Sample records for access transmission service

  1. FERC examines transmission access pricing policies

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

    Burkhart, L.A.

    1993-02-15

    The Federal Energy Regulatory Commission (FERC) has approved two orders dealing with transmission pricing issues that evolved from its March 1992 Pennsylvania Electric Co. (Penelec) decision dealing with cost recovery of transmission plant expansion. Commissioner Betsy Moler said the cases represented the first time the FERC has used incremental rates for wheeling transactions. In the first new order, Public Service Electric Gas Co. proposed charging for third-party transmission services to recover the sum of its standard embedded cost rate and the net incremental cost of making upgrades to its integrated transmission system. Public Service sought to provide service to EEAmore » I Limited, which proposed building and operating a cogeneration facility at a United States Gypsum Co. plant in New Jersey. Consolidated Edison Company of New York Inc. had agreed to purchase the project's output. In rejecting Public Service's proposal, the FERC ruled the utility must charge a transmission rate that is the higher of either its embedded cost rate or its incremental cost rate of accelerated expansion. (In this instance, the incremental rate was higher). In the second new order, Public Service Co. of Colorado (PSCC) filed a proposed open access transmission service tariff related to its acquisition of facilities from Colorado-Ute Electric Association Inc. The FERC rejected PSCC's tariff request that would have required a new transmission customer (in the event PSCC modified its integrated transmission grid) to pay the sum of PSCC's standard transmission rate (reflecting the average cost of the grid facilities) plus the expansion cost (reflecting the incremental facility cost).« less

  2. Operating a transmission company under open access: The basic requirements

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

    Hunt, S.; Shuttleworth, G.

    1993-03-01

    In both Europe and North America, technical and legal changes are increasing the opportunities for electricity traders to use transmission lines and grids that are owned by other companies. This article discusses the view that transmission maybe a service potentially separable from the production and retailing of electricity, and that transmission should be freely available at an appropriate price. Grid operators are wary of proposals to open access to transmission. European legislators want grid operators to become Transmission System Operators (TSO), moving energy around the network for others. Also discussed in this article are the powers that the TSO shouldmore » be allowed to exercise if access to transmission is made available.« less

  3. Stigma as experienced by women accessing prevention of parent to child transmission of HIV services in Karnataka, India

    PubMed Central

    Rahangdale, Lisa; Banandur, Pradeep; Sreenivas, Amita; Turan, Janet; Washington, Reynold; Cohen, Craig R.

    2010-01-01

    In Karnataka, India only one-third of HIV-infected pregnant women received antiretroviral prophylaxis at delivery in 2007 through the state government’s prevention of parent-to-child HIV transmission (PPTCT) program. The current qualitative study explored the role of HIV-associated stigma as a barrier to accessing PPTCT services in the rural northern Karnataka district of Bagalkot using in depth interviews and focus group discussions with HIV-infected women who had participated in the PPTCT program, male and female family members, and HIV service providers. Participants discussed personal experiences, community perceptions of HIV, and decision-making related to accessing PPTCT services. They described stigma towards HIV-infected individuals from multiple sources: healthcare workers, community members, family and self. Stigma-related behaviors were based on fears of HIV transmission through personal contact and moral judgment. Experience and/or fears of discrimination led pregnant women to avoid using PPTCT interventions. Government, cultural and historical factors are described as the roots of much the stigma-related behavior in this setting. Based on these formative data, PPTCT program planners should consider further research and interventions aimed at diminishing institutional and interpersonal HIV-associated stigma experienced by pregnant women. PMID:20635247

  4. Increasing access to prevention of mother-to-child transmission of HIV services through the private sector in Uganda.

    PubMed

    Mbonye, A K; Hansen, K S; Wamono, F; Magnussen, P

    2009-12-01

    To explore whether private midwives can perform HIV counselling and testing, provide antiretroviral treatment and contraceptives, and how this affects access to services especially among young and HIV-positive women. A formative study was conducted between January and April 2009 to assess care-seeking practices and perceptions on the prevention of mother-to-child transmission (PMTCT) and family planning services in Wakiso district, central Uganda. A household survey supplemented by 12 focus group discussions and 66 key informant interviews was carried out between January and April 2009. 10,706 women, mean age 25.8 years (14-49 years) were interviewed. The majority of women, 4786 (57%) were in the lowest wealth quintile; 62.0% were not using family planning (p<0.000); 56.2% did not access HIV counselling and testing because they feared knowing their HIV status (p<0.013), while 66.5% feared spouses knowing their HIV status (p<0.013). Access to these services among the young women and those with no education was also poor. Private midwives provide HIV testing to 7.8% of their clients; 5.9% received antiretroviral drugs and 8.6% received contraceptives. Client satisfaction with services at private midwifery practices was high. Private midwives are trusted and many clients confide in them. An intervention through private midwives was perceived to improve access because of short distances and no transport costs. Adolescents prioritized confidentiality, while subsidizing costs, community sensitisation and focusing on male spouses were overwhelmingly recommended. Private midwives clinics are potential delivery outlets for PMTCT in Uganda. A well-designed intervention linking them to the public sector and the community could increase access to services.

  5. Sliceable transponders for metro-access transmission links

    NASA Astrophysics Data System (ADS)

    Wagner, C.; Madsen, P.; Spolitis, S.; Vegas Olmos, J. J.; Tafur Monroy, I.

    2015-01-01

    This paper presents a solution for upgrading optical access networks by reusing existing electronics or optical equipment: sliceable transponders using signal spectrum slicing and stitching back method after direct detection. This technique allows transmission of wide bandwidth signals from the service provider (OLT - optical line terminal) to the end user (ONU - optical network unit) over an optical distribution network (ODN) via low bandwidth equipment. We show simulation and experimental results for duobinary signaling of 1 Gbit/s and 10 Gbit/s waveforms. The number of slices is adjusted to match the lowest analog bandwidth of used electrical devices and scale from 2 slices to 10 slices. Results of experimental transmission show error free signal recovery by using post forward error correction with 7% overhead.

  6. Accessibility, Textbooks, and Access Services

    ERIC Educational Resources Information Center

    Kahler, Janice E.

    2017-01-01

    Putting access in Access Services is the goal. The Course Reserves unit is the place. Textbooks are the focus. Electronic technologies are the future. Patron-centric services will be our standard. Access to textbooks by all patrons will be the achievement. Course Reserves located in Library West at the University of Florida George A. Smathers…

  7. 75 FR 13299 - Lower Colorado River Authority Transmission Services Corporation; Construction, Operation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-19

    ...] Lower Colorado River Authority Transmission Services Corporation; Construction, Operation, Maintenance... activities associated with LCRA TSC's construction, maintenance, operation, and repair of four Competitive..., substation upgrades, and access roads) required to be constructed by the Public Utility Commission of Texas...

  8. The cost of accessing infant HIV medications and health services in Uganda.

    PubMed

    Bergmann, Julie N; Wanyenze, Rhoda K; Stockman, Jamila K

    2017-11-01

    Patient costs are a critical barrier to the elimination of mother to child HIV transmission. Despite the Ugandan government providing free public HIV services, infant antiretroviral (ARV) prophylaxis coverage remains low (25%). To understand costs mothers incur in accessing ARV prophylaxis for their infants, we conducted a mixed methods study to quantify and identify their direct costs. We used cross-sectional survey data and focus group discussions from 49 HIV-positive mothers in Uganda. Means and standard deviations were calculated for the direct costs (e.g., transportation, caretaker, services/medications) involved in accessing infant HIV services. The direct cost of attending HIV clinic visits averaged $3.71 (SD = $3.52). Focus group discussions identified two costs hindering access to infant HIV services: transportation costs and informal service charges. All participants reported significant costs associated with accessing infant HIV services - the equivalent of 2-3 days' income. To address transportation costs, community and home care models should be explored. Additionally, stricter policies and oversight should be implemented to prevent informal HIV service charges.

  9. 18 CFR 2.20 - Good faith requests for transmission services and good faith responses by transmitting utilities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... section 212 of the FPA, access to the electric transmission system for the purposes of wholesale... on its transmission system. (5) The names of any other parties likely to provide transmission service... requirement by specifying a rate methodology (e.g., embedded or incremental cost) or by referencing an...

  10. 18 CFR 35.28 - Non-discriminatory open access transmission tariff.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Non-discriminatory open... AND TARIFFS Other Filing Requirements § 35.28 Non-discriminatory open access transmission tariff. (a... concerns regarding unnecessary market inefficiencies. (c) Non-discriminatory open access transmission...

  11. Accessible transit services for all.

    DOT National Transportation Integrated Search

    2014-12-01

    Ensuring the provision of accessible transit services for all requires that both accessible fixed-route transit services and Americans with Disabilities Act (ADA) complementary paratransit services be provided. Significant progress has been made on b...

  12. A service-oriented data access control model

    NASA Astrophysics Data System (ADS)

    Meng, Wei; Li, Fengmin; Pan, Juchen; Song, Song; Bian, Jiali

    2017-01-01

    The development of mobile computing, cloud computing and distributed computing meets the growing individual service needs. Facing with complex application system, it's an urgent problem to ensure real-time, dynamic, and fine-grained data access control. By analyzing common data access control models, on the basis of mandatory access control model, the paper proposes a service-oriented access control model. By regarding system services as subject and data of databases as object, the model defines access levels and access identification of subject and object, and ensures system services securely to access databases.

  13. Allocation and management issues in multiple-transaction open access transmission networks

    NASA Astrophysics Data System (ADS)

    Tao, Shu

    This thesis focuses on some key issues related to allocation and management by the independent grid operator (IGO) of unbundled services in multiple-transaction open access transmission networks. The three unbundled services addressed in the thesis are transmission real power losses, reactive power support requirements from generation sources, and transmission congestion management. We develop the general framework that explicitly represents multiple transactions undertaken simultaneously in the transmission grid. This framework serves as the basis for formulating various problems treated in the thesis. We use this comprehensive framework to develop a physical-flow-based mechanism to allocate the total transmission losses to each transaction using the system. An important property of the allocation scheme is its capability to effectively deal with counter flows that result in the presence of specific transactions. Using the loss allocation results as the basis, we construct the equivalent loss compensation concept and apply it to develop flexible and effective procedures for compensating losses in multiple-transaction networks. We present a new physical-flow-based mechanism for allocating the reactive power support requirements provided by generators in multiple-transaction networks. The allocatable reactive support requirements are formulated as the sum of two specific components---the voltage magnitude variation component and the voltage angle variation component. The formulation utilizes the multiple-transaction framework and makes use of certain simplifying approximations. The formulation leads to a natural allocation as a function of the amount of each transaction. The physical interpretation of each allocation as a sensitivity of the reactive output of a generator is discussed. We propose a congestion management allocation scheme for multiple-transaction networks. The proposed scheme determines the allocation of congestion among the transactions on a physical

  14. Service composition towards increasing end-user accessibility.

    PubMed

    Kaklanis, Nikolaos; Votis, Konstantinos; Tzovaras, Dimitrios

    2015-01-01

    This paper presents the Cloud4all Service Synthesizer Tool, a framework that enables efficient orchestration of accessibility services, as well as their combination into complex forms, providing more advanced functionalities towards increasing the accessibility of end-users with various types of functional limitations. The supported services are described formally within an ontology, enabling, thus, semantic service composition. The proposed service composition approach is based on semantic matching between services specifications on the one hand and user needs/preferences and current context of use on the other hand. The use of automatic composition of accessibility services can significantly enhance end-users' accessibility, especially in cases where assistive solutions are not available in their device.

  15. A transaction assessment method for allocation of transmission services

    NASA Astrophysics Data System (ADS)

    Banunarayanan, Venkatasubramaniam

    The purpose of this research is to develop transaction assessment methods for allocating transmission services that are provided by an area/utility to power transactions. Transmission services are the services needed to deliver, or provide the capacity to deliver, real and reactive power from one or more supply points to one or more delivery points. As the number of transactions increase rapidly in the emerging deregulated environment, accurate quantification of the transmission services an area/utility provides to accommodate a transaction is becoming important, because then appropriate pricing schemes can be developed to compensate for the parties that provide these services. The Allocation methods developed are based on the "Fair Resource Allocation Principle" and they determine for each transaction the following: the flowpath of the transaction (both real and reactive power components), generator reactive power support from each area/utility, real power loss support from each area/utility. Further, allocation methods for distributing the cost of relieving congestion on transmission lines caused by transactions are also developed. The main feature of the proposed methods is representation of actual usage of the transmission services by the transactions. The proposed method is tested extensively on a variety of systems. The allocation methods developed in this thesis for allocation of transmission services to transactions is not only useful in studying the impact of transactions on a transmission system in a multi-transaction case, but they are indeed necessary to meet the criteria set forth by FERC with regard to pricing based on actual usage. The "consistency" of the proposed allocation methods has also been investigated and tested.

  16. BioServices: a common Python package to access biological Web Services programmatically.

    PubMed

    Cokelaer, Thomas; Pultz, Dennis; Harder, Lea M; Serra-Musach, Jordi; Saez-Rodriguez, Julio

    2013-12-15

    Web interfaces provide access to numerous biological databases. Many can be accessed to in a programmatic way thanks to Web Services. Building applications that combine several of them would benefit from a single framework. BioServices is a comprehensive Python framework that provides programmatic access to major bioinformatics Web Services (e.g. KEGG, UniProt, BioModels, ChEMBLdb). Wrapping additional Web Services based either on Representational State Transfer or Simple Object Access Protocol/Web Services Description Language technologies is eased by the usage of object-oriented programming. BioServices releases and documentation are available at http://pypi.python.org/pypi/bioservices under a GPL-v3 license.

  17. Accessible Bus Service in Palm Beach County, Florida

    DOT National Transportation Integrated Search

    1983-03-01

    The Palm Beach County Transportation Authority introduced accessible fixed-route service on its countywide CoTran bus service in May 1980. CoTran provided 100% (full-fleet) accessible service, using 23 retrofitted buses and 40 new buses, all equipped...

  18. Limited accessibility to HIV services for persons with disabilities living with HIV in Ghana, Uganda and Zambia.

    PubMed

    Tun, Waimar; Okal, Jerry; Schenk, Katie; Esantsi, Selina; Mutale, Felix; Kyeremaa, Rita Kusi; Ngirabakunzi, Edson; Asiah, Hilary; McClain-Nhlapo, Charlotte; Moono, Grimond

    2016-01-01

    Knowledge about experiences in accessing HIV services among persons with disabilities who are living with HIV in sub-Saharan Africa is limited. Although HIV transmission among persons with disabilities in Africa is increasingly acknowledged, there is a need to bring to life the experiences and voices from persons with disabilities living with HIV to raise awareness of programme implementers and policy makers about their barriers in accessing HIV services. This paper explores how the barriers faced by persons with disabilities living with HIV impede their ability to access HIV-related services and manage their disease. We conducted focus group discussions with 76 persons (41 females; 35 males) with physical, visual and/or hearing impairments who were living with HIV in Ghana, Uganda and Zambia (2012-2013). We explored challenges and facilitators at different levels (individual, psychosocial and structural) of access to HIV services. Transcripts were analyzed using a framework analysis approach. Persons with disabilities living with HIV encountered a wide variety of challenges in accessing HIV services. Delays in testing for HIV were common, with most waiting until they were sick to be tested. Reasons for delayed testing included challenges in getting to the health facilities, lack of information about HIV and testing, and HIV- and disability-related stigma. Barriers to HIV-related services, including care and treatment, at health facilities included lack of disability-friendly educational materials and sign interpreters, stigmatizing treatment by providers and other patients, lack of skills to provide tailored services to persons with disabilities living with HIV and physically inaccessible infrastructure, all of which make it extremely difficult for persons with disabilities to initiate and adhere to HIV treatment. Accessibility challenges were greater for women than men due to gender-related roles. Challenges were similar across the three countries. Favourable

  19. Limited accessibility to HIV services for persons with disabilities living with HIV in Ghana, Uganda and Zambia

    PubMed Central

    Tun, Waimar; Okal, Jerry; Schenk, Katie; Esantsi, Selina; Mutale, Felix; Kyeremaa, Rita Kusi; Ngirabakunzi, Edson; Asiah, Hilary; McClain-Nhlapo, Charlotte; Moono, Grimond

    2016-01-01

    Introduction Knowledge about experiences in accessing HIV services among persons with disabilities who are living with HIV in sub-Saharan Africa is limited. Although HIV transmission among persons with disabilities in Africa is increasingly acknowledged, there is a need to bring to life the experiences and voices from persons with disabilities living with HIV to raise awareness of programme implementers and policy makers about their barriers in accessing HIV services. This paper explores how the barriers faced by persons with disabilities living with HIV impede their ability to access HIV-related services and manage their disease. Methods We conducted focus group discussions with 76 persons (41 females; 35 males) with physical, visual and/or hearing impairments who were living with HIV in Ghana, Uganda and Zambia (2012–2013). We explored challenges and facilitators at different levels (individual, psychosocial and structural) of access to HIV services. Transcripts were analyzed using a framework analysis approach. Results Persons with disabilities living with HIV encountered a wide variety of challenges in accessing HIV services. Delays in testing for HIV were common, with most waiting until they were sick to be tested. Reasons for delayed testing included challenges in getting to the health facilities, lack of information about HIV and testing, and HIV- and disability-related stigma. Barriers to HIV-related services, including care and treatment, at health facilities included lack of disability-friendly educational materials and sign interpreters, stigmatizing treatment by providers and other patients, lack of skills to provide tailored services to persons with disabilities living with HIV and physically inaccessible infrastructure, all of which make it extremely difficult for persons with disabilities to initiate and adhere to HIV treatment. Accessibility challenges were greater for women than men due to gender-related roles. Challenges were similar across the

  20. 47 CFR 36.213 - Network access services revenues.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Network access services revenues. 36.213 Section 36.213 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Income Accounts Operating Revenues § 36.213 Network access services revenues. (a) End User Revenue...

  1. 47 CFR 36.213 - Network access services revenues.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Network access services revenues. 36.213 Section 36.213 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Income Accounts Operating Revenues § 36.213 Network access services revenues. (a) End User Revenue...

  2. 47 CFR 25.211 - Analog video transmissions in the Fixed-Satellite Services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Analog video transmissions in the Fixed...) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Technical Standards § 25.211 Analog video transmissions in the Fixed-Satellite Services. (a) Downlink analog video transmissions in the band 3700-4200 MHz...

  3. 47 CFR 25.211 - Analog video transmissions in the Fixed-Satellite Services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Analog video transmissions in the Fixed...) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Technical Standards § 25.211 Analog video transmissions in the Fixed-Satellite Services. (a) Downlink analog video transmissions in the band 3700-4200 MHz...

  4. 47 CFR 25.211 - Analog video transmissions in the Fixed-Satellite Services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Analog video transmissions in the Fixed...) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Technical Standards § 25.211 Analog video transmissions in the Fixed-Satellite Services. (a) Downlink analog video transmissions in the band 3700-4200 MHz...

  5. 47 CFR 25.211 - Analog video transmissions in the Fixed-Satellite Services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Analog video transmissions in the Fixed...) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Technical Standards § 25.211 Analog video transmissions in the Fixed-Satellite Services. (a) Downlink analog video transmissions in the band 3700-4200 MHz...

  6. 47 CFR 25.211 - Analog video transmissions in the Fixed-Satellite Services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Analog video transmissions in the Fixed...) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Technical Standards § 25.211 Analog video transmissions in the Fixed-Satellite Services. (a) Downlink analog video transmissions in the band 3700-4200 MHz...

  7. 45 CFR 1624.5 - Accessibility of legal services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Accessibility of legal services. 1624.5 Section 1624.5 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PROHIBITION AGAINST DISCRIMINATION ON THE BASIS OF DISABILITY § 1624.5 Accessibility of legal services. (a) No...

  8. 45 CFR 1624.5 - Accessibility of legal services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Accessibility of legal services. 1624.5 Section 1624.5 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PROHIBITION AGAINST DISCRIMINATION ON THE BASIS OF DISABILITY § 1624.5 Accessibility of legal services. (a) No...

  9. 45 CFR 1624.5 - Accessibility of legal services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Accessibility of legal services. 1624.5 Section 1624.5 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PROHIBITION AGAINST DISCRIMINATION ON THE BASIS OF DISABILITY § 1624.5 Accessibility of legal services. (a) No...

  10. 45 CFR 1624.5 - Accessibility of legal services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Accessibility of legal services. 1624.5 Section 1624.5 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION PROHIBITION AGAINST DISCRIMINATION ON THE BASIS OF DISABILITY § 1624.5 Accessibility of legal services. (a) No...

  11. 39 CFR 3055.91 - Consumer access to postal services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Consumer access to postal services. 3055.91 Section 3055.91 Postal Service POSTAL REGULATORY COMMISSION PERSONNEL SERVICE PERFORMANCE AND CUSTOMER SATISFACTION REPORTING Reporting of Customer Satisfaction § 3055.91 Consumer access to postal services. (a) The...

  12. 42 CFR 422.114 - Access to services under an MA private fee-for-service plan.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Access to services under an MA private fee-for... Benefits and Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must...

  13. 42 CFR 422.114 - Access to services under an MA private fee-for-service plan.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Access to services under an MA private fee-for... Benefits and Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must...

  14. 42 CFR 422.114 - Access to services under an MA private fee-for-service plan.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Access to services under an MA private fee-for... Benefits and Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must...

  15. 42 CFR 422.114 - Access to services under an MA private fee-for-service plan.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Access to services under an MA private fee-for... Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must demonstrate to CMS...

  16. 42 CFR 422.114 - Access to services under an MA private fee-for-service plan.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Access to services under an MA private fee-for... Beneficiary Protections § 422.114 Access to services under an MA private fee-for-service plan. (a) Sufficient access. (1) An MA organization that offers an MA private fee-for-service plan must demonstrate to CMS...

  17. Access Services Are Human Services: Collaborating to Provide Textbook Access to Students

    ERIC Educational Resources Information Center

    McElroy, Kelly; Moore, Dan; Hilterbrand, Lori; Hindes, Nicole

    2017-01-01

    Despite the clear negative impact of high textbook costs on students, limits--including space, funding, and policies--prevent many academic libraries from fully supporting textbook collections. Partnering with other campus units on textbook lending requires creative thinking but can provide students access to other services in addition to the…

  18. Access to Jobs and Workers via Transit - Service

    EPA Pesticide Factsheets

    A collection of performance indicators and regional benchmarks for consistently comparing neighborhoods (census block groups) across the US in regards to their accessibility to jobs or workers via public transit service. Accessibility was modeled by calculating total travel time between block group centroids inclusive of walking to/from transit stops, wait times, and transfers. Block groups that can be accessed in 45 minutes or less from the origin block group are considered accessible. Indicators reflect public transit service in December 2012 and employment/worker counts in 2010. Coverage is limited to census block groups within metropolitan regions served by transit agencies who share their service data in a standardized format called GTFS.

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

    PubMed

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

    2016-01-01

    Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA) method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population), was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms) used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons). An integrated geocoding approach was used to establish PHC locations. The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs. The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood level. In

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

    PubMed Central

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

    2016-01-01

    Background Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. Methods This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA) method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population), was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms) used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons). An integrated geocoding approach was used to establish PHC locations. Results The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs. Conclusions The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care

  1. 47 CFR 74.831 - Scope of service and permissible transmissions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Power Auxiliary Stations § 74.831 Scope of service and permissible transmissions. The license for a low power auxiliary station authorizes the transmission of cues and orders to production personnel and... transmission of comments, interviews, and reports from the scene of a remote broadcast. Low power auxiliary...

  2. Access to healthcare for disabled persons. How are blind people reached by HIV services?

    PubMed

    Saulo, Bryson; Walakira, Eddy; Darj, Elisabeth

    2012-03-01

    Disabled people are overlooked and marginalised globally. There is a lack of information on blind people and HIV-related services and it is unclear how HIV-services target blind people in a sub-Saharan urban setting. To explore how blind people are reached by HIV-services in Kampala, Uganda. A purposeful sample of blind people and seeing healthcare workers were interviewed, and data on their opinions and experiences were collected. The data were analysed by qualitative content analysis, with a focus on manifest content. Three categories emerged from the study, reaching for HIV information and knowledge, lack of services, and experiences of discrimination. General knowledge on HIV prevention/transmission methods was good; however, there was scepticism about condom use. Blind people mainly relied on others for accessing HIV information, and a lack of special services for blind people to be able to test for HIV was expressed. The health service for blind people was considered inadequate, unequal and discriminatory, and harassment by healthcare staff was expressed, but not sexual abuse. Concerns about disclosure of personal medical information were revealed. Access to HIV services and other healthcare related services for blind people is limited and the objectives of the National Strategic Plan for HIV/AIDS 2007-2012 have not been achieved. There is a need for alternative methods for sensitisation and voluntary counselling and testing (VCT) for blind people. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. 47 CFR 54.807 - Interstate access universal service support.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... supported service within the study area of a price cap local exchange carrier shall receive Interstate Access Universal Service Support for each line that it serves within that study area. (b) In any study... Service Support Per Line by dividing Study Area Access Universal Service Support by twelve times all...

