emergency), and type of operation. Undergoing surgical procedures at critical access vs non-critical access hospitals. Thirty-day mortality, postoperative serious complications (eg, myocardial infarction, pneumonia, or acute renal failure and a length of stay >75th percentile). Hospital costs were assessed using price-standardized Medicare payments during hospitalization. Patients (mean age, 76.5 years; 56.2% women) undergoing surgery at critical access hospitals were less likely to have chronic medical problems, and they had lower rates of heart failure (7.7% vs 10.7%, P < .0001), diabetes (20.2% vs 21.7%, P < .001), obesity (6.5% vs 10.6%, P < .001), or multiple comorbid diseases (% of patients with ≥2 comorbidities; 60.4% vs 70.2%, P < .001). After adjustment for patient factors, critical access and non

  4. Global Explorers: An Examination of Program Processes and Outcomes

    ERIC Educational Resources Information Center

    Duerden, Mathew David

    2009-01-01

    This study utilizes longitudinal, mixed-method data drawn from participants in an environmental education/international immersion program for middle high-school students to study outcomes and processes associated with program participation. Studies of program outcomes and processes are important for better understanding the design and impact of…

  5. Nurse managed prenatal programs affect outcomes for corporations.

    PubMed

    Thompson, P E; Bitowski, B E; Bell, P L

    1997-09-01

    Faced with higher medical costs and increased insurance premiums, corporations are focusing on health promotion and wellness. With increasing numbers of women in the workforce, corporations have identified the need for prenatal programs. By developing, initiating, and evaluating outcome-based prenatal programs nurses can target the health care needs of this select population. One such program documented several outcomes including improved employee health and an 86% reduction in maternal/newborn costs.

  6. Students Talking about Assessment: Insights on Program Learning Outcomes

    ERIC Educational Resources Information Center

    Donohue, William J.

    2017-01-01

    This study examines the student writer perspective of a first-year composition program's student learning outcomes. Student descriptions of learning are a valuable, yet often overlooked data source. The student voice broadens a first-year composition program's outcomes-based, student learning assessment process as program assessment data is often…

  7. Outcomes Assessment in Accredited Health Information Management Programs

    ERIC Educational Resources Information Center

    Bennett, Dorine

    2010-01-01

    The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…

  8. 32 CFR 2001.49 - Special access programs.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... enhanced for information in special access programs (SAP), established under the provisions of section 4.3 of the Order by the agency head responsible for creating the SAP. Agency heads shall ensure that the... Agreement/Understanding is established for each SAP that has significant interagency support requirements...

  9. Global Pattern of Nasopharyngeal Cancer: Correlation of Outcome With Access to Radiation Therapy

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

    Lam, Ka-On; Lee, Anne W.M., E-mail: annelee@hku-szh.org; Choi, Cheuk-Wai

    Purpose: This study aimed to estimate the treatment outcome of nasopharyngeal cancer (NPC) across the world and its correlation with access to radiation therapy (RT). Methods and Materials: The age-standardized mortality (ASM) and age-standardized incidence (ASI) rates of NPC from GLOBOCAN (2012) were summarized, and [1−(ASM/ASI)] was computed to give the proxy relative survival (RS). Data from the International Atomic Energy Agency (IAEA) and the World Bank were used to assess the availability of RT in surrogate terms: the number of RT equipment units and radiation oncologists per million population. Results: A total of 112 countries with complete valid datamore » were analyzed, and the proxy RS varied widely from 0% to 83% (median, 50%). Countries were categorized into Good, Median, and Poor outcome groups on the basis of their proxy RS (<45%, 45%-55%, and >55%). Eighty percent of new cases occurred in the Poor outcome group. Univariable linear regression showed a significant correlation between outcome and the availability of RT: proxy RS increased at 3.4% (P<.001) and 1.5% (P=.001) per unit increase in RT equipment and oncologist per million population, respectively. The median number of RT equipment units per million population increased significantly from 0.5 in the Poor, to 1.5 in the Median, to 4.6 in the Good outcome groups, and the corresponding number of oncologists increased from 1.1 to 3.3 to 7.1 (P<.001). Conclusions: Nasopharyngeal cancer is a highly treatable disease, but the outcome varies widely across the world. The current study shows a significant correlation between survival and access to RT based on available surrogate indicators. However, the possible reasons for poor outcome are likely to be multifactorial and complex. Concerted international efforts are needed not only to address the fundamental requirement for adequate RT access but also to obtain more comprehensive and accurate data for research to improve cancer outcome.« less

  10. 44 CFR 16.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Program accessibility: New construction and alterations. 16.151 Section 16.151 Emergency Management and Assistance FEDERAL EMERGENCY... HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL EMERGENCY MANAGEMENT AGENCY § 16.151 Program...

  11. Application of Matrix Outcome Mapping to Constructively Align Program Outcomes and Course Outcomes in Higher Education

    ERIC Educational Resources Information Center

    Mazouz, Abdelkader; Crane, Keenan

    2013-01-01

    Establishing a link between Course Learning Outcomes (LOs) and Program Outcomes (POs) while assessing the course contents and delivery are among the most challenging issues in Higher Education. In the present study two forms were generated based on specific Course Learning Outcomes identified in the syllabus at the beginning of the teaching term:…

  12. Public-access AED pad application and outcomes for out-of-hospital cardiac arrests in Osaka, Japan.

    PubMed

    Kiyohara, Kosuke; Kitamura, Tetsuhisa; Sakai, Tomohiko; Nishiyama, Chika; Nishiuchi, Tatsuya; Hayashi, Yasuyuki; Sakamoto, Tetsuya; Marukawa, Seishiro; Iwami, Taku

    2016-09-01

    Actual application of public-access automated external defibrillator (AED) pads to patients with an out-of-hospital cardiac arrest (OHCA) by the public has been poorly investigated. AED applications, prehospital characteristics, and one-month outcomes of OHCAs occurring in Osaka Prefecture from 2011 to 2012 were obtained from the Utstein Osaka Project registry. Patients with a non-traumatic OHCA occurring before emergency medical service attendance were enrolled. The proportion of AED pads that were applied to the patients' chests by the public and one-month outcomes were analysed according to the location of OHCA. In total, public-access AED pads were applied to 3.5% of OHCA patients (351/9978) during the study period. In the multivariate analyses, OHCAs that occurred in public places and received bystander-initiated cardiopulmonary resuscitation were associated with significantly higher application of public-access AEDs. Among the patients for whom public-access AED pads were applied, 29.6% (104/351) received public-access defibrillation. One-month survival with a favourable neurological outcome was significantly higher among patients who had an AED applied compared to those who did not (19.4% vs. 3.0%; OR: 2.76 [95% CI: 1.92-3.97]). The application of public-access AEDs leads to favourable outcomes after an OHCA, but utilisation of available equipment remains insufficient, and varies considerably according to the location of the OHCA event. Alongside disseminating public-access AEDs, further strategic approaches for the deployment of AEDs at the scene, as well as basic life support training for the public are required to improve survival rates after OHCAs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Brazil's National Program for Improving Primary Care Access and Quality (PMAQ)

    PubMed Central

    Harris, Matthew J.; Rocha, Marcia Gomes

    2017-01-01

    Despite some remarkable achievements, there are several challenges facing Brazil's Family Health Strategy (FHS), including expanding access to primary care and improving its quality. These concerns motivated the development of the National Program for Improving Primary Care Access and Quality (PMAQ). Although voluntary, the program now includes nearly 39 000 FHS teams in the country and has led to a near doubling of the federal investment in primary care in its first 2 rounds. In this article, we introduce the PMAQ and advance several recommendations to ensure that it continues to improve primary care access and quality in Brazil. PMID:28252498

  14. Public vs. Private Insurance: Cost, Use, Accessibility, and Outcomes of Services for Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Young, April; Ruble, Lisa; McGrew, John

    2009-01-01

    Very little research has been conducted on insurance type (private vs. public funded) and costs, accessibility, and use of services of children with autism. Analysis of five parent reported outcomes: (a) out-of-pocket expenditures, (b) variety of services used, (c) access to services, (d) child and family service outcomes, and (e) satisfaction…

  15. Impact of arterial access site on outcomes after primary percutaneous coronary intervention: prespecified subgroup analysis from the EUROMAX trial.

    PubMed

    Hamon, Martial; Coste, Pierre; Van't Hof, Arnoud; Ten Berg, Jurrien; Clemmensen, Peter; Tabone, Xavier; Benamer, Hakim; Kristensen, Steen D; Cavallini, Claudio; Marzocchi, Antonio; Hamm, Christian; Kanic, Vojko; Bernstein, Debra; Anthopoulos, Prodromos; Deliargyris, Efthymios N; Steg, Philippe Gabriel

    2015-06-01

    In European Ambulance Acute Coronary Syndrome Angiography (EUROMAX), bivalirudin improved 30-day clinical outcomes with reduced major bleeding compared with heparins plus optional glycoprotein IIb/IIIa inhibitors. We assessed whether choice of access site (radial or femoral) had an impact on 30-day outcomes and whether it interacted with the benefit of bivalirudin. In EUROMAX, choice of arterial access was left to operator discretion. Overall, 47% of patients underwent radial and 53% femoral access. Baseline risk was higher in the femoral access group. Unadjusted proportions for the primary outcome (death or noncoronary artery bypass graft protocol major bleeding at 30 days) were lower with radial access, however, without differences in major or major plus minor bleeding proportions. After multivariable adjustment, ischemic outcomes were no longer different between access site groups, except for a lower risk of stroke in radial patients. Bivalirudin was associated with lower proportions of the primary outcome in both the radial (odds ratio, 0.58; 95% CI, 0.33-1.03; P=0.058) and the femoral groups (odds ratio, 0.59; 95% CI, 0.37-0.93; P=0.022; interaction P=0.97). Bleeding was significantly lower in the bivalirudin group both in the radial- and femoral-treated patients but no significant difference was observed in ischemic outcomes. In multivariable analysis, bivalirudin emerged as the only independent predictor of reduced major bleeding (odds ratio, 0.45; 95% CI, 0.27-0.74; P=0.002). In this prespecified analysis from EUROMAX, radial access was preferred in lower risk patients and did not improve clinical outcomes. Bivalirudin was associated with less bleeding irrespective of access site. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01087723. © 2015 American Heart Association, Inc.

  16. 41 CFR 51-10.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Program accessibility: Existing facilities. 51-10.150 Section 51-10.150 Public Contracts and Property Management Other Provisions... result in a fundamental alteration in the nature of a program or activity or in undue financial and...

  17. 76 FR 19356 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-07

    ... FEDERAL COMMUNICATIONS COMMISSION [DA 11-390] Video Programming and Accessibility Advisory.... SUMMARY: This document announces the next meeting of the Video Programming Accessibility Advisory... Internet programming previously captioned on television, video description of television programming...

  18. Impact of Socioeconomic Inequality on Access, Adherence, and Outcomes of Antiretroviral Treatment Services for People Living with HIV/AIDS in Vietnam.

    PubMed

    Tran, Bach Xuan; Hwang, Jongnam; Nguyen, Long Hoang; Nguyen, Anh Tuan; Latkin, Noah Reed Knowlton; Tran, Ngoc Kim; Minh Thuc, Vu Thi; Nguyen, Huong Lan Thi; Phan, Huong Thu Thi; Le, Huong Thi; Tran, Tho Dinh; Latkin, Carl A

    2016-01-01

    Ensuring an equal benefit across different patient groups is necessary while scaling up free-of-charge antiretroviral treatment (ART) services. This study aimed to measure the disparity in access, adherence, and outcomes of ART in Vietnam and the effects of socioeconomic status (SES) characteristics on the levels of inequality. A cross-sectional study was conducted in 1133 PLWH in Vietnam. ART access, adherence, and treatment outcomes were self-reported using a structured questionnaire. Wealth-related inequality was calculated using a concentration index, and a decomposition analysis was used to determine the contribution of each SES variable to inequality in access, adherence, and outcomes of ART. Based on SES, minor inequality was found in ART access and adherence while there was considerable inequality in ART outcomes. Poor people were more likely to start treatment early, while rich people had better adherence and overall treatment outcomes. Decomposition revealed that occupation and education played important roles in inequality in ART access, adherence, and treatment outcomes. The findings suggested that health services should be integrated into the ART regimen. Furthermore, occupational orientation and training courses should be provided to reduce inequality in ART access, adherence, and treatment outcomes.

  19. Outcomes and lessons learned from evaluating TRICARE's disease management programs.

    PubMed

    Dall, Timothy M; Askarinam Wagner, Rachel C; Zhang, Yiduo; Yang, Wenya; Arday, David R; Gantt, Cynthia J

    2010-06-01

    To share outcomes and lessons learned from an evaluation of disease management (DM) programs for asthma, congestive heart failure (CHF), and diabetes for TRICARE patients. Multiyear evaluation of participants in voluntary, opt-out DM programs. Patient-centered programs, administered by 3 regional contractors, provide phone-based consultations with a care manager, educational materials, and newsletters. The study sample consisted of 23,793 asthma, 4092 CHF, and 29,604 diabetes patients with at least 6 months' tenure in the program. Medical claims were analyzed to quantify program effect on healthcare utilization, medical costs, and clinical outcomes. Multivariate regression analysis with an historical control group was used to predict patient outcomes in the absence of DM. The difference between actual and predicted DM patient outcomes was attributed to the program. A patient survey collected data on program satisfaction and perceived usefulness of program information and services. Modest improvements in patient outcomes included reduced inpatient days and medical costs, and (with few exceptions) increased percentages of patients receiving appropriate medications and tests. Annual per patient reductions in medical costs were $453, $371, and $783 for asthma, CHF, and diabetes program participants, respectively. The estimated return on investment was $1.26 per $1.00 spent on DM services. Findings suggest that the DM programs more than pay for themselves, in addition to improving patient health and quality of life. Lessons learned in program design, implementation, effectiveness, and evaluation may benefit employers contemplating DM, DM providers, and evaluators of DM programs.

  20. Multidimensional outcome considerations in assessing the efficacy of medical educational programs.

    PubMed

    Blumberg, Phyllis

    2003-01-01

    To be accredited, schools must evaluate the effectiveness of their programs. Educators are looking for specific indicators beyond the traditional measures. Data from multiple methods, including indicators of student performance and of the institutional environment, can be used to determine if educational program goals are met. This article outlines specific ways to consider three types of efficacy outcomes that are consistent with accreditation guidelines: educational, clinical career, and environmental outcomes. Specific measurable outcomes for each of these categories are derived from higher education literature: for example, learning approaches and information acquisition for education; professional behaviors and interpersonal dimensions for clinical career, and scholarship of teaching and teaching itself as a shared and valued activity for environmental outcomes. These outcomes address student assessment and program evaluation. Data from problem-based learning programs illustrate these outcomes. Educators can determine if educational program innovations have met their goals by collecting efficacy outcome data.

  1. Regional consolidation of orthopedic surgery: impacts on hip fracture surgery access and outcomes.

    PubMed

    Kreindler, Sara A; Siragusa, Lanette; Bohm, Eric; Rudnick, Wendy; Metge, Colleen J

    2017-09-01

    Timely access to orthopedic trauma surgery is essential for optimal outcomes. Regionalization of some types of surgery has shown positive effects on access, timeliness and outcomes. We investigated how the consolidation of orthopedic surgery in 1 Canadian health region affected patients requiring hip fracture surgery. We retrieved administrative data on all regional emergency department visits for lower-extremity injury and all linked inpatient stays from January 2010 through March 2013, identifying 1885 hip-fracture surgeries. Statistical process control and interrupted time series analysis controlling for demographics and comorbidities were used to assess impacts on access (receipt of surgery within 48-h benchmark) and surgical outcomes (complications, in-hospital/30-d mortality, length of stay). There was a significant increase in the proportion of patients receiving surgery within the benchmark. Complication rates did not change, but there appeared to be some decrease in mortality (significant at 6 mo). Length of stay increased at a hospital that experienced a major increase in patient volume, perhaps reflecting challenges associated with patient flow. Regionalization appeared to improve the timeliness of surgery and may have reduced mortality. The specific features of the present consolidation (including pre-existing interhospital performance variation and the introduction of daytime slates at the referral hospital) should be considered when interpreting the findings.

  2. Outcomes and Research in Out-of-School Time Program Design.

    ERIC Educational Resources Information Center

    Peter, Nancy

    Out-of-school time (OST) programs have taken on a new importance in recent years because of changes in society. This paper examines OST programming and suggests reasons and mechanisms for integrating outcomes and research into program design. It explains and promotes the integration of outcomes and research into program development, provides…

  3. A Structural Model for Student Outcomes: Assessment Programs in Community Colleges.

    ERIC Educational Resources Information Center

    Altieri, Guy

    1990-01-01

    Presents a model for establishing a community college student outcomes assessment program, listing types of student outcomes that should be assessed, and sources of information and measures typically used to assess the outcomes. Reviews steps in program development and in tailoring the program to the college. (DMM)

  4. Outcomes from the Productivity Places Program 2009: Technical Notes. Support Document

    ERIC Educational Resources Information Center

    National Centre for Vocational Education Research (NCVER), 2009

    2009-01-01

    This paper was produced as an added resource for the report "Outcomes from the Productivity Places Program 2009." "Outcomes from the Productivity Places Program 2009" presents information about the outcomes of students who completed their vocational education and training (VET) under the Productivity Places Program (PPP)…

  5. New graduate nurse transition programs: Relationships with bullying and access to support.

    PubMed

    Rush, Kathy L; Adamack, Monica; Gordon, Jason; Janke, Robert

    2014-01-01

    Abstract New graduate nurses are often targets of bullying and horizontal violence. The support offered by new graduate nurse transition programs may moderate the effects of bullying and limit its negative impact on new graduate nurse transition. This study examined the relationships between access to support, workplace bullying and new graduate nurse transition within the context of new graduate transition programs. As part of a mixed methods study, an online survey was administered to new graduates (N = 245) approximately a year from starting employment. Bullied new graduate nurses were less able to access support when needed and had poorer transition experiences than their non-bullied peers. Participation in a formal transition program improved access to support and transition for bullied new graduate nurses. People supports within transition programs positively influenced the new graduate nurse transition experience. Formal transition programs provide support that attenuates the impact of bullying on new graduate nurses and improves transition.

  6. 45 CFR 606.52 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SCIENCE FOUNDATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL SCIENCE FOUNDATION § 606.52 Program accessibility: New construction and... usable by individuals with handicaps. The definitions, requirements, and standards of the Architectural...

  7. Universal programming interface with concurrent access

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

    Alferov, Oleg

    2004-10-07

    There exist a number of devices with a positioning nature of operation, such as mechanical linear stages, temperature controllers, or filterwheels with discrete state, and most of them have different programming interfaces. The Universal Positioner software suggests the way to handle all of them is with a single approach, whereby a particular hardware driver is created from the template and by translating the actual commands used by the hardware to and from the universal programming interface. The software contains the universal API module itself, the demo simulation of hardware, and the front-end programs to help developers write their own softwaremore » drivers along with example drivers for actual hardware controllers. The software allows user application programs to call devices simultaneously without race conditions (multitasking and concurrent access). The template suggested in this package permits developers to integrate various devices easily into their applications using the same API. The drivers can be stacked; i.e., they can call each other via the same interface.« less

  8. Low-income individuals’ perceptions about fruit and vegetable access programs: A qualitative study

    PubMed Central

    Haynes-Maslow, Lindsey; Auvergne, Lauriane; Mark, Barbara; Ammerman, Alice; Weiner, Bryan J.

    2015-01-01

    Objective To examine how fruit and vegetable (F&V) programs address barriers to F&V access and consumption as perceived by low-income individuals. Design From 2011–2012 thirteen focus groups were used to better understand low-income individuals’ perceptions about F&V programs. Setting Five North Carolina counties at community-serving organizations. Participants Low-income participants ages 18 or older were included in the study. A majority were African American females with a high school education or less and received government assistance. Phenomenon of Interest Low-income individuals’ perceptions about how F&V access programs can reduce barriers and increase consumption. Analysis A socioecological framework guided data analysis, and 2 trained researchers coded transcripts, identified major themes, and summarized findings. Results A total of 105 participants discussed that mobile markets could overcome barriers such as availability, convenience, transportation, and quality/variety. Some were worried about safety in higher crime communities. Participants’ opinions about how successful food assistance programs were at overcoming cost barriers were mixed. Participants agreed that community gardens could increase access to affordable, conveniently located produce, but worried about feasibility/implementation issues. Implications for Research and Practice Addressing access barriers through F&V programs could improve consumption. Programs have the potential to be successful if they address multiple access barriers. (200 words). PMID:25910929

  9. Tobacco User Characteristics and Outcomes Related to Intensity of Quitline Program Use: Results From Minnesota and Pennsylvania.

    PubMed

    Lien, Rebecca K; Schillo, Barbara A; Mast, Jay L; Lukowski, Amy V; Greenseid, Lija O; Keith, Jennifer D; Keller, Paula A

    2016-01-01

    Tobacco users in all 50 states have access to quitline telephone counseling and cessation medications. While studies show multiple calls relate to quit success, most participants do not complete a full call series. To date, quitline program use studies have analyzed single factors-such as number of calls or counseling minutes. This study combines multiple factors of quitline program use across 2 states to describe how participants use a 5-call program; assess whether intensity of program use is associated with participant subgroups; and assess whether key outcomes (quitting, satisfaction) are associated with intensity. This observational study examines data for quitline participants in Minnesota (n = 2844) and Pennsylvania (n = 14 359) in 2011 and 2012. A subset of participants was surveyed 7 months after registration to assess key outcomes (response rates: Minnesota 65%; Pennsylvania 60%). Quitline utilization data were used to identify program use variables: nicotine replacement therapy provision, number of counseling calls, number of counseling minutes, days from first to last counseling call, and days from registration to first counseling call. Ten program use groups were created using all 5 program use variables, from lowest (1) to highest (10) intensity. Results were similar for both states. Only 11% of Minnesota and 8% of Pennsylvania participants completed all 5 calls. Intensity of quitline program use was associated with several participant characteristics including health conditions and age. Both quit status and program satisfaction were associated with program use intensity. Quit rates peaked in group 9, participants who received the full 5-call program. Quitlines should focus on engaging participants in multiple calls to improve quit outcomes. In addition, it is important to leverage multiple program use factors for a fuller understanding of how quitline participants use a program.

  10. Fidelity and outcomes in six integrated dual disorders treatment programs.

    PubMed

    Chandler, Daniel W

    2011-02-01

    Fidelity scores and outcomes were measured in six outpatient programs in California which implemented Integrated Dual Disorders Treatment (IDDT). Outcomes were measured for 1 year in four sites and 2 years in two sites; fidelity was assessed at 6 month intervals. Three of the six sites achieved high fidelity (at least a 4 on a 5 point fidelity scale) and three moderate fidelity (at least a 3). Retention in treatment, mental health functioning, stage of substance abuse treatment, abstinence, and psychiatric hospitalization were measured. Outcomes for individual programs were generally positive but not consistent within programs or across programs. Using pooled data in a longitudinal regression model with random effects at person level and adjustment of standard errors for clustering by site, change over time was not statistically significant for the primary outcomes. Fidelity scores had limited association with positive outcomes.

  11. 76 FR 57989 - Video Programming and Accessibility Advisory Committee; Announcement of Date of Next Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-19

    ... FEDERAL COMMUNICATIONS COMMISSION [DA 11-1527] Video Programming and Accessibility Advisory.... SUMMARY: This document announces the next meeting of the Video Programming Accessibility Advisory... Commission regarding video description, and the delivery of video description, access to emergency...

  12. [Programs of early detection of breast cancer and access of mammography in Spain].

    PubMed

    Luengo, S; Azcona, B; Lázaro, P; Madero, R

    1997-05-24

    We studied availability to mammography among Spanish women aged 40 to 70 years, variation in use of the mammography by autonomous community, and the situation and importance of breast cancer screening programs among other factors, in the access to mammography. A cross-sectional population survey was conducted in 1994 in a sample of 3,218 women. A questionnaire was used to collect data on the variable access (receipt of at least one mammogram in the last 2 years) as well as different access-related variables. Information on breast cancer screening programs was collected by contacting the responsible institutions. We considered that a program had total coverage if it included all the municipalities in the province and partial if it did not include all municipalities. Twenty-eight percent of women had performed a mammogram. This proportion varied among autonomous communities (AACC) from 11.5 to 73.8%. Breast cancer screening programs existed in 8 AACC. The multivariant analysis revealed an association between access to mammography and the existence of a screening program, especially when the later had total coverage (OR = 7.64; 95% CI = 5.24-11.10). An association was also found between access to mammography and physician-related factors, place of residence and attitudes of women toward mammography. Less than one third of women aged 40-70 have performed a mammography in the last 2 years, and this proportion varies among AACC. Gynecologist visits and the existence of breast cancer screening programs are fundamental factors in the access to mammography in Spain.