  4. EARS: Electronic Access to Reference Service.

    PubMed

    Weise, F O; Borgendale, M

    1986-10-01

    Electronic Access to Reference Service (EARS) is a front end to the Health Sciences Library's electronic mail system, with links to the online public catalog. EARS, which became operational in September 1984, is accessed by users at remote sites with either a terminal or microcomputer. It is menu-driven, allowing users to request: a computerized literature search, reference information, a photocopy of a journal article, or a book. This paper traces the history of EARS and discusses its use, its impact on library staff and services, and factors that influence the diffusion of new technology.

  5. SWS: accessing SRS sites contents through Web Services.

    PubMed

    Romano, Paolo; Marra, Domenico

    2008-03-26

    Web Services and Workflow Management Systems can support creation and deployment of network systems, able to automate data analysis and retrieval processes in biomedical research. Web Services have been implemented at bioinformatics centres and workflow systems have been proposed for biological data analysis. New databanks are often developed by taking into account these technologies, but many existing databases do not allow a programmatic access. Only a fraction of available databanks can thus be queried through programmatic interfaces. SRS is a well know indexing and search engine for biomedical databanks offering public access to many databanks and analysis tools. Unfortunately, these data are not easily and efficiently accessible through Web Services. We have developed 'SRS by WS' (SWS), a tool that makes information available in SRS sites accessible through Web Services. Information on known sites is maintained in a database, srsdb. SWS consists in a suite of WS that can query both srsdb, for information on sites and databases, and SRS sites. SWS returns results in a text-only format and can be accessed through a WSDL compliant client. SWS enables interoperability between workflow systems and SRS implementations, by also managing access to alternative sites, in order to cope with network and maintenance problems, and selecting the most up-to-date among available systems. Development and implementation of Web Services, allowing to make a programmatic access to an exhaustive set of biomedical databases can significantly improve automation of in-silico analysis. SWS supports this activity by making biological databanks that are managed in public SRS sites available through a programmatic interface.

  6. 18 CFR 35.28 - Non-discriminatory open access transmission tariff.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Non-discriminatory open access transmission tariff. 35.28 Section 35.28 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE FEDERAL POWER ACT FILING OF RATE SCHEDULES...

  7. Interoperable Data Access Services for NOAA IOOS

    NASA Astrophysics Data System (ADS)

    de La Beaujardiere, J.

    2008-12-01

    The Integrated Ocean Observing System (IOOS) is intended to enhance our ability to collect, deliver, and use ocean information. The goal is to support research and decision-making by providing data on our open oceans, coastal waters, and Great Lakes in the formats, rates, and scales required by scientists, managers, businesses, governments, and the public. The US National Oceanic and Atmospheric Administration (NOAA) is the lead agency for IOOS. NOAA's IOOS office supports the development of regional coastal observing capability and promotes data management efforts to increase data accessibility. Geospatial web services have been established at NOAA data providers including the National Data Buoy Center (NDBC), the Center for Operational Oceanographic Products and Services (CO-OPS), and CoastWatch, and at regional data provider sites. Services established include Open-source Project for a Network Data Access Protocol (OpenDAP), Open Geospatial Consortium (OGC) Sensor Observation Service (SOS), and OGC Web Coverage Service (WCS). These services provide integrated access to data holdings that have been aggregated at each center from multiple sources. We wish to collaborate with other groups to improve our service offerings to maximize interoperability and enhance cross-provider data integration, and to share common service components such as registries, catalogs, data conversion, and gateways. This paper will discuss the current status of NOAA's IOOS efforts and possible next steps.

  8. Universal filtered multi-carrier system for asynchronous uplink transmission in optical access network

    NASA Astrophysics Data System (ADS)

    Kang, Soo-Min; Kim, Chang-Hun; Han, Sang-Kook

    2016-02-01

    In passive optical network (PON), orthogonal frequency division multiplexing (OFDM) has been studied actively due to its advantages such as high spectra efficiency (SE), dynamic resource allocation in time or frequency domain, and dispersion robustness. However, orthogonal frequency division multiple access (OFDMA)-PON requires tight synchronization among multiple access signals. If not, frequency orthogonality could not be maintained. Also its sidelobe causes inter-channel interference (ICI) to adjacent channel. To prevent ICI caused by high sidelobes, guard band (GB) is usually used which degrades SE. Thus, OFDMA-PON is not suitable for asynchronous uplink transmission in optical access network. In this paper, we propose intensity modulation/direct detection (IM/DD) based universal filtered multi-carrier (UFMC) PON for asynchronous multiple access. The UFMC uses subband filtering to subsets of subcarriers. Since it reduces sidelobe of each subband by applying subband filtering, it could achieve better performance compared to OFDM. For the experimental demonstration, different sample delay was applied to subbands to implement asynchronous transmission condition. As a result, time synchronization robustness of UFMC was verified in asynchronous multiple access system.

  9. IQ imbalance tolerable parallel-channel DMT transmission for coherent optical OFDMA access network

    NASA Astrophysics Data System (ADS)

    Jung, Sang-Min; Mun, Kyoung-Hak; Jung, Sun-Young; Han, Sang-Kook

    2016-12-01

    Phase diversity of coherent optical communication provides spectrally efficient higher-order modulation for optical communications. However, in-phase/quadrature (IQ) imbalance in coherent optical communication degrades transmission performance by introducing unwanted signal distortions. In a coherent optical orthogonal frequency division multiple access (OFDMA) passive optical network (PON), IQ imbalance-induced signal distortions degrade transmission performance by interferences of mirror subcarriers, inter-symbol interference (ISI), and inter-channel interference (ICI). We propose parallel-channel discrete multitone (DMT) transmission to mitigate transceiver IQ imbalance-induced signal distortions in coherent orthogonal frequency division multiplexing (OFDM) transmissions. We experimentally demonstrate the effectiveness of parallel-channel DMT transmission compared with that of OFDM transmission in the presence of IQ imbalance.

  10. Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services

    PubMed Central

    Chersich, Matthew F; Luchters, Stanley; Ntaganira, Innocent; Gerbase, Antonio; Lo, Ying-Ru; Scorgie, Fiona; Steen, Richard

    2013-01-01

    Introduction Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. Methods We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes. Results We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for safer sex. One study found that interventions to counter hazardous alcohol-use lowered unprotected sex. Data also show effectiveness of screening for sexually transmitted infections (STIs) and syndromic STI treatment, but experience with periodic presumptive treatment is limited. HIV testing and counselling is essential for facilitating sex workers’ access to care and antiretroviral treatment (ART), but testing models for sex workers and indeed for ART access are little studied, as are structural interventions, which create conditions conducive for risk reduction. With the exception of Senegal, persistent criminalization of sex work across Africa reduces sex workers’ control over working conditions and impedes their access to health services. It also obstructs health-service provision and legal protection. Conclusions There is sufficient evidence of effectiveness of targeted interventions with female sex workers in Africa to inform delivery of services for this population. With improved planning and political will, services – including peer interventions, condom promotion and STI screening – would act at multiple levels to reduce HIV exposure and transmission efficiency among sex workers. Initiatives are

  11. Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services.

    PubMed

    Chersich, Matthew F; Luchters, Stanley; Ntaganira, Innocent; Gerbase, Antonio; Lo, Ying-Ru; Scorgie, Fiona; Steen, Richard

    2013-03-04

    Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes. We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for safer sex. One study found that interventions to counter hazardous alcohol-use lowered unprotected sex. Data also show effectiveness of screening for sexually transmitted infections (STIs) and syndromic STI treatment, but experience with periodic presumptive treatment is limited. HIV testing and counselling is essential for facilitating sex workers' access to care and antiretroviral treatment (ART), but testing models for sex workers and indeed for ART access are little studied, as are structural interventions, which create conditions conducive for risk reduction. With the exception of Senegal, persistent criminalization of sex work across Africa reduces sex workers' control over working conditions and impedes their access to health services. It also obstructs health-service provision and legal protection. There is sufficient evidence of effectiveness of targeted interventions with female sex workers in Africa to inform delivery of services for this population. With improved planning and political will, services - including peer interventions, condom promotion and STI screening - would act at multiple levels to reduce HIV exposure and transmission efficiency among sex workers. Initiatives are required to enhance access to HIV testing and ART for

  12. 28 CFR 115.182 - Access to emergency medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Access to emergency medical services. 115...

  13. 28 CFR 115.182 - Access to emergency medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Access to emergency medical services. 115...

  14. 28 CFR 115.182 - Access to emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Access to emergency medical services. 115...

  15. 18 CFR 35.28 - Non-discriminatory open access transmission tariff.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Non-discriminatory open access transmission tariff. 35.28 Section 35.28 Conservation of Power and Water Resources FEDERAL ENERGY.... (4) Demand response means a reduction in the consumption of electric energy by customers from their...

  16. 18 CFR 35.28 - Non-discriminatory open access transmission tariff.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Non-discriminatory open access transmission tariff. 35.28 Section 35.28 Conservation of Power and Water Resources FEDERAL ENERGY.... (4) Demand response means a reduction in the consumption of electric energy by customers from their...

  17. 42 CFR 422.112 - Access to services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... services in accordance with § 422.113. (10) Prevailing patterns of community health care delivery... 42 Public Health 3 2010-10-01 2010-10-01 false Access to services. 422.112 Section 422.112 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...

  18. Access to dental public services by disabled persons.

    PubMed

    Leal Rocha, Lyana; Vieira de Lima Saintrain, Maria; Pimentel Gomes Fernandes Vieira-Meyer, Anya

    2015-03-13

    According to the World Health Organization, one in every 10 people has a disability, and more than two-thirds of them do not receive any type of oral dental care. The Brazilian Constitution of 1988 guarantees all civilians including disabled people the right to healthcare, shaping the guidelines of the Brazilian National Health Care System (Sistema Único de Saúde--SUS). However, there is limited information about the true accessibility of dental services. This study evaluated the accessibility of public dental services to persons with disabilities in Fortaleza, Ceará, which has the third highest disability rate in Brazil. A cross-sectional quantitative study using structured questionnaires was administered to dentists (n = 89) and people with disabilities (n = 204) to evaluate the geographical, architectural, and organizational accessibility of health facilities, the communication between professionals and patients with disabilities, the demand for dental services, and factors influencing the use of dental services by people with motor, visual, and hearing impairments. 43.1% of people with disabilities do not recognize their service as a priority of Basic Health Units (BHU), 52.5% do not usually seek dental care, and of those who do (n = 97), 76.3% find it difficult to receive care and 84.5% only seek care on an emergency basis. Forty-five percent are unaware of the services offered in the BHU. Of the dentists, 56.2% reported difficulty in communicating with deaf patients, and 97.8% desired interpreters stationed in the BHU. People with disabilities gave better accessibility ratings than dentists (p = 0.001). 37.3% of the patients and 43.8% of dentists reported inadequate physical access infrastructure (including doors, hallways, waiting rooms, and offices). Dentists (60%) reported unsafe environments and transportation difficulties as geographical barriers, while most people with disabilities did not report noticing these barriers. While access to dental

  19. Pilot evaluation of a web-based intervention targeting sexual health service access.

    PubMed

    Brown, K E; Newby, K; Caley, M; Danahay, A; Kehal, I

    2016-04-01

    Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among 13-19-year olds are reported. A pre-post questionnaire-based design was used. Matched baseline and follow-up data were identified from 148 respondents aged 13-18 years. Outcome measures were self-reported service access, self-reported intention to access services and beliefs about services and service access identified through needs analysis. Objective service access data provided by local sexual health services were also analyzed. Analysis suggests the intervention had a significant positive effect on psychological barriers to and antecedents of service access among females. Males, who reported greater confidence in service access compared with females, significantly increased service access by time 2 follow-up. Available objective service access data support the assertion that the intervention may have led to increases in service access. There is real promise for this novel digital intervention. Further evaluation is planned as the model is licensed to and rolled out by other local authorities in the United Kingdom. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  20. EARS: Electronic Access to Reference Service.

    PubMed Central

    Weise, F O; Borgendale, M

    1986-01-01

    Electronic Access to Reference Service (EARS) is a front end to the Health Sciences Library's electronic mail system, with links to the online public catalog. EARS, which became operational in September 1984, is accessed by users at remote sites with either a terminal or microcomputer. It is menu-driven, allowing users to request: a computerized literature search, reference information, a photocopy of a journal article, or a book. This paper traces the history of EARS and discusses its use, its impact on library staff and services, and factors that influence the diffusion of new technology. PMID:3779167

  1. Access to specialty mental health services among women in California.

    PubMed

    Kimerling, Rachel; Baumrind, Nikki

    2005-06-01

    The Anderson behavioral model was used to investigate racial and ethnic disparities in access to specialty mental health services among women in California as well as factors that might account for such disparities. The study was a cross-sectional examination of a probability sample of 3,750 California women. The main indicators of access to services were perceived need, service seeking, and service use. Multivariate models were constructed that accounted for need and enabling and demographic variables. Significant racial and ethnic variations in access to specialty mental health services were observed. African-American, Hispanic, and Asian women were significantly less likely to use specialty mental health services than white women. Multivariate analyses showed that Hispanic and Asian women were less likely than white women to report perceived need, even after frequent mental distress had been taken into account. Among women with perceived need, African-American and Asian women were less likely than white women to seek mental health services after differences in insurance status had been taken into account. Among women who sought services, Hispanic women were less likely than white women to obtain services after adjustment for the effects of poverty. Need and enabling factors did not entirely account for the observed disparities in access to services. Additional research is needed to identify gender- and culture-specific models for access to mental health services in order to decrease disparities in access. Factors such as perceived need and decisions to seek services are important factors that should be emphasized in future studies.

  2. The Future of Access Services: Should There Be One?

    ERIC Educational Resources Information Center

    Hersey, Denise P.

    2004-01-01

    The creation of "Access Services" departments in academic libraries did not translate into the creation or offering of new services for patrons. Instead, it was typically just the combination of three already existing departments. Recent changes and trends in Access Services, including new NCIP and ISO standards, an increase in the use of…

  3. Making Spatial Statistics Service Accessible On Cloud Platform

    NASA Astrophysics Data System (ADS)

    Mu, X.; Wu, J.; Li, T.; Zhong, Y.; Gao, X.

    2014-04-01

    Web service can bring together applications running on diverse platforms, users can access and share various data, information and models more effectively and conveniently from certain web service platform. Cloud computing emerges as a paradigm of Internet computing in which dynamical, scalable and often virtualized resources are provided as services. With the rampant growth of massive data and restriction of net, traditional web services platforms have some prominent problems existing in development such as calculation efficiency, maintenance cost and data security. In this paper, we offer a spatial statistics service based on Microsoft cloud. An experiment was carried out to evaluate the availability and efficiency of this service. The results show that this spatial statistics service is accessible for the public conveniently with high processing efficiency.

  4. 42 CFR 422.112 - Access to services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Access to services. (a) Rules for coordinated care plans. An MA organization that offers an MA... organization ensures that all covered services, including supplemental services contracted for by (or on behalf... organization must meet the following requirements: (1) Provider network. (i) Maintain and monitor a network of...

  5. 42 CFR 422.112 - Access to services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Access to services. (a) Rules for coordinated care plans. An MA organization that offers an MA... organization ensures that all covered services, including supplemental services contracted for by (or on behalf... organization must meet the following requirements: (1) Provider network. (i) Maintain and monitor a network of...

  6. 42 CFR 422.112 - Access to services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Access to services. (a) Rules for coordinated care plans. An MA organization that offers an MA... organization ensures that all covered services, including supplemental services contracted for by (or on behalf... organization must meet the following requirements: (1) Provider network. (i) Maintain and monitor a network of...

  7. Accessing Geospatial Services in Limited Bandwidth Service-Oriented Architecture (SOA) Environments

    ERIC Educational Resources Information Center

    Boggs, James D.

    2013-01-01

    First responders are continuously moving at an incident site and this movement requires them to access Service-Oriented Architecture services, such as a Web Map Service, via mobile wireless networks. First responders from inside a building often have problems in communicating to devices outside that building due to propagation obstacles. Dynamic…

  8. Concurrent access to a virtual microscope using a web service oriented architecture

    NASA Astrophysics Data System (ADS)

    Corredor, Germán.; Iregui, Marcela; Arias, Viviana; Romero, Eduardo

    2013-11-01

    Virtual microscopy (VM) facilitates visualization and deployment of histopathological virtual slides (VS), a useful tool for education, research and diagnosis. In recent years, it has become popular, yet its use is still limited basically because of the very large sizes of VS, typically of the order of gigabytes. Such volume of data requires efficacious and efficient strategies to access the VS content. In an educative or research scenario, several users may require to access and interact with VS at the same time, so, due to large data size, a very expensive and powerful infrastructure is usually required. This article introduces a novel JPEG2000-based service oriented architecture for streaming and visualizing very large images under scalable strategies, which in addition need not require very specialized infrastructure. Results suggest that the proposed architecture enables transmission and simultaneous visualization of large images, while it is efficient using resources and offering users proper response times.

  9. Transparent data service with multiple wireless access

    NASA Technical Reports Server (NTRS)

    Dean, Richard A.; Levesque, Allen H.

    1993-01-01

    The rapid introduction of digital wireless networks is an important part of the emerging digital communications scene. The introduction of Digital Cellular, LEO and GEO Satellites, and Personal Communications Services poses both a challenge and an opportunity for the data user. On the one hand wireless access will introduce significant new portable data services such as personal notebooks, paging, E-mail, and fax that will put the information age in the user's pocket. On the other hand the challenge of creating a seamless and transparent environment for the user in multiple access environments and across multiple network connections is formidable. A summary of the issues associated with developing techniques and standards that can support transparent and seamless data services is presented. The introduction of data services into the radio world represents a unique mix of RF channel problems, data protocol issues, and network issues. These problems require that experts from each of these disciplines fuse the individual technologies to support these services.

  10. [Accessibility of health services for users].

    PubMed

    Sousa-Fragoso, M A; Villarreal-Ríos, E

    2000-01-01

    To measure the accessibility to health services and determine a model to explain this accessibility. All states of the Mexican Republic were included. The measurement of accessibility considers the availability of resources and the perception of barriers. Place of residence, education, participation in the work forces and household conditions were included in the model. The average of availability resources was 64.59% sd 15.68 (range 42 to 100) and the average corresponding to perception of barriers, 87.61% SD 4.04 (range 79.23 to 95.65). Accessibility was 71.50% SD 10.74 (range 56 to 96). The states with highest accessibility were the Federal District and Baja California Sur and the lowest, Chiapas and Oaxaca. The model included education and labor participation (R2 = 0.67, p < 0.05). Accessibility was determined by socioeconomic factors.

  11. Making public mental-health services accessible to deaf consumers: Illinois Deaf Services 2000.

    PubMed

    Munro-Ludders, Bruce; Simpatico, Thomas; Zvetina, Daria

    2004-01-01

    Illinois Deaf Services 2000 (IDS2000), a public/private partnership, promotes the creation and implementation of strategies to develop and increase access to mental health services for deaf, hard of hearing, late-deafened, and deaf-blind consumers. IDS2000 has resulted in the establishment of service accessibility standards, a technical support and adherence monitoring system, and the beginnings of a statewide telepsychiatry service. These system modifications have resulted in increase by 60% from baseline survey data in the number of deaf, hard of hearing, late-deafened, and deaf-blind consumers identified in community mental-health agencies in Illinois. Depending on the situation of deaf services staff and infrastructure, much of IDS2000 could be replicated in other states in a mostly budget-neutral manner.

  12. Demonstrate provider accessibility with desktop and online services.

    PubMed

    2001-10-01

    It's available on personal computers with a CD or through Internet access. Assess instantly the accessibility of your provider network or the most promising areas to establish a health service with new GIS tools.

  13. Recommendations for a service framework to access astronomical archives

    NASA Technical Reports Server (NTRS)

    Travisano, J. J.; Pollizzi, J.

    1992-01-01

    There are a large number of astronomical archives and catalogs on-line for network access, with many different user interfaces and features. Some systems are moving towards distributed access, supplying users with client software for their home sites which connects to servers at the archive site. Many of the issues involved in defining a standard framework of services that archive/catalog suppliers can use to achieve a basic level of interoperability are described. Such a framework would simplify the development of client and server programs to access the wide variety of astronomical archive systems. The primary services that are supplied by current systems include: catalog browsing, dataset retrieval, name resolution, and data analysis. The following issues (and probably more) need to be considered in establishing a standard set of client/server interfaces and protocols: Archive Access - dataset retrieval, delivery, file formats, data browsing, analysis, etc.; Catalog Access - database management systems, query languages, data formats, synchronous/asynchronous mode of operation, etc.; Interoperability - transaction/message protocols, distributed processing mechanisms (DCE, ONC/SunRPC, etc), networking protocols, etc.; Security - user registration, authorization/authentication mechanisms, etc.; Service Directory - service registration, lookup, port/task mapping, parameters, etc.; Software - public vs proprietary, client/server software, standard interfaces to client/server functions, software distribution, operating system portability, data portability, etc. Several archive/catalog groups, notably the Astrophysics Data System (ADS), are already working in many of these areas. In the process of developing StarView, which is the user interface to the Space Telescope Data Archive and Distribution Service (ST-DADS), these issues and the work of others were analyzed. A framework of standard interfaces for accessing services on any archive system which would benefit

  14. Optical splitter design for telecommunication access networks with triple-play services

    NASA Astrophysics Data System (ADS)

    Agalliu, Rajdi; Burtscher, Catalina; Lucki, Michal; Seyringer, Dana

    2018-01-01

    In this paper, we present various designs of optical splitters for access networks, such as GPON and XG-PON by ITU-T with triple-play services (ie data, voice and video). The presented designs exhibit a step forward, compared to the solutions recommended by the ITU, in terms of performance in transmission systems using WDM. The quality of performance is represented by the bit error rate and the Q-factor. Besides the standard splitter design, we propose a new length-optimized splitter design with a smaller waveguide core, providing some reduction of non-uniformity of the power split between the output waveguides. The achieved splitting parameters are incorporated in the simulations of passive optical networks. For this purpose, the OptSim tool employing Time Domain Split Step method was used.

  15. Accessibility to health services among migrant workers in the Northeast of Thailand.

    PubMed

    Khongthanachayopit, Suprawee; Laohasiriwong, Wongsa

    2017-01-01

    Background . There is an increasing trend of trans-border migration from neighboring countries to Thailand. According to human rights laws, everyone must have access to health services, even if they are from other nationalities.  However, a small minority of health personnel in Thailand discriminate against immigrant workers, as they are from a lower financial bracket. Methods . This cross-sectional study aims to determine the prevalence of accessibility to health services and factors associated with access to health services among migrant workers who work along the Northeast border of Thailand. A total of 621 legal migrant workers were randomly selected to respond to a structured questionnaire about the satisfaction of health services, using the 5As of health services: availability; accessibility; accommodation; affordability; acceptability.  Associations between independent variables and access to health services were analysed   using multiple logistic regression analysis. Results . The results indicated that the majority of these registered migrant workers were female (63.9%) with an average age of 29± 8.61 years old, and were married (54.3%). Most of the workers worked at restaurants (80%), whereas only 20% were in agricultural sectors. Only 14% (95% CI: 11-17%) of migrant workers had access to health services. The factors that were significantly associated with accessibility to health service experienced ill health during the past one year (OR = 2.48; 95%CI; 1.54-3.97; p-value<0.001) ; have been married (OR = 2.32; 95% CI: 1.40 - 3.90; p-value <0.001). Conclusions . Most of the migrant workers could not access health services. The ones who did access health services were married or ill.

  16. 42 CFR 422.112 - Access to services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... services. (a) Rules for coordinated care plans. An MA organization that offers an MA coordinated care plan may specify the networks of providers from whom enrollees may obtain services if the MA organization... Medicare enrollee, are available and accessible under the plan. To accomplish this, the MA organization...

  17. 47 CFR 9.7 - Access to 911 and E911 service capabilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Access to 911 and E911 service capabilities. 9.7 Section 9.7 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL INTERCONNECTED VOICE OVER INTERNET PROTOCOL SERVICES § 9.7 Access to 911 and E911 service capabilities. (a) Access. Subject to the...

  18. 47 CFR 9.7 - Access to 911 and E911 service capabilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Access to 911 and E911 service capabilities. 9.7 Section 9.7 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL INTERCONNECTED VOICE OVER INTERNET PROTOCOL SERVICES § 9.7 Access to 911 and E911 service capabilities. (a) Access. Subject to the...

  19. 47 CFR 9.7 - Access to 911 and E911 service capabilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Access to 911 and E911 service capabilities. 9.7 Section 9.7 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL INTERCONNECTED VOICE OVER INTERNET PROTOCOL SERVICES § 9.7 Access to 911 and E911 service capabilities. (a) Access. Subject to the...

  20. Access to Health Care Services among Young People Exchanging Sex in Detroit.

    PubMed

    Knittel, Andrea K; Graham, Louis F; Peterson, Jerry; Lopez, William; Snow, Rachel C

    2018-04-05

    Within the related epidemics of sex exchange, drug use, and poverty, access to health care is shaped by intersecting identities, policy, and infrastructure. This study uses a unique survey sample of young adults in Detroit, who are exchanging sex on the street, in strip clubs, and at after-hours parties and other social clubs. Factors predicting access to free or affordable health care services, such as venue, patterns of sexual exchange influence, drug use and access to transportation, were examined using multivariable logistic regression and qualitative comparative analysis. The most significant predictors of low access to health care services were unstable housing and lack of access to reliable transportation. In addition, working on the street was associated with decreased access to services. Coordinated policy and programming changes are needed to increase health care access to this group, including improved access to transportation, housing, and employment, and integration of health care services.