  13. Do Program Implementation Factors or Fidelity Affect Chronic Disease Self-Management Education Programs' Outcomes?

    PubMed

    Brady, Teresa J; Murphy, Louise B; O'Colmain, Benita J; Hobson, Reeti Desai

    2017-09-01

    To evaluate whether implementation factors or fidelity moderate chronic disease self-management education program outcomes. Meta-analysis of 34 Arthritis Self-Management Program and Chronic Disease Self-Management Program studies. Community. N = 10 792. Twelve implementation factors: program delivery fidelity and setting and leader and participant characteristics. Eighteen program outcomes: self-reported health behaviors, physical health status, psychological health status, and health-care utilization. Meta-analysis using pooled effect sizes. Modest to moderate statistically significant differences for 4 of 6 implementation factors; these findings were counterintuitive with better outcomes when leaders and participants were unpaid, leaders had less than minimum training, and implementation did not meet fidelity requirements. Exploratory study findings suggest that these interventions tolerate some variability in implementation factors. Further work is needed to identify key elements where fidelity is essential for intervention effectiveness.

  14. 15 CFR 8c.49 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Program accessibility: Discrimination prohibited. 8c.49 Section 8c.49 Commerce and Foreign Trade Office of the Secretary of Commerce ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF COMMERCE § 8c.49...

  15. Long-Term Outcome of the Lidcombe Program for Early Stuttering Intervention

    ERIC Educational Resources Information Center

    Miller, Barbara; Guitar, Barry

    2009-01-01

    Purpose: To report long-term outcomes of the first 15 preschool children treated with the Lidcombe Program by speech-language pathologists (SLPs) who were inexperienced with the program and independent of the program developers. Research questions were: Would the treatment have a similar outcome with inexperienced SLPs compared to outcomes when…

  16. Impact of Socioeconomic Inequality on Access, Adherence, and Outcomes of Antiretroviral Treatment Services for People Living with HIV/AIDS in Vietnam

    PubMed Central

    Nguyen, Long Hoang; Nguyen, Anh Tuan; Latkin, Noah Reed Knowlton; Tran, Ngoc Kim; Minh Thuc, Vu Thi; Nguyen, Huong Lan Thi; Phan, Huong Thu Thi; Le, Huong Thi; Tran, Tho Dinh; Latkin, Carl A.

    2016-01-01

    Background Ensuring an equal benefit across different patient groups is necessary while scaling up free-of-charge antiretroviral treatment (ART) services. This study aimed to measure the disparity in access, adherence, and outcomes of ART in Vietnam and the effects of socioeconomic status (SES) characteristics on the levels of inequality. Methods A cross-sectional study was conducted in 1133 PLWH in Vietnam. ART access, adherence, and treatment outcomes were self-reported using a structured questionnaire. Wealth-related inequality was calculated using a concentration index, and a decomposition analysis was used to determine the contribution of each SES variable to inequality in access, adherence, and outcomes of ART. Results Based on SES, minor inequality was found in ART access and adherence while there was considerable inequality in ART outcomes. Poor people were more likely to start treatment early, while rich people had better adherence and overall treatment outcomes. Decomposition revealed that occupation and education played important roles in inequality in ART access, adherence, and treatment outcomes Conclusion The findings suggested that health services should be integrated into the ART regimen. Furthermore, occupational orientation and training courses should be provided to reduce inequality in ART access, adherence, and treatment outcomes. PMID:28005937

  17. Hand Society and Matching Program Web Sites Provide Poor Access to Information Regarding Hand Surgery Fellowship.

    PubMed

    Hinds, Richard M; Klifto, Christopher S; Naik, Amish A; Sapienza, Anthony; Capo, John T

    2016-08-01

    The Internet is a common resource for applicants of hand surgery fellowships, however, the quality and accessibility of fellowship online information is unknown. The objectives of this study were to evaluate the accessibility of hand surgery fellowship Web sites and to assess the quality of information provided via program Web sites. Hand fellowship Web site accessibility was evaluated by reviewing the American Society for Surgery of the Hand (ASSH) on November 16, 2014 and the National Resident Matching Program (NRMP) fellowship directories on February 12, 2015, and performing an independent Google search on November 25, 2014. Accessible Web sites were then assessed for quality of the presented information. A total of 81 programs were identified with the ASSH directory featuring direct links to 32% of program Web sites and the NRMP directory directly linking to 0%. A Google search yielded direct links to 86% of program Web sites. The quality of presented information varied greatly among the 72 accessible Web sites. Program description (100%), fellowship application requirements (97%), program contact email address (85%), and research requirements (75%) were the most commonly presented components of fellowship information. Hand fellowship program Web sites can be accessed from the ASSH directory and, to a lesser extent, the NRMP directory. However, a Google search is the most reliable method to access online fellowship information. Of assessable programs, all featured a program description though the quality of the remaining information was variable. Hand surgery fellowship applicants may face some difficulties when attempting to gather program information online. Future efforts should focus on improving the accessibility and content quality on hand surgery fellowship program Web sites.

  18. Treatment Outcomes in an Adolescent Chemical Dependency Program.

    ERIC Educational Resources Information Center

    Ralph, Norbert; McMenamy, Carol

    1996-01-01

    Investigates treatment outcomes for all admissions to an adolescent chemical dependency program over a 10-month period. Interviews with parents of patients were conducted. The effect of various pretreatment and treatment factors on outcomes were investigated. Better treatment outcome was associated with older adolescents, greater participation in…

  19. ACCESS 1: Approximation Concepts Code for Efficient Structural Synthesis program documentation and user's guide

    NASA Technical Reports Server (NTRS)

    Miura, H.; Schmit, L. A., Jr.

    1976-01-01

    The program documentation and user's guide for the ACCESS-1 computer program is presented. ACCESS-1 is a research oriented program which implements a collection of approximation concepts to achieve excellent efficiency in structural synthesis. The finite element method is used for structural analysis and general mathematical programming algorithms are applied in the design optimization procedure. Implementation of the computer program, preparation of input data and basic program structure are described, and three illustrative examples are given.

  20. 50 CFR 550.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Program accessibility: New construction and alterations. 550.151 Section 550.151 Wildlife and Fisheries MARINE MAMMAL COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY MARINE MAMMAL...

  1. 22 CFR 1005.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Program accessibility: New construction and alterations. 1005.151 Section 1005.151 Foreign Relations INTER-AMERICAN FOUNDATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE INTER-AMERICAN FOUNDATION...

  2. 47 CFR 79.2 - Accessibility of programming providing emergency information.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) BROADCAST RADIO SERVICES CLOSED CAPTIONING AND VIDEO DESCRIPTION OF VIDEO PROGRAMMING § 79.2 Accessibility... information. (1) Video programming distributors must make emergency information, as defined in paragraph (a...; (ii) Emergency information that is provided in the video portion of a regularly scheduled newscast, or...

  3. 47 CFR 79.2 - Accessibility of programming providing emergency information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) BROADCAST RADIO SERVICES CLOSED CAPTIONING AND VIDEO DESCRIPTION OF VIDEO PROGRAMMING § 79.2 Accessibility... information. (1) Video programming distributors must make emergency information, as defined in paragraph (a...; (ii) Emergency information that is provided in the video portion of a regularly scheduled newscast, or...

  4. 47 CFR 79.2 - Accessibility of programming providing emergency information.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) BROADCAST RADIO SERVICES CLOSED CAPTIONING AND VIDEO DESCRIPTION OF VIDEO PROGRAMMING § 79.2 Accessibility... information. (1) Video programming distributors must make emergency information, as defined in paragraph (a...; (ii) Emergency information that is provided in the video portion of a regularly scheduled newscast, or...

  5. Closing the College Graduation Gap: National College Access and Success Benchmarking Report

    ERIC Educational Resources Information Center

    DeBaun, Bill; Melnick, Sara; Morgan, Elizabeth

    2016-01-01

    This report, the first of an annual series, establishes meaningful metrics about the outcomes of students served by college access and success programs. Using data collected from 24 college access programs, enrollment and graduation rates for the high school classes of 2007, 2008, and 2009 and an enrollment rate for the high school class of 2013…

  6. Regional consolidation of orthopedic surgery: impacts on hip fracture surgery access and outcomes

    PubMed Central

    Kreindler, Sara A.; Siragusa, Lanette; Bohm, Eric; Rudnick, Wendy; Metge, Colleen J.

    2017-01-01

    Background Timely access to orthopedic trauma surgery is essential for optimal outcomes. Regionalization of some types of surgery has shown positive effects on access, timeliness and outcomes. We investigated how the consolidation of orthopedic surgery in 1 Canadian health region affected patients requiring hip fracture surgery. Methods We retrieved administrative data on all regional emergency department visits for lower-extremity injury and all linked inpatient stays from January 2010 through March 2013, identifying 1885 hip-fracture surgeries. Statistical process control and interrupted time series analysis controlling for demographics and comorbidities were used to assess impacts on access (receipt of surgery within 48-h benchmark) and surgical outcomes (complications, in-hospital/30-d mortality, length of stay). Results There was a significant increase in the proportion of patients receiving surgery within the benchmark. Complication rates did not change, but there appeared to be some decrease in mortality (significant at 6 mo). Length of stay increased at a hospital that experienced a major increase in patient volume, perhaps reflecting challenges associated with patient flow. Conclusion Regionalization appeared to improve the timeliness of surgery and may have reduced mortality. The specific features of the present consolidation (including pre-existing interhospital performance variation and the introduction of daytime slates at the referral hospital) should be considered when interpreting the findings. PMID:28930037

  7. Evaluation of the content and accessibility of microsurgery fellowship program websites.

    PubMed

    Silvestre, Jason; Vargas, Christina R; Ho, Olivia; Lee, Bernard T

    2015-10-01

    Microsurgery fellowship applicants utilize Internet-based resources such as the San Francisco Match (SF Match) to manage their applications. In deciding where to apply, applicants rely on advice from mentors and online resources including microsurgery fellowship websites (MFWs). The purpose of this study was to evaluate the content and accessibility of MFWs. While microsurgery is practiced by many surgical specialties, this study focused on MFWs for programs available in the 2014 Microsurgery Fellowship Match. Program lists from the American Society for Reconstructive Microsurgery (ASRM) and the San Francisco Match (SF Match) were analyzed for the accessibility of MFW links. MFWs were evaluated for education and recruitment content, and MFW comprehensiveness was compared on the basis of program characteristics using chi square tests. Of the 25 fellowships available, only 18 had websites (72%). SF Match and ASRM listed similar programs (96% overlap) and provided website links (89%, 76%), but only a minority connected directly to the MFW (38%, 23%). A minority of programs were responsive via email inquiry (36%). MFWs maintained minimal education and recruitment content. MFW comprehensiveness was not associated with program characteristics. MFWs are often not readily accessible and contain limited information for fellowship applicants. Given the relative low-cost of website development, MFWs may be improved to facilitate fellow recruitment. © 2015 Wiley Periodicals, Inc.

  8. 75 FR 39135 - Voluntary Public Access and Habitat Incentive Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-08

    ... Public Access and Habitat Incentive Program AGENCY: Farm Service Agency and Commodity Credit Corporation... available through the Farm Service Agency (FSA) home page at http://www.fsa.usda.gov/ . FOR FURTHER... Program (CREP) land; (4) Supplement funding and services from other Federal, State, tribal government, or...

  9. 49 CFR 28.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Program accessibility: New construction and alterations. 28.151 Section 28.151 Transportation Office of the Secretary of Transportation ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE DEPARTMENT OF TRANSPORTATION...

  10. 43 CFR 17.551 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Program accessibility: New construction and alterations. 17.551 Section 17.551 Public Lands: Interior Office of the Secretary of the Interior NONDISCRIMINATION IN FEDERALLY ASSISTED PROGRAMS OF THE DEPARTMENT OF THE INTERIOR Enforcement of Nondiscrimination...

  11. 22 CFR 1600.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Program accessibility: New construction and alterations. 1600.151 Section 1600.151 Foreign Relations JAPAN-UNITED STATES FRIENDSHIP COMMISSION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE JAPAN-UNITED...

  12. Measuring outcomes of community aged care programs: challenges, opportunities and the Australian Community Outcomes Measurement ACCOM tool.

    PubMed

    Cardona, Beatriz

    2018-05-29

    Measuring health and wellbeing outcomes of community aged care programs is a complex task given the diverse settings in which care takes place and the intersection of numerous factors affecting an individual's quality of life outcomes. Knowledge of a strong causal relationship between services provided and the final outcome enables confidence in assuming the care provided was largely responsible for the outcome achieved (Courtney et al., Aust J Adv Nurs 26:49-57, 2009). The Department of Health has recently reported on the findings of The National Aged Care Quality Indicator Program - Home Care Pilot (KPMG, National Aged Care Quality Indicator Program - Home Care Pilot, 2017). The Program sought to test various tools to measure quality of life outcomes of their community aged care programs. Some of the key issues raised in the study reiterate the findings from The Australian Community Care Outcome Measurement (ACCOM) pilot study (Cardona et al., Australas J Ageing 36: 69-71, 2017), including the value of the ASCOT SCT4 tool (Adult Social care Outcomes Toolkit, http://www.pssru.ac.uk/ascot/downloads/questionnaires/sct4.pdf ) to measure social care related quality of life (SCRQoL) in community aged care programs in the Australian context, the collection of additional data to map the relationship of various variables such as functional ability, demographic characteristics and quality of life scores and the governance and administration of measurement tools for the purpose of quality reporting and consumer choice.

  13. Use of program logic models in the Southern Rural Access Program evaluation.

    PubMed

    Pathman, Donald; Thaker, Samruddhi; Ricketts, Thomas C; Albright, Jennifer B

    2003-01-01

    The Southern Rural Access Program (SRAP) evaluation team used program logic models to clarify grantees' activities, objectives, and timelines. This information was used to benchmark data from grantees' progress reports to assess the program's successes. This article presents a brief background on the use of program logic models--essentially charts or diagrams specifying a program's planned activities, objectives, and goals--for evaluating and managing a program. It discusses the structure of the logic models chosen for the SRAP and how the model concept was introduced to the grantees to promote acceptance and use of the models. The article describes how the models helped clarify the program's objectives and helped lead agencies plan and manage the many program initiatives and subcontractors in their states. Models also provided a framework for grantees to report their progress to the National Program Office and evaluators and promoted the evaluators' visibility and acceptance by the grantees. Program logics, however, increased grantees' reporting requirements and demanded substantial time of the evaluators. Program logic models, on balance, proved their merit in the SRAP through their contributions to its management and evaluation and by providing a better understanding of the program's initiatives, successes, and potential impact.

  14. 41 CFR 51-10.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Relating to Public Contracts COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED 10... FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED § 51-10.149 Program accessibility...

  15. 41 CFR 51-10.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Relating to Public Contracts COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED 10... FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED § 51-10.150 Program accessibility...

  16. 41 CFR 51-10.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Relating to Public Contracts COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED 10... FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED § 51-10.149 Program accessibility...

  17. 41 CFR 51-10.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Relating to Public Contracts COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED 10... FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED § 51-10.150 Program accessibility...

  18. 41 CFR 51-10.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Relating to Public Contracts COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED 10... FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED § 51-10.149 Program accessibility...

  19. 41 CFR 51-10.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Relating to Public Contracts COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED 10... FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED § 51-10.149 Program accessibility...

  20. 41 CFR 51-10.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Relating to Public Contracts COMMITTEE FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED 10... FOR PURCHASE FROM PEOPLE WHO ARE BLIND OR SEVERELY DISABLED § 51-10.150 Program accessibility...

  1. 76 FR 26341 - Medicaid Program; Methods for Assuring Access to Covered Medicaid Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ... Medicare & Medicaid Services 42 CFR Part 447 Medicare Program; Methods for Assuring Access to Covered... Services 42 CFR Part 447 [CMS 2328-P] RIN 0938-AQ54 Medicaid Program; Methods for Assuring Access to... design the procedures for enrolling providers of such care, and to set the methods for establishing...

  2. Open access to an outpatient intravenous diuresis program in a systolic heart failure disease management program.

    PubMed

    Hebert, Kathy; Dias, Andre; Franco, Emiliana; Tamariz, Leonardo; Steen, Dylan; Arcement, Lee M

    2011-01-01

    In order to provide efficient utilization of resources in an outpatient setting for acute exacerbation of heart failure (HF), the authors piloted an open-access outpatient intravenous (IV) diuretic program (IVDP) to evaluate utilization in an HF disease management program (HFDMP), patient characteristics for users of the program, and safety. An outpatient HFDMP at Jackson Memorial Hospital in Miami, Florida, enrolling 577 patients 18 years and older with an ejection fraction ≤40% was implemented. For symptoms or weight gain ≥5 pounds, patients were eligible to use an open-access IVDP during clinic hours. A total of 130 HFDM patients (22.5%) used the IVDP. IVDP users were more likely to be diabetic, with lower body mass indices than non-IVDP users. New York Heart Association class IV patients and previously hospitalized patients were more likely to use the IVDP. There were no documented adverse reactions for patients receiving treatment and no difference in mortality between groups. This open-access outpatient IVDP model for patients with HF was readily utilized by the HFDMP participants and appears safe for use in this population. This unique model may provide alternative access for acute HF treatment. Congest Heart Fail. © 2011 Wiley Periodicals, Inc.

  3. Environmental Technology Verification (ETV) Program Case Studies: Demonstrating Program Outcomes, Volume III

    EPA Science Inventory

    This booklet, ETV Program Case Studies: Demonstrating Program Outcomes, Volume III contains two case studies, addressing verified environmental technologies for decentalized wastewater treatment and converting animal waste to energy. Each case study contains a brief description ...

  4. 11 CFR 6.149 - Program accessibility: Discrimination prohibited.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... prohibited. 6.149 Section 6.149 Federal Elections FEDERAL ELECTION COMMISSION ENFORCEMENT OF... § 6.149 Program accessibility: Discrimination prohibited. Except as otherwise provided in 11 CFR 6.150 and 11 CFR 6.151, no qualified handicapped person shall be denied the benefits of, be excluded from...

  5. Student Standpoints about Access Programs in Higher Education

    ERIC Educational Resources Information Center

    Lundell, Dana B., Ed.; Higbee, Jeanne L., Ed.; Duranczyk, Irene M., Ed.; Goff, Emily, Ed.

    2007-01-01

    This monograph consists of 13 chapters featuring a diverse range of perspectives centralizing student standpoints about their experiences in higher education and access programs. Chapter 1, "Student Perspectives on College Readiness" (Jeanne L. Higbee), provides the results of a survey of developmental education students regarding college…

  6. Early access programs: Benefits, challenges, and key considerations for successful implementation

    PubMed Central

    Patil, Sanjaykumar

    2016-01-01

    Early access programs, (EAPs) are adopted by an increasing number of pharma companies due to several benefits offered by these programs. EAPs offer ethical, compliant, and controlled mechanisms of access to investigational drugs outside of the clinical trial space and before the commercial launch of the drug, to patients with life-threatening diseases having no treatment options available. In addition to the development of positive relationships with key opinion leaders (KOL), patients, advocacy groups and regulators, the data captured from the implementation of EAPs supports in the formulation of global commercialization strategies. This white paper outlines various circumstances to be considered for the implementation of EAPs named patient programs, the regulatory landscape, the benefits and challenges associated with implementing these programs and the key considerations for their successful implementation. PMID:26955570

  7. 49 CFR 807.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) NATIONAL TRANSPORTATION SAFETY BOARD ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE NATIONAL TRANSPORTATION SAFETY BOARD § 807.151 Program accessibility... the Architectural Barriers Act (42 U.S.C. 4151-4157), as established in 41 CFR 101-19.600 to 101-19...

  8. 28 CFR 513.43 - Inmate access to certain Bureau Program Statements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Statements. 513.43 Section 513.43 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE GENERAL... simple local access procedures described in this section to review certain Bureau Program Statements... 28 CFR), local access is available through the institution law library. (b) For a current Bureau...

  9. 50 CFR 648.262 - Effort-control program for red crab limited access vessels.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Effort-control program for red crab... UNITED STATES Management Measures for the Atlantic Deep-Sea Red Crab Fishery § 648.262 Effort-control program for red crab limited access vessels. (a) General. A vessel issued a limited access red crab permit...

  10. Access 5 - Step 1: Human Systems Integration Program Plan (HSIPP)

    NASA Technical Reports Server (NTRS)

    2005-01-01

    This report describes the Human System Interface (HSI) analysis, design and test activities that will be performed to support the development of requirements and design guidelines to facilitate the incorporation of High Altitude Long Endurance (HALE) Remotely Operated Aircraft (ROA) at or above FL400 in the National Airspace System (NAS). These activities are required to support the design and development of safe, effective and reliable ROA operator and ATC interfaces. This plan focuses on the activities to be completed for Step 1 of the ACCESS 5 program. Updates to this document will be made for each of the four ACCESS 5 program steps.

  11. The Incremental Validity of the MMPI-2: When Does Therapist Access Not Enhance Treatment Outcome?

    ERIC Educational Resources Information Center

    Lima, Elizabeth N.; Stanley, Sheila; Kaboski, Beth; Reitzel, Lorraine R.; Richey, Anthony; Castro, Yezzennya; Williams, Foluso M.; Tannenbaum, Kendra R.; Stellrecht, Nadia E.; Jakobsons, Lara J.; Wingate, LaRicka R.; Joiner, Thomas E.

    2005-01-01

    The present study examined whether therapist access to the Minnesota Multiphasic Personality Inventory (MMPI-2) predicted favorable treatment outcome, above and beyond other assessment measures. A manipulated assessment design was used, in which patients were randomly assigned either to a group in which therapists had access to their MMPI-2 data…

  12. 34 CFR 105.32 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Section 105.32 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES... entirety, is readily accessible to and usable by individuals with handicaps. This paragraph does not— (1...

  13. 34 CFR 105.32 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Section 105.32 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES... entirety, is readily accessible to and usable by individuals with handicaps. This paragraph does not— (1...

  14. 46 CFR 507.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL MARITIME COMMISSION... and usable by handicapped persons. This paragraph does not— (1) Necessarily require the agency to make each of its existing facilities accessible to and usable by handicapped persons; (2) In the case of...

  15. 22 CFR 1005.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Program accessibility: Existing facilities. 1005.150 Section 1005.150 Foreign Relations INTER-AMERICAN FOUNDATION ENFORCEMENT OF NONDISCRIMINATION ON... undertaken, such changes shall be made by August 22, 1989, but in any event as expeditiously as possible. (d...

  16. Massachusetts Child Psychiatry Access Project 2.0: A Case Study in Child Psychiatry Access Program Redesign.

    PubMed

    Sarvet, Barry D; Ravech, Marcy; Straus, John H

    2017-10-01

    The Massachusetts Child Psychiatry Access Program is a statewide public mental health initiative designed to provide consultation, care navigation, and education to assist pediatric primary care providers in addressing mental health problems for children and families. To improve program performance, adapt to changes in the environment of pediatric primary care services, and ensure the program's long-term sustainability, program leadership in consultation with the Massachusetts Department of Mental Health embarked on a process of redesign. The redesign process is described, moving from an initial strategic assessment of program and the planning of structural and functional changes, through transition and implementation. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Project Access V: An Investigation of the Impact of P.L. 89-313 Funds on Early Intervention Programs: Summative Evaluation Reports 1984 and 1985.

    ERIC Educational Resources Information Center

    Kochanek, Thomas T.

    The reports document achievements of early intervention programs (EIPs) for handicapped infants and young children in Massachusetts. The first report focuses on Project Access V and on evaluation of four major evaluation outcomes: (1) statutory compliance and generic impact of P.L. 89-313 expenditures; (2) overall P.L. 89-313 grant management and…

  18. 12 CFR 410.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Program accessibility: New construction and alterations. 410.151 Section 410.151 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY EXPORT-IMPORT BANK OF THE UNITED...

  19. 34 CFR 1200.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Program accessibility: Existing facilities. 1200.150 Section 1200.150 Education Regulations of the Offices of the Department of Education (Continued) NATIONAL... Architectural Barriers Act of 1968, as amended (42 U.S.C. 4151-4157), and any regulations implementing it. In...

  20. 76 FR 37779 - Rural Broadband Access Loans and Loan Guarantees Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-28

    ... DEPARTMENT OF AGRICULTURE Rural Utilities Service Rural Broadband Access Loans and Loan Guarantees... of $325,663,157 in loan funds for the Rural Broadband Access Loans and Loan Guarantees Program for... identifying a definite funding amount. The maximum amount of a loan under this authority will be $75 million...

  1. 75 FR 34960 - Import Administration IA ACCESS Pilot Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-21

    ... DEPARTMENT OF COMMERCE International Trade Administration 19 CFR Part 351 [Docket No. 100602237-0250-02] Import Administration IA ACCESS Pilot Program AGENCY: Import Administration, International Trade Administration, Department of Commerce. ACTION: Public notice and request for comments; correction...

  2. Access to Employee Wellness Programs and Use of Preventive Care Services Among U.S. Adults.

    PubMed

    Isehunwa, Oluwaseyi O; Carlton, Erik L; Wang, Yang; Jiang, Yu; Kedia, Satish; Chang, Cyril F; Fijabi, Daniel; Bhuyan, Soumitra S

    2017-12-01

    There is little research at the national level on access to employee wellness programs and the use of preventive care services. This study examined the use of seven preventive care services among U.S working adults with access to employee wellness programs. The study population comprised 17,699 working adults aged ≥18 years, obtained from the 2015 National Health Interview Survey. Multivariate logistic regression models examined the relationship between access to employee wellness programs and use of seven preventive care services: influenza vaccination, blood pressure check, diabetes check, cholesterol check, Pap smear test, mammogram, and colon cancer screening. Data analysis began in Fall 2016. Overall, 46.6% of working adults reported having access to employee wellness programs in 2015. Working adults with access to employee wellness programs had higher odds of receiving influenza vaccination (OR=1.57, 95% CI=1.43, 1.72, p<0.001), blood pressure check (OR=2.46, 95% CI=2.17, 2.78, p<0.001), diabetes check (OR=1.30, 95% CI=1.12, 1.50, p<0.001), cholesterol check (OR=1.48, 95% CI=1.33, 1.67, p<0.001), and mammogram (OR=1.57, 95% CI=1.24, 1.98, p<0.001). However, there was no significant difference between access to employee wellness programs and the use of Pap smear test and colon cancer screening services. Using a nationally representative sample of individuals, this study found a positive association between access to employee wellness programs and the use of preventive care services. The results support favorable policies to encourage implementing wellness programs in all worksites, especially those with <50 employees. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Outcomes of a College Wilderness Orientation Program

    ERIC Educational Resources Information Center

    Lien, Matt; Goldenberg, Marni

    2012-01-01

    Wilderness orientation programs have been utilized by colleges and universities in the United States for nearly 75 years. This study, using means-end theory, reveals the outcomes of a wilderness orientation program for incoming students. A retroactive study was conducted for all participants who had taken part in a wilderness orientation program…

  4. Considering disparities: How do nurse practitioner regulatory policies, access to care, and health outcomes vary across four states?

    PubMed

    Sonenberg, Andréa; Knepper, Hillary J

    Health disparities persist among morbidity and mortality rates in the United States. Contributing significantly to these disparities are the ability to pay for health care (largely, access to health insurance) and access to, and capacity of, the primary care health workforce. This article examines key determinants of health (DOH) including demographics, public and regulatory policies, health workforce capacity, and primary health outcomes of four states of the United States. The context of this study is the potential association among health care disparities and myriad DOH, among them, the restrictive nurse practitioner (NP) scope of practice (SOP) regulatory environment, which are documented to influence access to care and health outcomes. This descriptive study explores current NP SOP regulations, access to primary care, and health outcomes of key chronic disease indicators-diabetes, hypertension, and obesity in Alabama, Colorado, Mississippi, and Utah. These states represent both the greatest disparity in chronic disease health outcomes (obesity, diabetes, and hypertension) and the greatest difference in modernization of their NP SOP laws. The Affordable Care Act has greatly expanded access to health care. However, it is estimated that 23 million Americans, 7% of its total population, will remain uninsured by 2019. Restrictive and inconsistent NP SOP policies may continue to contribute to health workforce capacity and population health disparities across the country, with particular concern for primary care indicators. The study findings bring into question whether states with more restrictive NP SOP regulations impact access to primary care, which may in turn influence population health outcomes. These findings suggest the need for further research. NPs are essential for meeting the increasing demands of primary care in the United States, and quality-of-care indicator research supports their use. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Survey of Airport Access Analysis Techniques - Models, Data and a Research Program

    DOT National Transportation Integrated Search

    1972-06-01

    The report points up the differences and similarities between airport access travel and general urban trip making. Models and surveys developed for, or applicable, to airport access planning are reviewed. A research program is proposed which would ge...

  6. 29 CFR 1615.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... INFORMATION TECHNOLOGY § 1615.151 Program accessibility: New construction and alterations. Each building or... with disabilities. The definitions, requirements, and standards of the Architectural Barriers Act (42 U...

  7. 29 CFR 1615.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... INFORMATION TECHNOLOGY § 1615.151 Program accessibility: New construction and alterations. Each building or... with disabilities. The definitions, requirements, and standards of the Architectural Barriers Act (42 U...

  8. 14 CFR 1251.551 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... readily accessible to and usable by individuals with handicaps. The definitions, requirements, and...

  9. 14 CFR 1251.551 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... readily accessible to and usable by individuals with handicaps. The definitions, requirements, and...

  10. 14 CFR 1251.551 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... readily accessible to and usable by individuals with handicaps. The definitions, requirements, and...

  11. 14 CFR 1251.551 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... NONDISCRIMINATION ON BASIS OF HANDICAP Enforcement of Nondiscrimination on the Basis of Handicap in Programs or... readily accessible to and usable by individuals with handicaps. The definitions, requirements, and...

  12. When Children Learn Programming: Antecedents, Concepts and Outcomes.

    ERIC Educational Resources Information Center

    Shneiderman, Ben

    1985-01-01

    Discusses components of an educational plan which supports acquisition of computer programing skills by elementary school children, including antecedent knowledge required (sequencing, similarity, character recognition, part/whole relationships, conditional forms, repetition, and incrementation); initial programing concepts; and outcomes valuable…

  13. Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes.

    PubMed

    Borzych-Duzalka, Dagmara; Aki, T Fazil; Azocar, Marta; White, Colin; Harvey, Elizabeth; Mir, Sevgi; Adragna, Marta; Serdaroglu, Erkin; Sinha, Rajiv; Samaille, Charlotte; Vanegas, Juan Jose; Kari, Jameela; Barbosa, Lorena; Bagga, Arvind; Galanti, Monica; Yavascan, Onder; Leozappa, Giovanna; Szczepanska, Maria; Vondrak, Karel; Tse, Kei-Chiu; Schaefer, Franz; Warady, Bradley A

    2017-01-06

    Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015. In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of follow-up, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 months, respectively. By multivariate logistic regression analysis, risk of access revision was associated with younger age (odds ratio, 0.93; 95% confidence interval, 0.92 to 0.95; P<0.001), diagnosis of congenital anomalies of the kidney and urinary tract (odds ratio, 1.28; 95% confidence interval, 1.03 to 1.59; P=0.02), coexisting ostomies (odds ratio, 1.42; 95% confidence interval, 1.07 to 1.87; P=0.01), presence of swan neck tunnel with curled intraperitoneal portion (odds ratio, 1.30; 95% confidence interval, 1.04 to 1.63; P=0.02), and high gross national income (odds ratio, 1.10; 95% confidence interval, 1.02 to 1.19; P=0.01). Main reasons for access revisions included mechanical malfunction (60%), peritonitis (16%), exit site infection (12%), and leakage (6%). Need for access revision increased the risk of peritoneal dialysis technique failure or death (hazard ratio, 1.35; 95% confidence interval, 1.10 to 1.65; P=0.003). Access dysfunction due to mechanical causes doubled the risk

  14. Peritoneal Dialysis Access Revision in Children: Causes, Interventions, and Outcomes

    PubMed Central

    Aki, T. Fazil; Azocar, Marta; White, Colin; Harvey, Elizabeth; Mir, Sevgi; Adragna, Marta; Serdaroglu, Erkin; Sinha, Rajiv; Samaille, Charlotte; Vanegas, Juan Jose; Kari, Jameela; Barbosa, Lorena; Bagga, Arvind; Galanti, Monica; Yavascan, Onder; Leozappa, Giovanna; Szczepanska, Maria; Vondrak, Karel; Tse, Kei-Chiu; Schaefer, Franz; Warady, Bradley A.

    2017-01-01

    Background and objectives Little published information is available about access failure in children undergoing chronic peritoneal dialysis. Our objectives were to evaluate frequency, risk factors, interventions, and outcome of peritoneal dialysis access revision. Design, setting, participants, & measurements Data were derived from 824 incident and 1629 prevalent patients from 105 pediatric nephrology centers enrolled in the International Pediatric Peritoneal Dialysis Network Registry between 2007 and 2015. Results In total, 452 access revisions were recorded in 321 (13%) of 2453 patients over 3134 patient-years of follow-up, resulting in an overall access revision rate of 0.14 per treatment year. Among 824 incident patients, 186 (22.6%) underwent 188 access revisions over 1066 patient-years, yielding an access revision rate of 0.17 per treatment year; 83% of access revisions in incident patients were reported within the first year of peritoneal dialysis treatment. Catheter survival rates in incident patients were 84%, 80%, 77%, and 73% at 12, 24, 36, and 48 months, respectively. By multivariate logistic regression analysis, risk of access revision was associated with younger age (odds ratio, 0.93; 95% confidence interval, 0.92 to 0.95; P<0.001), diagnosis of congenital anomalies of the kidney and urinary tract (odds ratio, 1.28; 95% confidence interval, 1.03 to 1.59; P=0.02), coexisting ostomies (odds ratio, 1.42; 95% confidence interval, 1.07 to 1.87; P=0.01), presence of swan neck tunnel with curled intraperitoneal portion (odds ratio, 1.30; 95% confidence interval, 1.04 to 1.63; P=0.02), and high gross national income (odds ratio, 1.10; 95% confidence interval, 1.02 to 1.19; P=0.01). Main reasons for access revisions included mechanical malfunction (60%), peritonitis (16%), exit site infection (12%), and leakage (6%). Need for access revision increased the risk of peritoneal dialysis technique failure or death (hazard ratio, 1.35; 95% confidence interval, 1

  15. A workplace intervention program and the increase in HIV knowledge, perceived accessibility and use of condoms among young factory workers in Thailand.

    PubMed

    Chamratrithirong, Aphichat; Ford, Kathleen; Punpuing, Sureeporn; Prasartkul, Pramote

    2017-12-01

    Vulnerability to Human Immunodeficiency Virus (HIV) infection among factory workers is a global problem. This study investigated the effectiveness of an intervention to increase AIDS knowledge, perceived accessibility to condoms and condom use among young factory workers in Thailand. The intervention was a workplace program designed to engage the private sector in HIV prevention. A cross-sectional survey conducted in 2008 to measure program outcomes in factories in Thailand was used in this study. The workplace intervention included the development of policies for management of HIV-positive employees, training sessions for managers and workers, and distribution of educational materials and condoms. A multi-level analysis was used to investigate the effect of HIV/AIDS prevention program components at the workplace on HIV/AIDS knowledge, perceived accessibility to condoms and condom use with regular sexual partners among 699 young factory workers (aged 18-24 years), controlling for their individual socio-demographic characteristics. Interventions related to the management and services component including workplace AIDS policy formulation, condom services programs and behavioral change campaigns were found to be significantly related to increased AIDS knowledge, perceived accessibility to condoms and condom use with regular partners. The effect of the HIV/AIDS training for managers, peer leaders and workers was positive but not statistically significant. With some revision of program components, scaling up of workplace interventions and the engagement of the private sector in HIV prevention should be seriously considered.

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

    PubMed

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

    2015-02-01

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

  17. Association of mandated language access programming and quality of care provided by mental health agencies.

    PubMed

    McClellan, Sean R; Snowden, Lonnie

    2015-01-01

    This study examined the association between language access programming and quality of psychiatric care received by persons with limited English proficiency (LEP). In 1999, the California Department of Mental Health required county Medicaid agencies to implement a "threshold language access policy" to meet the state's Title VI obligations. This policy required Medi-Cal agencies to provide language access programming, including access to interpreters and translated written material, to speakers of languages other than English if the language was spoken by at least 3,000, or 5%, of the county's Medicaid population. Using a longitudinal study design with a nonequivalent control group, this study examined the quality of care provided to Spanish speakers with LEP and a severe mental illness before and after implementation of mandatory language access programming. Quality was measured by receipt of at least two follow-up medication visits within 90 days or three visits within 180 days of an initial medication visit over a period of 38 quarter-years. On average, only 40% of Spanish-speaking clients received at least three medication follow-up visits within 180 days. In multivariate analyses, language access programming was not associated with receipt of at least two medication follow-up visits within 90 days or at least three visits within 180 days. This study found no evidence that language access programming led to increased rates of follow-up medication visits for clients with LEP.

  18. Spanish-language community-based mental health treatment programs, policy-required language-assistance programming, and mental health treatment access among Spanish-speaking clients.

    PubMed

    Snowden, Lonnie R; McClellan, Sean R

    2013-09-01

    We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California's Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997-2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P < .05). However, the increase was insufficient to significantly reduce language-related disparities. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.

  19. Spanish-Language Community-Based Mental Health Treatment Programs, Policy-Required Language-Assistance Programming, and Mental Health Treatment Access Among Spanish-Speaking Clients

    PubMed Central

    McClellan, Sean R.

    2013-01-01

    Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P < .05). However, the increase was insufficient to significantly reduce language-related disparities. Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services. PMID:23865663

  20. The relationship of travel distance with cystectomy access and outcomes.

    PubMed

    Smith, Angela B; Meyer, Anne-Marie; Meng, Ke; Nielsen, Matthew E; Pruthi, Raj; Wallen, Eric; Woods, Michael; Tan, Hung-Jui

    2018-06-01

    Regionalization of care and travel distance may result in unintended consequences for complex surgery such as cystectomy. Our objective was to evaluate effect of differential distance on cystectomy receipt among patients with muscle-invasive bladder cancer (MIBC) and investigate the association between travel distance and cystectomy outcomes such as readmission. Using a linked data resource combining the NC Central Cancer Registry with claims data from Medicare, Medicaid, and private insurance plans, we included 736 patients with MIBC and 1,082 who underwent cystectomy. To evaluate access, differential distance was calculated as the difference between the nearest urologist and nearest cystectomy provider. To assess outcomes, logistic regression was used to evaluate rehospitalization and major complications, and Cox proportional hazards model for survival analysis. To evaluate access and outcomes, 736 patients with MIBC and 1,082 patients undergoing cystectomy were evaluated, respectively. Overall, 29% (211 of 736) with MIBC underwent cystectomy. Differential distance was not a predictor of cystectomy receipt (odds ratio = 1.0; 95% CI: 1.00, 1.01). Among patients undergoing cystectomy, travel distance from cystectomy provider was not a significant predictor of 30- or 31 to 90day readmissions (odds ratio = 1.0; 95% CI: 1.00, 1.00) although patients who lived further from their cystectomy provider were more likely to be readmitted to a nonindex hospital (P<0.001) when controlling for other factors. Although travel distance did not have a significant effect on overall survival, patients readmitted between 31 to 90days had worse overall survival (P<0.0001). The additional distance needed to reach a cystectomy provider did not predict receipt of surgery for MIBC. Furthermore, travel distance from cystectomy provider was not a significant predictor for subsequent readmission after cystectomy and did not affect overall survival. Copyright © 2018 Elsevier Inc. All rights

  1. Migrant Students' College Access: Emerging Evidence from the Migrant Student Leadership Institute

    ERIC Educational Resources Information Center

    Nunez, Anne-Marie

    2009-01-01

    Little is known about migrant students' college access. Outreach programs serving such students rarely track their participants' postsecondary trajectories, nor do they compare participants' college access outcomes with those of similar students. This study examines the California public college application, acceptance, and enrollment patterns of…

  2. Enhancing Promise Programs to Improve College Access and Success. Issue Focus

    ERIC Educational Resources Information Center

    Ratledge, Alyssa

    2017-01-01

    Community college students face many barriers to success. College Promise programs, which now number more than 200, provide financial support to pay local students' tuition and fees. These programs have received bipartisan support from state and municipal policymakers to improve students' "access" to college, putting college financially…

  3. Implementation and outcomes of commercial disease management programs in the United States: the disease management outcomes consolidation survey.

    PubMed

    Fitzner, Karen; Fox, Kathe; Schmidt, Joseph; Roberts, Mark; Rindress, Donna; Hay, Joel

    2005-08-01

    Despite widespread adoption of disease management (DM) programs by US health plans, gaps remain in the evidence for their benefit. The Disease Management Outcomes Consolidation Survey was designed to gather data on DM programs for commercial health plans, to assess program success and DM effectiveness. The questionnaire was mailed to 292 appropriate health plan contacts; 26 plans covering more than 14 million commercial members completed and returned the survey. Respondents reported that DM plays a significant and increasing role in their organizations. Key reasons for adopting DM were improving clinical outcomes, reducing medical costs and utilization, and improving member satisfaction. More respondents were highly satisfied with clinical results than with utilization or cost outcomes of their programs (46%, 17%, and 13%, respectively). Detailed results were analyzed for 57 DM programs with over 230,000 enrollees. Most responding plans offered DM programs for diabetes and asthma, with return on investment (ROI) ranging from 0.16:1 to 4:1. Weighted by number of enrollees per DM program, average ROI was 2.56:1 for asthma (n = 1,136 enrollees) and 1.98:1 for diabetes (n = 25,364). Most (but not all) respondents reported reduced hospital admissions, increasing rates of preventive care, and improved clinical measures. Few respondents provided detailed information about DM programs for other medical conditions, but most that did reported positive outcomes. Lack of standardized methodology was identified as a major barrier to in-house program evaluation. Although low response rate precluded drawing many general conclusions, a clear need emerged for more rigorous evaluation methods and greater standardization of outcomes measurement.

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

    PubMed

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

    2010-01-01

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

  5. A Parent-Focused Early Intervention Program for Autism: Who Gets Access?

    ERIC Educational Resources Information Center

    Birkin, Christina; Anderson, Angelika; Seymour, Fred; Moore, Dennis W.

    2008-01-01

    Background: The EarlyBird program is a psycho-educational early intervention program for parents of children with autistic spectrum disorder (ASD). It aims to provide parents with skills to increase their child's communication and manage challenging behaviour using behavioural techniques. Method: Two interlinked studies examined access to the…

  6. Access & Excellence: The Open-Door College.

    ERIC Educational Resources Information Center

    Roueche, John E.; Baker, George A., III

    Drawing from an in-depth case study of the organizational climate, leadership, teaching, systems, programs, and student outcomes at Miami-Dade Community College (MDCC), this book addresses questions related to the achievement of both open access and high academic standards in the community college. Chapter I presents the rationale for the study…

  7. Program Evaluation of Outcomes Based Orthotic and Prosthetic Education

    DTIC Science & Technology

    2008-12-01

    the Student Learning Outcomes Assessment group (SLOAC) at California State University Dominguez Hills. She is an assessment expert and consultant...identified in the program-level outcomes (Essential Elements of Learning Outcomes Assessment, Indicators 4 & 5, University Student Learning Outcomes...A short 70-mile trip is changing the lives of O&P students and impacting future care of returning military service members. By Jennifer Hoydicz

  8. 24 CFR 570.508 - Public access to program records.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Public access to program records. 570.508 Section 570.508 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF...

  9. Is More Always Better in Designing Workplace Wellness Programs?: A Comparison of Wellness Program Components Versus Outcomes.

    PubMed

    Batorsky, Benjamin; Van Stolk, Christian; Liu, Hangsheng

    2016-10-01

    Assess whether adding more components to a workplace wellness program is associated with better outcomes by measuring the relationship of program components to one another and to employee participation and perceptions of program effectiveness. Data came from a 2014 survey of 24,393 employees of 81 employers about services offered, leadership, incentives, and promotion. Logistic regressions were used to model the relationship between program characteristics and outcomes. Components individually are related to better outcomes, but this relationship is weaker in the presence of other components and non-significant for incentives. Within components, a moderate level of services and work time participation opportunities are associated with higher participation and effectiveness. The "more of everything" approach does not appear to be advisable for all programs. Programs should focus on providing ample opportunities for employees to participate and initiatives like results-based incentives.

  10. Educational Infrastructure and Resources for Sustainable Access to Schooling and Outcomes: The Case of Early Literacy Development in Southern Tanzania

    ERIC Educational Resources Information Center

    Ngwaru, Jacob Marriote; Oluga, Mary

    2015-01-01

    Following on the 1990 and 2000 World Conferences on Education for All, African governments increased their focus on access to schooling (but not necessarily on outcomes) by providing more facilities for increased enrolments. The learning outcomes that had been neglected led to a call to focus on more sustainable access--re-examining the quality of…

  11. The Role of Boards in College Access Programs: Creating and Maintaining Quality

    ERIC Educational Resources Information Center

    Center for Higher Education Policy Analysis, University of Southern California, 2006

    2006-01-01

    Access programs are facing increased scrutiny. Not all programs are equally effective. In an environment in which resources are short, funders increasingly require criteria that enable them to make informed decisions about program quality. As elaborated in this report , one role of a high performance board is to help develop benchmarks of…

  12. Developing a blended learning program for nursing and midwifery students in Iran: Process and preliminary outcomes.

    PubMed

    Zolfaghari, Mitra; Negarandeh, Reza; Eybpoosh, Sana

    2013-01-01

    We aimed to develop and evaluate outcomes of a blended learning (BL) program for educating nursing and midwifery students of Tehran university of medical sciences (Tehran, Iran). This was a participatory action research project. After designing BL website, providing technological infrastructures, and holding preparatory workshops, 22 blended courses were designed. BL method was implemented for one semester. Students' grade point average, participation with courses, and opinion about educational methods, and instructors' attitude and opinion about educational methods were assessed. Most students (n = 181; 72.1%) and 17 instructors (28.3%) consented to participate in the study. Students' grade point average and participation was significantly higher in BL rather than in face-to-face method (P < 0.0001). Most instructors (n = 11, 65%) had positive attitude toward BL method. Textual analysis of participants' opinion showed that most students preferred BL method and felt more independent in this method. However, they complained about lack of easy access to Internet and weakness in computer skills. Instructors admired the flexibility and incentives that had been provided in the program. However, some of them complained about the time-consuming nature of BL course design. The program showed positive effect on students' learning outcomes and participation. The strengths and weaknesses of the program should be considered for development of next phase of the project. Lessons learned in this phase might be helpful for decision makers who tend to develop similar programs in Iran. Motivational and communicational issues and users' IT skills should be addressed in every BL program.

  13. Policies and Programs to Facilitate Access to Targeted Cancer Therapies in Thailand

    PubMed Central

    Sruamsiri, Rosarin; Ross-Degnan, Dennis; Lu, Christine Y.; Chaiyakunapruk, Nathorn; Wagner, Anita K.

    2015-01-01

    Background Increasing access to clinically beneficial targeted cancer medicines is a challenge in every country due to their high cost. We describe the interplay of innovative policies and programs involving multiple stakeholders to facilitate access to these medicines in Thailand, as well as the utilization of selected targeted therapies over time. Methods We selected two medicines on the 2013 Thai national list of essential medicines (NLEM) [letrozole and imatinib] and three unlisted medicines for the same indications [trastuzumab, nilotinib and dasatinib]. We created timelines of access policies and programs for these products based on scientific and grey literature. Using IMS Health sales data, we described the trajectories of sales volumes of the study medicines between January 2001 and December 2012. We compared estimated average numbers of patients treated before and after the implementation of policies and programs for each product. Results Different stakeholders implemented multiple interventions to increase access to the study medicines for different patient populations. During 2007–2009, the Thai Government created a special NLEM category with different coverage requirements for payers and issued compulsory licenses; payers negotiated prices with manufacturers and engaged in pooled procurement; pharmaceutical companies expanded patient assistance programs and lowered prices in different ways. Compared to before the interventions, estimated numbers of patients treated with each medicine increased significantly afterwards: for letrozole from 645 (95% CI 366–923) to 3683 (95% CI 2,748–4,618); for imatinib from 103 (95% CI 72–174) to 350 (95% CI 307–398); and for trastuzumab from 68 (95% CI 45–118) to 412 (95% CI 344–563). Conclusions Government, payers, and manufacturers implemented multi-pronged approaches to facilitate access to targeted cancer therapies for the Thai population, which differed by medicine. Routine monitoring is needed to

  14. Assessment of Student Learning Outcomes in FCS Programs

    ERIC Educational Resources Information Center

    Weaver-Kaulis, Amy; Crutsinger, Christy

    2006-01-01

    Accreditation, budget, and accountability pressures at the institution and program levels lead to the involvement of faculty in assessment-based activities. Increasingly, programs are being expected to document student learning beyond traditional course grades. The use of outcomes as a tool to improve learning relies heavily on the active…

  15. Multiple Year Extension Program Outcomes & Impacts through Evaluation

    ERIC Educational Resources Information Center

    Hachfeld, Gary A.; Bau, David B.; Holcomb, C. Robert; Craig, J. William

    2013-01-01

    Dwindling public funding as well as greater competition for grant dollars create a challenge for Extension. For Extension to remain a financially viable organization, educators have to be able to produce substantive, measurable program outcomes and impacts. Evaluative data can inform program development and delivery, and helps administrators…

  16. Focus Group Outcomes of the Happy Kids Program

    ERIC Educational Resources Information Center

    Anderson, Karen; Ferguson, Neil; Partington, Gary; Byrne, Matt

    2015-01-01

    In this article, the outcomes of The Happy Kids project, a strategy to improve the social and emotional well-being of primary school students, were examined. Results indicated that the Happy Kids program had demonstrated positive social and emotional outcomes for students in all schools, in particular, a positive impact upon students' confidence,…

  17. Evaluation of Access, a Primary Care Program for Indigent Patients: Inpatient and Emergency Room Utilization.

    ERIC Educational Resources Information Center

    Davidson, Richard A.; Giancola, Angela; Gast, Andrea; Ho, Janice; Waddell, Rhondda

    2003-01-01

    Evaluated the impact of Accessing Community Care through Eastside Social Services (ACCESS), a program that provided indigent patients with free primary care, on inpatient admissions, emergency room (ER) visits, and subsequent charges. Data on 19 people before and after program enrollment showed significant decreases in ER visits following…

  18. Early Head Start Relationships: Association with Program Outcomes

    ERIC Educational Resources Information Center

    Elicker, James; Wen, Xiaoli; Kwon, Kyong-Ah; Sprague, Jill B.