  1. 76 FR 44323 - National Grid Transmission Services Corporation; Bangor Hydro Electric Company; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-25

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL11-49-000] National Grid Transmission Services Corporation; Bangor Hydro Electric Company; Notice of Petition for Declaratory Order Take..., 18 CFR 385.207, National Grid Transmission Services Corporation and Bangor Hydro Electric Company...

  2. Discussing the Issues: A Report on the 2013 Ivies + Access Services Symposium

    ERIC Educational Resources Information Center

    Wilson, Andrew M.

    2014-01-01

    As access services emerges as a discrete discipline within the field of librarianship, opportunities for access services librarians to meet and discuss the issues facing today's libraries continue to grow. One annual meeting that has attracted less attention over the years is the Ivies + Access Services Symposium. Held at various member…

  3. Hierarchy Bayesian model based services awareness of high-speed optical access networks

    NASA Astrophysics Data System (ADS)

    Bai, Hui-feng

    2018-03-01

    As the speed of optical access networks soars with ever increasing multiple services, the service-supporting ability of optical access networks suffers greatly from the shortage of service awareness. Aiming to solve this problem, a hierarchy Bayesian model based services awareness mechanism is proposed for high-speed optical access networks. This approach builds a so-called hierarchy Bayesian model, according to the structure of typical optical access networks. Moreover, the proposed scheme is able to conduct simple services awareness operation in each optical network unit (ONU) and to perform complex services awareness from the whole view of system in optical line terminal (OLT). Simulation results show that the proposed scheme is able to achieve better quality of services (QoS), in terms of packet loss rate and time delay.

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

    PubMed

    Riggs, Elisha; Davis, Elise; Gibbs, Lisa; Block, Karen; Szwarc, Jo; Casey, Sue; Duell-Piening, Philippa; Waters, Elizabeth

    2012-05-15

    Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH) service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0-6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refugee backgrounds. This study aims to explore experiences of using MCH services, from the perspective of families from refugee backgrounds and service providers. We used a qualitative study design informed by the socioecological model of health and a cultural competence approach. Two geographical areas of Melbourne were selected to invite participants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived an average of 4.7 years in Australia (range one month-18 years). Participants had a total of 249 children, of these 150 were born in Australia. Four focus groups and five interviews were conducted with MCH nurses, other healthcare providers and bicultural workers. Four themes were identified: facilitating access to MCH services; promoting continued engagement with the MCH service; language challenges; and what is working well and could be done better. Several processes were identified that facilitated initial access to the MCH service but there were implications for continued use of the service. The MCH service was not formally notified of new parents arriving with young children. Pre-arranged group appointments by MCH nurses for parents who attended playgroups worked well to increase ongoing service engagement. Barriers for parents in using MCH services included access to transportation, lack of confidence in speaking English and making phone bookings. Service users and providers reported that

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

    PubMed

    Wiebe, Ellen R; Sandhu, Supna

    2008-04-01

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

  6. 47 CFR 51.217 - Nondiscriminatory access: Telephone numbers, operator services, directory assistance services...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... to have access to its directory assistance services, including directory assistance databases, so... provider, including transfer of the LECs' directory assistance databases in readily accessible magnetic.... Updates to the directory assistance database shall be made in the same format as the initial transfer...

  7. Barriers to accessing low vision services.

    PubMed

    Pollard, Tamara L; Simpson, John A; Lamoureux, Ecosse L; Keeffe, Jill E

    2003-07-01

    To investigate barriers to accessing low vision services in Australia. Adults with a vision impairment (<6/12 in the better eye and/or significant visual field defect), who were current patients at the Royal Victorian Eye and Ear Hospital (RVEEH), were interviewed. The questions investigated self-perceived vision difficulties, duration of vision loss and satisfaction with vision and also examined issues of awareness of low vision services and referral to services. Focus groups were also conducted with vision impaired (<6/12 in the better eye) patients from the RVEEH, listeners of the Radio for the Print Handicapped and peer workers at Vision Australia Foundation. The discussions were recorded and transcribed. The questionnaire revealed that referral to low vision services was associated with a greater degree of vision loss (p = 0.002) and a greater self-perception of low vision (p = 0.005) but that referral was not associated with satisfaction (p = 0.144) or difficulties related to vision (p = 0.169). Participants with mild and moderate vision impairment each reported similar levels of difficulties with daily activities and satisfaction with their vision (p > 0.05). However, there was a significant difference in the level of difficulties experienced with daily activities between those with mild-moderate and severe vision impairment (p < 0.05). The participants of the focus groups identified barriers to accessing low vision services related to awareness of services among the general public and eye care professionals, understanding of low vision and the services available, acceptance of low vision, the referral process, and transport. In addition to the expected difficulties with lack of awareness of services by people with low vision, many people do not understand what the services provide and do not identify themselves as having low vision. Knowledge of these barriers, from the perspective of people with low vision, can now be used to guide the development and

  8. Access to primary health care services for Indigenous peoples: A framework synthesis.

    PubMed

    Davy, Carol; Harfield, Stephen; McArthur, Alexa; Munn, Zachary; Brown, Alex

    2016-09-30

    Indigenous peoples often find it difficult to access appropriate mainstream primary health care services. Securing access to primary health care services requires more than just services that are situated within easy reach. Ensuring the accessibility of health care for Indigenous peoples who are often faced with a vast array of additional barriers including experiences of discrimination and racism, can be complex. This framework synthesis aimed to identify issues that hindered Indigenous peoples from accessing primary health care and then explore how, if at all, these were addressed by Indigenous health care services. To be included in this framework synthesis papers must have presented findings focused on access to (factors relating to Indigenous peoples, their families and their communities) or accessibility of Indigenous primary health care services. Findings were imported into NVivo and a framework analysis undertaken whereby findings were coded to and then thematically analysed using Levesque and colleague's accessibility framework. Issues relating to the cultural and social determinants of health such as unemployment and low levels of education influenced whether Indigenous patients, their families and communities were able to access health care. Indigenous health care services addressed these issues in a number of ways including the provision of transport to and from appointments, a reduction in health care costs for people on low incomes and close consultation with, if not the direct involvement of, community members in identifying and then addressing health care needs. Indigenous health care services appear to be best placed to overcome both the social and cultural determinants of health which hamper Indigenous peoples from accessing health care. Findings of this synthesis also suggest that Levesque and colleague's accessibility framework should be broadened to include factors related to the health care system such as funding.

  9. A framework for implementing data services in multi-service mobile satellite systems

    NASA Astrophysics Data System (ADS)

    Ali, Mohammed O.; Leung, Victor C. M.; Spolsky, Andrew I.

    1988-05-01

    Mobile satellite systems being planned for introduction in the early 1990s are expected to be invariably of the multi-service type. Mobile Telephone Service (MTS), Mobile Radio Service (MRS), and Mobile Data Service (MDS) are the major classifications used to categorize the many user applications to be supported. The MTS and MRS services encompass circuit-switched voice communication applications, and may be efficiently implemented using a centralized Demand-Assigned Multiple Access (DAMA) scheme. Applications under the MDS category are, on the other hand, message-oriented and expected to vary widely in characteristics; from simplex mode short messaging applications to long duration, full-duplex interactive data communication and large file transfer applications. For some applications under this service category, the conventional circuit-based DAMA scheme may prove highly inefficient due to the long time required to set up and establish communication links relative to the actual message transmission time. It is proposed that by defining a set of basic bearer services to be supported in MDS and optimizing their transmission and access schemes independent of the MTS and MRS services, the MDS applications can be more efficiently integrated into the multi-service design of mobile satellite systems.

  10. A framework for implementing data services in multi-service mobile satellite systems

    NASA Technical Reports Server (NTRS)

    Ali, Mohammed O.; Leung, Victor C. M.; Spolsky, Andrew I.

    1988-01-01

    Mobile satellite systems being planned for introduction in the early 1990s are expected to be invariably of the multi-service type. Mobile Telephone Service (MTS), Mobile Radio Service (MRS), and Mobile Data Service (MDS) are the major classifications used to categorize the many user applications to be supported. The MTS and MRS services encompass circuit-switched voice communication applications, and may be efficiently implemented using a centralized Demand-Assigned Multiple Access (DAMA) scheme. Applications under the MDS category are, on the other hand, message-oriented and expected to vary widely in characteristics; from simplex mode short messaging applications to long duration, full-duplex interactive data communication and large file transfer applications. For some applications under this service category, the conventional circuit-based DAMA scheme may prove highly inefficient due to the long time required to set up and establish communication links relative to the actual message transmission time. It is proposed that by defining a set of basic bearer services to be supported in MDS and optimizing their transmission and access schemes independent of the MTS and MRS services, the MDS applications can be more efficiently integrated into the multi-service design of mobile satellite systems.

  11. 47 CFR 25.212 - Narrowband analog transmissions, digital transmissions, and video transmissions in the GSO Fixed...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... transmissions, and video transmissions in the GSO Fixed-Satellite Service. 25.212 Section 25.212... Technical Standards § 25.212 Narrowband analog transmissions, digital transmissions, and video transmissions... narrowband and/or wideband digital services, including digital video services, if the maximum input spectral...

  12. 47 CFR 25.212 - Narrowband analog transmissions, digital transmissions, and video transmissions in the GSO Fixed...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... transmissions, and video transmissions in the GSO Fixed-Satellite Service. 25.212 Section 25.212... Technical Standards § 25.212 Narrowband analog transmissions, digital transmissions, and video transmissions... narrowband and/or wideband digital services, including digital video services, if the maximum input spectral...

  13. 47 CFR 25.212 - Narrowband analog transmissions, digital transmissions, and video transmissions in the GSO Fixed...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... transmissions, and video transmissions in the GSO Fixed-Satellite Service. 25.212 Section 25.212... Technical Standards § 25.212 Narrowband analog transmissions, digital transmissions, and video transmissions... narrowband and/or wideband digital services, including digital video services, if the maximum input spectral...

  14. A new optical transmission spectrum of WASP-43b from ACCESS

    NASA Astrophysics Data System (ADS)

    Weaver, Ian; University of Arizona, Católica, Carnegie

    2018-01-01

    We present a new ground-based optical transmission spectrum of the Hot Jupiter WASP--43b obtained with the Inamori-Magellan Areal Camera and Spectrograph (IMACS) on the Baade Telescope at Las Campanas Observatory. These observations were made as part of the Arizona-CfA-Catolica+Carnegie Exoplanet Spectroscopy Survey (ACCESS), which aims at providing a uniform, large sample of visible transmission spectra of gaseous exoplanets that will become key in the era of JWST and comparative exoplanetology. Using multi-object differential spectrophotometry, we produce a high precision spectrum of this planet between 400 and 900 nm, combining three different transit epochs. In this analysis, we search for signals of Na I, H-alpha, and K I, as well as for the presence of hazes/clouds.

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

    PubMed Central

    2012-01-01

    Background Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH) service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0–6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refugee backgrounds. This study aims to explore experiences of using MCH services, from the perspective of families from refugee backgrounds and service providers. Methods We used a qualitative study design informed by the socioecological model of health and a cultural competence approach. Two geographical areas of Melbourne were selected to invite participants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived an average of 4.7 years in Australia (range one month-18 years). Participants had a total of 249 children, of these 150 were born in Australia. Four focus groups and five interviews were conducted with MCH nurses, other healthcare providers and bicultural workers. Results Four themes were identified: facilitating access to MCH services; promoting continued engagement with the MCH service; language challenges; and what is working well and could be done better. Several processes were identified that facilitated initial access to the MCH service but there were implications for continued use of the service. The MCH service was not formally notified of new parents arriving with young children. Pre-arranged group appointments by MCH nurses for parents who attended playgroups worked well to increase ongoing service engagement. Barriers for parents in using MCH services included access to transportation, lack of confidence in speaking English and making phone bookings. Service users

  16. Methodology for designing and implementing a class for service for the transmission of medical images over a common network

    NASA Astrophysics Data System (ADS)

    Dimond, David A.; Burgess, Robert; Barrios, Nolan; Johnson, Neil D.

    2000-05-01

    Traditionally, to guarantee the network performance of medical image data transmission, imaging traffic was isolated on a separate network. Organizations are depending on a new generation of multi-purpose networks to transport both normal information and image traffic as they expand access to images throughout the enterprise. These organi want to leverage their existing infrastructure for imaging traffic, but are not willing to accept degradations in overall network performance. To guarantee 'on demand' network performance for image transmissions anywhere at any time, networks need to be designed with the ability to 'carve out' bandwidth for specific applications and to minimize the chances of network failures. This paper will present the methodology Cincinnati Children's Hospital Medical Center (CHMC) used to enhance the physical and logical network design of the existing hospital network to guarantee a class of service for imaging traffic. PACS network designs should utilize the existing enterprise local area network i.e. (LAN) infrastructure where appropriate. Logical separation or segmentation provides the application independence from other clinical and administrative applications as required, ensuring bandwidth and service availability.

  17. Unifying Access to National Hydrologic Data Repositories via Web Services

    NASA Astrophysics Data System (ADS)

    Valentine, D. W.; Jennings, B.; Zaslavsky, I.; Maidment, D. R.

    2006-12-01

    The CUAHSI hydrologic information system (HIS) is designed to be a live, multiscale web portal system for accessing, querying, visualizing, and publishing distributed hydrologic observation data and models for any location or region in the United States. The HIS design follows the principles of open service oriented architecture, i.e. system components are represented as web services with well defined standard service APIs. WaterOneFlow web services are the main component of the design. The currently available services have been completely re-written compared to the previous version, and provide programmatic access to USGS NWIS. (steam flow, groundwater and water quality repositories), DAYMET daily observations, NASA MODIS, and Unidata NAM streams, with several additional web service wrappers being added (EPA STORET, NCDC and others.). Different repositories of hydrologic data use different vocabularies, and support different types of query access. Resolving semantic and structural heterogeneities across different hydrologic observation archives and distilling a generic set of service signatures is one of the main scalability challenges in this project, and a requirement in our web service design. To accomplish the uniformity of the web services API, data repositories are modeled following the CUAHSI Observation Data Model. The web service responses are document-based, and use an XML schema to express the semantics in a standard format. Access to station metadata is provided via web service methods, GetSites, GetSiteInfo and GetVariableInfo. The methdods form the foundation of CUAHSI HIS discovery interface and may execute over locally-stored metadata or request the information from remote repositories directly. Observation values are retrieved via a generic GetValues method which is executed against national data repositories. The service is implemented in ASP.Net, and other providers are implementing WaterOneFlow services in java. Reference implementation of

  18. SIDECACHE: Information access, management and dissemination framework for web services.

    PubMed

    Doderer, Mark S; Burkhardt, Cory; Robbins, Kay A

    2011-06-14

    Many bioinformatics algorithms and data sets are deployed using web services so that the results can be explored via the Internet and easily integrated into other tools and services. These services often include data from other sites that is accessed either dynamically or through file downloads. Developers of these services face several problems because of the dynamic nature of the information from the upstream services. Many publicly available repositories of bioinformatics data frequently update their information. When such an update occurs, the developers of the downstream service may also need to update. For file downloads, this process is typically performed manually followed by web service restart. Requests for information obtained by dynamic access of upstream sources is sometimes subject to rate restrictions. SideCache provides a framework for deploying web services that integrate information extracted from other databases and from web sources that are periodically updated. This situation occurs frequently in biotechnology where new information is being continuously generated and the latest information is important. SideCache provides several types of services including proxy access and rate control, local caching, and automatic web service updating. We have used the SideCache framework to automate the deployment and updating of a number of bioinformatics web services and tools that extract information from remote primary sources such as NCBI, NCIBI, and Ensembl. The SideCache framework also has been used to share research results through the use of a SideCache derived web service.

  19. Use, access, and equity in health care services in São Paulo, Brazil.

    PubMed

    Monteiro, Camila Nascimento; Beenackers, Mariëlle A; Goldbaum, Moisés; Barros, Marilisa Berti de Azevedo; Gianini, Reinaldo José; Cesar, Chester Luiz Galvão; Mackenbach, Johan P

    2017-05-18

    The study analyzed how socioeconomic factors are associated with seeking, access, use, and quality of health care services in São Paulo, Brazil. Data were obtained from two household health surveys in São Paulo. We used logistic regression to analyze associations between socioeconomic factors and seeking, access, use, and quality of health care services. Access to health care services was high among those who sought it (94.91% in 2003 and 94.98% in 2008). The proportion of access to and use of health care services did not change significantly from 2003 to 2008. Use of services in the public sector was more frequent in lower socioeconomic groups. There were some socioeconomic differences in seeking health care and resolution of health problems. The study showed almost universal access to health care services, but the results suggest problems in quality of services and differences in quality experienced by lower socioeconomic groups, who mostly use the Brazilian Unified National Health System (SUS).

  20. Accessing the SEED genome databases via Web services API: tools for programmers.

    PubMed

    Disz, Terry; Akhter, Sajia; Cuevas, Daniel; Olson, Robert; Overbeek, Ross; Vonstein, Veronika; Stevens, Rick; Edwards, Robert A

    2010-06-14

    The SEED integrates many publicly available genome sequences into a single resource. The database contains accurate and up-to-date annotations based on the subsystems concept that leverages clustering between genomes and other clues to accurately and efficiently annotate microbial genomes. The backend is used as the foundation for many genome annotation tools, such as the Rapid Annotation using Subsystems Technology (RAST) server for whole genome annotation, the metagenomics RAST server for random community genome annotations, and the annotation clearinghouse for exchanging annotations from different resources. In addition to a web user interface, the SEED also provides Web services based API for programmatic access to the data in the SEED, allowing the development of third-party tools and mash-ups. The currently exposed Web services encompass over forty different methods for accessing data related to microbial genome annotations. The Web services provide comprehensive access to the database back end, allowing any programmer access to the most consistent and accurate genome annotations available. The Web services are deployed using a platform independent service-oriented approach that allows the user to choose the most suitable programming platform for their application. Example code demonstrate that Web services can be used to access the SEED using common bioinformatics programming languages such as Perl, Python, and Java. We present a novel approach to access the SEED database. Using Web services, a robust API for access to genomics data is provided, without requiring large volume downloads all at once. The API ensures timely access to the most current datasets available, including the new genomes as soon as they come online.

  1. Geographic Disparities in Access to Agencies Providing Income-Related Social Services.

    PubMed

    Bauer, Scott R; Monuteaux, Michael C; Fleegler, Eric W

    2015-10-01

    Geographic location is an important factor in understanding disparities in access to health-care and social services. The objective of this cross-sectional study is to evaluate disparities in the geographic distribution of income-related social service agencies relative to populations in need within Boston. Agency locations were obtained from a comprehensive database of social services in Boston. Geographic information systems mapped the spatial relationship of the agencies to the population using point density estimation and was compared to census population data. A multivariate logistic regression was conducted to evaluate factors associated with categories of income-related agency density. Median agency density within census block groups ranged from 0 to 8 agencies per square mile per 100 population below the federal poverty level (FPL). Thirty percent (n = 31,810) of persons living below the FPL have no access to income-related social services within 0.5 miles, and 77 % of persons living below FPL (n = 83,022) have access to 2 or fewer agencies. 27.0 % of Blacks, 30.1 % of Hispanics, and 41.0 % of non-Hispanic Whites with incomes below FPL have zero access. In conclusion, some neighborhoods in Boston with a high concentration of low-income populations have limited access to income-related social service agencies.

  2. Accessibility and distribution of the Norwegian National Air Emergency Service: 1988-1998.

    PubMed

    Heggestad, Torhild; Børsheim, Knut Yngve

    2002-01-01

    To evaluate the accessibility and distribution of the Norwegian National Air Emergency Service in the 10-year period from 1988 to 1998. The primary material was annual standardized activity data that included all helicopter missions. A multivariate model of determinants for use of the helicopter service was computed by linear regression. Accessibility was measured as the percentage of the population reached in different flying times, and we evaluated the service using a simulation of alternative locations for the helicopter bases. The helicopter service (HEMS) has short access times, with a mean reaction time of 8 minutes and a mean response time of 26 minutes for acute missions. Nearly all patients (98%) are reached within 1 hour. A simulation that tested alternative locations of the helicopter bases compared with current locations showed no increase in accessibility. The use of the service shows large regional differences. Multivariate analyses showed that the distances of the patients from the nearest helicopter base and the nearest hospital are significant determinants for the use of HEMS. Establishment of a national service has given the Norwegian population better access to highly qualified prehospital emergency services. Furthermore, the HEMS has a compensating effect in adjusting for differences in traveling distances to a hospital. Safety, cost-containment, and gatekeeper functions remain challenges.

  3. Web service activities at the IRIS DMC to support federated and multidisciplinary access

    NASA Astrophysics Data System (ADS)

    Trabant, Chad; Ahern, Timothy K.

    2013-04-01

    At the IRIS Data Management Center (DMC) we have developed a suite of web service interfaces to access our large archive of, primarily seismological, time series data and related metadata. The goals of these web services include providing: a) next-generation and easily used access interfaces for our current users, b) access to data holdings in a form usable for non-seismologists, c) programmatic access to facilitate integration into data processing workflows and d) a foundation for participation in federated data discovery and access systems. To support our current users, our services provide access to the raw time series data and metadata or conversions of the raw data to commonly used formats. Our services also support simple, on-the-fly signal processing options that are common first steps in many workflows. Additionally, high-level data products derived from raw data are available via service interfaces. To support data access by researchers unfamiliar with seismic data we offer conversion of the data to broadly usable formats (e.g. ASCII text) and data processing to convert the data to Earth units. By their very nature, web services are programmatic interfaces. Combined with ubiquitous support for web technologies in programming & scripting languages and support in many computing environments, web services are very well suited for integrating data access into data processing workflows. As programmatic interfaces that can return data in both discipline-specific and broadly usable formats, our services are also well suited for participation in federated and brokered systems either specific to seismology or multidisciplinary. Working within the International Federation of Digital Seismograph Networks, the DMC collaborated on the specification of standardized web service interfaces for use at any seismological data center. These data access interfaces, when supported by multiple data centers, will form a foundation on which to build discovery and access mechanisms

  4. 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.

  5. Health system weaknesses constrain access to PMTCT and maternal HIV services in South Africa: a qualitative enquiry.

    PubMed

    Sprague, Courtenay; Chersich, Matthew F; Black, Vivian

    2011-03-03

    HIV remains responsible for an estimated 40% of mortality in South African pregnant women and their children. To address these avoidable deaths, eligibility criteria for antiretroviral therapy (ART) in pregnant women were revised in 2010 to enhance ART coverage. With greater availability of HIV services in public health settings and increasing government attention to poor maternal-child health outcomes, this study used the patient's journey through the continuum of maternal and child care as a framework to track and document women's experiences of accessing ART and prevention of mother-to-child HIV transmission (PMTCT) programmes in the Eastern Cape (three peri-urban facilities) and Gauteng provinces (one academic hospital). In-depth interviews identified considerable weaknesses within operational HIV service delivery. These manifested as missed opportunities for HIV testing in antenatal care due to shortages of test kits; insufficient staff assigned to HIV services; late payment of lay counsellors, with consequent absenteeism; and delayed transcription of CD4 cell count results into patient files (required for ART initiation). By contrast, individual factors undermining access encompassed psychosocial concerns, such as fear of a positive test result or a partner's reaction; and stigma. Data and information systems for monitoring in the three peri-urban facilities were markedly inadequate. A single system- or individual-level delay reduced the likelihood of women accessing ART or PMTCT interventions. These delays, when concurrent, often signalled wholesale denial of prevention and treatment. There is great scope for health systems' reforms to address constraints and weaknesses within PMTCT and ART services in South Africa. Recommendations from this study include: ensuring autonomy over resources at lower levels; linking performance management to facility-wide human resources interventions; developing accountability systems; improving HIV services in labour wards

  6. Access to care for autism-related services.

    PubMed

    Thomas, Kathleen C; Ellis, Alan R; McLaurin, Carolyn; Daniels, Julie; Morrissey, Joseph P

    2007-11-01

    This paper identifies family characteristics associated with use of autism-related services. A telephone or in-person survey was completed during 2003-2005 by 383 North Carolina families with a child 11 years old or younger with ASD. Access to care is limited for racial and ethnic minority families, with low parental education, living in nonmetropolitan areas, and not following a major treatment approach. Service use is more likely when parents have higher stress. Families use a broad array of services; the mix varies with child ASD diagnosis and age group. Disparities in service use associated with race, residence and education point to the need to develop policy, practice and family-level interventions that can address barriers to services for children with ASD.

  7. Utilizing Syllabi to Support Access Services and Beyond: A Case Study

    ERIC Educational Resources Information Center

    Parrott, Justin; Lindsay, Beth Daniel

    2017-01-01

    New York University Abu Dhabi (NYUAD) Library receives copies of all course syllabi to provide a number of services to faculty and students related to acquisitions, access, collection development, subject liaison, and library instruction. Access services and acquisitions staff, as well as subject liaison librarians, work together using specific…

  8. 45 CFR 152.22 - Access to services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... CONDITION INSURANCE PLAN PROGRAM Benefits § 152.22 Access to services. (a) General rule. A PCIP may specify... failure to obtain immediate treatment could present a serious risk to his or her life or health; and (2...