    2013-01-01

    Research Findings: Interpersonal relationships among staff caregivers, parents, and children have been recommended as essential aspects of early childhood intervention. This study explored the associations of these relationships with program outcomes for children and parents in 3 Early Head Start programs. A total of 71 children (8-35 months,…

  19. Urban-rural differences in the association between access to healthcare and health outcomes among older adults in China.

    PubMed

    Zhang, Xufan; Dupre, Matthew E; Qiu, Li; Zhou, Wei; Zhao, Yuan; Gu, Danan

    2017-07-19

    Studies have shown that inadequate access to healthcare is associated with lower levels of health and well-being in older adults. Studies have also shown significant urban-rural differences in access to healthcare in developing countries such as China. However, there is limited evidence of whether the association between access to healthcare and health outcomes differs by urban-rural residence at older ages in China. Four waves of data (2005, 2008/2009, 2011/2012, and 2014) from the largest national longitudinal survey of adults aged 65 and older in mainland China (n = 26,604) were used for analysis. The association between inadequate access to healthcare (y/n) and multiple health outcomes were examined-including instrumental activities of daily living (IADL) disability, ADL disability, cognitive impairment, and all-cause mortality. A series of multivariate models were used to obtain robust estimates and to account for various covariates associated with access to healthcare and/or health outcomes. All models were stratified by urban-rural residence. Inadequate access to healthcare was significantly higher among older adults in rural areas than in urban areas (9.1% vs. 5.4%; p < 0.01). Results from multivariate models showed that inadequate access to healthcare was associated with significantly higher odds of IADL disability in older adults living in urban areas (odds ratio [OR] = 1.58-1.79) and rural areas (OR = 1.95-2.30) relative to their counterparts with adequate access to healthcare. In terms of ADL disability, we found significant increases in the odds of disability among rural older adults (OR = 1.89-3.05) but not among urban older adults. Inadequate access to healthcare was also associated with substantially higher odds of cognitive impairment in older adults from rural areas (OR = 2.37-3.19) compared with those in rural areas with adequate access to healthcare; however, no significant differences in cognitive impairment were found among older

  20. Community College Student Retention: Determining the Effects of a Comprehensive Support and Access Intervention Program Targeting Low-Income and Working Poor at a Large Urban Minority-Serving Institution

    ERIC Educational Resources Information Center

    Saltiel, Henry

    2011-01-01

    A quasi-experiment using quantitative methods was conducted to examine the effects on academic student outcomes when a cohort of employed low-SES community college commuter students (the treatment group, N=198) participated in a comprehensive support and access intervention program, compared with similar students (the matched comparison group,…

  1. Expanding access to sterile syringes through pharmacies: assessment of New York's Expanded Syringe Access Program.

    PubMed

    Tesoriero, James M; Battles, Haven B; Klein, Susan J; Kaufman, Erin; Birkhead, Guthrie S

    2009-01-01

    To investigate the evolution of pharmacist practices, attitudes, and experiences with the Expanded Syringe Access Program (ESAP), which permits over-the-counter sale of syringes by registered pharmacies in New York State. Longitudinal study. New York State in 2002 and 2006. 506 (2002) and 682 (2006) managing pharmacists (response rates approximately 70%) at ESAP-registered pharmacies (n = 346 in both years). Mailed surveys (2002 and 2006). Pharmacist practices, attitudes, and experiences with ESAP over time. Approximately 75% of pharmacists reported that ESAP had facilitated timely/emergency access to syringes, and more than 90% in each year reported no problems or very few problems administering ESAP. The practice of placing additional requirements on the sale of syringes decreased from 2002 (51.4%) to 2006 (45.1%), while a 55% increase in syringe sales was reported between 2002 (43.3/month) and 2006 (67.1/month). The sale of sharps containers also increased between 2002 (85.2%) and 2006 (92.8%). Community independent pharmacies and those located outside New York City generally expressed more favorable attitudes and experiences with ESAP, although these differences decreased over time. Pharmacy-based syringe access is a viable harm-reduction alternative in the fight against blood-borne diseases, with ESAP now equaling the number of syringes being distributed by syringe exchange programs in New York State. Continued education/training is necessary to increase participation in ESAP and to further reduce barriers to ESAP use.

  2. The Influence of Perceived Characteristics of Management Development Programs on Employee Outcomes

    ERIC Educational Resources Information Center

    Ardts, Joost C. A.; van der Velde, Mandy E. G.; Maurer, Todd J.

    2010-01-01

    Employees' perceptions of Management Development (MD) programs is the topic of this study. The purpose is to examine the influence of three important perceived characteristics of MD programs on relevant MD outcomes. The MD characteristics are: availability of role models, perceived control, and understanding the MD program. Outcomes are:…

  3. An Outcome Evaluation of the Success for Kids Program. Technical Report

    ERIC Educational Resources Information Center

    Maestas, Nicole; Gaillot, Sarah

    2010-01-01

    This report presents results from a multisite, quantitative evaluation of the international Success for Kids (SFK) after-school program. The program seeks to build resilience in children by teaching them to access inner resources and build positive connections with others. The SFK program is unlike most after-school programs both in its focus on…

  4. 78 FR 77209 - Accessibility of User Interfaces, and Video Programming Guides and Menus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-20

    ... user interfaces on digital apparatus and video programming guides and menus on navigation devices for... apparatus and navigation devices used to view video programming. The rules we adopt here will effectuate...--that is, devices and other equipment used by consumers to access multichannel video programming and...

  5. 77 FR 5295 - Over-the-Road Bus Accessibility Program Announcement of Project Selections

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-02

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Over-the-Road Bus Accessibility...-Road Bus (OTRB) Accessibility Program, authorized by Section 3038 of the Transportation Equity Act for... of over-the-road buses to help finance the incremental capital and training costs of complying with...

  6. Funding, coverage, and access under Thailand's universal health insurance program: an update after ten years.

    PubMed

    Damrongplasit, Kannika; Melnick, Glenn

    2015-04-01

    In 2001, Thailand implemented a universal coverage program by expanding government-funded health coverage to uninsured citizens and limited their out-of-pocket payments to 30 Baht per encounter and, in 2006, eliminated out-of-pocket payments entirely. Prior research covering the early years of the program showed that the program effectively expanded coverage while a more recent paper of the early effects of the program found that improved access from the program led to a reduction in infant mortality. We expand and update previous analyses of the effects of the 30 Baht program on access and out-of-pocket payments. We analyze national survey and governmental budgeting data through 2011 to examine trends in health care financing, coverage and access, including out-of-pocket payments. By 2011, only 1.64 % of the population remained uninsured in Thailand (down from 2.61 % in 2009). While government funding increased 75 % between 2005 and 2010, budgetary requests by health care providers exceeded approved amounts in many years. The 30 Baht program beneficiaries paid zero out-of-pocket payments for both outpatient and inpatient care. Inpatient and outpatient contact rates across all insurance categories fell slightly over time. Overall, the statistical results suggest that the program is continuing to achieve its goals after 10 years of operation. Insurance coverage is now virtually universal, access has been more or less maintained, government funding has continued to grow, though at rates below requested levels and 30 Baht patients are still guaranteed access to care with limited or no out-of-pocket costs. Important issues going forward are the ability of the government to sustain continued funding increases while minimizing cost sharing.

  7. Outcome Assessment of the Visiting Fulbright Scholar Program

    ERIC Educational Resources Information Center

    US Department of State, 2005

    2005-01-01

    The Office of Policy and Evaluation of the Bureau of Educational and Cultural Affairs of the U.S. Department of State contracted with SRI International to conduct a series of assessments of outcomes and impacts of various specialized exchange programs under the overall umbrella of the Fulbright Educational Exchange Program, the U.S. government's…

  8. Quality of Care and Patient Outcomes in Critical Access Hospitals

    PubMed Central

    Joynt, Karen E.; Harris, Yael; Orav, E. John; Jha, Ashish K.

    2012-01-01

    Context Critical Access Hospitals (CAHs) play a crucial role in the nation’s rural safety net. Current policy efforts have focused primarily on helping these small, isolated hospitals remain financially viable to ensure access for Americans living in rural areas. However, we know little about the quality of care they provide, or the outcomes their patients achieve. Objective To examine the quality of care and patient outcomes at CAHs, and to understand why patterns of care might differ for CAHs versus non-CAHs. Design Retrospective analysis of national data from Medicare and other sources. Setting U.S. hospitals. Patients Medicare fee-for-service beneficiaries with acute myocardial infarction (AMI), congestive heart failure (CHF), and pneumonia, discharged in 2008–2009. Main Outcome Measures Clinical capabilities, performance on processes of care, and 30-day mortality rates. Results Compared to other hospitals, CAHs were less likely to have intensive care units (30.0% versus 74.4%, p<0.001), cardiac catheterization capabilities (0.5% versus 47.7%, p<0.001), and at least basic electronic health records (4.6% versus 9.9%, p<0.001). CAHs had lower performance on process measures than non-CAHs for all three conditions examined (Hospital Quality Alliance summary score for AMI 91.0% versus 97.8%, for CHF, 80.6% versus 93.5%, and for pneumonia 89.3% versus 93.7%, p<0.001 for each). Patients admitted to a CAH had higher 30-day mortality rates for each condition than those admitted to non-CAHs (for AMI, 23.5% versus 16.2%, Odds Ratio (OR) 1.70 (95% confidence interval 1.61, 1.80), p<0.001; for CHF, 13.4% versus 10.9%, OR 1.28 (1.23, 1.32), p<0.001; and for pneumonia 14.1% versus 12.1%, OR 1.20 (1.16, 1.24) p<0.001). Conclusions Care in CAHs, compared with non-CAHs, is associated with worse processes of care and higher mortality rates. PMID:21730240

  9. Evolution and outcomes of a quality improvement program.

    PubMed

    Thor, Johan; Herrlin, Bo; Wittlöv, Karin; Øvretveit, John; Brommels, Mats

    2010-01-01

    The purpose of this paper is to examine the outcomes and evolution over a five-year period of a Swedish university hospital quality improvement program in light of enduring uncertainty regarding the effectiveness of such programs in healthcare and how best to evaluate it. The paper takes the form of a case study, using data collected as part of the program, including quality indicators from clinical improvement projects and participants' program evaluations. Overall, 58 percent of the program's projects (39/67) demonstrated success. A greater proportion of projects led by female doctors demonstrated success (91 percent, n=11) than projects led by male doctors (51 percent, n=55). Facilitators at the hospital continuously adapted the improvement methods to the local context. A lack of dedicated time for improvement efforts was the participants' biggest difficulty. The dominant benefits included an increased ability to see the "bigger picture" and the improvements achieved for patients and employees. Quality measurement, which is important for conducting and evaluating improvement efforts, was weak with limited reliability. Nevertheless, the present study adds evidence about the effectiveness of healthcare improvement programs. Gender differences in improvement team leadership merit further study. Improvement program evaluation should assess the extent to which improvement methods are locally adapted and applied. This case study reports the outcomes of all improvement projects undertaken in one healthcare organization over a five-year period and provides in-depth insight into an improvement program's changeable nature.

  10. 77 FR 6479 - Leased Commercial Access; Development of Competition and Diversity in Video Programming...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-08

    ... Commercial Access; Development of Competition and Diversity in Video Programming Distribution and Carriage... contained in the Second Report and Order, FCC 11-119, pertaining to carriage of video programming vendors by multichannel video programming distributors (program carriage rules). This notice is consistent with the Secord...

  11. 16 CFR 1034.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... alterations. 1034.151 Section 1034.151 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL... PRODUCT SAFETY COMMISSION § 1034.151 Program accessibility: New construction and alterations. Each... handicapped persons. The definitions, requirements, and standards of the Architectural Barriers Act (42 U.S.C...

  12. A Pilot Randomized Controlled Trial of the ACCESS Program: A Group Intervention to Improve Social, Adaptive Functioning, Stress Coping, and Self-Determination Outcomes in Young Adults with Autism Spectrum Disorder.

    PubMed

    Oswald, Tasha M; Winder-Patel, Breanna; Ruder, Steven; Xing, Guibo; Stahmer, Aubyn; Solomon, Marjorie

    2018-05-01

    The purpose of this pilot randomized controlled trial was to investigate the acceptability and efficacy of the Acquiring Career, Coping, Executive control, Social Skills (ACCESS) Program, a group intervention tailored for young adults with autism spectrum disorder (ASD) to enhance critical skills and beliefs that promote adult functioning, including social and adaptive skills, self-determination skills, and coping self-efficacy. Forty-four adults with ASD (ages 18-38; 13 females) and their caregivers were randomly assigned to treatment or waitlist control. Compared to controls, adults in treatment significantly improved in adaptive and self-determination skills, per caregiver report, and self-reported greater belief in their ability to access social support to cope with stressors. Results provide evidence for the acceptability and efficacy of the ACCESS Program.

  13. Student Learning Outcomes Assessment in College Foreign Language Programs

    ERIC Educational Resources Information Center

    Norris, John M., Ed.; Davis, John McE., Ed.

    2015-01-01

    Changes in accreditation policies and institutional practices have led to the emergence of student learning outcomes assessment as an important, increasingly common expectation in U.S. college foreign language programs. This volume investigates contemporary outcomes assessment activity, with a primary focus on useful assessment, that is,…

  14. Understanding Program Monitoring: The Relationships among Outcomes, Indicators, Measures, and Targets. REL 2014-011

    ERIC Educational Resources Information Center

    Malone, Nolan; Mark, Lauren; Narayan, Krishna

    2014-01-01

    This guide offers educators, program managers, administrators, and researchers a resource for building capacity for monitoring program outcomes. It provides concise definitions of program monitoring components and a framework for assessing program progress. Examples demonstrate the relationships among program components: outcomes, indicators,…

  15. Lack of financial barriers to pediatric cochlear implantation: impact of socioeconomic status on access and outcomes.

    PubMed

    Chang, David T; Ko, Alvin B; Murray, Gail S; Arnold, James E; Megerian, Cliff A

    2010-07-01

    (1) To analyze if socioeconomic status influences access to cochlear implantation in an environment with adequate Medicaid reimbursement. (2) To determine the impact of socioeconomic status on outcomes after unilateral cochlear implantation. Retrospective cohort study. University Hospitals Case Medical Center and Rainbow Babies and Children's Hospital (tertiary referral center), Cleveland, Ohio. Pediatric patients (age range, newborn to 18 years) who received unilateral cochlear implantation during the period 1996 to 2008. Access to cochlear implantation after referral to a cochlear implant center, postoperative complications, compliance with follow-up appointments, and access to sequential bilateral cochlear implantation. A total of 133 pediatric patients were included in this study; 64 were Medicaid-insured patients and 69 were privately insured patients. There was no statistical difference in the odds of initial cochlear implantation, age at referral, or age at implantation between the 2 groups. The odds of prelingual Medicaid-insured patients receiving sequential bilateral cochlear implantation was less than half that of the privately insured group (odds ratio [OR], 0.43; P = .03). The odds of complications in Medicaid-insured children were almost 5-fold greater than the odds for privately insured children (OR, 4.6; P = .03). There were 10 complications in 51 Medicaid-insured patients (19.6%) as opposed to 3 in 61 privately insured patients (4.9%). Medicaid-insured patients missed substantially more follow-up appointments overall (35% vs 23%) and more consecutive visits (1.9 vs 1.1) compared with privately insured patients. In an environment with adequate Medicaid reimbursement, eligible children have equal access to cochlear implantation, regardless of socioeconomic background. However, lower socioeconomic background is associated with higher rates of postoperative complications, worse follow-up compliance, and lower rates of sequential bilateral implantation

  16. 45 CFR 287.145 - What measures will be used to determine NEW Program outcomes?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Program outcomes? 287.145 Section 287.145 Public Welfare Regulations Relating to Public Welfare OFFICE OF... What measures will be used to determine NEW Program outcomes? Each grantee must develop its own... must identify planned program outcomes and the measures the Tribe will use to determine them. ACF will...

  17. The effect of an educational program for vascular access care on nurses' knowledge at dialysis centers in Khartoum State, Sudan.

    PubMed

    Yousif, Kalthoum Ibrahim; Abu-Aisha, Hasan; Abboud, Omar Ibrahim

    2017-01-01

    End-stage renal disease is a worldwide problem that requires highly skilled nursing care. Hemodialysis (HD) is a corner-stone procedure in the management of most patients who require renal replacement therapy. Adequate vascular access is essential for the successful use of HD. Appropriate knowledge in taking care of vascular access is essential for minimizing complications and accurately recognizing vascular access-related problems. This study was to evaluate the effect of an educational program for vascular access care on nurses' knowledge at nine dialysis centers in Khartoum State. This was a Quasi experimental study (pre-and post-test for the same group). Sixty-one nurses working in these HD centers were chosen by simple random sampling method. A structured face-to-face interview questionnaire based on the Kidney Dialysis Outcome Quality Initiative (K/DOQI) clinical practice guidelines for vascular access care was used. Instrument validity was determined through content validity by a panel of experts. Reliability of the instrument was tested by a pilot study to test the knowledge scores for 15 nurses. The Pearson correlation coefficient obtained was (r = 0.82). Data collection was taken before and after the educational intervention. A follow-up test was performed three month later, using the same data collection tools. Twenty-two individual variables assessing the knowledge levels in aspects related to the six K/DOQI guidelines showed improvement in all scores of the nurses' knowledge after the educational intervention; and the differences from the preeducational scores were statistically significant (P < 0.001). The study showed that a structured educational program based on the K/DOQI clinical practice guidelines had a significant impact on the dialysis nurses knowledge in caring for vascular access in HD patients. The knowledge level attained was maintained for at least three months after the educational intervention.

  18. How to start a minimal access mitral valve program.

    PubMed

    Hunter, Steven

    2013-11-01

    The seven pillars of governance established by the National Health Service in the United Kingdom provide a useful framework for the process of introducing new procedures to a hospital. Drawing from local experience, the author present guidance for institutions considering establishing a minimal access mitral valve program. The seven pillars of governance apply to the practice of minimally invasive mitral valve surgery, based on the principle of patient-centred practice. The author delineate the benefits of minimally invasive mitral valve surgery in terms of: "clinical effectiveness", including reduced length of hospital stay, "risk management effectiveness", including conversion to sternotomy and aortic dissection, "patient experience" including improved cosmesis and quicker recovery, and the effectiveness of communication, resources and strategies in the implementation of minimally invasive mitral valve surgery. Finally, the author have identified seven learning curves experienced by surgeons involved in introducing a minimal access mitral valve program. The learning curves are defined as: techniques of mitral valve repair, Transoesophageal Echocardiography-guided cannulation, incisions, instruments, visualization, aortic occlusion and cardiopulmonary bypass strategies. From local experience, the author provide advice on how to reduce the learning curves, such as practising with the specialised instruments and visualization techniques during sternotomy cases. Underpinning the NHS pillars are the principles of systems awareness, teamwork, communication, ownership and leadership, all of which are paramount to performing any surgery but more so with minimal access surgery, as will be highlighted throughout this paper.

  19. How to start a minimal access mitral valve program

    PubMed Central

    2013-01-01

    The seven pillars of governance established by the National Health Service in the United Kingdom provide a useful framework for the process of introducing new procedures to a hospital. Drawing from local experience, the author present guidance for institutions considering establishing a minimal access mitral valve program. The seven pillars of governance apply to the practice of minimally invasive mitral valve surgery, based on the principle of patient-centred practice. The author delineate the benefits of minimally invasive mitral valve surgery in terms of: “clinical effectiveness”, including reduced length of hospital stay, “risk management effectiveness”, including conversion to sternotomy and aortic dissection, “patient experience” including improved cosmesis and quicker recovery, and the effectiveness of communication, resources and strategies in the implementation of minimally invasive mitral valve surgery. Finally, the author have identified seven learning curves experienced by surgeons involved in introducing a minimal access mitral valve program. The learning curves are defined as: techniques of mitral valve repair, Transoesophageal Echocardiography-guided cannulation, incisions, instruments, visualization, aortic occlusion and cardiopulmonary bypass strategies. From local experience, the author provide advice on how to reduce the learning curves, such as practising with the specialised instruments and visualization techniques during sternotomy cases. Underpinning the NHS pillars are the principles of systems awareness, teamwork, communication, ownership and leadership, all of which are paramount to performing any surgery but more so with minimal access surgery, as will be highlighted throughout this paper. PMID:24349981

  20. An Accessible User Interface for Geoscience and Programming

    NASA Astrophysics Data System (ADS)

    Sevre, E. O.; Lee, S.

    2012-12-01

    The goal of this research is to develop an interface that will simplify user interaction with software for scientists. The motivating factor of the research is to develop tools that assist scientists with limited motor skills with the efficient generation and use of software tools. Reliance on computers and programming is increasing in the world of geology, and it is increasingly important for geologists and geophysicists to have the computational resources to use advanced software and edit programs for their research. I have developed a prototype of a program to help geophysicists write programs using a simple interface that requires only simple single-mouse-clicks to input code. It is my goal to minimize the amount of typing necessary to create simple programs and scripts to increase accessibility for people with disabilities limiting fine motor skills. This interface can be adapted for various programming and scripting languages. Using this interface will simplify development of code for C/C++, Java, and GMT, and can be expanded to support any other text based programming language. The interface is designed around the concept of maximizing the amount of code that can be written using a minimum number of clicks and typing. The screen is split into two sections: a list of click-commands is on the left hand side, and a text area is on the right hand side. When the user clicks on a command on the left hand side the applicable code is automatically inserted at the insertion point in the text area. Currently in the C/C++ interface, there are commands for common code segments that are often used, such as for loops, comments, print statements, and structured code creation. The primary goal is to provide an interface that will work across many devices for developing code. A simple prototype has been developed for the iPad. Due to the limited number of devices that an iOS application can be used with, the code has been re-written in Java to run on a wider range of devices

  1. Scaling Up a Water, Sanitation, and Hygiene Program in Rural Bangladesh: The Role of Program Implementation.

    PubMed

    Benjamin-Chung, Jade; Sultana, Sonia; Halder, Amal K; Ahsan, Mohammed Ali; Arnold, Benjamin F; Hubbard, Alan E; Unicomb, Leanne; Luby, Stephen P; Colford, John M

    2017-05-01

    To evaluate whether the quality of implementation of a water, sanitation, and hygiene program called SHEWA-B and delivered by UNICEF to 20 million people in rural Bangladesh was associated with health behaviors and sanitation infrastructure access. We surveyed 33 027 households targeted by SHEWA-B and 1110 SHEWA-B hygiene promoters in 2011 and 2012. We developed an implementation quality index and compared the probability of health behaviors and sanitation infrastructure access in counterfactual scenarios over the range of implementation quality. Forty-seven percent of households (n = 14 622) had met a SHEWA-B hygiene promoter, and 47% of hygiene promoters (n = 527) could recall all key program messages. The frequency of hygiene promoter visits was not associated with improved outcomes. Higher implementation quality was not associated with better health behaviors or infrastructure access. Outcomes differed by only 1% to 3% in scenarios in which all clusters received low versus high implementation quality. SHEWA-B did not meet UNICEF's ideal implementation quality in any area. Improved implementation quality would have resulted in marginal changes in health behaviors or infrastructure access. This suggests that SHEWA-B's design was suboptimal for improving these outcomes.

  2. Primary prevention research: a preliminary review of program outcome studies.

    PubMed

    Schaps, E; Churgin, S; Palley, C S; Takata, B; Cohen, A Y

    1980-07-01

    This article reviews 35 drug abuse prevention program evaluations employing drug-specific outcome measures. Many of these evaluations assessed the effects of "new generation" prevention strategies: affective, peer-oriented, and multidimensional approaches. Only 14 studies evaluated purely informational programs. Evaluations were analyzed to ascertain (1) characteristics of the programs under study, (2) characteristics of the research designs, and (3) patterns among findings. This review provides some evidence that the newer prevention strategies may produce more positive and fewer negative outcomes than did older drug information approaches. Over 70% of the programs using the newer strategies produced some positive effects; only 29% showed negative effects. In contrast, 46% of informational programs showed positive effects; 46% showed negative effects. These findings must be approached with great caution, since the research was frequently scientifically inadequate, and since rigor of research was negatively correlated with intensity and duration of program services.

  3. Mapping integration of midwives across the United States: Impact on access, equity, and outcomes

    PubMed Central

    Stoll, Kathrin; MacDorman, Marian; Declercq, Eugene; Cramer, Renee; Cheyney, Melissa; Fisher, Timothy; Butt, Emma; Yang, Y. Tony; Powell Kennedy, Holly

    2018-01-01

    Poor coordination of care across providers and birth settings has been associated with adverse maternal-newborn outcomes. Research suggests that integration of midwives into regional health systems is a key determinant of optimal maternal-newborn outcomes, yet, to date, the characteristics of an integrated system have not been described, nor linked to health disparities. Methods Our multidisciplinary team examined published regulatory data to inform a 50-state database describing the environment for midwifery practice and interprofessional collaboration. Items (110) detailed differences across jurisdictions in scope of practice, autonomy, governance, and prescriptive authority; as well as restrictions that can affect patient safety, quality, and access to maternity providers across birth settings. A nationwide survey of state regulatory experts (n = 92) verified the ‘on the ground’ relevance, importance, and realities of local interpretation of these state laws. Using a modified Delphi process, we selected 50/110 key items to include in a weighted, composite Midwifery Integration Scoring (MISS) system. Higher scores indicate greater integration of midwives across all settings. We ranked states by MISS scores; and, using reliable indicators in the CDC-Vital Statistics Database, we calculated correlation coefficients between MISS scores and maternal-newborn outcomes by state, as well as state density of midwives and place of birth. We conducted hierarchical linear regression analysis to control for confounding effects of race. Results MISS scores ranged from lowest at 17 (North Carolina) to highest at 61 (Washington), out of 100 points. Higher MISS scores were associated with significantly higher rates of spontaneous vaginal delivery, vaginal birth after cesarean, and breastfeeding, and significantly lower rates of cesarean, preterm birth, low birth weight infants, and neonatal death. MISS scores also correlated with density of midwives and access to care across

  4. 47 CFR 76.1004 - Applicability of program access rules to common carriers and affiliates.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Cable Programming § 76.1004 Applicability of program access rules to common carriers and affiliates. (a... common carrier or its affiliate that provides video programming by any means directly to subscribers. Any such provision that applies to a satellite cable programming vendor in which a cable operator has an...

  5. 47 CFR 76.1004 - Applicability of program access rules to common carriers and affiliates.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Cable Programming § 76.1004 Applicability of program access rules to common carriers and affiliates. (a... common carrier or its affiliate that provides video programming by any means directly to subscribers. Any such provision that applies to a satellite cable programming vendor in which a cable operator has an...

  6. 47 CFR 76.1004 - Applicability of program access rules to common carriers and affiliates.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Cable Programming § 76.1004 Applicability of program access rules to common carriers and affiliates. (a... common carrier or its affiliate that provides video programming by any means directly to subscribers. Any such provision that applies to a satellite cable programming vendor in which a cable operator has an...

  7. 47 CFR 76.1004 - Applicability of program access rules to common carriers and affiliates.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Cable Programming § 76.1004 Applicability of program access rules to common carriers and affiliates. (a... common carrier or its affiliate that provides video programming by any means directly to subscribers. Any such provision that applies to a satellite cable programming vendor in which a cable operator has an...

  8. 47 CFR 76.1004 - Applicability of program access rules to common carriers and affiliates.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Cable Programming § 76.1004 Applicability of program access rules to common carriers and affiliates. (a... common carrier or its affiliate that provides video programming by any means directly to subscribers. Any such provision that applies to a satellite cable programming vendor in which a cable operator has an...

  9. Delivering accessible fieldwork: preliminary findings from a collaborative international study

    NASA Astrophysics Data System (ADS)

    Stokes, Alison; Atchison, Christopher; Feig, Anthony; Gilley, Brett

    2017-04-01

    Students with disabilities are commonly excluded from full participation in geoscience programs, and encounter significant barriers when accessing field-learning experiences. In order to increase talent and diversity in the geoscience workforce, more inclusive learning experiences must be developed that will enable all students to complete the requirements of undergraduate degree programs, including fieldwork. We discuss the outcomes of a completely accessible field course developed through the collaborative effort of geoscience education practitioners from the US, Canada and the UK. This unique field workshop has brought together current geoscience academics and students with disabilities to share perspectives on commonly-encountered barriers to learning in the field, and explore methods and techniques for overcoming them. While the student participants had the opportunity to learn about Earth processes while situated in the natural environment, participating geoscience instructors began to identify how to improve the design of field courses, making them fully inclusive of learners with disabilities. The outcomes from this experience will be used to develop guidelines to facilitate future development and delivery of accessible geoscience fieldwork.

  10. Treatment effects model for assessing disease management: measuring outcomes and strengthening program management.

    PubMed

    Wendel, Jeanne; Dumitras, Diana

    2005-06-01

    This paper describes an analytical methodology for obtaining statistically unbiased outcomes estimates for programs in which participation decisions may be correlated with variables that impact outcomes. This methodology is particularly useful for intraorganizational program evaluations conducted for business purposes. In this situation, data is likely to be available for a population of managed care members who are eligible to participate in a disease management (DM) program, with some electing to participate while others eschew the opportunity. The most pragmatic analytical strategy for in-house evaluation of such programs is likely to be the pre-intervention/post-intervention design in which the control group consists of people who were invited to participate in the DM program, but declined the invitation. Regression estimates of program impacts may be statistically biased if factors that impact participation decisions are correlated with outcomes measures. This paper describes an econometric procedure, the Treatment Effects model, developed to produce statistically unbiased estimates of program impacts in this type of situation. Two equations are estimated to (a) estimate the impacts of patient characteristics on decisions to participate in the program, and then (b) use this information to produce a statistically unbiased estimate of the impact of program participation on outcomes. This methodology is well-established in economics and econometrics, but has not been widely applied in the DM outcomes measurement literature; hence, this paper focuses on one illustrative application.

  11. Racial Disparities in Access and Outcomes of Cholecystectomy in the United States.

    PubMed

    Gahagan, John V; Hanna, Mark H; Whealon, Matthew D; Maximus, Steven; Phelan, Michael J; Lekawa, Michael; Barrios, Cristobal; Bernal, Nicole P

    2016-10-01

    Disparities in access to health care between white and minority patients are well described. We aimed to analyze the trends and outcomes of cholecystectomy based on racial classification. The Nationwide Inpatient Sample database was reviewed for all patients undergoing cholecystectomy from 2009 to 2012. Patients were stratified as white or non-white. A total of 243,536 patients were analyzed: 159,901 white and 83,635 non-white. Non-white patients had significantly higher proportions of Medicaid (25% vs 9.3%), self-pay (14% vs 7.1%), and no-charge (1.8% vs 0.64%). Non-white patients had significantly higher rates of emergent admission (84% vs 78%) compared with the white patients. Multivariate analysis revealed that non-whites had a significantly longer length of stay [mean difference of 0.14 days, 95% confidence interval (CI) 0.08-0.20] and higher total hospital charges (mean difference of $6748.00, 95% CI 5994.19-7501.81) than whites, despite a lower morbidity (odds ratio 0.94, 95% CI 0.90-0.98). Use of laparoscopy and mortality were not different. These differences persisted on subgroup analysis by insurance type. These findings suggest a gap in access to and outcomes of cholecystectomy in the minority population nationwide.

  12. An Outcome Evaluation of the Spirituality for Kids Program. Technical Report

    ERIC Educational Resources Information Center

    Maestas, Nicole; Gaillot, Sarah

    2008-01-01

    This report presents results from a multisite, quantitative evaluation of the international Spirituality for Kids (SFK) after-school program. Despite its name, SFK is a nonreligious program that seeks to build resilience in children by teaching them to access inner resources and build positive connections with others. The SFK program is unlike…

  13. 34 CFR 105.33 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Program accessibility: New construction and alterations. 105.33 Section 105.33 Education Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN...

  14. 78 FR 36478 - Accessibility of User Interfaces, and Video Programming Guides and Menus

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... equipment: ``digital apparatus'' and ``navigation devices.'' Specifically, section 204 applies to ``digital... apparatus, including equipment purchased at retail by a consumer to access video programming, would be..., and video programming guides, and menus provided by digital apparatus and navigation devices are...

  15. 76 FR 21325 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-15

    ... for the 2012 Market Access Program (MAP). The intended effect of this notice is to solicit... INFORMATION CONTACT: Entities wishing to apply for funding assistance should contact the Program Operations....gov/mos/programs/map.asp . SUPPLEMENTARY INFORMATION: I. Funding Opportunity Description Authority...

  16. Program Characteristics and Enrollees' Outcomes in the Program of All-Inclusive Care for the Elderly (PACE)

    PubMed Central

    Mukamel, Dana B; Peterson, Derick R; Temkin-Greener, Helena; Delavan, Rachel; Gross, Diane; Kunitz, Stephen J; Williams, T Franklin

    2007-01-01

    The Program of All-Inclusive Care for the Elderly (PACE) is a unique program providing a full spectrum of health care services, from primary to acute to long-term care for frail elderly individuals certified to require nursing home care. The objective of this article is to identify program characteristics associated with better risk-adjusted health outcomes: mortality, functional status, and self-assessed health. The article examines statistical analyses of information combining DataPACE (individual-level clinical data), a survey of direct care staff about team performance, and interviews with management in twenty-three PACE programs. Several program characteristics were associated with better functional outcomes. Fewer were associated with long-term self-assessed health, and only one with mortality. These findings offer strategies that may lead to better care. PMID:17718666

  17. Use of Mobile Devices to Access Resources Among Health Professions Students: A Systematic Review.

    PubMed

    Mi, Misa; Wu, Wendy; Qiu, Maylene; Zhang, Yingting; Wu, Lin; Li, Jie

    2016-01-01

    This systematic review examines types of mobile devices used by health professions students, kinds of resources and tools accessed via mobile devices, and reasons for using the devices to access the resources and tools. The review included 20 studies selected from articles published in English between January 2010 and April 2015, retrieved from PubMed and other sources. Data extracted included participants, study designs, mobile devices used, mobile resources/apps accessed, outcome measures, and advantages of and barriers to using mobile devices. The review indicates significant variability across the studies in terms of research methods, types of mobile programs implemented, resources accessed, and outcomes. There were beneficial effects of using mobile devices to access resources as well as conspicuous challenges or barriers in using mobile devices.

  18. Using Distance Learning to Impact Access of Diverse Learners to Advanced Placement Programs

    ERIC Educational Resources Information Center

    Fenty, Nicole S.; Allio, Andrea

    2017-01-01

    Distance learning has been used as one method to increase access for students who have otherwise been underrepresented in college preparatory courses like Advanced Placement (AP). This study evaluated the impact of a statewide Virtual Advanced Placement (VAP) program on access to AP courses for students from underrepresented populations. Survey…

  19. 22 CFR 144.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... alterations. 144.151 Section 144.151 Foreign Relations DEPARTMENT OF STATE CIVIL RIGHTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE UNITED STATES DEPARTMENT OF..., constructed, or altered so as to be readily accessible to and usable by handicapped persons. The definitions...

  20. 22 CFR 144.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... alterations. 144.151 Section 144.151 Foreign Relations DEPARTMENT OF STATE CIVIL RIGHTS ENFORCEMENT OF NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE UNITED STATES DEPARTMENT OF..., constructed, or altered so as to be readily accessible to and usable by handicapped persons. The definitions...

  1. Reproductive Health Outcomes of Insured Women Who Access Oral Levonorgestrel Emergency Contraception

    PubMed Central

    Raine-Bennett, Tina; Merchant, Maqdooda; Sinclair, Fiona; Lee, Justine W.; Goler, Nancy

    2015-01-01

    Objectives To assess the level of risk for women who seek emergency contraception through various clinical routes and the opportunities for improved care provision. Methods This study looked at a retrospective cohort to assess contraception and other reproductive health outcomes among women aged 15-44 who accessed oral levonorgestrel emergency contraception through an office visit or the call center at Kaiser Permanente Northern California from 2010 to 2011. Results Of 21,421 prescriptions, 14,531(67.8%) were accessed through the call center. In the subsequent 12 months, 12,127(56.6%) women had short-acting contraception (pills, patches, rings, depot medroxyprogesterone) dispensed and 2,264(10.6%) initiated very effective contraception (intrauterine contraception, implants, sterilization). Initiation of very effective contraception was similar for women who accessed it through the call center -1,569(10.8%) and office visits – 695(10.1%) (adjusted OR 1.02 95% confidence interval (CI) 0.93-1.13). In the subsequent 6 months, 2,056(9.6%) women became pregnant. Women who accessed emergency contraception through the call center were less likely to become pregnant within 3 months of accessing emergency contraception than woman who accessed it through office visits (adjusted OR 0.82 95% CI 0.72-0.94); however they were more likely to become pregnant within 4-6 months (adjusted OR 1.37 95%CI 1.16-1.60). Among women who were tested for chlamydia and gonorrhea, 689(7.8%) and 928(7.9%) were positive in the 12 months before and after accessing emergency contraception, respectively. Conclusions Protocols to routinely address unmet need for contraception at every call for emergency contraception and all office visits including visits with primary care providers should be investigated. PMID:25751211

  2. Using Targeting Outcomes of Programs as a Framework to Target Photographic Events in Nonformal Educational Programs

    ERIC Educational Resources Information Center

    Rockwell, S. Kay; Albrecht, Julie A.; Nugent, Gwen C.; Kunz, Gina M.

    2012-01-01

    Targeting Outcomes of Programs (TOP) is a seven-step hierarchical programming model in which the program development and performance sides are mirror images of each other. It served as a framework to identify a simple method for targeting photographic events in nonformal education programs, indicating why, when, and how photographs would be useful…

  3. What Works after School? The Relationship between After-School Program Quality, Program Attendance, and Academic Outcomes

    ERIC Educational Resources Information Center

    Leos-Urbel, Jacob

    2015-01-01

    This article examines the relationship between after-school program quality, program attendance, and academic outcomes for a sample of low-income after-school program participants. Regression and hierarchical linear modeling analyses use a unique longitudinal data set including 29 after-school programs that served 5,108 students in Grades 4 to 8…

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

    DTIC Science & Technology

    2013-07-08

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

  5. Access and success with less: improving productivity in broad-access postsecondary institutions.

    PubMed

    Jenkins, Davis; Rodríguez, Olga

    2013-01-01

    Achieving national goals for increased college completion in a time of scarce resources will require the postsecondary institutions that enroll the majority of undergraduates--community colleges and less-selective public universities--to graduate more students at a lower cost. Davis Jenkins and Olga Rodriguez examine research on how these "broad-access" institutions can do so without sacrificing access or quality. Research indicates that the strategies broad-access institutions have relied on in the past to cut costs--using part-time instructors and increasing student-faculty ratios--may in fact reduce productivity and efficiency. The limited evidence available suggests that some of the most popular strategies for improving student success are not cost-effective. New strategies to cut costs and improve college success are therefore imperative. Some believe that redesigning courses to make use of instructional technologies will lead to better outcomes at lower cost, although the evidence is mixed. Recently, a growing number of institutions are going beyond redesigning courses and instead changing the way they organize programs and supports along the student's "pathway" through college. These efforts are promising, but their effects on cost per completion are not yet certain. Meager funding has so far hampered efforts by policy makers to fund colleges based on outcomes rather than how many students they enroll, but some states are beginning to increase the share of appropriations tied to outcomes. Jenkins and Rodriquez argue that as policy makers push colleges to lower the cost per graduate, they must avoid providing incentives to lower academic standards. They encourage policy makers to capitalize on recent research on the economic value of postsecondary education to measure quality, and urge colleges and universities to redouble efforts to define learning outcomes and measure student mastery.

  6. Children with Special Health Care Needs in CHIP: Access, Use, and Child and Family Outcomes.

    PubMed

    Zickafoose, Joseph S; Smith, Kimberly V; Dye, Claire

    2015-01-01

    To assess how the Children's Health Insurance Program (CHIP) affects outcomes for children with special health care needs (CSHCN). We used data from a survey of parents of recent and established CHIP enrollees conducted from January 2012 through March 2013 as part of a congressionally mandated evaluation of CHIP. We identified CSHCN in the sample using the Child and Adolescent Health Measurement Initiative's CSHCN screener. We compared the health care experiences of established CHIP enrollees to the pre-enrollment experiences of previously uninsured and privately insured recent CHIP enrollees, controlling for observable characteristics. Parents of 4142 recent enrollees and 5518 established enrollees responded to the survey (response rates, 46% recent enrollees and 51% established enrollees). In the 10 survey states, about one-fourth of CHIP enrollees had a special health care need. Compared to being uninsured, parents of CSHCN who were established CHIP enrollees reported greater access to and use of medical and dental care, less difficulty meeting their child's health care needs, fewer unmet needs, and better dental health status for their child. Compared to having private insurance, parents of CSHCN who were established CHIP enrollees reported similar levels of access to and use of medical and dental care and unmet needs, and less difficulty meeting their child's health care needs. CHIP has significant benefits for eligible CSHCN and their families compared to being uninsured and appears to have some benefits compared to private insurance. Copyright © 2015 Academic Pediatric Association. All rights reserved.

  7. 29 CFR 2205.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... 2205.151 Section 2205.151 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND... ACTIVITIES CONDUCTED BY THE OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION § 2205.151 Program accessibility... the Architectural Barriers Act (42 U.S.C. 4151-4157), as established in 41 CFR 101-19.600 to 101-19...

  8. Environmental monitoring for public access and community tracking (EMPACT): Discussion of the program

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

    Engel-Cox, J.A.

    1999-07-01

    The Environmental Monitoring for Public Access and Community Tracking (EMPACT) program is a unique initiative to provide time-relevant environmental information that is easily accessible and clearly communicated to residents in 86 of the nation's largest metropolitan areas. EMPACT is a US Environmental Protection Agency (EPA) program to use innovative and time-relevant monitoring and communication technologies. President Clinton articulated his vision for right-to-know programs when he directed the EPA to provide local environmental information to communities. EPA Administrator Carol Browner created EMPACT and other programs to meet this vision, giving EMPACT the goal of providing timely, useful and accurate environmental andmore » public health information to all Americans. This paper is an analysis of the status of the EMPACT program during its first 2 years. EMPACT has launched 27 environmental monitoring and communication projects, including metropolitan grants, EPA Headquarter and Regional projects, and research activities. These projects are located in 37 states and 68 cities throughout the United States, and represent significant progress towards EMPACT's goal of reaching 86 major metropolitan areas throughout all 50 states, the District of Columbia and Puerto Rico by 2001. These projects focus on five principles established by EPA Administrator Browner: using advanced technology and science, establishing partnerships, increasing public access to data, communicating useful action-oriented information, and establishing a framework for sharing monitoring techniques and data between projects.« less

  9. Peripheral Venous Access Ports: Outcomes Analysis in 109 Patients

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

    Bodner, Leonard J.; Nosher, John L.; Patel, Kaushik M.

    Purpose: To perform a retrospective outcomes analysis of central venous catheters with peripheral venous access ports, with comparison to published data.Methods: One hundred and twelve central venous catheters with peripherally placed access ports were placed under sonographic guidance in 109 patients over a 4-year period. Ports were placed for the administration of chemotherapy, hyperalimentation, long-term antibiotic therapy, gamma-globulin therapy, and frequent blood sampling. A vein in the upper arm was accessed in each case and the catheter was passed to the superior vena cava or right atrium. Povidone iodine skin preparation was used in the first 65 port insertions. Amore » combination of Iodophor solution and povidone iodine solution was used in the last 47 port insertions. Forty patients received low-dose (1 mg) warfarin sodium beginning the day after port insertion. Three patients received higher doses of warfarin sodium for preexistent venous thrombosis. Catheter performance and complications were assessed and compared with published data.Results: Access into the basilic or brachial veins was obtained in all cases. Ports remained functional for a total of 28,936 patient days. The port functioned in 50% of patients until completion of therapy, or the patient's expiration. Ports were removed prior to completion of therapy in 18% of patients. Eleven patients (9.9% of ports placed) suffered an infectious complication (0.38 per thousand catheter-days)-in nine, at the port implantation site, in two along the catheter. In all 11 instances the port was removed. Port pocket infection in the early postoperative period occurred in three patients (4.7%) receiving a Betadine prep vs two patients (4.2%) receiving a standard O.R. prep. This difference was not statistically significant (p = 0.9). Venous thrombosis occurred in three patients (6.8%) receiving warfarin sodium and in two patients (3%) not receiving warfarin sodium. This difference was not statistically

  10. 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

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

    ERIC Educational Resources Information Center

    Means, Darris R.; Pyne, Kimberly B.

    2016-01-01

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

  12. Outcome Evaluation: Student Development Program, Special Studies Division, Cleveland State University.

    ERIC Educational Resources Information Center

    Pasch, Marvin

    Techniques and procedures used to evaluate the outcomes of the student development program, and to use the evaluation results, are presented. Specific evaluation questions are posed that address overall outcomes, not individual student outcomes, and quantitative measures are suggested to accompany the questions. The measures include statistical…

  13. 29 CFR 2706.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... 2706.151 Section 2706.151 Labor Regulations Relating to Labor (Continued) FEDERAL MINE SAFETY AND... ACTIVITIES CONDUCTED BY THE FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION § 2706.151 Program accessibility... the Architectural Barriers Act (42 U.S.C. 4151-4157), as established in 41 CFR 101-19.600 to 101-19...

  14. 34 CFR 1200.151 - Program accessibility: New construction and alterations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Program accessibility: New construction and alterations. 1200.151 Section 1200.151 Education Regulations of the Offices of the Department of Education... standards of the Architectural Barriers Act (42 U.S.C. 4151-4157), as established in 41 CFR 101-19.600 to...

  15. Implementation and Outcomes of Forensic Housing First Programs.

    PubMed

    Kriegel, Liat S; Henwood, Benjamin F; Gilmer, Todd P

    2016-01-01

    This mixed-method study used administrative data from 68 supportive housing programs and evaluative and qualitative site visit data from a subset of four forensic programs to (a) compare fidelity to the Housing First model and residential client outcomes between forensic and nonforensic programs and (b) investigate whether and how providers working in forensic programs can navigate competing Housing First principles and criminal justice mandates. Quantitative findings suggested that forensic programs were less likely to follow a harm reduction approach to substance use and clients in those programs were more likely to live in congregate settings. Qualitative findings suggested that an interplay of court involvement, limited resources, and risk environments influenced staff decisions regarding housing and treatment. Existing mental health and criminal justice collaborations necessitate adaptation to the Housing First model to accommodate client needs.

  16. Does Participation in Home-delivered Meals Programs Improve Outcomes for Older Adults?: Results of a Systematic Review

    PubMed Central

    Campbell, Anthony D.; Godfryd, Alice; Buys, David R.; Locher, Julie L.

    2015-01-01

    Participation in home-delivered meals programs may contribute to the health and independence of older adults living in the community, especially those who are food insecure or those who are making transitions from acute, subacute, and chronic care settings to the home. The purpose of this study was to conduct a comprehensive and systematic review of ALL studies related to home-delivered meals in order to shed light on the state of the science. A complete review of articles appearing in PubMed using the Keyword “Meal” was conducted; and titles, abstracts, and full-texts were screened for relevance. Included in this review are 80 articles. Most studies are descriptive and do not report on outcomes. Frequently reported outcomes included nutritional status based upon self-reported dietary intake. Additionally, most studies included in this review are cross-sectional, have a small sample size, and/or are limited to a particular setting or participant population. More rigorous research is needed to: 1) gain insight into why so few eligible older adults access home-delivered meals programs, 2) support expansion of home-delivered meals to all eligible older adults, 3) better identify what home-delivered meals models alone and in combination with other services works best and for whom, and 4) better target home-delivered meals programs where and when resources are scarce. PMID:26106985

  17. A framework for monitoring social process and outcomes in environmental programs.

    PubMed

    Chapman, Sarah

    2014-12-01

    When environmental programs frame their activities as being in the service of human wellbeing, social variables need to be integrated into monitoring and evaluation (M&E) frameworks. This article draws upon ecosystem services theory to develop a framework to guide the M&E of collaborative environmental programs with anticipated social benefits. The framework has six components: program need, program activities, pathway process variables, moderating process variables, outcomes, and program value. Needs are defined in terms of ecosystem services, as well as other human needs that must be addressed to achieve outcomes. The pathway variable relates to the development of natural resource governance capacity in the target community. Moderating processes can be externalities such as the inherent capacity of the natural system to service ecosystem needs, local demand for natural resources, policy or socio-economic drivers. Internal program-specific processes relate to program service delivery, targeting and participant responsiveness. Ecological outcomes are expressed in terms of changes in landscape structure and function, which in turn influence ecosystem service provision. Social benefits derived from the program are expressed in terms of the value of the eco-social service to user-specified goals. The article provides suggestions from the literature for identifying indicators and measures for components and component variables, and concludes with an example of how the framework was used to inform the M&E of an adaptive co-management program in western Kenya. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. The Stanford Medical Youth Science Program: educational and science-related outcomes.