  9. A Pacific population's access to and use of health services in Dunedin.

    PubMed

    Sopoaga, Faafetai; Parkin, Lianne; Gray, Andrew

    2012-10-26

    Pacific peoples in New Zealand (mostly of Samoan, Tongan, or Cook Islands origin) have poor health compared to the total New Zealand population. Understanding their access to and use of health services is important in resolving this. A survey of Pacific peoples in Dunedin obtained information about their access to and use of health services. 372 questionnaires were analysed. Approximately one-quarter did not have a regular doctor or health service. At least 50% used hospital emergency services for non-urgent illnesses. Nearly two-thirds used a "walk-in" primary care service. A significant proportion of Pacific peoples did not have a regular GP or health service in Dunedin. It was surprising students were more likely to be in this category because student health services should be more affordable. A "walk-in" primary care facility has a role in the delivery of primary care services. Pacific organisations can assist primary care providers to encourage access to and the appropriate use of health services.

  10. Migrant's access to preventive health services in five EU countries.

    PubMed

    Rosano, Aldo; Dauvrin, Marie; Buttigieg, Sandra C; Ronda, Elena; Tafforeau, Jean; Dias, Sonia

    2017-08-23

    Preventive health services (PHSs) form part of primary healthcare with the aim of screening to prevent disease. Migrants show significant differences in lifestyle, health beliefs and risk factors compared with the native populations. This can have a significant impact on migrants' access to health systems and participation in prevention programmes. Even in countries with widely accessible healthcare systems, migrants' access to PHSs may be difficult. The aim of the study was to compare access to preventive health services between migrants and native populations in five European Union (EU) countries. Information from Health Interview Surveys of Belgium, Italy, Malta, Portugal and Spain were used to analyse access to mammography, Pap smear tests, colorectal cancer screening and flu vaccination among migrants. The comparative risk of not accessing PHSs was calculated using a mixed-effects multilevel model, adjusting for potential confounding factors (sex, education and the presence of disability). Migrant status was defined according to citizenship, with a distinction made between EU and non-EU countries. Migrants, in particular those from non-EU countries, were found to have poorer access to PHSs. The overall risk of not reporting a screening test or a flu vaccination ranged from a minimum of 1.8 times (colorectal cancer screening), to a high of 4.4 times (flu vaccination) for migrants. The comparison among the five EU countries included in the study showed similarities, with particularly limited access recorded in Italy and in Belgium for non-EU migrants. The findings of this study are in accordance with evidence from the scientific literature. Poor organization of health services, in Italy, and lack of targeted health policies in Belgium may explain these findings. PHSs should be responsive to patient diversity, probably more so than other health services. There is a need for diversity-oriented, migrant-sensitive prevention. Policies oriented to removing

  11. Index of Access: a new innovative and dynamic tool for rural health service and workforce planning.

    PubMed

    McGrail, Matthew R; Russell, Deborah J; Humphreys, John S

    2017-10-01

    Objective Improving access to primary health care (PHC) remains a key issue for rural residents and health service planners. This study aims to show that how access to PHC services is measured has important implications for rural health service and workforce planning. Methods A more sophisticated tool to measure access to PHC services is proposed, which can help health service planners overcome the shortcomings of existing measures and long-standing access barriers to PHC. Critically, the proposed Index of Access captures key components of access and uses a floating catchment approach to better define service areas and population accessibility levels. Moreover, as demonstrated through a case study, the Index of Access enables modelling of the effects of workforce supply variations. Results Hypothetical increases in supply are modelled for a range of regional centres, medium and small rural towns, with resulting changes of access scores valuable to informing health service and workforce planning decisions. Conclusions The availability and application of a specific 'fit-for-purpose' access measure enables a more accurate empirical basis for service planning and allocation of health resources. This measure has great potential for improved identification of PHC access inequities and guiding redistribution of PHC services to correct such inequities. What is known about the topic? Resource allocation and health service planning decisions for rural and remote health settings are currently based on either simple measures of access (e.g. provider-to-population ratios) or proxy measures of access (e.g. standard geographical classifications). Both approaches have substantial limitations for informing rural health service planning and decision making. What does this paper add? The adoption of a new improved tool to measure access to PHC services, the Index of Access, is proposed to assist health service and workforce planning. Its usefulness for health service planning is

  12. De-optical-line-terminal hybrid access-aggregation optical network for time-sensitive services based on software-defined networking orchestration

    NASA Astrophysics Data System (ADS)

    Bai, Wei; Yang, Hui; Xiao, Hongyun; Yu, Ao; He, Linkuan; Zhang, Jie; Li, Zhen; Du, Yi

    2017-11-01

    With the increase in varieties of services in network, time-sensitive services (TSSs) appear and bring forward an impending need for delay performance. Ultralow-latency communication has become one of the important development goals for many scenarios in the coming 5G era (e.g., robotics and driverless cars). However, the conventional methods, which decrease delay by promoting the available resources and the network transmission speed, have limited effect; a new breakthrough for ultralow-latency communication is necessary. We propose a de-optical-line-terminal (De-OLT) hybrid access-aggregation optical network (DAON) for TSS based on software-defined networking (SDN) orchestration. In this network, low-latency all-optical communication based on optical burst switching can be achieved by removing OLT. For supporting this network and guaranteeing the quality of service for TSSs, we design SDN-driven control method and service provision method. Numerical results demonstrate the proposed DAON promotes network service efficiency and avoids traffic congestion.

  13. The Role of the Access Services Manager in the Virtual Library

    ERIC Educational Resources Information Center

    Jetton, Lora Lennertz; Bailey, Alberta S.

    2010-01-01

    This article updates a previous article published in 1992 that described the role of the access services manager in policy formation. Since that time, the access services department and mission has matured and evolved to a prominent position within the library organization. Technological changes and innovation in the marketplace of wired and…

  14. Access Services: Organization and Management. SPEC Kit #179.

    ERIC Educational Resources Information Center

    Steel, Virginia, Comp.

    This Systems and Exchange Center (SPEC) kit begins with a summary by Virginia Steel of the findings of a survey of Association of Research Libraries (ARL) member libraries that was conducted in 1991 to determine the prevalence of the organizational model of access services--i.e., a department or division responsible for the services and operations…

  15. Diabetes care and service access among elderly Vietnamese with type 2 diabetes.

    PubMed

    Carolan-Olah, Mary C; Cassar, Angie; Quiazon, Regina; Lynch, Sean

    2013-10-29

    Vietnamese patients are disproportionately represented in type 2 diabetes mellitus statistics and also incur high rates of diabetes complications. This situation is compounded by limited access to health care. The aim of this project was to gain a deeper understanding of the difficulties Vietnamese patients experience when accessing services and managing their type 2 diabetes mellitus, and to identify factors that are important in promoting health service use. Three focus groups with 15 Vietnamese participants with type 2 diabetes mellitus, 60 to >70 years of age, were conducted in Vietnamese. Open-ended questions were used and focussed on experiences of living with diabetes and access to healthcare services in the Inner Northwest Melbourne region. Audio recordings were transcribed and then translated into English. Data were analysed using a thematic analysis framework. Findings indicate four main themes, which together provide some insight into the experiences of living with diabetes and accessing ongoing care and support, for elderly Vietnamese with type 2 diabetes. Themes included: (1) the value of being healthy; (2) controlling diabetes; (3) staying healthy; and (4) improving services and information access. Participants in this study were encouraged to adhere to diabetes self-management principles, based largely on a fear of medical complications. Important aspects of healthcare access were identified as; being treated with respect, having their questions answered and having access to interpreters and information in Vietnamese. Attention to these details is likely to lead to improved access to healthcare services and ultimately to improve glycemic control and overall health status for this community.

  16. Ancillary-service costs for 12 US electric utilities

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

    Kirby, B.; Hirst, E.

    1996-03-01

    Ancillary services are those functions performed by electrical generating, transmission, system-control, and distribution-system equipment and people to support the basic services of generating capacity, energy supply, and power delivery. The Federal Energy Regulatory Commission defined ancillary services as ``those services necessary to support the transmission of electric power from seller to purchaser given the obligations of control areas and transmitting utilities within those control areas to maintain reliable operations of the interconnected transmission system.`` FERC divided these services into three categories: ``actions taken to effect the transaction (such as scheduling and dispatching services) , services that are necessary to maintainmore » the integrity of the transmission system [and] services needed to correct for the effects associated with undertaking a transaction.`` In March 1995, FERC published a proposed rule to ensure open and comparable access to transmission networks throughout the country. The rule defined six ancillary services and developed pro forma tariffs for these services: scheduling and dispatch, load following, system protection, energy imbalance, loss compensation, and reactive power/voltage control.« less

  17. Measuring geographical accessibility to rural and remote health care services: Challenges and considerations.

    PubMed

    Shah, Tayyab Ikram; Milosavljevic, Stephan; Bath, Brenna

    2017-06-01

    This research is focused on methodological challenges and considerations associated with the estimation of the geographical aspects of access to healthcare with a focus on rural and remote areas. With the assumption that GIS-based accessibility measures for rural healthcare services will vary across geographic units of analysis and estimation techniques, which could influence the interpretation of spatial access to rural healthcare services. Estimations of geographical accessibility depend on variations of the following three parameters: 1) quality of input data; 2) accessibility method; and 3) geographical area. This research investigated the spatial distributions of physiotherapists (PTs) in comparison to family physicians (FPs) across Saskatchewan, Canada. The three-steps floating catchment areas (3SFCA) method was applied to calculate the accessibility scores for both PT and FP services at two different geographical units. A comparison of accessibility scores to simple healthcare provider-to-population ratios was also calculated. The results vary considerably depending on the accessibility methods used and the choice of geographical area unit for measuring geographical accessibility for both FP and PT services. These findings raise intriguing questions regarding the nature and extent of technical issues and methodological considerations that can affect GIS-based measures in health services research and planning. This study demonstrates how the selection of geographical areal units and different methods for measuring geographical accessibility could affect the distribution of healthcare resources in rural areas. These methodological issues have implications for determining where there is reduced access that will ultimately impact health human resource priorities and policies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. 47 CFR 64.1508 - Blocking access to 900 service.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Blocking access to 900 service. 64.1508 Section 64.1508 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Interstate Pay-Per-Call and Other Information...

  19. Hospital-Based Outpatient Direct Access to Physical Therapist Services: Current Status in Wisconsin.

    PubMed

    Boissonnault, William G; Lovely, Karen

    2016-11-01

    Direct access to physical therapist services is available in all 50 states, with reported benefits including reduced health care costs, enhanced patient satisfaction, and no apparent compromised patient safety. Despite the benefits and legality of direct access, few data exist regarding the degree of model adoption, implementation, and utilization. The purposes of the study were: (1) to investigate the extent of implementation and utilization of direct access to outpatient physical therapist services in Wisconsin hospitals and medical centers, (2) to identify barriers to and facilitators for the provisioning of such services, and (3) to identify potential differences between facilities that do and do not provide direct access services. A descriptive survey was conducted. Eighty-nine survey questionnaires were distributed via email to the directors of rehabilitation services at Wisconsin hospitals and medical centers. The survey investigated facility adoption of the direct access model, challenges to and resources utilized during model implementation, and current barriers affecting model utilization. Forty-seven (52.8%) of the 89 survey questionnaires were completed and returned. Forty-two percent of the survey respondents (20 of 47) reported that their facility offered direct access to physical therapist services, but fewer than 10% of patients were seen via direct access at 95% of the facilities offering such services. The most frequently reported obstacles to model implementation and utilization were lack of health care provider, administrator, and patient knowledge of direct access; its legality in Wisconsin; and physical therapists' differential diagnosis and medical screening abilities. Potential respondent bias and limited generalizability of the results are limitations of the study. These findings apply to hospitals and medical centers located in Wisconsin, not to facilities located in other geographic regions. Respondents representing direct access

  20. Assessing potential spatial accessibility of health services in rural China: a case study of Donghai county

    PubMed Central

    2013-01-01

    Introduction There is a great health services disparity between urban and rural areas in China. The percentage of people who are unable to access health services due to long travel times increases. This paper takes Donghai County as the study unit to analyse areas with physician shortages and characteristics of the potential spatial accessibility of health services. We analyse how the unequal health services resources distribution and the New Cooperative Medical Scheme affect the potential spatial accessibility of health services in Donghai County. We also give some advice on how to alleviate the unequal spatial accessibility of health services in areas that are more remote and isolated. Methods The shortest traffic times of from hospitals to villages are calculated with an O-D matrix of GIS extension model. This paper applies an enhanced two-step floating catchment area (E2SFCA) method to study the spatial accessibility of health services and to determine areas with physician shortages in Donghai County. The sensitivity of the E2SFCA for assessing variation in the spatial accessibility of health services is checked using different impedance coefficient valuesa. Geostatistical Analyst model and spatial analyst method is used to analyse the spatial pattern and the edge effect of potential spatial accessibility of health services. Results The results show that 69% of villages have access to lower potential spatial accessibility of health services than the average for Donghai County, and 79% of the village scores are lower than the average for Jiangsu Province. The potential spatial accessibility of health services diminishes greatly from the centre of the county to outlying areas. Using a smaller impedance coefficient leads to greater disparity among the villages. The spatial accessibility of health services is greater along highway in the county. Conclusions Most of villages are in underserved health services areas. An unequal distribution of health service

  1. Accessibility of Catering Service Venues and Adolescent Drinking in Beijing, China.

    PubMed

    Lu, Shijun; Du, Songming; Ren, Zhoupeng; Zhao, Jing; Chambers, Christina; Wang, Jinfeng; Ma, Guansheng

    2015-06-26

    This study assessed the association between accessibility of catering service venues and adolescents' alcohol use over the previous 30 days. The data were collected from cross-sectional surveys conducted in 2014, 2223 students at 27 high schools in Chaoyang and Xicheng districts, Beijing using self-administered questionnaires to collect the adolescents information on socio-demographic characteristics and recent alcohol experiences. The accessibility of, and proximity to, catering service venues were summarized by weights, which were calculated by multiplication of the type-weight and the distance-weight. All sampled schools were categorized into three subgroups (low, middle, and high geographic density) based on the tertile of nearby catering service venues, and a multi-level logistic regression analysis was performed to explore variance between the school levels. Considering the setting characteristics, the catering service venues weighted value was found to account for 8.6% of the school level variance of adolescent alcohol use. The odds ratios (OR) and 95% confidence intervals (CI) of drinking over the past 30-days among adolescents with medium and high accessibility of catering service venues were 1.17 (0.86, 1.57) and 1.47 (1.06, 2.02), respectively (p < 0.001 for trend test). This study addressed a gap in the adolescent drinking influence by the catering service venues around schools in China. Results suggest that the greater accessibility of catering service venues around schools is associated with a growing risk of recent drinking.

  2. Accessibility of Catering Service Venues and Adolescent Drinking in Beijing, China

    PubMed Central

    Lu, Shijun; Du, Songming; Ren, Zhoupeng; Zhao, Jing; Chambers, Christina; Wang, Jinfeng; Ma, Guansheng

    2015-01-01

    This study assessed the association between accessibility of catering service venues and adolescents’ alcohol use over the previous 30 days. The data were collected from cross-sectional surveys conducted in 2014, 2223 students at 27 high schools in Chaoyang and Xicheng districts, Beijing using self-administered questionnaires to collect the adolescents information on socio-demographic characteristics and recent alcohol experiences. The accessibility of, and proximity to, catering service venues were summarized by weights, which were calculated by multiplication of the type-weight and the distance-weight. All sampled schools were categorized into three subgroups (low, middle, and high geographic density) based on the tertile of nearby catering service venues, and a multi-level logistic regression analysis was performed to explore variance between the school levels. Considering the setting characteristics, the catering service venues weighted value was found to account for 8.6% of the school level variance of adolescent alcohol use. The odds ratios (OR) and 95% confidence intervals (CI) of drinking over the past 30-days among adolescents with medium and high accessibility of catering service venues were 1.17 (0.86, 1.57) and 1.47 (1.06, 2.02), respectively (p < 0.001 for trend test). This study addressed a gap in the adolescent drinking influence by the catering service venues around schools in China. Results suggest that the greater accessibility of catering service venues around schools is associated with a growing risk of recent drinking. PMID:26132475

  3. Access to Complex Abortion Care Service and Planning Improved through a Toll-Free Telephone Resource Line

    PubMed Central

    Norman, Wendy V.; Hestrin, Barbara; Dueck, Royce

    2014-01-01

    Background. Providing equitable access to the full range of reproductive health services over wide geographic areas presents significant challenges to any health system. We present a review of a service provision model which has provided improved access to abortion care; support for complex issues experienced by women seeking nonjudgmental family planning health services; and a mechanism to collect information on access barriers. The toll-free pregnancy options service (POS) of British Columbia Women's Hospital and Health Centre sought to improve access to services and overcome barriers experienced by women seeking abortion. Methods. We describe the development and implementation of a province-wide toll-free telephone counseling and access facilitation service, including establishment of a provincial network of local abortion service providers in the Canadian province of British Columbia from 1998 to 2010. Results. Over 2000 women annually access service via the POS line, networks of care providers are established and linked to central support, and central program planners receive timely information on new service gaps and access barriers. Conclusion. This novel service has been successful in addressing inequities and access barriers identified as priorities before service establishment. The service provided unanticipated benefits to health care planning and monitoring of provincial health care related service delivery and gaps. This model for low cost health service delivery may realize similar benefits when applied to other health care systems where access and referral barriers exist. PMID:24693291

  4. Barriers to health service access among female migrant Ugandan sex workers in Guangzhou, China.

    PubMed

    Davis, Alissa; Meyerson, Beth E; Aghaulor, Blessing; Brown, Katherine; Watson, Adisyn; Muessig, Kathryn E; Yang, Ligang; Tucker, Joseph D

    2016-10-14

    Increased trade between China and Uganda has fueled trafficking of female Ugandans into China. These women may face challenges accessing health services. This study focused on examining barriers to health care access among female Ugandan sex workers in China. In 2014, we undertook in-depth interviews with 19 female Ugandan sex workers in Guangzhou, China. Interviews focused on barriers to health service access and were analyzed using an a priori coding framework followed by open-coding to capture emergent themes. Out of 19 women, 12 women reported a history of being trafficked into China. None of the women had a valid Chinese visa. Fear of being arrested for lack of documentation discouraged women in this sample from accessing hospital services. Low pay, housing exploitation, and remittances contributed to participants' lack of financial resources, which further inhibited their ability to access health services. Participants expressed feeling social isolation from the local community and reported mistrust of local individuals and organizations, including hospitals. Ugandan sex workers in China faced substantial structural barriers that limited health service access. Policy changes and the development of new programs are urgently needed to ensure these women have improved access to health services.

  5. Population Accessibility to Radiotherapy Services in New South Wales Region of Australia: a methodological contribution

    NASA Astrophysics Data System (ADS)

    Shukla, Nagesh; Wickramasuriya, Rohan; Miller, Andrew; Perez, Pascal

    2015-05-01

    This paper proposes an integrated modelling process to assess the population accessibility to radiotherapy treatment services in future based on future cancer incidence and road network-based accessibility. Previous research efforts assessed travel distance/time barriers affecting access to cancer treatment services, as well as epidemiological studies that showed that cancer incidence rates vary with population demography. It is established that travel distances to treatment centres and demographic profiles of the accessible regions greatly influence the demand for cancer radiotherapy (RT) services. However, an integrated service planning approach that combines spatially-explicit cancer incidence projections, and the RT services accessibility based on patient road network have never been attempted. This research work presents this novel methodology for the accessibility assessment of RT services and demonstrates its viability by modelling New South Wales (NSW) cancer incidence rates for different age-sex groups based on observed cancer incidence trends; estimating the road network-based access to current NSW treatment centres; and, projecting the demand for RT services in New South Wales, Australia from year 2011 to 2026.

  6. Organizing uninsured safety-net access to specialist physician services.

    PubMed

    Hall, Mark A

    2013-05-01

    Arranging referrals for specialist services is often the greatest difficulty that safety-net access programs face in attempting to provide fairly comprehensive services for the uninsured. When office-based community specialists are asked to care for uninsured patients, they cite the following barriers: difficulty determining which patients merit charity care, having to arrange for services patients need from other providers, and concerns about liability for providing inadequate care. Solutions to these barriers to specialist access can be found in the same institutional arrangements that support primary care and hospital services for the uninsured. These safety-net organization structures can be extended to include specialist physician care by funding community health centers to contract for specialist referrals, using free-standing referral programs to subsidize community specialists who accept uninsured patients at discounted rates, and encouraging hospitals through tax exemption or disproportionate share funding to require specialists on their medical staffs to accept an allocation of uninsured office-based referrals.

  7. 7 CFR 1755.500 - RUS standard for service installations at customers access locations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false RUS standard for service installations at customers... customers access locations. (a) Sections 1755.501 through 1755.510 cover service installations at permanent or mobile home customer access locations. Sections 1755.501 through 1755.510 do not cover service...

  8. Dual-mode ultraflow access networks: a hybrid solution for the access bottleneck

    NASA Astrophysics Data System (ADS)

    Kazovsky, Leonid G.; Shen, Thomas Shunrong; Dhaini, Ahmad R.; Yin, Shuang; De Leenheer, Marc; Detwiler, Benjamin A.

    2013-12-01

    Optical Flow Switching (OFS) is a promising solution for large Internet data transfers. In this paper, we introduce UltraFlow Access, a novel optical access network architecture that offers dual-mode service to its end-users: IP and OFS. With UltraFlow Access, we design and implement a new dual-mode control plane and a new dual-mode network stack to ensure efficient connection setup and reliable and optimal data transmission. We study the impact of the UltraFlow system's design on the network throughput. Our experimental results show that with an optimized system design, near optimal (around 10 Gb/s) OFS data throughput can be attained when the line rate is 10Gb/s.

  9. Simultaneous 10 Gbps data and polarization-based pulse-per-second clock transmission using a single VCSEL for high-speed optical fibre access networks

    NASA Astrophysics Data System (ADS)

    Isoe, G. M.; Wassin, S.; Gamatham, R. R. G.; Leitch, A. W. R.; Gibbon, T. B.

    2017-01-01

    Access networks based on vertical cavity surface emitting laser (VCSEL) transmitters offer alternative solution in delivering different high bandwidth, cost effective services to the customer premises. Clock and reference frequency distribution is critical for applications such as Coordinated Universal Time (UTC), GPS, banking and big data science projects. Simultaneous distribution of both data and timing signals over shared infrastructure is thus desirable. In this paper, we propose and experimentally demonstrate a novel, cost-effective technique for multi-signal modulation on a single VCSEL transmitter. Two signal types, an intensity modulated 10 Gbps data signal and a polarization-based pulse per second (PPS) clock signal are directly modulated onto a single VCSEL carrier at 1310 nm. Spectral efficiency is maximized by exploiting inherent orthogonal polarization switching of the VCSEL with changing bias in transmission of the PPS signal. A 10 Gbps VCSEL transmission with PPS over 11 km of G.652 fibre introduced a transmission penalty of 0.52 dB. The contribution of PPS to this penalty was found to be 0.08 dB.

  10. Service Accessibility for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth

    ERIC Educational Resources Information Center

    Acevedo-Polakovich, Ignacio David; Bell, Bailey; Gamache, Peter; Christian, Allison S.