    PubMed

    Crump, Casey; Ned, Judith; Winkleby, Marilyn A

    2015-05-01

    Biomedical preparatory programs (pipeline programs) have been developed at colleges and universities to better prepare youth for entering science- and health-related careers, but outcomes of such programs have seldom been rigorously evaluated. We conducted a matched cohort study to evaluate the Stanford Medical Youth Science Program's Summer Residential Program (SRP), a 25-year-old university-based biomedical pipeline program that reaches out to low-income and underrepresented ethnic minority high school students. Five annual surveys were used to assess educational outcomes and science-related experience among 96 SRP participants and a comparison group of 192 youth who applied but were not selected to participate in the SRP, using ~2:1 matching on sociodemographic and academic background to control for potential confounders. SRP participants were more likely than the comparison group to enter college (100.0 vs. 84.4 %, p = 0.002), and both of these matriculation rates were more than double the statewide average (40.8 %). In most areas of science-related experience, SRP participants reported significantly more experience (>twofold odds) than the comparison group at 1 year of follow-up, but these differences did not persist after 2-4 years. The comparison group reported substantially more participation in science or college preparatory programs, more academic role models, and less personal adversity than SRP participants, which likely influenced these findings toward the null hypothesis. SRP applicants, irrespective of whether selected for participation, had significantly better educational outcomes than population averages. Short-term science-related experience was better among SRP participants, although longer-term outcomes were similar, most likely due to college and science-related opportunities among the comparison group. We discuss implications for future evaluations of other biomedical pipeline programs.

  19. Implementation of a Program of Outcomes Research in Residential Care Settings: Outcomes for Children and Youth

    ERIC Educational Resources Information Center

    Portwood, Sharon G.; Boyd, A. Suzanne; Murdock, Tamera B.

    2016-01-01

    Background: There is a need to examine behavioral and mental health outcomes for children in out-of-home care across settings. Objective: Using a participatory research approach, researchers and agency personnel aimed to implement a program of scientific outcomes research in residential care settings. Data were used to examine children's…

  20. The Stanford Medical Youth Science Program: Educational and Science-Related Outcomes

    ERIC Educational Resources Information Center

    Crump, Casey; Ned, Judith; Winkleby, Marilyn A.

    2015-01-01

    Biomedical preparatory programs (pipeline programs) have been developed at colleges and universities to better prepare youth for entering science- and health-related careers, but outcomes of such programs have seldom been rigorously evaluated. We conducted a matched cohort study to evaluate the Stanford Medical Youth Science Program's Summer…

  1. Programmatic assessment of a university-based implant training program using patient-reported outcomes.

    PubMed

    Al-Sabbagh, Mohanad; Jenkins, Diane W; de Leeuw, Reny; Nihill, Patricia; Robinson, Fonda G; Thomas, Mark V

    2014-11-01

    The University of Kentucky College of Dentistry (UKCD) established an implant training program that provides training in the use of a single implant system, evidence-based diagnostic and treatment protocols (standardized work practices), and a total quality management system (Implant Quality Assurance Program). The aim of this study was to assess the programmatic effectiveness of the UKCD implant training program by reporting the success and survival of implants placed, using patient-reported outcomes and comparing them to previously established benchmarks. A total of 415 patients (963 implants) were interviewed, approximately 50 percent of all qualified patients. The implant survival rate was 97 percent, and 88 percent of the implants were considered successful (as determined by patient-centric criteria). These outcomes were consistent with the program's previously established benchmarks of 90 percent. These results suggest that work standardization (in the form of specific treatment protocols) and the use of a formal, incremental learning system can result in positive patient outcomes. Clinical outcomes should be monitored in academic dental settings as part of clinical process improvement, and these outcomes can provide a means of assessing the effectiveness of the training program.

  2. Scaling Up a Water, Sanitation, and Hygiene Program in Rural Bangladesh: The Role of Program Implementation

    PubMed Central

    Sultana, Sonia; Halder, Amal K.; Ahsan, Mohammed Ali; Arnold, Benjamin F.; Hubbard, Alan E.; Unicomb, Leanne; Luby, Stephen P.; Colford, John M.

    2017-01-01

    Objectives. To evaluate whether the quality of implementation of a water, sanitation, and hygiene program called SHEWA-B and delivered by UNICEF to 20 million people in rural Bangladesh was associated with health behaviors and sanitation infrastructure access. Methods. We surveyed 33 027 households targeted by SHEWA-B and 1110 SHEWA-B hygiene promoters in 2011 and 2012. We developed an implementation quality index and compared the probability of health behaviors and sanitation infrastructure access in counterfactual scenarios over the range of implementation quality. Results. Forty-seven percent of households (n = 14 622) had met a SHEWA-B hygiene promoter, and 47% of hygiene promoters (n = 527) could recall all key program messages. The frequency of hygiene promoter visits was not associated with improved outcomes. Higher implementation quality was not associated with better health behaviors or infrastructure access. Outcomes differed by only 1% to 3% in scenarios in which all clusters received low versus high implementation quality. Conclusions. SHEWA-B did not meet UNICEF’s ideal implementation quality in any area. Improved implementation quality would have resulted in marginal changes in health behaviors or infrastructure access. This suggests that SHEWA-B’s design was suboptimal for improving these outcomes. PMID:28323462

  3. A geographical perspective on access to sexual and reproductive health care for women in rural Africa.

    PubMed

    Yao, Jing; Murray, Alan T; Agadjanian, Victor

    2013-11-01

    Utilization of sexual and reproductive health (SRH) services can significantly impact health outcomes, such as pregnancy and birth, prenatal and neonatal mortality, maternal morbidity and mortality, and vertical transmission of infectious diseases like HIV/AIDS. It has long been recognized that access to SRH services is essential to positive health outcomes, especially in rural areas of developing countries, where long distances as well as poor transportation conditions, can be potential barriers to health care acquisition. Improving accessibility of health services for target populations is therefore critical for specialized healthcare programs. Thus, understanding and evaluation of current access to health care is crucial. Combining spatial information using geographical information system (GIS) with population survey data, this study details a gravity model-based method to measure and evaluate access to SRH services in rural Mozambique, and analyzes potential geographic access to such services, using family planning as an example. Access is found to be a significant factor in reported behavior, superior to traditional distance-based indicators. Spatial disparities in geographic access among different population groups also appear to exist, likely affecting overall program success. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. A geographical perspective on access to sexual and reproductive health care for women in rural Africa

    PubMed Central

    Yao, Jing; Murray, Alan T.; Agadjanian, Victor

    2015-01-01

    Utilization of sexual and reproductive health (SRH) services can significantly impact health outcomes, such as pregnancy and birth, prenatal and neonatal mortality, maternal morbidity and mortality, and vertical transmission of infectious diseases like HIV/AIDS. It has long been recognized that access to SRH services is essential to positive health outcomes, especially in rural areas of developing countries, where long distances as well as poor transportation conditions, can be potential barriers to health care acquisition. Improving accessibility of health services for target populations is therefore critical for specialized healthcare programs. Thus, understanding and evaluation of current access to health care is crucial. Combining spatial information using geographical information system (GIS) with population survey data, this study details a gravity model-based method to measure and evaluate access to SRH services in rural Mozambique, and analyzes potential geographic access to such services, using family planning as an example. Access is found to be a significant factor in reported behavior, superior to traditional distance-based indicators. Spatial disparities in geographic access among different population groups also appear to exist, likely affecting overall program success. PMID:24034952

  5. Outcomes from the Mount Sinai Social Work Leadership Enhancement Program: Evaluation and extrapolation.

    PubMed

    Nilsson, David; Wellington-Boyd, Anna

    2006-01-01

    This article presents an overview of outcomes from the Mount Sinai Leadership Enhancement Program as identified by previous program participants from Melbourne, Australia. These are categorised into: (1) Personal/professional, (2) Intra-organisational, (3) Interorganisational, and (4) International outcomes. Two illustrative examples are provided of international outcomes demonstrating how the ongoing commitment of Professor Epstein has extended and embedded the principles of practice-based research in Melbourne, and how the over-riding principles of the program have been applied by participants in establishing collaborative relationships with colleagues in our neighbouring South-East Asian region.

  6. Multi-component access to a community-based weight loss program: 12 week results

    USDA-ARS?s Scientific Manuscript database

    The current study examined weight loss between a comprehensive lifestyle modification program (Weight Watchers PointsPlus program) that included three ways to access and a self-help (SH) condition. A total of 293 participants were randomized to either a Weight Watchers condition (WW) (n=148) or a SH...

  7. Pharmacoeconomics and outcomes research degree-granting PhD programs in the United States.

    PubMed

    Slejko, Julia F; Libby, Anne M; Nair, Kavita V; Valuck, Robert J; Campbell, Jonathan D

    2013-01-01

    Evidence is missing on showcasing current practices of degree programs specific to the field of pharmaceutical outcomes research. To measure current practices of pharmacoeconomics and outcomes research PhD programs in the United States and synthesize recommendations for improving the success of programs and prospective students. A 23-question online survey instrument was created and distributed to 32 program directors identified in the International Society for Pharmacoeconomics and Outcomes Research educational directory. Descriptive statistics summarized both the program characteristics (including observed and desired number of faculty and students) and training recommendations (traits of program and student success). Of 30 eligible programs that conferred a PhD in pharmacoeconomics, pharmaceutical outcomes research, or a related field, 16 respondents (53%) completed the survey. Seventy-five percent of respondents were located in a school of pharmacy. The average observed number of faculty (7.5) and students (11.5) was lower than the average desired numbers (8.1) and (14.7), respectively. Reputation of faculty research and a collaborative environment with other disciplines were rated highest for a program's success. Faculty's mentoring experience and reputation and student funding opportunities were rated highest for prospective students' success. Existing and emerging programs as well as prospective students can use these findings to further their chances of success. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. 78 FR 23893 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-23

    ... inviting proposals for the 2014 Market Access Program (MAP). The intended effect of this notice is to... Agricultural Service (FAS). The funding authority for MAP expires at the end of fiscal year 2013. This notice... program funding is reauthorized prior to that time. In the event this program is not reauthorized, or is...

  9. Development and Testing of a Conceptual Model Regarding Men's Access to Health Care.

    PubMed

    Leone, James E; Rovito, Michael J; Mullin, Elizabeth M; Mohammed, Shan D; Lee, Christina S

    2017-03-01

    Epidemiologic data suggest men often experience excessive morbidity and early mortality, possibly compromising family and community health over the lifespan. Moreover, the negative financial/economic consequences affected by poor male health outcomes also has been of great concern in the United States and abroad. Early and consistent access to preventative health care may improve health outcomes; however, men are far less likely to access these services. The purpose of this study was to understand what factors preclude men from accessing health care. We surveyed 485 participants using a 58-item online survey built from a conceptual model previously developed by the researchers using hegemonic masculinity theory, the theory of normative contentment, and the health belief model. For men, three items significantly ( ps < .05) predicted whether they had seen a health care provider in the past year: "I/Men do not access healthcare because I do not think there is anything wrong with me," "My health is only about me," and "I/Men do not access healthcare because most men in my family do not access healthcare." Other correlations of practical significance also were noted. Results suggest gender norms and masculine ideals may play a primary role in how men access preventative health care. Future programming targeting males should consider barriers and plan programs that are gender-sensitive in addition to being gender-specific. Clinical implications are discussed.

  10. International Monetary Fund Programs and Tuberculosis Outcomes in Post-Communist Countries

    PubMed Central

    Stuckler, David; King, Lawrence P; Basu, Sanjay

    2008-01-01

    Background Previous studies have indicated that International Monetary Fund (IMF) economic programs have influenced health-care infrastructure in recipient countries. The post-communist Eastern European and former Soviet Union countries experienced relatively similar political and economic changes over the past two decades, and participated in IMF programs of varying size and duration. We empirically examine how IMF programs related to changes in tuberculosis incidence, prevalence, and mortality rates among these countries. Methods and Findings We performed multivariate regression of two decades of tuberculosis incidence, prevalence, and mortality data against variables potentially influencing tuberculosis program outcomes in 21 post-communist countries for which comparative data are available. After correcting for confounding variables, as well as potential detection, selection, and ecological biases, we observed that participating in an IMF program was associated with increased tuberculosis incidence, prevalence, and mortality rates by 13.9%, 13.2%, and 16.6%, respectively. Each additional year of participation in an IMF program was associated with increased tuberculosis mortality rates by 4.1%, and each 1% increase in IMF lending was associated with increased tuberculosis mortality rates by 0.9%. On the other hand, we estimated a decrease in tuberculosis mortality rates of 30.7% (95% confidence interval, 18.3% to 49.5%) associated with exiting the IMF programs. IMF lending did not appear to be a response to worsened health outcomes; rather, it appeared to be a precipitant of such outcomes (Granger- and Sims-causality tests), even after controlling for potential political, socioeconomic, demographic, and health-related confounders. In contrast, non-IMF lending programs were connected with decreased tuberculosis mortality rates (−7.6%, 95% confidence interval, −1.0% to −14.1%). The associations observed between tuberculosis mortality and IMF programs were

  11. Longitudinal Outcomes of an Institutionally Developed Nurse Residency Program

    PubMed Central

    Cline, Debbie; La Frentz, Kelly; Fellman, Bryan; Summers, Barbara; Brassil, Kelly

    2017-01-01

    Nurse residency programs are widely implemented to enhance integration of new graduate nurses entering the workforce. This article presents a retrospective analysis of 10 years of residency data from an internally developed residency program that utilized the Casey-Fink Graduate Nurse Experience Survey. Outcomes of this program were similar to those from studies using commercially available products, suggesting an internally developed residency curricula may be equally beneficial to the development of new graduate nurses. PMID:28727624

  12. 42 CFR 417.106 - Quality assurance program; Availability, accessibility, and continuity of basic and supplemental...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Qualified Health Maintenance Organizations: Services § 417.106 Quality assurance program; Availability, accessibility, and continuity of basic and supplemental health services. (a) Quality assurance program. Each HMO or CMP must have an ongoing quality assurance program for its health services that meets the...

  13. Integrated worker health protection and promotion programs: overview and perspectives on health and economic outcomes.

    PubMed

    Pronk, Nicolaas P

    2013-12-01

    To describe integrated worker health protection and promotion (IWHPP) program characteristics, to discuss the rationale for the integration of occupational safety and health and worksite health promotion programs, and to summarize what is known about the impact of these programs on health and economic outcomes. A descriptive assessment of the current state of the IWHPP field and a review of studies on the effectiveness of IWHPP programs on health and economic outcomes were undertaken. Sufficient evidence of effectiveness was found for IWHPP programs when health outcomes were considered. Impact on productivity-related outcomes is considered promising, but inconclusive, whereas insufficient evidence was found for health care expenditures. Existing evidence supports an integrated approach in terms of health outcomes but will benefit significantly from research designed to support the business case for employers of various company sizes and industry types.

  14. Integrated Worker Health Protection and Promotion Programs: Overview and Perspectives on Health and Economic Outcomes

    PubMed Central

    Pronk, Nicolaas P.

    2014-01-01

    Objective To describe integrated worker health protection and promotion (IWHPP) program characteristics, to discuss the rationale for integration of OSH and WHP programs, and to summarize what is known about the impact of these programs on health and economic outcomes. Methods A descriptive assessment of the current state of the IWHPP field and a review of studies on the effectiveness of IWHPP programs on health and economic outcomes. Results Sufficient evidence of effectiveness was found for IWHPP programs when health outcomes are considered. Impact on productivity-related outcomes is considered promising, but inconclusive, whereas insufficient evidence was found for health care expenditures. Conclusions Existing evidence supports an integrated approach in terms of health outcomes but will benefit significantly from research designed to support the business case for employers of various company sizes and industry types. PMID:24284747

  15. A Program to Improve Access to Health Care Among Mexican Immigrants in Rural Colorado

    ERIC Educational Resources Information Center

    Diaz-Perez, Maria de Jesus; Farley, Tillman; Cabanis, Clara Martin

    2004-01-01

    Migration to the United States from Mexico is increasing every year. Mexican immigrants tend to be poor, uninsured, monolingual Spanish speakers without adequate access to appropriate medical care. As a further barrier, many are also undocumented. This article describes a program developed to improve access to health care among Mexican immigrants…

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

    PubMed Central

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

    2017-01-01

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

  17. 75 FR 57829 - Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-22

    ... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration [Docket No. FAA-2010-0831] Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property AGENCY: Federal... inadvertent omission in the Privacy paragraph in the Notice of Proposed Policy Regarding Access to Airports...

  18. Neighborhood perceptions and parent outcomes in family based prevention programs for Thai adolescents: the role of program engagement.

    PubMed

    Byrnes, Hilary F; Miller, Brenda A; Chamratrithirong, Aphichat; Rhucharoenpornpanich, Orratai; Cupp, Pamela K; Atwood, Katharine A; Fongkaew, Warunee; Rosati, Michael J; Chookhare, Warunee

    2011-01-01

    Due to concerns over Thai adolescent risky behaviors, effective prevention strategies are needed. Determining the role neighborhood context plays in program engagement and outcomes may inform these strategies. This study includes 170 mother-adolescent pairs (M = 13.44, SD = .52) in Bangkok, Thailand in a prevention program for adolescent substance use and sexual risk. Neighborhoods were related to engagement, which was critical to outcomes. Neighborhood disorganization was related to confidence in program effects and program completion. Completion was related to increased ATOD communication. Neighborhood cohesion was related to less program enjoyment, while neighborhood social control was related to more enjoyment. Enjoyment was related to increased ATOD communication and formation and monitoring of alcohol rules. Prevention strategies should focus on neighborhood contexts and enhancing engagement.

  19. Web Accessibility and Accessibility Instruction

    ERIC Educational Resources Information Center

    Green, Ravonne A.; Huprich, Julia

    2009-01-01

    Section 508 of the Americans with Disabilities Act (ADA) mandates that programs and services be accessible to people with disabilities. While schools of library and information science (SLIS*) and university libraries should model accessible Web sites, this may not be the case. This article examines previous studies about the Web accessibility of…

  20. 75 FR 19464 - Interagency Guidance on Response Programs for Unauthorized Access to Customer Information and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-14

    ... for Unauthorized Access to Customer Information and Customer Notice AGENCY: Office of Thrift...: Interagency Guidance on Response Programs for Unauthorized Access to Customer Information and Customer Notice... physical safeguards to: (1) Ensure the security and confidentiality of customer records and information; (2...

  1. 9 CFR 306.2 - Program employees to have access to establishments.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Program employees to have access to establishments. 306.2 Section 306.2 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY...

  2. 77 FR 24169 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-23

    ... for the 2013 Market Access Program (MAP). The intended effect of this notice is to solicit... not be considered. FOR FURTHER INFORMATION CONTACT: Entities wishing to apply for funding assistance... at http://www.fas.usda.gov/mos/programs/map.asp . SUPPLEMENTARY INFORMATION: I. Funding Opportunity...

  3. Modeling hospital infrastructure by optimizing quality, accessibility and efficiency via a mixed integer programming model.

    PubMed

    Ikkersheim, David; Tanke, Marit; van Schooten, Gwendy; de Bresser, Niels; Fleuren, Hein

    2013-06-16

    The majority of curative health care is organized in hospitals. As in most other countries, the current 94 hospital locations in the Netherlands offer almost all treatments, ranging from rather basic to very complex care. Recent studies show that concentration of care can lead to substantial quality improvements for complex conditions and that dispersion of care for chronic conditions may increase quality of care. In previous studies on allocation of hospital infrastructure, the allocation is usually only based on accessibility and/or efficiency of hospital care. In this paper, we explore the possibilities to include a quality function in the objective function, to give global directions to how the 'optimal' hospital infrastructure would be in the Dutch context. To create optimal societal value we have used a mathematical mixed integer programming (MIP) model that balances quality, efficiency and accessibility of care for 30 ICD-9 diagnosis groups. Typical aspects that are taken into account are the volume-outcome relationship, the maximum accepted travel times for diagnosis groups that may need emergency treatment and the minimum use of facilities. The optimal number of hospital locations per diagnosis group varies from 12-14 locations for diagnosis groups which have a strong volume-outcome relationship, such as neoplasms, to 150 locations for chronic diagnosis groups such as diabetes and chronic obstructive pulmonary disease (COPD). In conclusion, our study shows a new approach for allocating hospital infrastructure over a country or certain region that includes quality of care in relation to volume per provider that can be used in various countries or regions. In addition, our model shows that within the Dutch context chronic care may be too concentrated and complex and/or acute care may be too dispersed. Our approach can relatively easily be adopted towards other countries or regions and is very suitable to perform a 'what-if' analysis.

  4. Dual Language Immersion Program Equity and Access: Is There Equity for All Students?

    ERIC Educational Resources Information Center

    Fernandez, Patricia Espinoza

    2016-01-01

    This is a mixed methods study of K-12 school administrators with dual language immersion school leadership expertise. The paramount research focus was to identify equity and access issues in dual language immersion programs serving grades K-12, as identified by school administrators who have led such programs. A total pool of 498 were invited to…

  5. Participatory Data Collection Technique for Capturing Beginning Farmer Program Outcomes

    ERIC Educational Resources Information Center

    Eschbach, Cheryl L.; Sirrine, J. R.; Lizotte, Erin; Rothwell, N. L.

    2016-01-01

    This article describes an innovative evaluation plan we employed to capture outcomes of a multiyear beginning farmer program and, specifically, highlights the facilitation technique we used to document short-term and intermediate goals of the program that matched U.S. Department of Agriculture grant requirements and Extension administration…

  6. Translating an effective group-based HIV prevention program to a program delivered primarily by a computer: methods and outcomes.

    PubMed

    Card, Josefina J; Kuhn, Tamara; Solomon, Julie; Benner, Tabitha A; Wingood, Gina M; DiClemente, Ralph J

    2011-04-01

    We describe development of SAHARA (SISTAS Accessing HIV/AIDS Resources At-a-click), an innovative HIV prevention program that uses a computer to deliver an updated version of SiSTA, a widely used, effective group-level HIV prevention intervention for African American women ages 18-29. Fidelity to SiSTA's core components was achieved using: (1) video clips featuring group discussions and modeling of appropriate sexual- and contraceptive-related behavior; and (2) interactive Flash modules facilitating cognitive rehearsal, providing learning experiences through games and quizzes, and providing opportunities for simulated role-play. A preliminary outcome study of SAHARA conducted at Planned Parenthood, Atlanta, found that SAHARA, when followed by a brief 20-minute wrap-up group session facilitated by a health educator, was effective in promoting consistent condom use for vaginal sex. We discuss the potential advantages and challenges of an intervention like SAHARA delivered by computer to an individual, versus one like SiSTA delivered by a health educator to a small group.

  7. Evaluating the Impact of Dental Care on Housing Intervention Program Outcomes Among Homeless Veterans

    PubMed Central

    Nunez, Elizabeth; Gibson, Gretchen; Jones, Judith A.; Schinka, John A.

    2013-01-01

    Objectives. In this retrospective longitudinal cohort study, we examined the impact of dental care on outcomes among homeless veterans discharged from a Department of Veterans Affairs (VA) transitional housing intervention program. Methods. Our sample consisted of 9870 veterans who were admitted into a VA homeless intervention program during 2008 and 2009, 4482 of whom received dental care during treatment and 5388 of whom did not. Primary outcomes of interest were program completion, employment or stable financial status on discharge, and transition to permanent housing. We calculated descriptive statistics and compared the 2 study groups with respect to demographic characteristics, medical and psychiatric history (including alcohol and substance use), work and financial support, and treatment outcomes. Results. Veterans who received dental care were 30% more likely than those who did not to complete the program, 14% more likely to be employed or financially stable, and 15% more likely to have obtained residential housing. Conclusions. Provision of dental care has a substantial positive impact on outcomes among homeless veterans participating in housing intervention programs. This suggests that homeless programs need to weigh the benefits and cost of dental care in program planning and implementation. PMID:23678921

  8. Pectus patient information website has improved access to care and patient reported outcomes.

    PubMed

    Tikka, Theofano; Webb, Joanne; Agostini, Paula; Kerr, Amy; Mannion, Glenn; Steyn, Richard S; Bishay, Ehab; Kalkat, Maninder S; Rajesh, Pala B; Naidu, Babu

    2016-04-26

    Pectus is the most common congenital disorder. Awareness amongst primary care physicians and the general public is poor. NHS commissioning bodies plan to withdraw funding for this surgery because they deem a lack of sufficient evidence of benefit. The purpose of this study is to assess the effects of introducing a patient information website on referral and activity patterns and on patients reported outcomes. We produced an innovative information website, www.pectus.co.uk , accessible to the general public, providing information about pectus deformities; management options and advice about surgery. Referral patterns and number of cases where studied before and after the introduction of the website in 2010. Patients' satisfaction post-op was assessed using the Brompton's single step questionnaire (SSQ). The website had considerable traffic with 2179 hits in 2012, 4983 in 2013 and 7416 in 2014. This has led to 1421 contacts and 372 email enquiries. These emails have resulted in an increased number of patients who have been assessed and go on to have surgery. We asked 59 pectus excavatum patients who were operated from 2008 to 2014 to complete the SSQ. We received 32 replies. Eighty-four percent (16/19) of patients who visited the website and then underwent surgery, found the website useful. All patients scored satisfactorily in SSQ. Even though those who visited the website tended to be more satisfied with the surgical outcomes this did not reach statistical significance. This group of patients said that would have the operation again given the option compared to 76.9 % of the group who did not visit the website before surgery (p=0.031). Despite the fact that patients who visited the website experienced more post-operative complications were equally or more satisfied with post-operative outcomes. The overall SSQ obtainable score was not different for the two subgroups, being more widespread in the group that did not visit the website. The introduction of a pectus

  9. The Arts and 504, A Handbook for Accessible Arts Programming. Revised.

    ERIC Educational Resources Information Center

    National Endowment for the Arts, Washington, DC.

    This handbook is designed to assist arts organizations in complying with disability access regulations. It details how to include the needs of disabled people into programming efforts and also provides information on the Arts Endowment's 504 Regulation, which applies to federally funded organizations, and the 1990 Americans with Disabilities Act…

  10. 75 FR 26194 - Notice of Funds Availability: Inviting Applications for the Market Access Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-11

    ... for the 2011 Market Access Program (MAP). The intended effect of this notice is to solicit... considers whether the applicant provides a clear, long-term agricultural trade strategy and a program... the greatest growth potential. These factors are part of the FAS resource allocation strategy to fund...

  11. Germany's Disease Management Program: Improving Outcomes in Congestive Heart Failure

    PubMed Central

    Kottmair, Stefan; Frye, Christian; Ziegenhagen, Dieter J.

    2005-01-01

    Hospital admissions among patients with congestive heart failure (CHF) are a major contributor to health care costs. A comprehensive disease management program for CHF was developed for private and statutory health insurance companies in order to improve health outcomes and reduce rehospitalization rates and costs. The program comprises care calls, written training material, telemetric monitoring, and health reports. Currently, 909 members from six insurance companies are enrolled. Routine evaluation, based on medical data warehouse software, demonstrates benefits in terms of improved health outcomes and processes of care. Economical evaluation of claims data indicates significant cost savings in a pre/post study design. PMID:17288080

  12. Facilities Planning Guide for Special Education Programs: Planning Accessibility for the Handicapped in Public Schools.

    ERIC Educational Resources Information Center

    Brooks, Kenneth W.

    The guide details characteristics to provide architecturally accessible special education programs for handicapped students. Impetus for the accessibility movement is traced to legislation, including the Architectural Barriers Act and Sections 503 and 504 of the Rehabilitation Act of 1973. Planning features considered are the development of a…

  13. 77 FR 51948 - Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-28

    ...-0754] Airport Improvement Program (AIP): Policy Regarding Access to Airports From Residential Property... Airports From Residential Property that was published in the Federal Register on July 30, 2012. The FAA is... policy, based on Federal law, concerning through-the- fence access to a federally obligated airport from...

  14. Relating Engagement to Outcomes in Prevention: The Case of a Parenting Program for Couples

    PubMed Central

    Brown, Louis D.; Goslin, Megan C.; Feinberg, Mark E.

    2011-01-01

    Analyses of program engagement can provide critical insight into how program involvement leads to outcomes. This study examines the relation between participant engagement and program outcomes in Family Foundations (FF), a universal preventive intervention designed to help couples manage the transition to parenthood by improving coparenting relationship quality. Previous intent-to-treat outcome analyses from a randomized trial indicate FF improves parental adjustment, interparental relationships, and parenting. Analyses for the current study use the same sample, and yield statistically reliable relations between participant engagement and interparental relationships but not parental adjustment or parenting. Discussion considers implications for FF and the difficulities researchers face when examining the relation between engagement and outcomes in preventive interventions. PMID:21826536

  15. Relating engagement to outcomes in prevention: the case of a parenting program for couples.

    PubMed

    Brown, Louis D; Goslin, Megan C; Feinberg, Mark E

    2012-09-01

    Analyses of program engagement can provide critical insight into how program involvement leads to outcomes. This study examines the relation between participant engagement and program outcomes in Family Foundations (FF), a universal preventive intervention designed to help couples manage the transition to parenthood by improving coparenting relationship quality. Previous intent-to-treat outcome analyses from a randomized trial indicate FF improves parental adjustment, interparental relationships, and parenting. Analyses for the current study use the same sample, and yield statistically reliable relations between participant engagement and interparental relationships but not parental adjustment or parenting. Discussion considers implications for FF and the difficulties researchers face when examining the relation between engagement and outcomes in preventive interventions.

  16. Impacts of the Interim Federal Health Program reforms: A stakeholder analysis of barriers to health care access and provision for refugees.

    PubMed

    Antonipillai, Valentina; Baumann, Andrea; Hunter, Andrea; Wahoush, Olive; O'Shea, Timothy

    2017-11-09

    Changes to the Interim Federal Health Program (IFHP) in 2012 reduced health care access for refugees and refugee claimants, generating concerns among key stakeholders. In 2014, a new IFHP temporarily reinstated access to some health services; however, little is known about these changes, and more information is needed to map the IFHP's impact. This study explores barriers occurring during the time period of the IFHP reforms to health care access and provision for refugees. A stakeholder analysis, using 23 semi-structured interviews, was conducted to obtain insight into stakeholder perceptions of the 2014 reforms, as well as stakeholders' position and their influence to assess the acceptability of the IFHP changes. The majority of stakeholders expressed concerns about the 2014 IFHP changes as a result of the continuing barriers posed by the 2012 retrenchments and the emergence of new barriers to health care access and provision for refugees. Key barriers identified included lack of communication and awareness, lack of continuity and comprehensive care, negative political discourse and increased costs. A few stakeholders supported the reforms as they represented some, but limited, access to health care. Overall, the reforms to the IFHP in 2014 generated barriers to health care access and provision that contributed to confusion among stakeholders, the transfer of refugee health responsibility to provincial authorities and the likelihood of increased health outcome disparities, as refugees and refugee claimants chose to delay seeking health care. The study recommends that policy-makers engage with refugee health stakeholders to formulate a policy that improves health care provision and access for refugee populations.

  17. Implementing a Farmers’ Market Incentive Program: Perspectives on the New York City Health Bucks Program

    PubMed Central

    Wethington, Holly; Olsho, Lauren; Jernigan, Jan; Farris, Rosanne; Walker, Deborah Klein

    2013-01-01

    Introduction One strategy for lowering the prevalence of obesity is to increase access to and affordability of fruits and vegetables through farmers’ markets. However, little has been documented in the literature on the implementation of such efforts. To address this gap, the Division of Nutrition, Physical Activity, and Obesity (DNPAO) sponsored an evaluation of the New York City Health Bucks program, a farmers’ market coupon incentive program intended to increase access to fresh fruits and vegetables in underserved neighborhoods while supporting local farmers. Methods We conducted a process evaluation of Health Bucks program implementation. We interviewed 6 farmer/vendors, 3 market managers, and 4 program administrators, and collected data on site at 86 farmers’ markets, including surveys of 81 managers and 141 farmer/vendors on their perspectives on promotion and redemption of the incentive coupons; knowledge and attitudes regarding the program; experiences with markets and products; and facilitators and barriers to program participation. Results Results indicate that respondents view Health Bucks as a positive program model. Farmers’ market incentive coupon programs like Health Bucks are one strategy to address the problem of obesity and were associated with higher fruit and vegetable access and purchases in low-income communities. Conclusions This evaluation identified some areas for improving implementation of the Health Bucks program. Farmers’ market incentive programs like Health Bucks may be one avenue to increase access to and affordability of fruits and vegetables among low-income persons. Further research is needed to assess the potential effects of these programs on access and health outcomes. PMID:23987251

  18. A Comprehensive Examination of the Influence of State Tobacco Control Programs and Policies on Youth Smoking

    PubMed Central

    Loomis, Brett R.; Han, Beth; Gfroerer, Joe; Kuiper, Nicole; Couzens, G. Lance; Dube, Shanta; Caraballo, Ralph S.

    2013-01-01

    Objectives. We examined the influence of tobacco control policies (tobacco control program expenditures, smoke-free air laws, youth access law compliance, and cigarette prices) on youth smoking outcomes (smoking susceptibility, past-year initiation, current smoking, and established smoking). Methods. We combined data from the 2002 to 2008 National Surveys on Drug Use and Health with state and municipality population data from the US Census Bureau to assess the associations between state tobacco control policy variables and youth smoking outcomes, focusing on youths aged 12 to 17 years. We also examined the influence of policy variables on youth access when these variables were held at 2002 levels. Results. Per capita funding for state tobacco control programs was negatively associated with all 4 smoking outcomes. Smoke-free air laws were negatively associated with all outcomes except past-year initiation, and cigarette prices were associated only with current smoking. We found no association between these outcomes and retailer compliance with youth access laws. Conclusions. Smoke-free air laws and state tobacco control programs are effective strategies for curbing youth smoking. PMID:23327252

  19. A comprehensive examination of the influence of state tobacco control programs and policies on youth smoking.

    PubMed

    Farrelly, Matthew C; Loomis, Brett R; Han, Beth; Gfroerer, Joe; Kuiper, Nicole; Couzens, G Lance; Dube, Shanta; Caraballo, Ralph S

    2013-03-01

    We examined the influence of tobacco control policies (tobacco control program expenditures, smoke-free air laws, youth access law compliance, and cigarette prices) on youth smoking outcomes (smoking susceptibility, past-year initiation, current smoking, and established smoking). We combined data from the 2002 to 2008 National Surveys on Drug Use and Health with state and municipality population data from the US Census Bureau to assess the associations between state tobacco control policy variables and youth smoking outcomes, focusing on youths aged 12 to 17 years. We also examined the influence of policy variables on youth access when these variables were held at 2002 levels. Per capita funding for state tobacco control programs was negatively associated with all 4 smoking outcomes. Smoke-free air laws were negatively associated with all outcomes except past-year initiation, and cigarette prices were associated only with current smoking. We found no association between these outcomes and retailer compliance with youth access laws. Smoke-free air laws and state tobacco control programs are effective strategies for curbing youth smoking.

  20. 9 CFR 306.2 - Program employees to have access to establishments.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Program employees to have access to establishments. 306.2 Section 306.2 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND CERTIFICATIO...

  1. 9 CFR 306.2 - Program employees to have access to establishments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Program employees to have access to establishments. 306.2 Section 306.2 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND CERTIFICATIO...

  2. 9 CFR 306.2 - Program employees to have access to establishments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Program employees to have access to establishments. 306.2 Section 306.2 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE AGENCY ORGANIZATION AND TERMINOLOGY; MANDATORY MEAT AND POULTRY PRODUCTS INSPECTION AND VOLUNTARY INSPECTION AND CERTIFICATIO...

  3. 25 CFR 170.128 - Are housing access roads and housing streets eligible for IRR Program funding?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the transportation planning process as required in subpart D, may include housing access roads and housing street projects on the Tribal Transportation Improvement Program (TTIP). IRR Program funds are...

  4. Yakima Tributary Access and Habitat Program, 2002-2003 Annual Report.

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

    Myra, D.; Ready, C.

    2003-12-01

    The Yakima Tributary Access and Habitat Program (YTAHP) was organized to restore salmonid passage to Yakima tributaries that historically supported salmonids and to improve habitat in areas where access is restored. This program intends to (a) screen unscreened diversion structures to prevent fish entrainment into artificial waterways; (b) provide for fish passage at man-made barriers, such as diversion dams, culverts, siphons and bridges; and (c) provide information and assistance to landowners interested in to contributing to the improvement of water quality, water reliability and stream habitat. The YTAHP developed from a number of groups actively engaged in watershed management, and/ormore » habitat restoration within the Yakima River Basin. These groups include the Washington State Fish and Wildlife (WDFW), Kittitas County Conservation District (KCCD), North Yakima Conservation District (NYCD), Kittitas County Water Purveyors (KCWP), and Ahtanum Irrigation District (AID). The US Bureau of Reclamation (Reclamation) and Yakama Nation (YN) both participated in the development of the objectives of YTAHP. Other entities that will be involved during permitting or project review may include the YN, the federal Natural Resources Conservation Service (NRCS), the US Fish and Wildlife Service (USFWS), the National Marine Fisheries Service (NMFS), and US Army Corps of Engineers (COE). The objectives of YTAHP are listed below and also include subtasks detailed in the report: (1) Conduct Early Action Projects; (2) Review Strategic Plan; (3) Restore Access, including stream inventory, prioritization, implementation; and (4) Provide opportunities to improve habitat and conserve resources. The BPA YTAHP funding supported activities of the program which are described in this report. These activities are primarily related to objective 1 (conduct early action projects) and parts of objectives 2-4. The work supported by YTAHP funding will support a series of scheduled projects

  5. Assessing Intermediate Outcomes of a Faith-Based Residential Prisoner Reentry Program

    ERIC Educational Resources Information Center

    Roman, Caterina G.; Wolff, Ashley; Correa, Vanessa; Buck, Janeen

    2007-01-01

    Objective: This study examined intermediate outcomes of a faith-based prisoner reentry program by assessing how client spirituality related to client- and program-level characteristics, investigating differences between completers and terminators, and examining how religious preference, religiosity/spirituality, religious salience, and…

  6. Examining the Effectiveness of a Learning Outcomes Assessment Program: A Four Frames Perspective

    ERIC Educational Resources Information Center

    Schoepp, Kevin; Tezcan-Unal, Burcu

    2017-01-01

    Assessment of learning outcomes at the program level is essential to evaluate whether students are achieving what is expected of them as graduates. In this article we present the results of a study in which faculty focus groups were consulted so as to understand the subjective issues that surround the learning outcomes assessment program of an…

  7. 76 FR 21741 - Twenty-First Century Communications and Video Programming Accessibility Act; Announcement of Town...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-18

    ... FEDERAL COMMUNICATIONS COMMISSION [DA 11-428] Twenty-First Century Communications and Video... The Twenty-First Century Communications and Video Programming Accessibility Act (the Act or CVAA... orientation to the Act, and discussed the advanced communications and video programming changes required by...

  8. Antimicrobial stewardship programs: interventions and associated outcomes.

    PubMed

    Patel, Dimple; Lawson, Wendy; Guglielmo, B Joseph

    2008-04-01

    Guidelines regarding antimicrobial stewardship programs recommend an infectious diseases-trained physician and an infectious diseases-trained pharmacist as core members. Inclusion of clinical microbiologists, infection-control practitioners, information systems experts and hospital epidemiologists is considered optimal. Recommended stewardship interventions include prospective audit and intervention, formulary restriction, education, guideline development, clinical pathway development, antimicrobial order forms and the de-escalation of therapy. The primary outcome associated with these interventions has been the associated cost savings; however, few published investigations have taken into account the overall cost of the intervention. Over the past 5 years, there has been an increased focus upon interventions intended to decrease bacterial resistance or reduce superinfection, including infections associated with Clostridium difficile colitis. Few programs have been associated with a reduction in antimicrobial drug adverse events. Antimicrobial stewardship programs are becoming increasingly associated with clear benefits and will be integral in the in-patient healthcare setting.

  9. Accessing Secondary Markets as a Capital Source for Energy Efficiency Finance Programs: Program Design Considerations for Policymakers and Administrators

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

    Kramer, C.; Martin, E. Fadrhonc; Thompson, P.

    Estimates of the total opportunity for investment in cost-effective energy efficiency in the United States are typically in the range of several hundred billion dollars (Choi Granade, et al., 2009 and Fulton & Brandenburg, 2012).1,2 To access this potential, many state policymakers and utility regulators have established aggressive energy efficiency savings targets. Current levels of taxpayer and utility bill-payer funding for energy efficiency is only a small fraction of the total investment needed to meet these targets (SEE Action Financing Solutions Working Group, 2013). Given this challenge, some energy efficiency program administrators are working to access private capital sources withmore » the aim of amplifying the funds available for investment. In this context, efficient access to secondary market capital has been advanced as one important enabler of the energy efficiency industry “at scale.”3 The question of what role secondary markets can play in bringing energy efficiency to scale is largely untested despite extensive attention from media, technical publications, advocates, and others. Only a handful of transactions of energy efficiency loan products have been executed to date, and it is too soon to draw robust conclusions from these deals. At the same time, energy efficiency program administrators and policymakers face very real decisions regarding whether and how to access secondary markets as part of their energy efficiency deployment strategy.« less

  10. The measurement of outcomes in the assessment of educational program effectiveness.

    PubMed

    Kassebaum, D G

    1990-05-01

    Postsecondary accrediting agencies recognized by the U.S. Secretary of Education and the Council on Postsecondary Accreditation, including the Liaison Committee on Medical Education (LCME), are required to evaluate educational program effectiveness by determining that institutions and programs document the achievement of their students and graduates in verifiable and consistent ways, indicating that institutional and program purposes are met. For the assessment of medical education programs this represents a departure from the traditional method of inferring quality from institutional compliance with standards for program organization and function. In the new assessment calculus, success is measured as the integrated product of the outcomes, the indicators of achievement that medical schools already are collecting from many sources, for instance, data on premedical achievement and attributes, medical school performance, graduate education ratings and test results, specialty certification, licensure, and practice. Although a recent LCME enquiry showed that 80% of U.S. medical schools were collecting outcome data on students and graduates, there was a lack of coherence and system, little integrated analysis, rare longitudinal study, and limited use of the information to evaluate and revise the curriculum or to validate admissions, promotion, and graduation criteria. The longitudinal study of the quantified results of educational programs need not resurrect old controversies about the linkage between learning in medical school and the quality of doctors' later practice. The purpose of examining outcomes is to gain sharper focus on the achievement of distinctive institutional goals, to facilitate program improvement and renewal, and to better assure the competence of graduates within the boundaries of achievement that schools have drawn as their educational objectives.

  11. Comparison between publicly accessible publications, registries, and protocols of phase III trials indicated persistence of selective outcome reporting.

    PubMed

    Zhang, Sheng; Liang, Fei; Li, Wenfeng

    2017-11-01

    The decision to make protocols of phase III randomized controlled trials (RCTs) publicly accessible by leading journals was a landmark event in clinical trial reporting. Here, we compared primary outcomes defined in protocols with those in publications describing the trials and in trial registration. We identified phase III RCTs published between January 1, 2012, and June 30, 2015, in The New England Journal of Medicine, The Lancet, The Journal of the American Medical Association, and The BMJ with available protocols. Consistency in primary outcomes between protocols and registries (articles) was evaluated. We identified 299 phase III RCTs with available protocols in this analysis. Out of them, 25 trials (8.4%) had some discrepancy for primary outcomes between publications and protocols. Types of discrepancies included protocol-defined primary outcome reported as nonprimary outcome in publication (11 trials, 3.7%), protocol-defined primary outcome omitted in publication (10 trials, 3.3%), new primary outcome introduced in publication (8 trials, 2.7%), protocol-defined nonprimary outcome reported as primary outcome in publication (4 trials, 1.3%), and different timing of assessment of primary outcome (4 trials, 1.3%). Out of trials with discrepancies in primary outcome, 15 trials (60.0%) had discrepancies that favored statistically significant results. Registration could be seen as a valid surrogate of protocol in 237 of 299 trials (79.3%) with regard to primary outcome. Despite unrestricted public access to protocols, selective outcome reporting persists in a small fraction of phase III RCTs. Only studies from four leading journals were included, which may cause selection bias and limit the generalizability of this finding. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Outcomes Program in a Small, Rural Community College.

    ERIC Educational Resources Information Center

    Carlson, Dale R.; Fleming, Donald

    Student educational outcomes and the quality of instruction are now being monitored by several programs at Worthington Community College (WCC) in southwest Minnesota. WCC, one of the 20 community colleges in the Minnesota Community College system, currently serves 875 students, and has been intensifying its efforts to serve the whole service area…

  13. Children's Program Outcome Review Team: 2001 Evaluation Results.

    ERIC Educational Resources Information Center

    Wade, Patricia C.

    In its eighth year of evaluating children's services in the state, the Children's Program Outcome Review Team (CPORT), under the direction of the Tennessee Commission on Children and Youth, continued to collect and analyze data to improve service delivery to children and families involved in state custody. Using the Quality Service Review…

  14. Italian Percutaneous EVAR (IPER) Registry: outcomes of 2381 percutaneous femoral access sites' closure for aortic stent-graft.

    PubMed

    Pratesi, G; Barbante, M; Pulli, R; Fargion, A; Dorigo, W; Bisceglie, R; Ippoliti, A; Pratesi, C

    2015-12-01

    The aim of this paper was to report outcomes of endovascular aneurysm repair with percutaneous femoral access (pEVAR) using Prostar XL and Proglide closure systems (Abbot Vascular, Santa Clara, CA, USA), from the multicenter Italian Percutaneous EVAR (IPER) registry. Consecutive patients affected by aortic pathology treated by EVAR with percutaneous access (pEVAR) between January 2010 and December 2014 at seven Italian centers were enrolled in this multicenter registry. All the operators had an experience of at least 50 percutaneous femoral access procedures. Data were prospectively collected into a dedicated online database including patient's demographics, anatomical features, intra- and postoperative outcomes. A retrospective analysis was carried out to report intraoperative and 30-day technical success and access-related complication rate. Uni- and multivariate analyses were performed to identify factors potentially associated with an increased risk of percutaneous pEVAR failure. A total of 2381 accesses were collected in 1322 patients, 1249 (94.4%) male with a mean age of 73.5±8.3 years (range 45-97). The overall technical success rate was 96.8% (2305/2381). Major intraoperative access-related complications requiring conversion to surgical cut-down were observed in 3.2% of the cases (76/2381). One-month pEVAR failure-rate was 0.25% (6/2381). Presence of femoral artery calcifications resulted to be a significant predictor of technical failure (OR: 1.69; 95% CI: 1.03-2.77; P=0.036) at multivariate analysis. No significant association was observed with sex (P=0.28), obesity (P=0.64), CFA diameter (P=0.32), level of CFA bifurcation (P=0.94) and sheath size >18 F (P=0.24). The use of Proglide was associated with a lower failure rate compared to Prostar XL (2.5% vs. 3.3%) despite not statistically significant (P=0.33). The results of the IPER registry confirm the high technical success rate of percutaneous EVAR when performed by experienced operators, even in

  15. Strength training in community settings: impact of lay leaders on program access and sustainability for rural older adults.

    PubMed

    Washburn, Lisa T; Cornell, Carol E; Phillips, Martha; Felix, Holly; Traywick, LaVona

    2014-09-01

    The effect of volunteer lay leaders on availability and sustainability of strength-training programs for older adults has not been well explored. We describe implementation of the StrongWomen strength training program by the Arkansas Cooperative Extension Service, and report on the relationship between delivery approach (agent-led, lay-led, or combination of agent- and lay-led) and program access and sustainability. All state Extension agents (n = 66) were surveyed on program implementation, continuance, and use of lay leaders. Program records were used to identify the number of trained lay leaders. Regression models were used to examine the relationship between delivery approach and group availability. Counties using lay leaders had twice as many groups as counties using only agents. There was a significant, positive relationship between the number of lay leaders and the number of groups. Counties using lay leaders were 8.3 times more likely to have continuing groups compared with counties not using lay leaders. Program continuance was significantly and positively associated with lay leader use. Lay delivery expanded access to strength training programs and increased the likelihood that programs would continue. This approach can be used to increase access to and sustainability of strength training programs, particularly in resource-constrained areas.

  16. Development and Testing of a Conceptual Model Regarding Men’s Access to Health Care

    PubMed Central

    Leone, James E.; Rovito, Michael J.; Mullin, Elizabeth M.; Mohammed, Shan D.; Lee, Christina S.

    2016-01-01

    Epidemiologic data suggest men often experience excessive morbidity and early mortality, possibly compromising family and community health over the lifespan. Moreover, the negative financial/economic consequences affected by poor male health outcomes also has been of great concern in the United States and abroad. Early and consistent access to preventative health care may improve health outcomes; however, men are far less likely to access these services. The purpose of this study was to understand what factors preclude men from accessing health care. We surveyed 485 participants using a 58-item online survey built from a conceptual model previously developed by the researchers using hegemonic masculinity theory, the theory of normative contentment, and the health belief model. For men, three items significantly (ps < .05) predicted whether they had seen a health care provider in the past year: “I/Men do not access healthcare because I do not think there is anything wrong with me,” “My health is only about me,” and “I/Men do not access healthcare because most men in my family do not access healthcare.” Other correlations of practical significance also were noted. Results suggest gender norms and masculine ideals may play a primary role in how men access preventative health care. Future programming targeting males should consider barriers and plan programs that are gender-sensitive in addition to being gender-specific. Clinical implications are discussed. PMID:27698256

  17. Maternal health behaviors and infant health outcomes among homeless mothers: U.S. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) 2000-2007.