    2013-01-01

    Although Lesbian, Gay, Bisexual, Transgender, Queer and/or Questioning (LGBTQ) youth experience alarming rates of behavioral and social problems, service use among these youth is disproportionately low. It is likely that decreased service accessibility plays a causal role in service underutilization among LGBTQ youth. To expand the existing…

  11. Automatic Transmission/Transaxle Specialist. Instructor Manual and Student Workbook. Automotive Service Series.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This curriculum guide for transmission/transaxle specialist is one in a series of automotive service speciality publications that is based on the National Institute of Automotive Service Excellence task lists. The curriculum contains nine units. Each unit of instruction includes some or all of the following components: objective sheet,…

  12. Access to Dental Services for People Using a Wheelchair

    PubMed Central

    Nicolau, Belinda; Bedos, Christophe

    2015-01-01

    Objectives. We investigated the perspectives of people using a wheelchair and their difficulties in accessing dental services. Methods. Our participatory research was on the basis of a partnership between people using a wheelchair, dental professionals, and academic researchers. Partners were involved in a committee that provided advice at all stages of the project. Our team adopted a qualitative descriptive design. Between October 2011 and October 2012 we conducted semistructured individual interviews with 13 adults who lived in Montreal, Québec, Canada, and used a wheelchair full time. We audio-recorded and transcribed verbatim interviews, and we interpreted data using an inductive thematic analysis. Results. Oral health is of heightened importance to this group of people, who tend to use their mouth as a “third hand.” We identified successive challenges in accessing dental services: finding a dentist and being accepted, organizing transportation, entering the building and circulating inside, interacting with the dental staff, transferring and overcoming discomfort on the dental chair, and paying for the treatments. Conclusions. Governments, dental professional bodies, dental schools, and researchers should work with groups representing wheelchair users to improve access to dental services. PMID:26378836

  13. Moving beyond the Amalgam: Restructuring Access Services

    ERIC Educational Resources Information Center

    Austin, Brice

    2010-01-01

    At least since the early 1990s, academic libraries have been merging Circulation and various other related functions into a single department typically labeled "Access Services." In many cases, however, that merger has proven to be administrative rather than functional, with minimal integration of common workflows. This article describes…

  14. Assessment and Evaluation Methods for Access Services

    ERIC Educational Resources Information Center

    Long, Dallas

    2014-01-01

    This article serves as a primer for assessment and evaluation design by describing the range of methods commonly employed in library settings. Quantitative methods, such as counting and benchmarking measures, are useful for investigating the internal operations of an access services department in order to identify workflow inefficiencies or…

  15. An Introduction to Services Accessible on the Internet.

    ERIC Educational Resources Information Center

    Giguere, Marlene

    1992-01-01

    Provides an overview of the INTERNET and INTERNET services of interest to libraries, including electronic mail, bulletin boards, electronic publishing, online public access catalogs and databases, and downloaded texts and software. (16 references) (MES)

  16. Postpolio Survivors: Needs for and Access to Social and Health Care Services.

    ERIC Educational Resources Information Center

    Foster, Larry W.; And Others

    1993-01-01

    Needs assessment survey of 268 polio survivors explored incidence of postpolio syndrome and perceived need for and access to social and health care services. Large proportion of respondents reported experiencing postpolio syndrome. Most perceived that they had no access to knowledgeable physicians or social and health care services, and most were…

  17. A Flexible Component based Access Control Architecture for OPeNDAP Services

    NASA Astrophysics Data System (ADS)

    Kershaw, Philip; Ananthakrishnan, Rachana; Cinquini, Luca; Lawrence, Bryan; Pascoe, Stephen; Siebenlist, Frank

    2010-05-01

    Network data access services such as OPeNDAP enable widespread access to data across user communities. However, without ready means to restrict access to data for such services, data providers and data owners are constrained from making their data more widely available. Even with such capability, the range of different security technologies available can make interoperability between services and user client tools a challenge. OPeNDAP is a key data access service in the infrastructure under development to support the CMIP5 (Couple Model Intercomparison Project Phase 5). The work is being carried out as part of an international collaboration including the US Earth System Grid and Curator projects and the EU funded IS-ENES and Metafor projects. This infrastructure will bring together Petabytes of climate model data and associated metadata from over twenty modelling centres around the world in a federation with a core archive mirrored at three data centres. A security system is needed to meet the requirements of organisations responsible for model data including the ability to restrict data access to registered users, keep them up to date with changes to data and services, audit access and protect finite computing resources. Individual organisations have existing tools and services such as OPeNDAP with which users in the climate research community are already familiar. The security system should overlay access control in a way which maintains the usability and ease of access to these services. The BADC (British Atmospheric Data Centre) has been working in collaboration with the Earth System Grid development team and partner organisations to develop the security architecture. OpenID and MyProxy were selected at an early stage in the ESG project to provide single sign-on capability across the federation of participating organisations. Building on the existing OPeNDAP specification an architecture based on pluggable server side components has been developed at the BADC

  18. Access to health services by lesbian, gay, bisexual, and transgender persons: systematic literature review.

    PubMed

    Alencar Albuquerque, Grayce; de Lima Garcia, Cintia; da Silva Quirino, Glauberto; Alves, Maria Juscinaide Henrique; Belém, Jameson Moreira; dos Santos Figueiredo, Francisco Winter; da Silva Paiva, Laércio; do Nascimento, Vânia Barbosa; da Silva Maciel, Érika; Valenti, Vitor Engrácia; de Abreu, Luiz Carlos; Adami, Fernando

    2016-01-14

    The relationship between users and health services is considered essential to strengthen the quality of care. However, the Lesbian, Gay, Bisexual, and Transgender population suffer from prejudice and discrimination in access and use of these services. This study aimed to identify the difficulties associated with homosexuality in access and utilization of health services. A systematic review conducted using PubMed, Cochrane, SciELO, and LILACS, considering the period from 2004 to 2014. The studies were evaluated according to predefined inclusion and exclusion criterias. Were included manuscripts written in English or Portuguese, articles examining the Lesbian, Gay, Bisexual, and Transgender population's access to health services and original articles with full text available online. The electronic databases search resulted in 667 studies, of which 14 met all inclusion criteria. Quantitative articles were predominant, showing the country of United States of America to be the largest producer of research on the topic. The studies reveal that the homosexual population have difficulties of access to health services as a result of heteronormative attitudes imposed by health professionals. The discriminatory attendance implies in human rights violations in access to health services. The non-heterosexual orientation was a determinant factor in the difficulties of accessing health care. A lot must still be achieved to ensure access to health services for sexual minorities, through the adoption of holistic and welcoming attitudes. The results of this study highlight the need for larger discussions about the theme, through new research and debates, with the aim of enhancing professionals and services for the health care of Lesbian, Gay, Bisexual, and Transgender Persons.

  19. Risk behavior and access to HIV/AIDS prevention services in a community sample of homeless persons entering permanent supportive housing.

    PubMed

    Wenzel, Suzanne L; Rhoades, Harmony; Harris, Taylor; Winetrobe, Hailey; Rice, Eric; Henwood, Ben

    2017-05-01

    Homeless persons suffer disproportionately high rates of HIV infection, and moving into permanent supportive housing (PSH) can provide a stable base from which to access needed prevention services. However, little is known about HIV risk or prevention behavior during this critical time of transition. The current study investigated STI and HIV risk and prevention behavior and recent use of prevention and treatment services (i.e., education, testing, medication) among homeless persons preparing to move into PSH. Data come from interviews with 421 homeless adults before they moved into PSH. Thirty-seven percent of the respondents were sexually active; of those, 75.7% reported unprotected sex. Nearly two-thirds (64%) reported past year HIV testing and 40% reported testing for another STI. Fewer than one-third (31%) of respondents reported receiving posttest counseling at their last HIV test. HIV seropositivity was self-reported by 10%. Among those persons who were HIV-positive, 57.1% reported less than 100% antiretroviral (ARV) adherence. Among HIV-negative respondents, less than 1% had been prescribed preexposure prophylaxis (PrEP). Less than half (46.4%) of the sample reported any HIV prevention education in the past year. This population of homeless adults about to move into PSH report high rates of HIV risk behavior, but low rates of HIV prevention education and very little PrEP utilization. Further, low rates of ARV adherence among HIV-positive respondents indicate significant risk for HIV transmission and acquisition. Entering PSH is a period of transition for homeless persons when integrated care is critically important to ensure positive health outcomes, but these data suggest that PrEP and other HIV prevention services are poorly accessed among this population. As such, multipronged services that integrate PrEP and other HIV prevention services are needed to prevent transmission and acquisition of HIV in this high-risk, vulnerable population and ensure the

  20. What systems participants know about access and service entry and why managers should listen.

    PubMed

    Duncombe, Rohena

    2017-08-01

    Objective The present study looked at the views of people directly involved in the entry process for community health counselling using the frame of the health access literature. The concurrence of system participants' views with the access literature highlights access issues, particularly for people who are vulnerable or disadvantaged. The paper privileges the voices of the system participants, inviting local health services to consider using participatory design to improve access at the entry point. Methods People involved in the entry process for community health counselling explored the question, 'What, for you, are the features of a good intake system?' They also commented on themes identified during pilot interviews. These were thematically analysed for each participant group by the researcher to develop a voice for each stakeholder group. Results People accessing the service could be vulnerable and the entry process failed to take that into account. People directly involved in the counselling service entry system, system participants, consisted of: professionals referring in, people seeking services and reception staff taking first enquiries. They shared substantially the same concerns as each other. The responses from these system participants are consistent with the international literature on access and entry into health services. Conclusion Participatory service design could improve primary healthcare service entry at the local level. Canvassing the experiences of system participants is important for delivering services to those who have the least access and, in that way, could contribute to health equity. What is known about the topic? People with the highest health needs receive the fewest services. Health inequality is increasing. What does this paper add? System participants can provide advice consistent with the academic research literature that is useful for improving service entry at the local level. What are the implications for practitioners

  1. A Privacy Access Control Framework for Web Services Collaboration with Role Mechanisms

    NASA Astrophysics Data System (ADS)

    Liu, Linyuan; Huang, Zhiqiu; Zhu, Haibin

    With the popularity of Internet technology, web services are becoming the most promising paradigm for distributed computing. This increased use of web services has meant that more and more personal information of consumers is being shared with web service providers, leading to the need to guarantee the privacy of consumers. This paper proposes a role-based privacy access control framework for Web services collaboration, it utilizes roles to specify the privacy privileges of services, and considers the impact on the reputation degree of the historic experience of services in playing roles. Comparing to the traditional privacy access control approaches, this framework can make the fine-grained authorization decision, thus efficiently protecting consumers' privacy.

  2. [Access to oral health services in children under twelve years of age in Peru, 2014].

    PubMed

    Hernández-Vásquez, Akram; Azañedo, Diego; Díaz-Seijas, Deysi; Bendezú-Quispe, Guido; Arroyo-Hernández, Hugo; Vilcarromero, Stalin; Agudelo-Suárez, Andrés A

    2016-01-01

    The aim of the study was to explore the patterns of dental health services access in children under twelve years of age in Peru. Data from 25,285 children under 12 years who participated in the Demographic and Family Health Survey of 2014 were reviewed. An exploratory spatial analysis was performed to project the proportions of children with access to dental health services, according to national regions, type of health service and urban or rural place of residence. The results show that of the total sample, 26.7% had access to dental health services in the last six months, 39.6% belonged to the age group 0-4 years, 40.6% lived in the Andean region and 58.3% lived in urban areas. The regions of Huancavelica, Apurimac, Ayacucho, Lima and Pasco had the highest percentages of access nationwide. In conclusion, there is low access to dental health services in the population under 12 years of age in Peru. The spatial distribution of access to dental health services allows regions to be identified and grouped according to similar access patterns, in order to better focus public health actions.

  3. 78 FR 17652 - Tri-State Generation and Transmission Association, Inc. v. Public Service Company of New Mexico...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-22

    ... Generation and Transmission Association, Inc. v. Public Service Company of New Mexico; Notice of Complaint... CFR 385.206 and 18 CFR 385.212, Tri-State Generation and Transmission Association, Inc. (Complainant), filed a complaint against the Public Service Company of New Mexico (Respondent or PNM) alleging that...

  4. Support Services for Remote Users of Online Public Access Catalogs.

    ERIC Educational Resources Information Center

    Kalin, Sally W.

    1991-01-01

    Discusses the needs of remote users of online public access catalogs (OPACs). User expectations are discussed; problems encountered by remote-access users are examined, including technical problems and searching problems; support services are described, including instruction, print guides, and online help; and differences from the needs of…

  5. 47 CFR 54.621 - Access to advanced telecommunications and information services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... cannot obtain toll-free access to an Internet service provider shall be entitled to receive the lesser of... monthly cost of eligible Internet access shall be eligible for universal support. Health care providers shall certify that the Internet access selected is the most cost-effective method for their health care...

  6. 47 CFR 76.1204 - Availability of equipment performing conditional access or security functions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... system; and (3) Does not provide access to any digital transmission of multichannel video programming or... COMMISSION (CONTINUED) BROADCAST RADIO SERVICES MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Competitive... security functions. (a)(1) A multichannel video programming distributor that utilizes navigation devices to...

  7. African Americans' Access to Vocational Rehabilitation Services after Antidiscrimination Legislation

    ERIC Educational Resources Information Center

    Mwachofi, Ari K.

    2008-01-01

    The purpose of this study was to determine changes in African Americans' access to occasional rehabilitation (VR) services subsequent to landmark legislative and judicial antidiscrimination provisions of the mid-20th century. This study compared African American VR access before the antidiscrimination legislation in 1937 and after the legislation…

  8. EPAct 2005: A Roadmap for Open Access

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

    Morrison, Jay A.

    After nine years of negotiation characterized by significant philosophical swings, Congress came together in the middle to support a moderate vision of open access intended primarily to enable load-serving entities to obtain the transmission service they need to meet the long-term needs of their consumers reliably and economically.

  9. Improving access to urologists through an electronic consultation service

    PubMed Central

    Witherspoon, Luke; Liddy, Clare; Afkham, Amir; Keely, Erin; Mahoney, John

    2017-01-01

    Introduction Access to specialist services is limited by wait times and geographic availability. Champlain Building Access to Specialist Advice (BASE) has been implemented in our service region to facilitate access to specialists by primary care providers (PCPs). Through a secure web-based system, PCPs are able to send eConsults instead of requesting a formal in-office consultation. Methods Urology eConsults completed through the Champlain BASE service from March 2013 to January 2015 were analyzed. Each consult was characterized in regard to the type of question asked by the referring physician and the clinical content of the referral. Using the mandatory close-out surveys, we analyzed rates of referral avoidance, physician satisfaction, and overall impact on patient care. Results Of 190 eConsultations, 70% were completed in less than 10 minutes. The most common clinical questions related to the interpretation of imaging reports (16%) and tests to choose for investigating a condition (15%). The most common diagnoses were hematuria (13%) and renal mass (8%). In 35% of cases, referral to a urologist had originally been contemplated and was avoided. In 8% of cases, a PCP did not believe a consultation was initially needed, but a referral was ultimately initiated after the eConsultation. Conclusions Our study shows that although certain clinical presentations still require a formal in-person urological consultation, eConsultations can potentially reduce unnecessary clinic visits while identifying patients who may benefit from early urological consultation. Through both these mechanisms, we may improve timely access to urologists. PMID:28798830

  10. Access to hyperacute stroke services across Canadian provinces: a geospatial analysis

    PubMed Central

    Eswaradass, Prasanna Venkatesan; Swartz, Richard H.; Rosen, Jamey; Hill, Michael D.; Lindsay, M. Patrice

    2017-01-01

    Background: Canada's vast geography creates challenges for ensuring prompt transport to hospital of patients who have had a stroke. We sought to determine the proportion of people across various Canadian provinces for whom hyperacute stroke services are accessible within evidence-based time targets. Methods: We calculated, for the 8 provinces with available data, drive-time polygons on a map of Canada that delineated the area around stroke centres and emergency medical services (EMS) base centres to which one can drive in 3.5-6 hours. We calculated the proportional area of each forward sortation area (first 3 digits of the postal code) contained within a drive-time polygon. We applied this ratio to the 2011 Canadian census population of the forward sortation area to estimate the population that can reach a stroke centre in a designated time. Results: A total of 47.1%-96.4% of Canadians live within a 4.5-hour drive to a stroke centre via road EMS, and 53.3%-96.8% live within a 6-hour drive. Assuming a total travel time of 5 hours by EMS from base centre to patient and patient to hospital, 84.7%-99.8% of the population has access to a current or proposed endovascular thrombectomy site. Interpretation: Most Canadians live within 6 hours' road access to a stroke centre. Geospatial mapping could be used to inform decisions for additional sites and identify gaps in service accessibility. Coordinated systems of care and ambulance bypass agreements must continue to evolve to ensure maximal access to time-sensitive emergency stroke services. PMID:28615192

  11. Mapping mental health service access: achieving equity through quality improvement.

    PubMed

    Green, Stuart A; Poots, Alan J; Marcano-Belisario, Jose; Samarasundera, Edgar; Green, John; Honeybourne, Emmi; Barnes, Ruth

    2013-06-01

    Improving access to psychological therapies (IAPTs) services deliver evidence-based care to people with depression and anxiety. A quality improvement (QI) initiative was undertaken by an IAPT service to improve referrals providing an opportunity to evaluate equitable access. QI methodologies were used by the clinical team to improve referrals to the service. The collection of geo-coded data allowed referrals to be mapped to small geographical areas according to deprivation. A total of 6078 patients were referred to the IAPT service during the period of analysis and mapped to 120 unique lower super output areas (LSOAs). The average weekly referral rate rose from 17 during the baseline phase to 43 during the QI implementation phase. Spatial analysis demonstrated all 15 of the high deprivation/low referral LSOAs were converted to high deprivation/high or medium referral LSOAs following the QI initiative. This work highlights the importance of QI in developing clinical services aligned to the needs of the population through the analysis of routine data matched to health needs. Mapping can be utilized to communicate complex information to inform the planning and organization of clinical service delivery and evaluate the progress and sustainability of QI initiatives.

  12. Public and Private Adoption: A Comparison of Service and Accessibility.

    ERIC Educational Resources Information Center

    Daly, Kerry J.; Sobol, Michael P.

    1994-01-01

    Used data from national survey of public and private adoption service providers in Canada to examine similarities and differences with respect to clients served, issues associated with adoption accessibility, and nature of postadoption services. Found high degree of homogeneity that cut across public and private division, with typical adoptive…

  13. Difficulties in the accessibility to health services for tuberculosis diagnoses in Brazilian municipalities.

    PubMed

    Scatena, Lúcia Marina; Villa, Tereza Cristina Scatena; Netto, Antonio Ruffino; Kritski, Afrânio Lineu; Figueiredo, Tânia Maria Ribeiro Monteiro de; Vendramini, Silvia Helena Figueiredo; Assis, Marluce Maria de Araújo; Motta, Maria Catarina Salvador da

    2009-06-01

    To assess difficulties in the accessibility to tuberculosis diagnoses in the health services in Brazil. The study was carried out in 2007 and surveyed tuberculosis patients treated in the primary care services in the cities of Ribeirão Preto, São José do Rio Preto, Itaboraí (these three in Southeastern Brazil), Campina Grande and Feira de Santana (these two in Northeastern Brazil). The instrument 'Primary Care Assessment Tool' was used, adapted to assess tuberculosis care in Brazil. Tuberculosis diagnosis in the health services was assessed by means of multiple correspondence factor analysis. The accessibility to the diagnosis was represented by the dimensions 'locomotion to the health service' and 'assistance service' in the factorial plan. The patients from Ribeirão Preto and Itaboraí were associated with more favorable conditions to the dimension 'locomotion to the health service' and the patients from Campina Grande and Feira de Santana were associated with less favorable conditions. Ribeirão Preto presented more favorable conditions to the dimension 'assistance service', followed by Itaboraí, Feira de Santana and Campina Grande. São José do Rio Preto presented less favorable conditions to both dimensions, 'locomotion to the health service' and 'assistance service', compared to the other cities. The factor analysis enabled the visualization of the organizational characteristics of the services that provide tuberculosis care. The decentralization of the actions to the family health program and reference centers seems not to present a satisfactory performance regarding accessibility to the tuberculosis diagnosis, as the form of services organization was not a determinant factor to guarantee the accessibility to the early diagnosis of the illness.

  14. Accessibility, affordability and use of health services in an urban area in South Africa.

    PubMed

    Stellenberg, Ethelwynn L

    2015-03-10

    Inequalities in healthcare between population groups of South Africa existed during the apartheid era and continue to exist both between and within many population groups. Accessibility and affordability of healthcare is a human right. The aim of the study was to explore and describe accessibility, affordability and the use of health services by the mixed race (coloured) population in the Western Cape, South Africa. A cross-sectional descriptive, non-experimental study with a quantitative approach was applied. A purposive convenient sample of 353 participants (0.6%) was drawn from a population of 63 004 economically-active people who lived in the residential areas as defined for the purpose of the study. All social classes were represented. The hypothesis set was that there is a positive relationship between accessibility, affordability and the use of health services. A pilot study was conducted which also supported the reliability and validity of the study. Ethics approval was obtained from the University of Stellenbosch and informed consent from respondents. A questionnaire was used to collect the data. The hypothesis was accepted. The statistical association between affordability (p = < 0.01), accessibility (p = < 0.01) and the use of health services was found to be significant using the Chi-square (χ²) test. The study has shown how affordability and accessibility may influence the use of healthcare services. Accessibility is not only the distance an individual must travel to reach the health service point but more so the utilisation of these services. Continuous Quality Management should be a priority in healthcare services, which should be user-friendly.

  15. 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...

  16. 76 FR 11680 - Service Contracts and Non-Vessel-Operating Service Arrangements; Transmission of Approved Log-In...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-03

    ... Contracts and Non-Vessel-Operating Service Arrangements; Transmission of Approved Log-In ID and Passwords... advise applicants for log-in IDs and passwords. DATES: The Final Rule is effective March 3, 2011. FOR... the U.S. Mail to transmit approved log-on IDs and password to registrants in the Commission's...

  17. Programmatic access to data and information at the IRIS DMC via web services

    NASA Astrophysics Data System (ADS)

    Weertman, B. R.; Trabant, C.; Karstens, R.; Suleiman, Y. Y.; Ahern, T. K.; Casey, R.; Benson, R. B.

    2011-12-01

    The IRIS Data Management Center (DMC) has developed a suite of web services that provide access to the DMC's time series holdings, their related metadata and earthquake catalogs. In addition, services are available to perform simple, on-demand time series processing at the DMC prior to being shipped to the user. The primary goal is to provide programmatic access to data and processing services in a manner usable by and useful to the research community. The web services are relatively simple to understand and use and will form the foundation on which future DMC access tools will be built. Based on standard Web technologies they can be accessed programmatically with a wide range of programming languages (e.g. Perl, Python, Java), command line utilities such as wget and curl or with any web browser. We anticipate these services being used for everything from simple command line access, used in shell scripts and higher programming languages to being integrated within complex data processing software. In addition to improving access to our data by the seismological community the web services will also make our data more accessible to other disciplines. The web services available from the DMC include ws-bulkdataselect for the retrieval of large volumes of miniSEED data, ws-timeseries for the retrieval of individual segments of time series data in a variety of formats (miniSEED, SAC, ASCII, audio WAVE, and PNG plots) with optional signal processing, ws-station for station metadata in StationXML format, ws-resp for the retrieval of instrument response in RESP format, ws-sacpz for the retrieval of sensor response in the SAC poles and zeros convention and ws-event for the retrieval of earthquake catalogs. To make the services even easier to use, the DMC is developing a library that allows Java programmers to seamlessly retrieve and integrate DMC information into their own programs. The library will handle all aspects of dealing with the services and will parse the returned

  18. A review of the incidence and transmission of Listeria monocytogenes in ready-to-eat products in retail and food service environments.

    PubMed

    Lianou, Alexandra; Sofos, John N

    2007-09-01

    Contamination of ready-to-eat products with Listeria monocytogenes may occur at several stages before consumption. Accessibility to the public and relatively limited control interventions at retail and food service establishments (compared with the processing sector of the food industry) and the lack of a specific regulatory framework increase the likelihood of introduction of this pathogen into some foods in these establishments. This review is a compilation of available information on the incidence and transmission of L. monocytogenes through ready-to-eat products at the retail and food service level. The potential transmission of L. monocytogenes within retail and food service operations has been indicated in epidemiological investigations and by survey data. Potential sources of the organism in these operations include the environment, food handlers, and incoming raw ingredients or processed products that have become contaminated after the lethality treatment at the manufacturing facility. L. monocytogenes may be present at retail and food service establishments in various ready-to-eat products, both prepackaged and those packaged in the store, and occasionally at high concentrations. This issue dictates the need for development and application of effective control measures, and potential control approaches are discussed here. Good manufacturing practices, appropriate cleaning, sanitation and hygiene programs, and temperature control required for prevention or inhibition of growth of the pathogen to high levels are critical for control of L. monocytogenes in the retail and food service sector. A comprehensive food safety system designed to be functional in retail and food service operations and based on the philosophy of hazard analysis and critical control point systems and a series of sound prerequisite programs can provide effective control of L. monocytogenes in these environments. However, competent delivery of food safety education and training to retail

  19. Dementia and the Deaf community: knowledge and service access.

    PubMed

    Ferguson-Coleman, Emma; Keady, John; Young, Alys

    2014-01-01

    This study concerns culturally Deaf people in the United Kingdom who use British Sign Language (BSL). Its objective was to explore how Deaf people's knowledge about dementia and access to services is mediated by their minoritised cultural-linguistic status. Twenty-six members of the Deaf community participated in one of three Deaf-led focus groups in BSL corresponding with the sample of: Deaf people over the age of 60 without dementia; Deaf people aged 18-60 working professional roles unconnected with dementia services; ordinary members of the Deaf community aged 18-60. Data were subjected to a thematic content analysis. Participants' concerns about their poor levels of knowledge and understanding of dementia were augmented by their awareness that without sustained social contact in BSL opportunities for earlier recognition of dementia would be lost. Although primary care services were identified as the first port of call for dementia-related concerns, there was widespread mistrust of their effectiveness because of failures in communication and cultural competence. Confirmed diagnosis of dementia was not viewed as a gateway to services and support because Deaf organisations, dementia-related organisations and mainstream adult services were perceived to be ill-equipped to respond to the needs of Deaf people with dementia. Locating problems of late diagnosis within the Deaf community's poor awareness and knowledge of dementia fails to recognise the structural barriers Deaf people face in timely access to services and accurate recognition of dementia-related changes.

  20. Personnel Management in Access Services: A General Overview of the Literature, 1990-2002

    ERIC Educational Resources Information Center

    Lee, Leslie A.; Wu, Michelle M.

    2003-01-01

    Access services is not unique in its need for effective personnel management. A review of the literature indicates that there are many publications on or relating to library personnel administration; however, relatively few of them are dedicated to the narrow topic of access services. As such, this review encompasses literature that is general to…

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

    NASA Astrophysics Data System (ADS)

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

    2012-09-01

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

  2. Challenges in accessing sexual and reproductive health services by people with physical disabilities in Kampala, Uganda

    PubMed Central

    2014-01-01

    Introduction Despite the universal right to access the same range, quality and standard of free or affordable health care and programs as provided to other persons, people with physical disabilities (PWPDs) continue to experience challenges in accessing these services. This article presents the challenges faced by PWPDs in accessing sexual and reproductive health (SRH) services in Kampala, Uganda. Methods This was a qualitative study that was conducted with male and female PWPDs in Kampala in 2007. Data on the challenges experienced by PWPDs in accessing SRH services were collected using in-depth interviews with 40 PWPDs and key informant interviews with 10 PWPDs’ representatives, staff of agencies supporting PWPDs and health workers. All data were captured verbatim using an audio-tape recorder, entered into a Microsoft Word computer program and analyzed manually following a content thematic approach. Results The study findings show that PWPDs face a multitude of challenges in accessing SRH services including negative attitudes of service providers, long queues at health facilities, distant health facilities, high costs of services involved, unfriendly physical structures and the perception from able-bodied people that PWPDs should be asexual. Conclusion People with physical disabilities (PWPDs) face health facility-related (service provider and facility-related challenges), economic and societal challenges in accessing SRH services. These findings call for a need to sensitize service providers on SRH needs of PWPDs for better support and for the government to enforce the provision of PWPD-friendly services in all health facilities. PMID:25086444

  3. Challenges in accessing sexual and reproductive health services by people with physical disabilities in Kampala, Uganda.

    PubMed

    Ahumuza, Sharon Eva; Matovu, Joseph K B; Ddamulira, John Bosco; Muhanguzi, Florence Kyoheirwe

    2014-08-02

    Despite the universal right to access the same range, quality and standard of free or affordable health care and programs as provided to other persons, people with physical disabilities (PWPDs) continue to experience challenges in accessing these services. This article presents the challenges faced by PWPDs in accessing sexual and reproductive health (SRH) services in Kampala, Uganda. This was a qualitative study that was conducted with male and female PWPDs in Kampala in 2007. Data on the challenges experienced by PWPDs in accessing SRH services were collected using in-depth interviews with 40 PWPDs and key informant interviews with 10 PWPDs' representatives, staff of agencies supporting PWPDs and health workers. All data were captured verbatim using an audio-tape recorder, entered into a Microsoft Word computer program and analyzed manually following a content thematic approach. The study findings show that PWPDs face a multitude of challenges in accessing SRH services including negative attitudes of service providers, long queues at health facilities, distant health facilities, high costs of services involved, unfriendly physical structures and the perception from able-bodied people that PWPDs should be asexual. People with physical disabilities (PWPDs) face health facility-related (service provider and facility-related challenges), economic and societal challenges in accessing SRH services. These findings call for a need to sensitize service providers on SRH needs of PWPDs for better support and for the government to enforce the provision of PWPD-friendly services in all health facilities.

  4. Impact of service delivery model on health care access among HIV-positive women in New York City.

    PubMed

    Pillai, Nandini V; Kupprat, Sandra A; Halkitis, Perry N

    2009-01-01

    As the New York City HIV=AIDS epidemic began generalizing beyond traditionally high-risk groups in the early 1990s, AIDS Service Organizations (ASO) sought to increase access to medical care and broaden service offerings to incorporate the needs of low-income women and their families. Strategies to achieve entry into and retention in medical care included the development of integrated care facilities, case management, and a myriad of supportive service offerings. This study examines a nonrandom sample of 60 HIV-positive women receiving case management and supportive services at New York City ASOs. Over 55% of the women interviewed reported high access to care, 43% reported the ability to access urgent care all of the time and 94% reported high satisfaction with obstetrics=gynecology (OB=GYN) care. This held true across race=ethnicity, income level, medical coverage, and service delivery model.Women who accessed services at integrated care facilities offering onsite medical care and case management=supportive services perceived lower access to medical specialists as compared to those who received services at nonintegrated sites. Data from this analysis indicate that supportive services increase access to and satisfaction with both HIV and non-HIV-related health care. Additionally, women who received services at a medical model agency were more likely to report accessing non-HIV care at a clinic compared to those receiving services at a nonmedical model agencies, these women were more likely to report receiving non-HIV care at a hospital.

  5. Gender, sexuality and the discursive representation of access and equity in health services literature: implications for LGBT communities

    PubMed Central

    2011-01-01

    Background This article considers how health services access and equity documents represent the problem of access to health services and what the effects of that representation might be for lesbian, gay, bisexual and transgender (LGBT) communities. We conducted a critical discourse analysis on selected access and equity documents using a gender-based diversity framework as determined by two objectives: 1) to identify dominant and counter discourses in health services access and equity literature; and 2) to develop understanding of how particular discourses impact the inclusion, or not, of LGBT communities in health services access and equity frameworks.The analysis was conducted in response to public health and clinical research that has documented barriers to health services access for LGBT communities including institutionalized heterosexism, biphobia, and transphobia, invisibility and lack of health provider knowledge and comfort. The analysis was also conducted as the first step of exploring LGBT access issues in home care services for LGBT populations in Ontario, Canada. Methods A critical discourse analysis of selected health services access and equity documents, using a gender-based diversity framework, was conducted to offer insight into dominant and counter discourses underlying health services access and equity initiatives. Results A continuum of five discourses that characterize the health services access and equity literature were identified including two dominant discourses: 1) multicultural discourse, and 2) diversity discourse; and three counter discourses: 3) social determinants of health (SDOH) discourse; 4) anti-oppression (AOP) discourse; and 5) citizen/social rights discourse. Conclusions The analysis offers a continuum of dominant and counter discourses on health services access and equity as determined from a gender-based diversity perspective. The continuum of discourses offers a framework to identify and redress organizational assumptions

  6. Gender, sexuality and the discursive representation of access and equity in health services literature: implications for LGBT communities.

    PubMed

    Daley, Andrea E; Macdonnell, Judith A

    2011-09-29

    This article considers how health services access and equity documents represent the problem of access to health services and what the effects of that representation might be for lesbian, gay, bisexual and transgender (LGBT) communities. We conducted a critical discourse analysis on selected access and equity documents using a gender-based diversity framework as determined by two objectives: 1) to identify dominant and counter discourses in health services access and equity literature; and 2) to develop understanding of how particular discourses impact the inclusion, or not, of LGBT communities in health services access and equity frameworks.The analysis was conducted in response to public health and clinical research that has documented barriers to health services access for LGBT communities including institutionalized heterosexism, biphobia, and transphobia, invisibility and lack of health provider knowledge and comfort. The analysis was also conducted as the first step of exploring LGBT access issues in home care services for LGBT populations in Ontario, Canada. A critical discourse analysis of selected health services access and equity documents, using a gender-based diversity framework, was conducted to offer insight into dominant and counter discourses underlying health services access and equity initiatives. A continuum of five discourses that characterize the health services access and equity literature were identified including two dominant discourses: 1) multicultural discourse, and 2) diversity discourse; and three counter discourses: 3) social determinants of health (SDOH) discourse; 4) anti-oppression (AOP) discourse; and 5) citizen/social rights discourse. The analysis offers a continuum of dominant and counter discourses on health services access and equity as determined from a gender-based diversity perspective. The continuum of discourses offers a framework to identify and redress organizational assumptions about, and ideological commitments to

  7. Beyond 'flood hotspots': Modelling emergency service accessibility during flooding in York, UK

    NASA Astrophysics Data System (ADS)

    Coles, Daniel; Yu, Dapeng; Wilby, Robert L.; Green, Daniel; Herring, Zara

    2017-03-01

    This paper describes the development of a method that couples flood modelling with network analysis to evaluate the accessibility of city districts by emergency responders during flood events. We integrate numerical modelling of flood inundation with geographical analysis of service areas for the Ambulance Service and the Fire & Rescue Service. The method was demonstrated for two flood events in the City of York, UK to assess the vulnerability of care homes and sheltered accommodation. We determine the feasibility of emergency services gaining access within the statutory 8- and 10-min targets for high-priority, life-threatening incidents 75% of the time, during flood episodes. A hydrodynamic flood inundation model (FloodMap) simulates the 2014 pluvial and 2015 fluvial flood events. Predicted floods (with depth >25 cm and areas >100 m2) were overlain on the road network to identify sites with potentially restricted access. Accessibility of the city to emergency responders during flooding was quantified and mapped using; (i) spatial coverage from individual emergency nodes within the legislated timeframes, and; (ii) response times from individual emergency service nodes to vulnerable care homes and sheltered accommodation under flood and non-flood conditions. Results show that, during the 2015 fluvial flood, the area covered by two of the three Fire & Rescue Service stations reduced by 14% and 39% respectively, while the remaining station needed to increase its coverage by 39%. This amounts to an overall reduction of 6% and 20% for modelled and observed floods respectively. During the 2014 surface water flood, 7 out of 22 care homes (32%) and 15 out of 43 sheltered accommodation nodes (35%) had modelled response times above the 8-min threshold from any Ambulance station. Overall, modelled surface water flooding has a larger spatial footprint than fluvial flood events. Hence, accessibility of emergency services may be impacted differently depending on flood mechanism

  8. A DTN-Based Multiple Access Fast Forward Service for the NASA Space Network

    NASA Technical Reports Server (NTRS)

    Israel, David; Davis, Faith; Marquart. Jane

    2011-01-01

    The NASA Space Network provides a demand access return link service capable of providing users a space link "on demand". An equivalent service in the forward link direction is not possible due to Tracking and Data Relay Spacecraft (TDRS) constraints. A Disruption Tolerant Networking (DTN)-based Multiple Access Fast Forward (MAFF) service has been proposed to provide a forward link to a user as soon as possible. Previous concept studies have identified a basic architecture and implementation approach. This paper reviews the user scenarios and benefits of an MAFF service and proposes an implementation approach based on the use of DTN protocols.

  9. [Indigenous peoples' access to health services in Cuiabá, Mato Grosso State, Brazil].

    PubMed

    Gomes, Silvana Cardoso; Esperidião, Monique Azevedo

    2017-06-12

    This study aimed to evaluate indigenous peoples' access to medium and high-complexity health services in the municipality of Cuiabá, Mato Grosso State, Brazil, through the Casa de Saúde Indígena or Indigenous Peoples' Clinic (CASAI Cuiabá). A single case study with a qualitative approach was conducted at CASAI Cuiabá. Data were obtained from observation of the work routines at CASAI Cuiabá, semi-structured interviews with health professionals and administrators from the Cuiabá Special Indigenous Health District (DSEI) and CASAI Cuiabá, and document analysis. Data analysis used a matrix derived from the theoretical and logical model of accessibility, validated by the Delphi method with a group of experts on indigenous peoples' health. Despite advances achieved by CASAI in improving indigenous peoples' access, there are persistent social, organizational, cultural, and geographic barriers in access to medium and high-complexity health services in Cuiabá. The study highlights the need for specific strategies to improve access to health services by indigenous peoples in Mato Grosso State.

  10. 47 CFR 54.806 - Calculation by the Administrator of interstate access universal service support for areas served...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... access universal service support for areas served by price cap local exchange carriers. 54.806 Section 54... Administrator of interstate access universal service support for areas served by price cap local exchange... calculate the Interstate Access Universal Service Support for areas served by price cap local exchange...

  11. Access to fertility services by transgender persons: an Ethics Committee opinion.

    PubMed

    2015-11-01

    This statement explores the ethical considerations surrounding the provision of fertility services to transgender individuals and concludes that denial of access to fertility services is not justified. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  12. A JEE RESTful service to access Conditions Data in ATLAS

    NASA Astrophysics Data System (ADS)

    Formica, Andrea; Gallas, E. J.

    2015-12-01

    Usage of condition data in ATLAS is extensive for offline reconstruction and analysis (e.g. alignment, calibration, data quality). The system is based on the LCG Conditions Database infrastructure, with read and write access via an ad hoc C++ API (COOL), a system which was developed before Run 1 data taking began. The infrastructure dictates that the data is organized into separate schemas (assigned to subsystems/groups storing distinct and independent sets of conditions), making it difficult to access information from several schemas at the same time. We have thus created PL/SQL functions containing queries to provide content extraction at multi-schema level. The PL/SQL API has been exposed to external clients by means of a Java application providing DB access via REST services, deployed inside an application server (JBoss WildFly). The services allow navigation over multiple schemas via simple URLs. The data can be retrieved either in XML or JSON formats, via simple clients (like curl or Web browsers).

  13. Access to low-vision rehabilitation services: barriers and enablers.

    PubMed

    Matti, Albert I; Pesudovs, Konrad; Daly, Andrew; Brown, Margaret; Chen, Celia S

    2011-03-01

    The current mismatch between the need for and uptake of low-vision services has been attributed to various barriers including different service delivery models and referral pathways. This study evaluates the referral pathway and low-vision service provision of the Royal Society for the Blind (RSB) in South Australia. All new referrals from the 2008-2009 financial year to the RSB were reviewed. Initially, patients were contacted by a triage officer within one week of referral. Initial appointments were made in the Low Vision Clinic with a multidisciplinary team. Reasons for declining the appointment or non-attendance were tracked via telephone. There were 1116 patients referred over a 12-month period and 1082 (97 per cent) were reviewed in the Low Vision Clinic. Most attendees (92 per cent) lived within 50 kilometres of the clinic. There were 34 referred patients, who declined or did not attend the assessment. All non-attendees also lived within 50 kilometres of the Low Vision Centre. Concurrent major health problems (27 per cent) and patients not feeling the need for low-vision rehabilitation (27 per cent) were the most common reasons for not accessing the service. Only 125 patients (11.6 per cent) accessed volunteer transport services and only 24 patients (2.2 per cent) needed an interpreter service. The attendance rate is significantly higher than in other published studies. The distance to travel or transport difficulties were not significant barriers. Patient perception that either the service was not required or would not help them was the main barrier. The referral and triage process appeared to be a major enabler of low-vision service uptake. © 2010 The Authors. Clinical and Experimental Optometry © 2010 Optometrists Association Australia.

  14. Factors affecting access to healthcare services by intermarried Filipino women in rural Tasmania: a qualitative study.

    PubMed

    Hannah, Chona T; Lê, Quynh

    2012-10-01

    Access to health care services is vital for every migrant's health and wellbeing. However, migrants' cultural health beliefs and views can hinder their ability to access available services. This study examined factors affecting access to healthcare services for intermarried Filipino women in rural Tasmania, Australia. A qualitative approach using semi-structured interviews was employed to investigate the factors affecting access to healthcare services for 30 intermarried Filipino women in rural Tasmania. The study used grounded theory and thematic analysis for its data analysis. Nvivo v8 (www.qsrinternational.com) was also used to assist the data coding process and analysis. Five influencing factors were identified: (1) language or communication barriers; (2) area of origin in the Philippines; (3) cultural barriers; (4) length of stay in Tasmania; and (5) expectations of healthcare services before and after migration. Factors affecting intermarried Filipino women in accessing healthcare services are shaped by their socio-demographic and cultural background. The insights gained from this study are useful to health policy-makers, healthcare professionals and to intermarried female migrants. The factors identified can serve as a guide to improve healthcare access for Filipino women and other migrants.

  15. Globus Identity, Access, and Data Management: Platform Services for Collaborative Science

    NASA Astrophysics Data System (ADS)

    Ananthakrishnan, R.; Foster, I.; Wagner, R.

    2016-12-01

    Globus is software-as-a-service for research data management, developed at, and operated by, the University of Chicago. Globus, accessible at www.globus.org, provides high speed, secure file transfer; file sharing directly from existing storage systems; and data publication to institutional repositories. 40,000 registered users have used Globus to transfer tens of billions of files totaling hundreds of petabytes between more than 10,000 storage systems within campuses and national laboratories in the US and internationally. Web, command line, and REST interfaces support both interactive use and integration into applications and infrastructures. An important component of the Globus system is its foundational identity and access management (IAM) platform service, Globus Auth. Both Globus research data management and other applications use Globus Auth for brokering authentication and authorization interactions between end-users, identity providers, resource servers (services), and a range of clients, including web, mobile, and desktop applications, and other services. Compliant with important standards such as OAuth, OpenID, and SAML, Globus Auth provides mechanisms required for an extensible, integrated ecosystem of services and clients for the research and education community. It underpins projects such as the US National Science Foundation's XSEDE system, NCAR's Research Data Archive, and the DOE Systems Biology Knowledge Base. Current work is extending Globus services to be compliant with FEDRAMP standards for security assessment, authorization, and monitoring for cloud services. We will present Globus IAM solutions and give examples of Globus use in various projects for federated access to resources. We will also describe how Globus Auth and Globus research data management capabilities enable rapid development and low-cost operations of secure data sharing platforms that leverage Globus services and integrate them with local policy and security.

  16. Measuring Equity in Access to Pharmaceutical Services Using Concentration Curve; Model Development.

    PubMed

    Davari, Majid; Khorasani, Elahe; Bakhshizade, Zahra; Jafarian Jazi, Marzie; Ghaffari Darab, Mohsen; Maracy, Mohammad Reza

    2015-01-01

    This paper has two objectives. First, it establishes a model for scoring the access to pharmaceutical services. Second, it develops a model for measuring socioeconomic indicators independent of the time and place of study. These two measures are used for measuring equity in access to pharmaceutical services using concentration curve. We prepared an open-ended questionnaire and distributed it to academic experts to get their ideas to form access indicators and assign score to each indicator based on the pharmaceutical system. An extensive literature review was undertaken for the selection of indicators in order to determine the socioeconomic status (SES) of individuals. Experts' opinions were also considered for scoring these indicators. These indicators were weighted by the Stepwise Adoption of Weights and were used to develop a model for measuring SES independent of the time and place of study. Nine factors were introduced for assessing the access to pharmaceutical services, based on pharmaceutical systems in middle-income countries. Five indicators were selected for determining the SES of individuals. A model for income classification based on poverty line was established. Likewise, a model for scoring home status based on national minimum wage was introduced. In summary, five important findings emerged from this study. These findings may assist researchers in measuring equity in access to pharmaceutical services and also could help them to apply a model for determining SES independent of the time and place of study. These also could provide a good opportunity for researchers to compare the results of various studies in a reasonable way; particularly in middle-income countries.

  17. The availability of community health center services and access to medical care.

    PubMed

    Kirby, James B; Sharma, Ravi

    2017-12-01

    Community Health Centers (CHCs) funded by Section 330 of the Public Health Service Act are an essential part of the health care safety net in the US. The Patient Protection and Affordable Care Act expanded the program significantly, but the extent to which the availability of CHCs improve access to care in general is not clear. In this paper, we examine the associations between the availability of CHC services in communities and two key measures of ambulatory care access - having a usual source of care and having any office-based medical visits over a one year period. We pooled six years of data from the Medical Expenditure Panel Survey (2008-2013) and linked it to geographic data on CHCs from Health Resources and Services Administration's Health Center Program Uniform Data System. We also link other community characteristics from the Area Health Resource File and the Dartmouth Institute's data files. The associations between CHC availability and our access measures are estimated with logistic regression models stratified by insurance status. The availability of CHC services was positively associated with both measures of access among those with no insurance coverage. Additionally, it was positively associated with having a usual source of care among those with Medicaid and private insurance. These findings persist after controlling for key individual- and community-level characteristics. Our findings suggest that an enhanced CHC program could be an important resource for supporting the efficacy of expanded Medicaid coverage under the Affordable Care Act and, ultimately, improving access to quality primary care for underserved Americans. Published by Elsevier Inc.

  18. Deficits in Young Men's Knowledge about Accessing Sexual and Reproductive Health Services

    ERIC Educational Resources Information Center

    Bersamin, Melina; Fisher, Deborah A.; Marcell, Arik V.; Finan, Laura J.

    2017-01-01

    Objective: The current study aimed to examine (1) gender differences in college students' knowledge of sexual and reproductive health care (K-SRHC) service access points, and (2) the relationship between demographic and psychosocial factors and college students' overall K-SRHC service access points. Methods and Participants: Self-report online…

  19. Telemental health technology in deaf and general mental-health services: access and use.

    PubMed

    Austen, Sally; McGrath, Melissa

    2006-01-01

    Long-distance travel to provide mental health services for deaf people has implications for efficiency, safety, and equality of service. However, uptake of Telemental Health (TMH) has been slow in both deaf and general mental health services. A quantitative study was used to investigate access to TMH and whether staff confidence, experience, or demographics affect TMH use. It was concluded that staff in neither deaf mental health services nor general mental health services had adequate knowledge of or access to TMH. Staff expressed concerns over TMH's appropriateness in their work. Previous use of videoconferencing was assosciated significantly with confidence, but previous use of videophones was not. Neither staff in deaf services nor deaf staff were more experienced with or more confident about videoconferencing, whereas, within deaf services, deaf staff were significantly more confident about videophone use. Training implications are discussed.

  20. Perceived Barriers Affecting Access to Preventive Dental Services: Application of DEMATEL Method.

    PubMed

    Bahadori, Mohammadkarim; Ravangard, Ramin; Asghari, Baratali

    2013-08-01

    Identifying perceived access barriers to preventive dental services is one of the basic steps to improve the public health. This study aimed to determine the perceived barriers affecting access to preventive dental services in one of Tehran dental clinics in 2012. This research was a cross-sectional descriptive-analytical study conducted in one of Tehran dental clinics in 2012 using decision-making trial and evaluation laboratory (DEMATEL) method. The study sample included all patients (100 patients) who had referred to the endodontic treatment department from 26 - 31 May, 2012. The required data were collected using a questionnaire. Collected data were analyzed using SPSS 18.0 and MATLAB 7.9.0 SPSSS 18.0, as well as, some descriptive and analytical tests including Mean, Standard Deviation (SD), and Independent T- Test. The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access to dental services among which the cost and patient-dentist relationship were identified as the first and last priorities with the coordinates (1.4 and 1.4) and (1.25 and -0.65), respectively. High cost of dental care has led to not referring patients to the clinic. Oral health costs are too high; however insurance organizations have no commitment to support such services. Policymakers, administrators, and insurance organizations have a major role in improving access to dental services. These decision-makers in making their policies can provide the required financial resources, shift the available resources towards preventive care and periodic checkups, and consider providing proper and sufficient places for dental care facilities.

  1. Contract management in USA hospitals: service duplication and access within local markets.

    PubMed

    Carey, Kathleen; Dor, Avi

    2008-08-01

    This paper examines the extent to which hospitals that are under external contract management engage in service duplication, as well as the degree to which the various services they offer contribute to or detract from community access. The study incorporates all USA hospitals using data from the American Hospital Association Annual Survey Database, supplemented by county level measures obtained from the area resource file (ARF). Using data on the 3794 hospitals classified as acute care facilities in 2002, we performed a set of logistic regressions that analyzed whether a hospital offered each of 74 distinct services. For each service (regression), key independent variables measured the number of other hospitals in the local market area that also offered the service. Local area market definitions are the areas circumscribed by the hospital within distances of 10 and 20 miles. Results suggest that contract-managed (CM) hospitals display a more competitive pattern (service duplication) than hospitals in general, but CM hospitals that are the sole provider of services locally are less likely to offer services than traditionally managed sole hospital providers. Contract management does not appear to offer any particular advantages in improving access to hospital services.

  2. Use of services for prevention of mother-to-child transmission in Angola: a retrospective analysis.

    PubMed

    Augusto, Gonçalo Figueiredo

    2016-06-01

    After a long civil war that destroyed much of the country's health infrastructure, Angola faced the challenge of reconstruction while fighting HIV/AIDS. This paper analyses recent progress in access and use of prevention of mother-to-child transmission (PMTCT) services in Angola. National level PMTCT data between 2005 and 2012 were analysed. Data were collected from national and international databases and reports. This study assesses progress made, developed best-fit regression models and predicted future points for four major PMTCT indicators. Between 2005 and 2012, the number of PMTCT sites increased from 9 to 347, and the number of HIV tests preformed to pregnant women increased from 12 061 to 314 805. However, in 2012, 46% of the pregnant women who tested positive for HIV at PMTCT sites and only 36% HIV exposed infants were receiving antiretroviral (ARV) prophylaxis. Based on current trends, this study predicts that by 2015, 35.5% of pregnant women will be tested for HIV, 1.1% of women will test positive for HIV at PMTCT and 46% of HIV-positive pregnant women will receive antiretroviral therapy. Despite expansion of PMTCT services, urgent action is needed to rapidly scale-up HIV prevention and treatment services for HIV-positive pregnant women and for children. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. 28 CFR 115.253 - Resident access to outside confidential support services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... with access to outside victim advocates for emotional support services related to sexual abuse by... confidential emotional support services related to sexual abuse. The agency shall maintain copies of agreements... communications will be monitored and the extent to which reports of abuse will be forwarded to authorities in...

  4. 28 CFR 115.253 - Resident access to outside confidential support services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... with access to outside victim advocates for emotional support services related to sexual abuse by... confidential emotional support services related to sexual abuse. The agency shall maintain copies of agreements... communications will be monitored and the extent to which reports of abuse will be forwarded to authorities in...

  5. 28 CFR 115.253 - Resident access to outside confidential support services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... with access to outside victim advocates for emotional support services related to sexual abuse by... confidential emotional support services related to sexual abuse. The agency shall maintain copies of agreements... communications will be monitored and the extent to which reports of abuse will be forwarded to authorities in...