    PubMed

    Richards, Rickelle; Merrill, Ray M; Baksh, Laurie; McGarry, Joanne

    2011-01-01

    To determine whether participation in the Women, Infants, and Children Program is associated with improved maternal and infant health outcomes among homeless women in the Pregnancy Risk Assessment Monitoring System. Analyses were based on Pregnancy Risk Assessment Monitoring System participants from 31 states/cities in the United States, 2000-2007 (n=272,859). Overall, 4% of women completing the Pregnancy Risk Assessment Monitoring System survey were homeless, with 76% participating in the Women, Infants, and Children Program, a federally-funded supplemental nutrition program for low-income women and children less than 5 years old. Among women in the Pregnancy Risk Assessment Monitoring System survey who reported using the Women, Infants, and Children Program, those experiencing homelessness were older, less educated, less likely to have private health insurance, and more likely to receive government assistance. Homeless women in the Women, Infants, and Children Program compared with those not in the program were significantly more likely to have a higher body mass index, to initiate breastfeeding after delivery, have prenatal care visits, have a longer gestational age, and have a greater infant birth weight. Characteristics of homeless pregnant women choosing to participate in the Women, Infants, and Children Program are consistent with the requirements for program participation for women in general. Homeless women accessing the Women, Infants, and Children Program had better maternal and infant health outcomes. Copyright © 2010 Elsevier Inc. All rights reserved.

  18. mobile Digital Access to a Web-enhanced Network (mDAWN): Assessing the Feasibility of Mobile Health Tools for Self-Management of Type-2 Diabetes.

    PubMed

    Ho, Kendall; Newton, Lana; Boothe, Allison; Novak-Lauscher, Helen

    2015-01-01

    The mobile Digital Access to a Web-enhanced Network (mDAWN) program was implemented as an online, mobile self-management system to support patients with type-2 diabetes and their informal caregivers. Patients used wireless physiological sensors, received text messages, and had access to a secure web platform with health resources and semi-facilitated discussion forum. Outcomes were evaluated using (1) pre and post self-reported health behavior measures, (2) physiological outcomes, (3) program cost, and (4) in-depth participant interviews. The group had significantly decreased health distress, HbA1c levels, and systolic blood pressure. Participants largely saw the mDAWN as providing good value for the costs involved and found the program to be empowering in gaining control over their diabetes. mHealth programs have the potential to improve clinical outcomes through cost effective patient-led care for chronic illness. Further evaluation needs to examine integration of similar mHealth programs into the patient-physician relationship.

  19. Metrics for DoD Mental Health Preclinical Program Effectiveness and Clinical Program Outcomes

    DTIC Science & Technology

    2010-06-08

    Program Outcomes 13. Tue Subcommittee understands that the tenn "pre-clinical" has two meanings, one broad (a), and one specific (b): a. Any...questions) During your deployment, were you forced or pressured into having sex ? During your deployment, did someone use force or the threat of force to

  20. Effect of universal MODS access on pulmonary tuberculosis treatment outcomes in new patients in Peru

    PubMed Central

    Alarcón, E.; Alarcón, V.; Bissell, K.; Castillo, E.; Sabogal, I.; Mora, J.; Moore, D.; Harries, A. D.

    2012-01-01

    Setting: Primary health care centres in Callao, Peru. Objectives: To evaluate the effect of universal access to the microscopic-observation drug susceptibility (MODS) assay on treatment outcomes in new and primary multidrug-resistant tuberculosis (MDR-TB) patients and on the process of drug susceptibility testing (DST). Design: Retrospective review of tuberculosis (TB) registers and clinical records before (2007) and after (2009) the introduction of MODS in 2008. Results: There were 281 patients in each cohort. Favourable treatment outcomes for 2007 (81%) and 2009 (77%) cohorts were similar. There was an increase in loss to follow-up (from 6% to 10%, P = 0.04) and a reduction in failure rates (from 4% to 0.4%, P = 0.01) in the 2009 compared with the 2007 cohort. In new MDR-TB cases (n = 22), a favourable treatment outcome was improved (from 46% to 82%, P = 0.183) in the 2009 cohort. DST coverage improved (from 24% to 74%, P < 0.001), and a significant reduction in time to diagnosis of drug-susceptible (from 118 to 33 days, P < 0.001) and MDR-TB (from 158 to 52 days, P = 0.003) was observed in the 2009 cohort. Conclusion: Universal access to MODS increased DST coverage, reduced the time required to obtain DST results and was associated with reduced failure rates. MODS can make an important contribution to TB management and control in Peru. PMID:24579063

  1. Open-Access Physical Activity Programs for Older Adults: A Pragmatic and Systematic Review.

    PubMed

    Balis, Laura E; Strayer, Thomas; Ramalingam, NithyaPriya; Wilson, Meghan; Harden, Samantha M

    2018-01-10

    Open-access, community-based programs are recommended to assist older adults in meeting physical activity guidelines, but the characteristics, impact, and scalability of these programs is less understood. The Land-Grant University Cooperative Extension System, an organization providing education through county-based educators, functions as a delivery system for these programs. A systematic review was conducted to determine characteristics of effective older adult physical activity programs and the extent to which programs delivered in Extension employ these characteristics. A systematic review of peer-reviewed and grey literature was conducted from August 2016 to February 2017. The review was limited to open-access (available to all), community-based physical activity interventions for older adults (≥65 years of age). The peer-reviewed literature search was conducted in PubMed and EBSCOhost; the grey literature search for Extension interventions was conducted through Extension websites, Land-Grant Impacts, and the Journal of Extension. Sixteen peer-reviewed studies and 17 grey literature sources met inclusion criteria and were analyzed. Peer-reviewed and Extension programs were similar in their limited use of behavioral theories and group-based strategies. Compared to Extension programs, those in the peer-reviewed literature were more likely to use a combination of physical activity components and be delivered by trained professionals. The results indicate notable differences between peer-reviewed literature and Extension programs and present an opportunity for Extension programs to more effectively use evidence-based program characteristics, including behavioral theories and group dynamics, a combination of physical activity components, and educator/agent-trained delivery agents. © The Author(s) 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Utilizing Quality Improvement Methods to Improve Patient Care Outcomes in a Pediatric Residency Program

    PubMed Central

    Akins, Ralitsa B.; Handal, Gilbert A.

    2009-01-01

    Objective Although there is an expectation for outcomes-oriented training in residency programs, the reality is that few guidelines and examples exist as to how to provide this type of education and training. We aimed to improve patient care outcomes in our pediatric residency program by using quality improvement (QI) methods, tools, and approaches. Methods A series of QI projects were implemented over a 3-year period in a pediatric residency program to improve patient care outcomes and teach the residents how to use QI methods, tools, and approaches. Residents experienced practice-based learning and systems-based assessment through group projects and review of their own patient outcomes. Resident QI experiences were reviewed quarterly by the program director and were a mandatory part of resident training portfolios. Results Using QI methodology, we were able to improve management of children with obesity, to achieve high compliance with the national patient safety goals, improve the pediatric hotline service, and implement better patient flow in resident continuity clinic. Conclusion Based on our experiences, we conclude that to successfully implement QI projects in residency programs, QI techniques must be formally taught, the opportunities for resident participation must be multiple and diverse, and QI outcomes should be incorporated in resident training and assessment so that they experience the benefits of the QI intervention. The lessons learned from our experiences, as well as the projects we describe, can be easily deployed and implemented in other residency programs. PMID:21975995

  3. After abduction: exploring access to reintegration programs and mental health status among young female abductees in Northern Uganda

    PubMed Central

    2014-01-01

    Background Reintegration programs are commonly offered to former combatants and abductees to acquire civilian status and support services to reintegrate into post-conflict society. Among a group of young female abductees in northern Uganda, this study examined access to post-abduction reintegration programming and tested for between group differences in mental health status among young women who had accessed reintegration programming compared to those who self-reintegrated. Methods This cross-sectional study analysed interviews from 129 young women who had previously been abducted by the Lords Resistance Army (LRA). Data was collected between June 2011-January 2012. Interviews collected information on abduction-related experiences including age and year of abduction, manner of departure, and reintegration status. Participants were coded as ‘reintegrated’ if they reported ≥1 of the following reintegration programs: traditional cleansing ceremony, received an amnesty certificate, reinsertion package, or had gone to a reception centre. A t-test was used to measure mean differences in depression and anxiety measured by the Acholi Psychosocial Assessment Instrument (APAI) to determine if abductees who participated in a reintegration program had different mental status from those who self-reintegrated. Results From 129 young abductees, 56 (43.4%) had participated in a reintegration program. Participants had been abducted between 1988–2010 for an average length of one year, the median age of abduction was 13 years (IQR:11–14) with escaping (76.6%), being released (15.6%), and rescued (7.0%) being the most common manner of departure from the LRA. Traditional cleansing ceremonies (67.8%) were the most commonly accessed support followed by receiving amnesty (37.5%), going to a reception centre (28.6%) or receiving a reinsertion package (12.5%). Between group comparisons indicated that the mental health status of abductees who accessed ≥1 reintegration program

  4. The Interplay of Socioeconomic Status, Distance to Center, and Interdonor Service Area Travel on Kidney Transplant Access and Outcomes

    PubMed Central

    Axelrod, David A.; Dzebisashvili, Nino; Schnitzler, Mark A.; Salvalaggio, Paolo R.; Segev, Dorry L.; Gentry, Sommer E.; Tuttle-Newhall, Janet

    2010-01-01

    Background and objectives: Variation in kidney transplant access across the United States may motivate relocation of patients with ability to travel to better-supplied areas. Design, setting, participants, & measurements: We examined national transplant registry and U.S. Census data for kidney transplant candidates listed in 1999 to 2009 with a reported residential zip code (n = 203,267). Cox's regression was used to assess associations of socioeconomic status (SES), distance from residence to transplant center, and relocation to a different donation service area (DSA) with transplant access and outcomes. Results: Patients in the highest SES quartile had increased access to transplant compared with those with lowest SES, driven strongly by 76% higher likelihood of living donor transplantation (adjusted hazard ratio [aHR] 1.76, 95% confidence interval [CI] 1.70 to 1.83). Waitlist death was reduced in high compared with low SES candidates (aHR 0.86, 95% CI 0.84 to 0.89). High SES patients also experienced lower mortality after living and deceased donor transplant. Patients living farther from the transplant center had reduced access to deceased donor transplant and increased risk of post-transplant death. Inter-DSA travel was associated with a dramatic increase in deceased donor transplant access (HR 1.94, 95% CI 1.88 to 2.00) and was predicted by high SES, white race, and longer deceased-donor allograft waiting time in initial DSA. Conclusions: Ongoing disparities exist in kidney transplantation access and outcomes on the basis of geography and SES despite near-universal insurance coverage under Medicare. Inter-DSA travel improves access and is more common among high SES candidates. PMID:20798250

  5. Delivery and Outcomes of a Yearlong Home Exercise Program After Hip Fracture

    PubMed Central

    Orwig, Denise L.; Hochberg, Marc; Yu-Yahiro, Janet; Resnick, Barbara; Hawkes, William G.; Shardell, Michelle; Hebel, J. Richard; Colvin, Perry; Miller, Ram R.; Golden, Justine; Zimmerman, Sheryl; Magaziner, Jay

    2011-01-01

    Background Hip fracture affects more than 1.6 million persons worldwide and causes substantial changes in body composition, function, and strength. Usual care (UC) has not successfully restored function to most patients, and prior research has not identified an effective restorative program. Our objective was to determine whether a yearlong home-based exercise program initiated following UC could be administered to older patients with hip fracture and improve outcomes. Methods A randomized controlled trial of 180 community dwelling female patients with hip fracture, 65 years and older, randomly assigned to intervention (n=91) or UC (n=89). Patients were recruited within 15 days of fracture from 3 Baltimore-area hospitals from November 1998 through September 2004. Follow-up assessments were conducted at 2, 6, and 12 months after fracture. The Exercise Plus Program was administered by exercise trainers that included supervised and independently performed aerobic and resistive exercises with increasing intensity. Main outcome measures included bone mineral density of the contralateral femoral neck. Other outcomes included time spent and kilocalories expended in physical activity using the Yale Physical Activity Scale, muscle mass and strength, fat mass, activities of daily living, and physical and psychosocial functioning. The effect of intervention for each outcome was estimated by the difference in outcome trajectories 2 to 12 months after fracture. Results More than 80% of participants received trainer visits, with the majority receiving more than 3 quarters (79%) of protocol visits. The intervention group reported more time spent in exercise activity during follow-up (P<.05). Overall, small effect sizes of 0 to 0.2 standard deviations were seen for bone mineral density measures, and no significant patterns of time-specific between-group differences were observed for the remaining outcome measures. Conclusion Patients with hip fracture who participate in a yearlong

  6. Mission Indicators of Success Outcomes Report, 2000/2001.

    ERIC Educational Resources Information Center

    Pima Community Coll., Tucson, AZ. Office of Institutional Research.

    This report on outcomes of education for Pima Community College (PCC) in Arizona discusses 10 of PCC's success indicators: (1) PCC students and employees will reflect the diversity of the community; (2) students will find the college's programs and services accessible and competitively affordable among Arizona community colleges; (3) college…

  7. An Analysis of the Effects of Program Structure and Content on Outcomes of Community Leadership Education Programs

    ERIC Educational Resources Information Center

    Apaliyah, Godwin Tayese

    2011-01-01

    This study examined community leadership education programs employed in rural communities and organizations of several states to empower both local leaders and residents. In particular, the study investigated the relationships between community leadership education program design and structure (contact hours and content) and six outcome indices of…

  8. Potential access to primary health care: what does the National Program for Access and Quality Improvement data show?

    PubMed Central

    Uchôa, Severina Alice da Costa; Arcêncio, Ricardo Alexandre; Fronteira, Inês Santos Estevinho; Coêlho, Ardigleusa Alves; Martiniano, Claudia Santos; Brandão, Isabel Cristina Araújo; Yamamura, Mellina; Maroto, Renata Melo

    2016-01-01

    Objective: to analyze the influence of contextual indicators on the performance of municipalities regarding potential access to primary health care in Brazil and to discuss the contribution from nurses working on this access. Method: a multicenter descriptive study based on secondary data from External Evaluation of the National Program for Access and Quality Improvement in Primary Care, with the participation of 17,202 primary care teams. The chi-square test of proportions was used to verify differences between the municipalities stratified based on size of the coverage area, supply, coordination, and integration; when necessary, the chi-square test with Yates correction or Fisher's exact test were employed. For the population variable, the Kruskal-Wallis test was used. Results: the majority of participants were nurses (n=15.876; 92,3%). Statistically significant differences were observed between the municipalities in terms of territory (p=0.0000), availability (p=0.0000), coordination of care (p=0.0000), integration (p=0.0000) and supply (p=0.0000), verifying that the municipalities that make up area 6 tend to have better performance in these dimensions. Conclusion: areas 4,5 and 6 performed better in every analyzed dimension, and the nurse had a leading role in the potential to access primary health care in Brazil. PMID:26959332

  9. 76 FR 17738 - Over-the-Road Bus Accessibility Program Announcement of Project Selections

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-30

    ... Transportation Equity Act for the 21st Century (TEA-21). The OTRB Accessibility Program makes funds available to... to any new vehicles delivered on or after June 9, 1998, the effective date of TEA-21, is eligible for...

  10. Federal transit administration : progress and challenges in implementing and evaluating the job access and reverse commute program.

    DOT National Transportation Integrated Search

    2010-05-01

    Established in 1998, the Job Access and Reverse Commute Program (JARC)administered by the Federal Transit Administration (FTA)awards grants to states and localities to provide transportation to help low-income individuals access jobs. In 2005, ...

  11. Does decreased access to emergency departments affect patient outcomes? Analysis of acute myocardial infarction population 1996-2005.

    PubMed

    Shen, Yu-Chu; Hsia, Renee Y

    2012-02-01

    We analyze whether decreased emergency department (ED) access results in adverse patient outcomes or changes in the patient health profile for patients with acute myocardial infarction (AMI). We merge Medicare claims, American Hospital Association annual surveys, Medicare hospital cost reports, and location information for 1995-2005. We define four ED access change categories and estimate a ZIP Code fixed-effects regression models on the following AMI outcomes: mortality rates, age, and probability of percutaneous transluminal coronary angioplasty (PTCA) on day of admission. We find a small increase in 30-day to 1-year mortality rates among patients in communities that experience a <10-minute increase in driving time. Among patients in communities with >30-minute increases, we find a substantial increase in long-term mortality rates, a shift to younger ages (suggesting that older patients die en route), and a higher probability of immediate PTCA. Most of the adverse effects disappear after the transition years. Deterioration in geographic access to ED affects a small segment of the population, and most adverse effects are transitory. Policy planners can minimize the adverse effects by providing assistance to ensure adequate capacity of remaining EDs, and facilitating the realignment of health care resources during the critical transition periods. © Health Research and Educational Trust.

  12. Branding MBA Programs: The Use of Target Market Desired Outcomes for Effective Brand Positioning

    ERIC Educational Resources Information Center

    Heslop, Louise A.; Nadeau, John

    2010-01-01

    Branding is about delivering on desired outcomes. The importance of positioning program offerings on the basis of outcomes sought in the education market is illustrated in this study of choice of an MBA program by prospective students. MBA fair attendees were surveyed and multiple methods were employed to determine the importance of desired…

  13. The association between alcohol outlet accessibility and adverse birth outcomes: A retrospective cohort study.

    PubMed

    Seabrook, J A; Woods, N; Clark, A; de Vrijer, B; Penava, D; Gilliland, J

    2018-01-01

    Alcohol outlet accessibility is positively associated with alcohol consumption, although this relationship has not been thoroughly examined in pregnant women. The present study examines the relationship between proximity and density of alcohol outlets and risk for low birth weight (LBW: <2,500 grams) and preterm birth (PTB: <37 weeks gestational age), and is the first Canadian study to investigate this association. Maternal accessibility to alcohol outlets was specified using a gravity-type measure of accessibility, which provides the amount of accessibility that a given household has to liquor stores within 30-minutes of their home. All singleton newborns without congenital anomalies that were born between February 2009 and February 2014 at London Health Sciences Centre in London, Ontario, were included in this cohort. The sample consisted of 25,734 live births, of which 5.8% were LBW and 7.6% were PTB. Only 2.0% of women reported alcohol use during pregnancy. Alcohol outlet gravity was positively correlated with the percentage of mothers living in poverty (rs = 0.33, p < 0.001) and in single-parent families (rs = 0.39, p < 0.001), and who self-identify as visible minorities (rs = 0.45, p < 0.001). Alcohol outlet gravity increased the odds that mothers drank alcohol during pregnancy (OR 1.05; 95% CI: 1.02, 1.07), although the association was weak. Furthermore, alcohol outlet gravity did not increase the likelihood of a LBW or PTB infant. Women with high accessibility to alcohol outlets are more likely to consume alcohol during pregnancy, but greater alcohol outlet accessibility does not translate into poor birth outcomes.

  14. Outcomes of Community-Based Prenatal Education Programs for Pregnant Women in Rural Texas.

    PubMed

    Ramsey, Joseph; Mayes, Brandii

    A prenatal, evidenced-based education program was implemented in 7 rural counties and provided by trained staff at the Texas Department of State Health Services. This was implemented to address health disparities, in regard to birth outcomes, in rural minorities of Southeast Texas. The participants were given a preassessment (N = 382) and a postassessment (N = 326) of relevant health knowledge and a follow-up assessment (N = 149) to document the outcomes of their birth as well as health practices they were employing as new parents. The assessment results were analyzed to determine the effectiveness of the programs on improving health outcomes and knowledge.

  15. Special delivery: an analysis of mHealth in maternal and newborn health programs and their outcomes around the world.

    PubMed

    Tamrat, Tigest; Kachnowski, Stan

    2012-07-01

    Mobile health (mHealth) encompasses the use of mobile telecommunication and multimedia into increasingly mobile and wireless health care delivery systems and has the potential to improve tens of thousands of lives each year. The ubiquity and penetration of mobile phones presents the opportunity to leverage mHealth for maternal and newborn care, particularly in under-resourced health ecosystems. Moreover, the slow progress and funding constraints in attaining the Millennium Development Goals for child and maternal health encourage harnessing innovative measures, such as mHealth, to address these public health priorities. This literature review provides a schematic overview of the outcomes, barriers, and strategies of integrating mHealth to improve prenatal and neonatal health outcomes. Six electronic databases were methodically searched using predetermined search terms. Retrieved articles were then categorized according to themes identified in previous studies. A total of 34 articles and reports contributed to the findings with information about the use and limitations of mHealth for prenatal and neonatal healthcare access and delivery. Health systems have implemented mHealth programs to facilitate emergency medical responses, point-of-care support, health promotion and data collection. However, the policy infrastructure for funding, coordinating and guiding the sustainable adoption of prenatal and neonatal mHealth services remains under-developed. The integration of mobile health for prenatal and newborn health services has demonstrated positive outcomes, but the sustainability and scalability of operations requires further feedback from and evaluation of ongoing programs.

  16. Early Exposure to Research: Outcomes of the ASTER Certification Program

    ERIC Educational Resources Information Center

    Griffard, Phyllis Baudoin; Golkowska, Krystyna

    2013-01-01

    This paper discusses a novel structure for providing a high-impact, first year experience for science students. ASTER (Access to Science Through Experience in Research) is an extracurricular certification program designed to introduce our students to the research culture via seminar attendance, journal clubs, book clubs, and lab visits.…

  17. Random-access technique for modular bathymetry data storage in a continental shelf wave refraction program

    NASA Technical Reports Server (NTRS)

    Poole, L. R.

    1974-01-01

    A study was conducted of an alternate method for storage and use of bathymetry data in the Langley Research Center and Virginia Institute of Marine Science mid-Atlantic continental-shelf wave-refraction computer program. The regional bathymetry array was divided into 105 indexed modules which can be read individually into memory in a nonsequential manner from a peripheral file using special random-access subroutines. In running a sample refraction case, a 75-percent decrease in program field length was achieved by using the random-access storage method in comparison with the conventional method of total regional array storage. This field-length decrease was accompanied by a comparative 5-percent increase in central processing time and a 477-percent increase in the number of operating-system calls. A comparative Langley Research Center computer system cost savings of 68 percent was achieved by using the random-access storage method.

  18. 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.

  19. Shared medical appointments: improving access, outcomes, and satisfaction for patients with chronic cardiac diseases.

    PubMed

    Bartley, Kelly Bauer; Haney, Rebecca

    2010-01-01

    Improving access to care, health outcomes, and patient satisfaction are primary objectives for healthcare practices. This article outlines benefits, concerns, and possible challenges of shared medical appointments (SMAs) for patients and providers. The SMA model was designed to support providers' demanding schedules by allowing patients with the same chronic condition to be seen in a group setting. By concentrating on patient education and disease management, interactive meetings provide an opportunity for patients to share both successes and struggles with others experiencing similar challenges. Studies demonstrated that SMAs improved patient access, enhanced outcomes, and promoted patient satisfaction. This article describes the potential benefits of SMAs for patients with chronic heart disease, which consumes a large number of healthcare dollars related to hospital admissions, acute exacerbations, and symptom management. Education for self-management of chronic disease can become repetitive and time consuming. The SMA model introduces a fresh and unique style of healthcare visits, allowing providers to devote more time and attention to patients and improve productivity. The SMA model provides an outstanding method for nurse practitioners to demonstrate their role as a primary care provider, by leading patients in group discussions and evaluating their current health status. Patient selection, preparation, and facilitation of an SMA are discussed to demonstrate the complementary nature of an SMA approach in a healthcare practice.

  20. Characteristics and Outcomes of an Innovative Train-in-Place Residency Program.

    PubMed

    Green-McKenzie, Judith; Emmett, Edward A

    2017-10-01

    Physicians who make a midcareer specialty change may find their options for formal training are limited. Here, we describe a train-in-place program, with measureable outcomes, created to train midcareer physicians who desire formal training in occupational medicine. We evaluated educational outcomes from a novel residency program for midcareer physicians seeking formal training and board certification in occupational medicine. Physicians train in place at selected clinical training sites where they practice, and participate in 18 visits to the primary training site over a 2-year period. Program components include competency-based training structured around rotations, mentored projects, and periodic auditing visits to train-in-site locations by program faculty. Main outcome measures are achievement of Accreditation Council for Graduate Medical Education Occupational Medicine Milestones, American College of Occupational and Environmental Medicine competencies, performance on the American College of Preventive Medicine examinations, diversity in selection, placement of graduates, and the number of graduates who remain in the field. Since inception of this program in 1997, there have been 109 graduates who comprise 7.2% of new American Board of Preventive Medicine diplomates over the past decade. Graduates scored competitively on the certifying examination, achieved all milestones, expressed satisfaction with training, and are geographically dispersed, representing every US region. Most practice outside the 25 largest standard metropolitan statistical areas. More than 95% have remained in the field. Training in place is an effective approach to provide midcareer physicians seeking comprehensive skills and board certification in occupational medicine formal training, and may be adaptable to other specialties.