  6. Access to and Use of Eye Care Services in Rural Arkansas

    ERIC Educational Resources Information Center

    Kilmer, Greta; Bynum, LaTonya; Balamurugan, Appathurai

    2010-01-01

    Context: Rural residents are more likely to be uninsured and have low income. Purpose: To determine if rural residents in Arkansas have decreased access to eye care services and use them less frequently than urban residents. Methods: Data from the 2006 Visual Impairment and Access to Eye Care Module from the Arkansas Behavioral Risk Factor…

  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. Association between Enhanced Access Services in Pediatric Primary Care and Utilization of Emergency Departments: A National Parent Survey

    PubMed Central

    Zickafoose, Joseph S.; DeCamp, Lisa R.; Prosser, Lisa A.

    2013-01-01

    Objectives To measure the prevalence of enhanced access services in pediatric primary care and to assess whether enhanced access services are associated with lower emergency department (ED) utilization. Study design Internet-based survey of a national sample of parents (n=820, response rate 41%). We estimated the prevalence of reported enhanced access services and ED use in the prior 12 months. We then used multivariate negative binomial regression to assess associations between enhanced access services and ED use. Results The majority of parents reported access to advice by telephone during office hours (80%), same-day sick visits (79%), and advice by telephone outside office hours (54%). Fewer than one-half of parents reported access to their child’s primary care office on weekends (47%), after 5:00 pm on any night (23%), or by email (13%). Substantial proportions of parents reported that they did not know if these services were available (7-56%, depending on service). Office hours after 5:00 pm on ≥5 nights a week was the only service significantly associated with ED utilization in multivariate analysis (adjusted incidence rate ratio: 0.51 [95% CI 0.28-0.92]). Conclusions The majority of parents report enhanced access to their child’s primary care office during office hours, but many parents do not have access or do not know if they have access outside of regular office hours. Extended office hours may be the most effective practice change to reduce emergency department use. Primary care practices should prioritize the most effective enhanced access services and communicate existing services to families. PMID:23759421

  9. Reaching the unreachable: barriers of the poorest to accessing NGO healthcare services in Bangladesh.

    PubMed

    Ahmed, Nizam U; Alam, Mohammed M; Sultana, Fadia; Sayeed, Shahana N; Pressman, Aliza M; Powers, Mary Beth

    2006-12-01

    The NGO Service Delivery Program (NSDP), a USAID-funded programme, is the largest NGO programme in Bangladesh. Its strategic flagship activity is the essential services package through which healthcare services are administered by NGOs in Bangladesh. The overall goal of the NSDP is to increase access to essential healthcare services by communities, especially the poor. Recognizing that the poorest in the community often have no access to essential healthcare services due to various barriers, a study was conducted to identify what the real barriers to access by the poor are. This included investigations to further understand the perceptions of the poor of real or imagined barriers to accessing healthcare; ways for healthcare centres to maximize services to the poor; how healthcare providers can maximize service-use; inter-personal communication between healthcare providers and those seeking healthcare among the poor; and ways to improve the capacity of service providers to reach the poorest segment of the community. The study, carried out in two phases, included 24 static and satellite clinics within the catchment areas of eight NGOs under the NSDP in Bangladesh, during June-September 2003. Participatory urban and rural appraisal techniques, focus-group discussions, and in-depth interviews were employed as research methods in the study. The target populations in the study included males and females, service-users and non-users, and special groups, such as fishermen, sex workers, potters, Bedes (river gypsies), and lower-caste people-all combined representing a heterogeneous community. The following four major categories of barriers emerged as roadblocks to accessing quality healthcare for the poor: (a) low income to be able to afford healthcare, (b) lack of awareness of the kind of healthcare services available, (c) deficiencies and inconsistencies in the quality of services, and (d) lack of close proximity to the healthcare facility. Those interviewed perceived

  10. Using Technology to Improve Access to Mental Health Services.

    PubMed

    Cortelyou-Ward, Kendall; Rotarius, Timothy; Honrado, Jed C

    Mental ill-health is a public health threat that is prevalent throughout the United States. Tens of millions of Americans have been diagnosed along the continuum of mental ill-health, and many more millions of family members and friends are indirectly affected by the pervasiveness of mental ill-health. Issues such as access and the societal stigma related to mental health issues serve as deterrents to patients receiving their necessary care. However, technological advances have shown the potential to increase access to mental health services for many patients.

  11. Access to HIV prevention services among gender based violence survivors in Tanzania

    PubMed Central

    Mboya, Beati; Temu, Florence; Awadhi, Bayoum; Ngware, Zubeda; Ndyetabura, Elly; Kiondo, Gloria; Maridadi, Janneth

    2012-01-01

    Introduction Currently, Tanzania's HIV prevalence is 5.7%. Gender inequality and Gender Based Violence (GBV) are among factors fuelling the spread of HIV in Tanzania. This study was conducted to assess universal access to HIV prevention services among GBV survivors in Iringa and Dar-es-Salaam where HIV prevalence is as high as 14.7% and 9% respectively compared to a national average of 5.7%. Methods In 2010, a mixed methods study using triangulation model was conducted in Iringa and Dar-es-Salaam regions to represent rural and urban settings respectively. Questionnaires were administered to 283 randomly selected survivors and 37 health providers while 28 in-depth interviews and 16 focus group discussions were conducted among various stakeholders. Quantitative data was analyzed in SPSS by comparing descriptive statistics while qualitative data was analyzed using thematic framework approach. Results Counseling and testing was the most common type of HIV prevention services received by GBV survivors (29%). Obstacles for HIV prevention among GBV survivors included: stigma, male dominance culture and fear of marital separation. Bribery in service delivery points, lack of confidentiality, inadequate GBV knowledge among health providers, and fear of being involved in legal matters were mentioned to be additional obstacles to service accessibility by survivors. Reported consequences of GBV included: psychological problems, physical trauma, chronic illness, HIV infection. Conclusion GBV related stigma and cultural norms are obstacles to HIV services accessibility. Initiation of friendly health services, integration of GBV into HIV services and community based interventions addressing GBV related stigma and cultural norms are recommended. PMID:23467278

  12. Access to HIV prevention services among gender based violence survivors in Tanzania.

    PubMed

    Mboya, Beati; Temu, Florence; Awadhi, Bayoum; Ngware, Zubeda; Ndyetabura, Elly; Kiondo, Gloria; Maridadi, Janneth

    2012-01-01

    Currently, Tanzania's HIV prevalence is 5.7%. Gender inequality and Gender Based Violence (GBV) are among factors fuelling the spread of HIV in Tanzania. This study was conducted to assess universal access to HIV prevention services among GBV survivors in Iringa and Dar-es-Salaam where HIV prevalence is as high as 14.7% and 9% respectively compared to a national average of 5.7%. In 2010, a mixed methods study using triangulation model was conducted in Iringa and Dar-es-Salaam regions to represent rural and urban settings respectively. Questionnaires were administered to 283 randomly selected survivors and 37 health providers while 28 in-depth interviews and 16 focus group discussions were conducted among various stakeholders. Quantitative data was analyzed in SPSS by comparing descriptive statistics while qualitative data was analyzed using thematic framework approach. Counseling and testing was the most common type of HIV prevention services received by GBV survivors (29%). Obstacles for HIV prevention among GBV survivors included: stigma, male dominance culture and fear of marital separation. Bribery in service delivery points, lack of confidentiality, inadequate GBV knowledge among health providers, and fear of being involved in legal matters were mentioned to be additional obstacles to service accessibility by survivors. Reported consequences of GBV included: psychological problems, physical trauma, chronic illness, HIV infection. GBV related stigma and cultural norms are obstacles to HIV services accessibility. Initiation of friendly health services, integration of GBV into HIV services and community based interventions addressing GBV related stigma and cultural norms are recommended.

  13. Perceived Barriers Affecting Access to Preventive Dental Services: Application of DEMATEL Method

    PubMed Central

    Bahadori, Mohammadkarim; Ravangard, Ramin; Asghari, Baratali

    2013-01-01

    Background Identifying perceived access barriers to preventive dental services is one of the basic steps to improve the public health. Objectives This study aimed to determine the perceived barriers affecting access to preventive dental services in one of Tehran dental clinics in 2012. Patients and Methods This research was a cross-sectional descriptive-analytical study conducted in one of Tehran dental clinics in 2012 using decision–making trial and evaluation laboratory (DEMATEL) method. The study sample included all patients (100 patients) who had referred to the endodontic treatment department from 26 - 31 May, 2012. The required data were collected using a questionnaire. Collected data were analyzed using SPSS 18.0 and MATLAB 7.9.0 SPSSS 18.0, as well as, some descriptive and analytical tests including Mean, Standard Deviation (SD), and Independent T- Test. Results The five determinants of cost, inconvenience, fear, organization, and patient-dentist relationship were determined as barriers to access to dental services among which the cost and patient-dentist relationship were identified as the first and last priorities with the coordinates (1.4 and 1.4) and (1.25 and -0.65), respectively. Conclusions High cost of dental care has led to not referring patients to the clinic. Oral health costs are too high; however insurance organizations have no commitment to support such services. Policymakers, administrators, and insurance organizations have a major role in improving access to dental services. These decision-makers in making their policies can provide the required financial resources, shift the available resources towards preventive care and periodic checkups, and consider providing proper and sufficient places for dental care facilities. PMID:24578831

  14. Accessibility to Specialized Public Oral Health Services from the Perspective of Brazilian Users

    PubMed Central

    de Castro, Ricardo Dias; Rangel, Marianne de Lucena; da Silva, Marcos André Azevedo; de Lucena, Brunna Thaís Lucwu; Cavalcanti, Alessandro Leite; Bonan, Paulo Rogério Ferreti; Oliveira, Julyana de Araújo

    2016-01-01

    The Specialized Dental Clinics (SDCs) represent the first government initiative in Latin America aimed at providing specialized oral health services. This study sought to evaluate the organizational accessibility to specialized oral health care services in Brazil and to understand the factors that may be associated with accessibility from the user’s perspective. This epidemiological, cross-sectional and quantitative study was conducted by means of interviews with individuals who sought specialized public oral health services in the city of João Pessoa, Paraíba, Brazil, and consisted of a sample of 590 individuals. Users expressed a favorable view of the classification and resolutive nature of specialized services offered by Brazilian public health. The binary logistic regression analysis revealed weak points highlighting the difficulty involved in obtaining such treatments leading to unfavorable evaluations. In the resolutive nature item, difficulty in accessing the location, queues and lack of materials and equipment were highlighted as statistically significant unfavorable aspects. While many of the users considered the service to be resolutive, weaknesses were mentioned that need to be detected to promote improvements and to prevent other health models adopted worldwide from reproducing the same flaws. PMID:27775584

  15. Distance Learning: Information Access and Services for Virtual Users.

    ERIC Educational Resources Information Center

    Iyer, Hemalata, Ed.

    This volume centers broadly on information support services for distance education. The articles in this book can be categorized into two areas: access to information resources for distance learners, and studies of distance learning programs. Contents include: "The Challenges and Benefits of Asynchronous Learning Networks" (Daphne…

  16. Propagation Characteristics in an Underground Shopping Area for 5GHz-band Wireless Access Systems

    NASA Astrophysics Data System (ADS)

    Itokawa, Kiyohiko; Kita, Naoki; Sato, Akio; Matsue, Hideaki; Mori, Daisuke; Watanabe, Hironobu

    5-GHz band wireless access systems, such as the RLAN (Radio Local Area Network) system of IEEE802.11a, HiperLAN/2, HiSWANa and AWA, are developed and provide transmission rates over 20 Mbps for indoor use. Those 5-GHz access systems are expected to extend service areas from the office to the so-called “hot-spot" in public areas. Underground shopping malls are one of the anticipated service areas for such a nomadic wireless access service. Broadband propagation characteristics are required for radio zone design in an underground mall environment despite previous results obtained by narrow band measurements. This paper presents results of an experimental study on the propagation characteristics for broadband wireless access systems in an underground mall environment. First, broadband propagation path loss is measured and formulated considering human body shadowing. A ray trace simulation is used to clarify the basic propagation mechanism in such a closed environment. Next, a distance dependency of the delay spread during a crowded time period, rush hour, is found to be at most 65 nsec, which is under the permitted maximum value of the present 5-GHz systems. Finally, above propagation characteristics support the result of transmission test carried out by using AWA equipment.

  17. Travellers accessing addiction services in Ireland (2007 to 2010): analysis of routine surveillance data.

    PubMed

    Carew, Anne Marie; Cafferty, Siobhán; Long, Jean; Bellerose, Delphine; Lyons, Suzi

    2013-01-01

    By accessing addiction treatment services recorded in routine national drug treatment data, the characteristics of Irish Travellers were analyzed to understand their needs and develop policies to tackle issues faced by this community. The number of Traveller cases accessing services increased by 163% between 2007 and 2010. Alcohol and opiates were the most common problem substances reported. Traveller women reported high rates of problem opiate use and risky injecting behaviors, contrary to the perception that problem substance use is a predominantly male issue. This presents a challenge to services to provide targeted, effective services to Travellers with problem substance use.

  18. Socioeconomic disparities in home health care service access and utilization: a scoping review.

    PubMed

    Goodridge, Donna; Hawranik, Pamela; Duncan, Vicky; Turner, Hollie

    2012-10-01

    Home health care services are expanding at a rapid pace in order to meet the needs of the growing population of older adults and those with chronic illnesses. Because of current restrictions on home health care as an insured service in some countries, individuals may be required to pay for some or all of their home care services out of pocket. These payments may potentially limit access to needed home care services for persons in the lowest socioeconomic strata. Previous research demonstrates a clear socioeconomic gradient in access to acute and primary care services, where those most in need of services are the most disadvantaged and under-serviced. There has been little attention paid thus far, however, to the way in which socioeconomic status may affect the receipt of home health care services. To determine what is known from existing literature about socioeconomic disparities in home health care access and utilization. A scoping review was used to map the extent and nature of the literature in this area. A search of the databases CINAHL, Medline, SocIndex and Sociological Abstracts as well as Dissertations International. A total of 206 potentially relevant articles were published between 2000 and April 2011. Two reviewers independently reviewed the articles, leaving 15 research articles to be included in the scoping review. The majority of articles reported secondary analyses of administrative datasets related to utilization of home health care. Several studies examined access and utilization using qualitative approaches. The distinction between professional and supportive home care services was not always clear in the articles. Individual and composite measures of socioeconomic status were reported, with the most frequently used indicator being income. Several studies used more complex composite ecological indicators of socieconomic status. There was general agreement that utilization of home health services favored persons with greater economic disadvantage

  19. Accessing disability services by people from culturally and linguistically diverse backgrounds in Australia.

    PubMed

    Zhou, Qingsheng

    2016-01-01

    To examine whether differences in access to specialist disability services by people from culturally and linguistically diverse (CALD) backgrounds when compared with those born in Australia represent a service gap or the healthy migrant effect. To use the latest disability statistics to measure the different rates of people with disability, and the rates of people with profound and severe disability, of people born in Australia and those born abroad; to compare the difference between those who mainly speak English with those who primarily speak a language other than English at home (LOTE); and examine the age-specific and standardised disability rates of these subgroups. The rate of access of specialist disability services by people with disability who were from CALD backgrounds is highly disproportionate to their presence in the community. As a whole, people from CALD backgrounds have a similar level of disability as Australia-born people. They have a greater rate of profound and severe disability and a higher level of need for assistance in undertaking core activities. For younger age cohorts targeted by specialist disability services, there is little difference in the level of need for assistance between people from CALD backgrounds and the rest of community. Those people who mainly speak LOTE at home have a relatively higher level of need for assistance than those who speak mainly English at home. The paper reveals a substantial gap in specialist disability services between people from CALD and the broader community. This cannot be explained by the difference in the level of need for assistance between Australia-born and overseas-born populations, therefore raises some policy questions as to the barriers to the use of such services and how to effectively narrow the service access gap and improve utilisation rates. The paper reveals a substantial accessibility gap in specialist disability services between people from culturally and linguistically diverse (CALD

  20. Barriers in access to home care services among ethnic minority and Dutch elderly--a qualitative study.

    PubMed

    Suurmond, Jeanine; Rosenmöller, Doenja L; El Mesbahi, Hakima; Lamkaddem, Majda; Essink-Bot, Marie-Louise

    2016-02-01

    Ethnic minority elderly have a high prevalence of functional limitations and chronic conditions compared to Dutch elderly. However, their use of home care services is low compared to Dutch elderly. Explore the barriers to access to home care services for Turkish, Moroccan Surinamese and ethnic Dutch elderly. Qualitative semi-structured group interviews and individual interviews. The Netherlands. Seven group interviews (n=50) followed by individual interviews (n=5) were conducted, in the preferred language of the participants. Results were ordered and reported according to a framework of access to health care services. This framework describes five dimensions of accessibility to generate access to health care services, from the perspective of the users: ability to perceive health needs, ability to seek health care, ability to reach, ability to pay and ability to engage. This study shows that while barriers are common among all groups, several specific barriers in access to home care services exist for ethnic minority elderly. Language and communication barriers as well as limited networks and a preference for informal care seem to mutually enforce each other, resulting in many barriers during the navigation process to home care. In order to provide equal access to home care for all who need it, the language and communication barriers should be tackled by home care services and home care nurses. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Location-Allocation and Accessibility Models for Improving the Spatial Planning of Public Health Services

    PubMed Central

    Polo, Gina; Acosta, C. Mera; Ferreira, Fernando; Dias, Ricardo Augusto

    2015-01-01

    This study integrated accessibility and location-allocation models in geographic information systems as a proposed strategy to improve the spatial planning of public health services. To estimate the spatial accessibility, we modified the two-step floating catchment area (2SFCA) model with a different impedance function, a Gaussian weight for competition among service sites, a friction coefficient, distances along a street network based on the Dijkstra’s algorithm and by performing a vectorial analysis. To check the accuracy of the strategy, we used the data from the public sterilization program for the dogs and cats of Bogot´a, Colombia. Since the proposed strategy is independent of the service, it could also be applied to any other public intervention when the capacity of the service is known. The results of the accessibility model were consistent with the sterilization program data, revealing that the western, central and northern zones are the most isolated areas under the sterilization program. Spatial accessibility improvement was sought by relocating the sterilization sites using the maximum coverage with finite demand and the p-median models. The relocation proposed by the maximum coverage model more effectively maximized the spatial accessibility to the sterilization service given the non-uniform distribution of the populations of dogs and cats throughout the city. The implementation of the proposed strategy would provide direct benefits by improving the effectiveness of different public health interventions and the use of financial and human resources. PMID:25775411

  2. 77 FR 29635 - Access to Confidential Business Information by Several Student Services Contractors

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-18

    ... Business Information by Several Student Services Contractors AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: EPA will be authorizing several Student Services contractors to access...? Under Order Number EP-12-H-000389, a Student Services contractor will assist the Office of Science...

  3. Income-Related Inequalities in Access to Dental Care Services in Japan.

    PubMed

    Nishide, Akemi; Fujita, Misuzu; Sato, Yasunori; Nagashima, Kengo; Takahashi, Sho; Hata, Akira

    2017-05-12

    Background : This study aimed to evaluate whether income-related inequalities in access to dental care services exist in Japan. Methods : The subjects included beneficiaries of the National Health Insurance (NHI) in Chiba City, Japan, who had been enrolled from 1 April 2014 to 31 March 2015. The presence or absence of dental visits and number of days spent on dental care services during the year were calculated using insurance claims submitted. Equivalent household income was calculated using individual income data from 1 January to 31 December 2013, declared for taxation. Results : Of the 216,211 enrolled subjects, 50.3% had dental care during the year. Among those with dental visits, the average number of days (standard deviation) spent on dental care services per year was 7.7 (7.1). Low income was associated with a decreased rate of dental care utilization regardless of age and sex. However, there was a significant inverse linear association between the number of days spent on dental care services and income levels for both sexes. Conclusions : There were income-related inequalities in access to dental care services, regardless of the age group or sex, within the Japanese universal health insurance system.

  4. The effect of access to contraceptive services on injectable use and demand for family planning in Malawi.

    PubMed

    Skiles, Martha Priedeman; Cunningham, Marc; Inglis, Andrew; Wilkes, Becky; Hatch, Ben; Bock, Ariella; Barden-O'Fallon, Janine

    2015-03-01

    Previous studies have identified positive relationships between geographic proximity to family planning services and contraceptive use, but have not accounted for the effect of contraceptive supply reliability or the diminishing influence of facility access with increasing distance. Kernel density estimation was used to geographically link Malawi women's use of injectable contraceptives and demand for birth spacing or limiting, as drawn from the 2010 Demographic and Health Survey, with contraceptive logistics data from family planning service delivery points. Linear probability models were run to identify associations between access to injectable services-measured by distance alone and by distance combined with supply reliability-and injectable use and family planning demand among rural and urban populations. Access to services was an important predictor of injectable use. The probability of injectable use among rural women with the most access by both measures was 7‒8 percentage points higher than among rural dwellers with the least access. The probability of wanting to space or limit births among urban women who had access to the most reliable supplies was 18 percentage points higher than among their counterparts with the least access. Product availability in the local service environment plays a critical role in women's demand for and use of contraceptive methods. Use of kernel density estimation in creating facility service environments provides a refined approach to linking women with services and accounts for both distance to facilities and supply reliability. Urban and rural differences should be considered when seeking to improve contraceptive access.

  5. Equity of access to reproductive health services among youths in resource-limited suburban communities of Mandalay City, Myanmar

    PubMed Central

    2012-01-01

    Background Inequity of accessibility to and utilization of reproductive health (RH) services among youths is a global concern, especially in resource-limited areas. The level of inequity also varies by cultural and socio-economic contexts. To tailor RH services to the needs of youths, relevant solutions are required. This study aimed to assess baseline information on access to and utilization of RH services and unmet needs among youths living in resource-limited, suburban communities of Mandalay City, Myanmar. Methods A community-based, cross-sectional study was conducted in all resource-limited, suburban communities of Mandalay City, Myanmar. A total of 444 randomly selected youths aged between 15 and 24 years were interviewed for three main outcomes, namely accessibility to and utilization of RH services and youth's unmet needs for these services. Factors associated with these outcomes were determined using multivariate logistic regression. Results Although geographical accessibility was high (79.3%), financial accessibility was low (19.1%) resulting in a low overall accessibility (34.5%) to RH services. Two-thirds of youths used some kind of RH services at least once in the past. Levels of unmet needs for sexual RH information, family planning, maternal care and HIV testing were 62.6%, 31.9%, 38.7% and 56.2%, respectively. Youths living in the south or south-western suburbs, having a deceased parent, never being married or never exposed to mass media were less likely to access RH services. Being a young adult, current student, working as a waste recycler, having ever experienced a sexual relationship, ever being married, ever exposed to mass media, having a high knowledge of RH services and providers or a high level of accessibility to RH services significantly increased the likelihood of utilization of those services. In addition to youths’ socio-demographic characteristics, exposure to mass media, norm of peer exposure and knowledge on types of providers and

  6. 47 CFR 64.402 - Policies and procedures for the provision of priority access service by commercial mobile radio...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... priority access service by commercial mobile radio service providers. 64.402 Section 64.402... RULES RELATING TO COMMON CARRIERS Procedures for Handling Priority Services in Emergencies § 64.402 Policies and procedures for the provision of priority access service by commercial mobile radio service...

  7. NASA Alternate Access to Station Service Concept

    NASA Technical Reports Server (NTRS)

    Bailey, Michelle D.; Crumbly, Chris

    2001-01-01

    The evolving nature of the NASA space enterprise compels the agency to develop new and innovative space systems concepts. NASA, working with increasingly strained budgets and a declining manpower base, is attempting to transform from operational activities to procurement of commercial services. NASA's current generation reusable launch vehicle, the Shuttle, is in transition from a government owned and operated entity to a commercial venture to reduce the civil servant necessities for that program. NASA foresees its second generation launch vehicles being designed and operated by industry for commercial and government services. The "service" concept is a pioneering effort by NASA. The purpose the "service" is not only to reduce the civil servant overhead but will free up government resources for further research - and enable industry to develop a space business case so that industry can sustain itself beyond government programs. In addition, NASA desires a decreased responsibility thereby decreasing liability. The Second Generation Reusable Launch Vehicle (RLV) program is implementing NASA's Space Launch Initiative (SLI) to enable industry to develop the launch vehicles of the future. The Alternate Access to Station (AAS) project office within this program is chartered with enabling industry to demonstrate an alternate access capability for the International Space Station (ISS). The project will not accomplish this by traditional government procurement methods, not by integrating the space system within the project office, or by providing the only source of business for the new capability. The project funds will ultimately be used to purchase a service to take re-supply cargo to the ISS, much the same as any business might purchase a service from FedEx to deliver a package to its customer. In the near term, the project will fund risk mitigation efforts for enabling technologies. AAS is in some ways a precursor to the 2nd Generation RLV. By accomplishing ISS resupply

  8. NASA Alternate Access to Station Service Concept

    NASA Astrophysics Data System (ADS)

    Bailey, M. D.; Crumbly, C.

    2002-01-01

    The evolving nature of the NASA space enterprise compels the agency to develop new and innovative space systems concepts. NASA, working with increasingly strained budgets and a declining manpower base, is attempting to transform from operational activities to procurement of commercial services. NASA's current generation reusable launch vehicle, the Shuttle, is in transition from a government owned and operated entity to a commercial venture to reduce the civil servant necessities for that program. NASA foresees its second generation launch vehicles being designed and operated by industry for commercial and government services. The "service" concept is a pioneering effort by NASA. The purpose the "service" is not only to reduce the civil servant overhead but will free up government resources for further research and enable industry to develop a space business case so that industry can sustain itself beyond government programs. In addition, NASA desires a decreased responsibility thereby decreasing liability. The Second Generation Reusable Launch Vehicle (RLV) program is implementing NASA's Space Launch Initiative (SLI) to enable industry to develop the launch vehicles of the future. The Alternate Access to Station (AAS) project office within this program is chartered with enabling industry to demonstrate an alternate access capability for the International Space Station (ISS). The project will not accomplish this by traditional government procurement methods, not by integrating the space system within the project office, or by providing the only source of business for the new capability. The project funds will ultimately be used to purchase a service to take re-supply cargo to the ISS, much the same as any business might purchase a service from FedEx to deliver a package to its customer. In the near term, the project will fund risk mitigation efforts for enabling technologies. AAS is in some ways a precursor to the 2nd Generation RLV. By accomplishing ISS resupply

  9. Disabled persons' knowledge of HIV prevention and access to health care prevention services in South Africa.

    PubMed

    Eide, Arne Henning; Schür, Clare; Ranchod, Chitra; Rohleder, Poul; Swartz, Leslie; Schneider, Marguerite

    2011-12-01

    The main research question in this article is how access to information about HIV/AIDS and level of HIV/AIDS prevention related knowledge are distributed among disabled people, and whether level of knowledge predicts access to HIV/AIDS related services. A survey was carried out among a sample of 285 disabled people from three provinces in South Africa. Analyses of the data revealed that gender and level of education, together with geographical differences, are key predictors for access to information and knowledge about HIV/AIDS among disabled people. For male respondents number of information sources predicts access to voluntary counselling and testing services and HIV testing, while knowledge about prevention predicts access to Voluntary Counselling and Testing centres. Significant gender differences with regards to information, knowledge and access to services highlight the need for gender specific prevention strategies among disabled people.

  10. Sexual stigma, criminalization, investment, and access to HIV services among men who have sex with men worldwide.

    PubMed

    Arreola, Sonya; Santos, Glenn-Milo; Beck, Jack; Sundararaj, Mohan; Wilson, Patrick A; Hebert, Pato; Makofane, Keletso; Do, Tri D; Ayala, George

    2015-02-01

    Globally, HIV disproportionately affects men who have sex with men (MSM). This study explored associations between access to HIV services and (1) individual-level perceived sexual stigma; (2) country-level criminalization of homosexuality; and (3) country-level investment in HIV services for MSM. 3,340 MSM completed an online survey assessing access to HIV services. MSM from over 115 countries were categorized according to criminalization of homosexuality policy and investment in HIV services targeting MSM. Lower access to condoms, lubricants, and HIV testing were each associated with greater perceived sexual stigma, existence of homosexuality criminalization policies, and less investment in HIV services. Lower access to HIV treatment was associated with greater perceived sexual stigma and criminalization. Criminalization of homosexuality and low investment in HIV services were both associated with greater perceived sexual stigma. Efforts to prevent and treat HIV among MSM should be coupled with structural interventions to reduce stigma, overturn homosexuality criminalization policies, and increase investment in MSM-specific HIV services.

  11. 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…

  12. Advancing Migrant Access to Health Services in Europe (AMASE): Protocol for a Cross-sectional Study

    PubMed Central

    Álvarez-del Arco, Débora; Monge, Susana; Copas, Andrew J; Gennotte, Anne-Francoise; Volny-Anne, Alain; Göpel, Siri; Touloumi, Giota; Prins, Maria; Barros, Henrique; Staehelin, Cornelia; del Amo, Julia; Burns, Fiona M

    2016-01-01

    Background Migrants form a substantial proportion of the population affected by the human immunodeficiency virus (HIV) epidemic in Europe, yet HIV prevention for this population is hindered by poor understanding of access to care and of postmigration transmission dynamics. Objective We present the design and methods of the advancing Migrant Access to health Services in Europe (aMASE) study, the first European cross-cultural study focused on multiple migrant populations. It aims to identify the structural, cultural, and financial barriers to HIV prevention, diagnosis, and treatment and to determine the likely country of HIV acquisition in HIV-positive migrant populations. Methods We delivered 2 cross-sectional electronic surveys across 10 countries (Belgium, France, Germany, Greece, Italy, the Netherlands, Portugal, Spain, Switzerland, and United Kingdom). A clinic survey aimed to recruit up to 2000 HIV-positive patients from 57 HIV clinics in 9 countries. A unique study number linked anonymized questionnaire data to clinical records data (viral loads, CD4 cell counts, viral clades, etc). This questionnaire was developed by expert panel consensus and cognitively tested, and a pilot study was carried out in 2 countries. A Web-based community survey (n=1000) reached those living with HIV but not currently accessing HIV clinics, as well as HIV-negative migrants. It was developed in close collaboration with a community advisory group (CAG) made up of representatives from community organizations in 9 of the participating countries. The CAG played a key role in data collection by promoting the survey to higher-risk migrant groups (sub-Saharan Africans, Latin Americans, men who have sex with men, and people who inject drugs). The questionnaires have considerable content overlap, allowing for comparison. Questions cover ethnicity, migration, immigration status, HIV testing and treatment, health-seeking behavior, sexual risk, and drug use. The electronic questionnaires

  13. Advancing Migrant Access to Health Services in Europe (AMASE): Protocol for a Cross-sectional Study.

    PubMed

    Fakoya, Ibidun; Álvarez-Del Arco, Débora; Monge, Susana; Copas, Andrew J; Gennotte, Anne-Francoise; Volny-Anne, Alain; Göpel, Siri; Touloumi, Giota; Prins, Maria; Barros, Henrique; Staehelin, Cornelia; Del Amo, Julia; Burns, Fiona M

    2016-05-16

    Migrants form a substantial proportion of the population affected by the human immunodeficiency virus (HIV) epidemic in Europe, yet HIV prevention for this population is hindered by poor understanding of access to care and of postmigration transmission dynamics. We present the design and methods of the advancing Migrant Access to health Services in Europe (aMASE) study, the first European cross-cultural study focused on multiple migrant populations. It aims to identify the structural, cultural, and financial barriers to HIV prevention, diagnosis, and treatment and to determine the likely country of HIV acquisition in HIV-positive migrant populations. We delivered 2 cross-sectional electronic surveys across 10 countries (Belgium, France, Germany, Greece, Italy, the Netherlands, Portugal, Spain, Switzerland, and United Kingdom). A clinic survey aimed to recruit up to 2000 HIV-positive patients from 57 HIV clinics in 9 countries. A unique study number linked anonymized questionnaire data to clinical records data (viral loads, CD4 cell counts, viral clades, etc). This questionnaire was developed by expert panel consensus and cognitively tested, and a pilot study was carried out in 2 countries. A Web-based community survey (n=1000) reached those living with HIV but not currently accessing HIV clinics, as well as HIV-negative migrants. It was developed in close collaboration with a community advisory group (CAG) made up of representatives from community organizations in 9 of the participating countries. The CAG played a key role in data collection by promoting the survey to higher-risk migrant groups (sub-Saharan Africans, Latin Americans, men who have sex with men, and people who inject drugs). The questionnaires have considerable content overlap, allowing for comparison. Questions cover ethnicity, migration, immigration status, HIV testing and treatment, health-seeking behavior, sexual risk, and drug use. The electronic questionnaires, which were available in 15

  14. ChEMBL web services: streamlining access to drug discovery data and utilities

    PubMed Central

    Davies, Mark; Nowotka, Michał; Papadatos, George; Dedman, Nathan; Gaulton, Anna; Atkinson, Francis; Bellis, Louisa; Overington, John P.

    2015-01-01

    ChEMBL is now a well-established resource in the fields of drug discovery and medicinal chemistry research. The ChEMBL database curates and stores standardized bioactivity, molecule, target and drug data extracted from multiple sources, including the primary medicinal chemistry literature. Programmatic access to ChEMBL data has been improved by a recent update to the ChEMBL web services (version 2.0.x, https://www.ebi.ac.uk/chembl/api/data/docs), which exposes significantly more data from the underlying database and introduces new functionality. To complement the data-focused services, a utility service (version 1.0.x, https://www.ebi.ac.uk/chembl/api/utils/docs), which provides RESTful access to commonly used cheminformatics methods, has also been concurrently developed. The ChEMBL web services can be used together or independently to build applications and data processing workflows relevant to drug discovery and chemical biology. PMID:25883136

  15. Fixed Route Accessible Bus Service in Connecticut : A Case Study

    DOT National Transportation Integrated Search

    1981-07-01

    U.S. Department of Transportation regulations implementing Section 504 of the Rehabilitation Act of 1973, require transit agencies to provide wheelchair accessibility on fixed-route bus service. The study is part of the series which included studies ...

  16. Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil.

    PubMed

    Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Amaral, Pedro Vasconcelos; Barbosa, Allan Claudius Queiroz; Rocha, João Victor Muniz; Alvares, Viviane; de Almeida, Dante Grapiuna; Thumé, Elaine; Thomaz, Erika Bárbara Abreu Fonseca; de Sousa Queiroz, Rejane Christine; de Souza, Marta Rovery; Lein, Adriana; Lopes, Daniel Paulino; Staton, Catherine A; Vissoci, João Ricardo Nickenig; Facchini, Luiz Augusto

    2017-08-22

    Unequal distribution of emergency care services is a critical barrier to be overcome to assure access to emergency and surgical care. Considering this context it was objective of the present work analyze geographic access barriers to emergency care services in Brazil. A secondary aim of the study is to define possible roles to be assumed by small hospitals in the Brazilian healthcare network to overcome geographic access challenges. The present work can be classified as a cross-sectional ecological study. To carry out the present study, data of all 5843 Brazilian hospitals were categorized among high complexity centers and small hospitals. The geographical access barriers were identified through the use of two-step floating catchment area method. Once concluded the previous step an evaluation using the Getis-Ord-Gi method was performed to identify spatial clusters of municipalities with limited access to high complexity centers but well covered by well-equipped small hospitals. The analysis of accessibility index of high complexity centers highlighted large portions of the country with nearly zero hospital beds by inhabitant. In contrast, it was possible observe a group of 1595 municipalities with high accessibility to small hospitals, simultaneously with a low coverage of high complexity centers. Among the 1595 municipalities with good accessibility to small hospitals, 74% (1183) were covered by small hospitals with at least 60% of minimum emergency service requirements. The spatial clusters analysis aggregated 589 municipalities with high values related to minimum emergency service requirements. Small hospitals in these 589 cities could promote the equity in access to emergency services benefiting more than eight million people. There is a spatial disequilibrium within the country with prominent gaps in the health care network for emergency services. Taking this challenge into consideration, small hospitals could be a possible solution and foster equity in access

  17. Non-Orthogonal Random Access in MIMO Cognitive Radio Networks: Beamforming, Power Allocation, and Opportunistic Transmission

    PubMed Central

    Lin, Huifa; Shin, Won-Yong

    2017-01-01

    We study secondary random access in multi-input multi-output cognitive radio networks, where a slotted ALOHA-type protocol and successive interference cancellation are used. We first introduce three types of transmit beamforming performed by secondary users, where multiple antennas are used to suppress the interference at the primary base station and/or to increase the received signal power at the secondary base station. Then, we show a simple decentralized power allocation along with the equivalent single-antenna conversion. To exploit the multiuser diversity gain, an opportunistic transmission protocol is proposed, where the secondary users generating less interference are opportunistically selected, resulting in a further reduction of the interference temperature. The proposed methods are validated via computer simulations. Numerical results show that increasing the number of transmit antennas can greatly reduce the interference temperature, while increasing the number of receive antennas leads to a reduction of the total transmit power. Optimal parameter values of the opportunistic transmission protocol are examined according to three types of beamforming and different antenna configurations, in terms of maximizing the cognitive transmission capacity. All the beamforming, decentralized power allocation, and opportunistic transmission protocol are performed by the secondary users in a decentralized manner, thus resulting in an easy implementation in practice. PMID:28076402

  18. Non-Orthogonal Random Access in MIMO Cognitive Radio Networks: Beamforming, Power Allocation, and Opportunistic Transmission.

    PubMed

    Lin, Huifa; Shin, Won-Yong

    2017-01-01

    We study secondary random access in multi-input multi-output cognitive radio networks, where a slotted ALOHA-type protocol and successive interference cancellation are used. We first introduce three types of transmit beamforming performed by secondary users, where multiple antennas are used to suppress the interference at the primary base station and/or to increase the received signal power at the secondary base station. Then, we show a simple decentralized power allocation along with the equivalent single-antenna conversion. To exploit the multiuser diversity gain, an opportunistic transmission protocol is proposed, where the secondary users generating less interference are opportunistically selected, resulting in a further reduction of the interference temperature. The proposed methods are validated via computer simulations. Numerical results show that increasing the number of transmit antennas can greatly reduce the interference temperature, while increasing the number of receive antennas leads to a reduction of the total transmit power. Optimal parameter values of the opportunistic transmission protocol are examined according to three types of beamforming and different antenna configurations, in terms of maximizing the cognitive transmission capacity. All the beamforming, decentralized power allocation, and opportunistic transmission protocol are performed by the secondary users in a decentralized manner, thus resulting in an easy implementation in practice.

  19. [Determining Factors in the Access to Mental Health Services by the Adult Colombian Population].

    PubMed

    González, Lina María; Peñaloza, Rolando Enrique; Matallana, María Alexandra; Gil, Fabián; Gómez-Restrepo, Carlos; Landaeta, Angela Patricia Vega

    2016-12-01

    Access to mental health services by people with mental disorders has traditionally been limited, and is associated with attitudinal, social, and structural variables. To analyse the factors that determine access to mental health services by the adult population (18-44 years old) in Colombia, from the results obtained in the 2015 National Mental Health Survey. Analysis of variables of access to attention in mental health care for adults. The reasons for not consulting were classified as barriers of behavioural supply and demand. To analyse the factors associated with access to mental health services in the Colombian adult population, the use of health services in the last 12 months for emotional, nervous or mental health problems was taken into account, as well as associated variables such as demographic characteristics, occupational activity, affiliation to social security, and health status variables. The relationships between these variables were estimated using bivariate multinomial logistic regression models. Rural residence, being married, and having a chronic disease were associated with the decision to consult or not to consult the doctor. Further studies should be conducted to evaluate the situation as regards mental health care access, as well as to determine the potential factors associated with these limitations. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  20. 47 CFR 69.709 - Dedicated transport and special access services other than channel terminations between LEC end...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... transport and special access services other than channel terminations between LEC end offices and customer... services other than channel terminations between LEC end offices and customer premises, determined as... 47 Telecommunication 3 2010-10-01 2010-10-01 false Dedicated transport and special access services...

  1. Equity in access to maternal and child health services in five developing countries: what works.

    PubMed

    Talukder, M D Noorunnabi; Rob, Ubaidur

    2010-01-01

    People living in rural areas are yet to have equitable access to maternal and child health services in many developing countries. This article examines selected health service delivery models that improved access to services in five developing countries. The article is based on the review of background papers on Bangladesh, Pakistan, Cambodia, Ghana, and Tanzania, prepared as part of a multi-country study on health systems and maternal and child health. Findings suggest that equity in access to health services largely depends on a system that ensures a combination of facility-based service delivery and outreach services with a functioning referral network. A key factor is the availability of health workforce at the community level. Community-based deployment of service providers or recruitment and training of community health workers is critical in enhancing service coverage and linking local populations to a health facility. Incentive is necessary to keep community health workers' interest in providing services. However, health workforce alone cannot ensure good health outcomes. They must be embedded in a functioning service delivery network to transform structural inputs into outcomes. Moreover, local-level health systems should have the ability to allocate resources in strategic ways addressing the pressing health needs of the people.

  2. The impact of health service variables on healthcare access in a low resourced urban setting in the Western Cape, South Africa.

    PubMed

    Scheffler, Elsje; Visagie, Surona; Schneider, Marguerite

    2015-06-19

    Health care access is complex and multi-faceted and, as a basic right, equitable access and services should be available to all user groups. The aim of this article is to explore how service delivery impacts on access to healthcare for vulnerable groups in an urban primary health care setting in South Africa. A descriptive qualitative study design was used. Data were collected through semi-structured interviews with purposively sampled participants and analysed through thematic content analysis. Service delivery factors are presented against five dimensions of access according to the ACCESS Framework. From a supplier perspective, the organisation of care in the study setting resulted in available, accessible, affordable and adequate services as measured against the DistrictHealth System policies and guidelines. However, service providers experienced significant barriers in provision of services, which impacted on the quality of care, resulting in poor client and provider satisfaction and ultimately compromising acceptability of service delivery. Although users found services to be accessible, the organisation of services presented them with challenges in the domains of availability, affordability and adequacy, resulting in unmet needs, low levels of satisfaction and loss of trust. These challenges fuelled perceptions of unacceptable services. Well developed systems and organisation of services can create accessible, affordable and available primary healthcare services, but do not automatically translate into adequate and acceptable services. Focussing attention on how services are delivered might restore the balance between supply (services) and demand (user needs) and promote universal and equitable access.

  3. Demonstration of an SOA-assisted open metro-access infrastructure for heterogeneous services.

    PubMed

    Schmuck, H; Bonk, R; Poehlmann, W; Haslach, C; Kuebart, W; Karnick, D; Meyer, J; Fritzsche, D; Weis, E; Becker, J; Freude, W; Pfeiffer, T

    2014-01-13

    An open converged metro-access network approach allows for sharing optical layer resources like fibers and optical spectrum among different services and operators. We demonstrated experimentally the feasibility of such a concept by the simultaneous operation of multiple services showing different modulation formats and multiplexing techniques. Flexible access nodes are implemented including semiconductor optical amplifiers to create a transparent and reconfigurable optical ring network. The impact of cascaded optical amplifiers on the signal quality is studied along the ring. In addition, the influence of high power rival signals in the same waveband and in the same fiber is analyzed.

  4. Health service access and utilization among Syrian refugees in Jordan.

    PubMed

    Doocy, Shannon; Lyles, Emily; Akhu-Zaheya, Laila; Burton, Ann; Burnham, Gilbert

    2016-07-14

    The influx of Syrian refugees into Jordan presents an immense burden to the Jordanian health system. Changing lifestyles and aging populations are shifting the global disease burden towards increased non-infectious diseases including chronic conditions, co-morbidities, and injuries which are more complicated and costly to manage. The strain placed on health systems threatens the ability to ensure the health needs of both refugees and host country populations are adequately addressed. In light of the increasing challenges facing host governments and humanitarian actors to meet health needs of Syrian refugees and affected host communities, this study was undertaken to assess utilization of health services among Syrian refugees in non-camp settings. A survey of Syrian refugees in Jordan was undertaken in June 2014 to characterize health seeking behaviors and issues related to accessing care. A cluster design with probability proportional to size sampling was used to attain a nationally representative sample of 1550 non-camp Syrian refugee households. Differences in household characteristics by geographic region, facility type, and sector utilized were examined using chi-square and t-test methods. Care-seeking was high with 86.1 % of households reporting an adult sought medical care the last time it was needed. Approximately half (51.5 %) of services were sought from public sector facilities, 38.7 % in private facilities, and 9.8 % in charity/NGO facilities. Among adult care seekers, 87.4 % were prescribed medication during the most recent visit, 89.8 % of which obtained the medication. Overall, 51.8 % of households reported out-of-pocket expenditures for the consultation or medications at the most recent visit (mean US$39.9, median US$4.2). Despite high levels of care-seeking, cost was an important barrier to health service access for Syrian refugees in Jordan. The cessation of free access to health care since the time of the survey is likely to have worsened

  5. Some Programs Should Not Run on Laptops - Providing Programmatic Access to Applications Via Web Services

    NASA Astrophysics Data System (ADS)

    Gupta, V.; Gupta, N.; Gupta, S.; Field, E.; Maechling, P.

    2003-12-01

    hosted these Web Services as a part of the SCEC Community Modeling Environment (SCEC/CME) ITR Project (http://www.scec.org/cme). We have implemented Web Services for several of the reasons sited previously. For example, we implemented a FORTRAN-based Earthquake Rupture Forecast (ERF) as a Web Service for use by client computers that don't support a FORTRAN runtime environment. We implemented a Generic Mapping Tool (GMT) Web Service for use by systems that don't have local access to GMT. We implemented a Hazard Map Calculator Web Service to execute Hazard calculations that are too computationally intensive to run on a local system. We implemented a Coordinate Conversion Web Service to enforce a standard and consistent method for converting between UTM and Lat/Lon. Our experience developing these services indicates both strengths and weakness in current Web Service technology. Client programs that utilize Web Services typically need network access, a significant disadvantage at times. Programs with simple input and output parameters were the easiest to implement as Web Services, while programs with complex parameter-types required a significant amount of additional development. We also noted that Web services are very data-oriented, and adapting object-oriented software into the Web Service model proved problematic. Also, the Web Service approach of converting data types into XML format for network transmission has significant inefficiencies for some data sets.

  6. "On the Sidelines": Access to Autism-Related Services in the West Bank

    ERIC Educational Resources Information Center

    Dababnah, Sarah; Bulson, Kathleen

    2015-01-01

    We examined access to autism-related services among Palestinians (N = 24) raising children with autism spectrum disorder (ASD) in the West Bank. Using qualitative methods, we identified five primary interview themes. Poor screening, diagnostic, and psychoeducational practices were prevalent, as parents reported service providers minimized parental…

  7. 47 CFR 61.26 - Tariffing of competitive interstate switched exchange access services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Tariffing of competitive interstate switched exchange access services. 61.26 Section 61.26 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) TARIFFS General Rules for Nondominant Carriers § 61.26 Tariffing of competitive interstate switched...

  8. ChEMBL web services: streamlining access to drug discovery data and utilities.

    PubMed

    Davies, Mark; Nowotka, Michał; Papadatos, George; Dedman, Nathan; Gaulton, Anna; Atkinson, Francis; Bellis, Louisa; Overington, John P

    2015-07-01

    ChEMBL is now a well-established resource in the fields of drug discovery and medicinal chemistry research. The ChEMBL database curates and stores standardized bioactivity, molecule, target and drug data extracted from multiple sources, including the primary medicinal chemistry literature. Programmatic access to ChEMBL data has been improved by a recent update to the ChEMBL web services (version 2.0.x, https://www.ebi.ac.uk/chembl/api/data/docs), which exposes significantly more data from the underlying database and introduces new functionality. To complement the data-focused services, a utility service (version 1.0.x, https://www.ebi.ac.uk/chembl/api/utils/docs), which provides RESTful access to commonly used cheminformatics methods, has also been concurrently developed. The ChEMBL web services can be used together or independently to build applications and data processing workflows relevant to drug discovery and chemical biology. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

  9. Data Access Tools And Services At The Goddard Distributed Active Archive Center (GDAAC)

    NASA Technical Reports Server (NTRS)

    Pham, Long; Eng, Eunice; Sweatman, Paul

    2003-01-01

    As one of the largest providers of Earth Science data from the Earth Observing System, GDAAC provides the latest data from the Moderate Resolution Imaging Spectroradiometer (MODIS), Atmospheric Infrared Sounder (AIRS), Solar Radiation and Climate Experiment (SORCE) data products via GDAAC's data pool (50TB of disk cache). In order to make this huge volume of data more accessible to the public and science communities, the GDAAC offers multiple data access tools and services: Open Source Project for Network Data Access Protocol (OPeNDAP), Grid Analysis and Display System (GrADS/DODS) (GDS), Live Access Server (LAS), OpenGlS Web Map Server (WMS) and Near Archive Data Mining (NADM). The objective is to assist users in retrieving electronically a smaller, usable portion of data for further analysis. The OPeNDAP server, formerly known as the Distributed Oceanographic Data System (DODS), allows the user to retrieve data without worrying about the data format. OPeNDAP is capable of server-side subsetting of HDF, HDF-EOS, netCDF, JGOFS, ASCII, DSP, FITS and binary data formats. The GrADS/DODS server is capable of serving the same data formats as OPeNDAP. GDS has an additional feature of server-side analysis. Users can analyze the data on the server there by decreasing the computational load on their client's system. The LAS is a flexible server that allows user to graphically visualize data on the fly, to request different file formats and to compare variables from distributed locations. Users of LAS have options to use other available graphics viewers such as IDL, Matlab or GrADS. WMS is based on the OPeNDAP for serving geospatial information. WMS supports OpenGlS protocol to provide data in GIs-friendly formats for analysis and visualization. NADM is another access to the GDAAC's data pool. NADM gives users the capability to use a browser to upload their C, FORTRAN or IDL algorithms, test the algorithms, and mine data in the data pool. With NADM, the GDAAC provides an

  10. Cancer support services--are they appropriate and accessible for Indigenous cancer patients in Queensland, Australia?

    PubMed

    Whop, Lisa J; Garvey, Gail; Lokuge, Kamalini; Mallitt, Kylie A; Valery, Patricia C

    2012-01-01

    In Queensland, Australia, the incidence of cancer (all cancers combined) is 21% lower for Indigenous people compared with non-Indigenous people but mortality is 36% higher. Support services play an important role in helping cancer patients through their cancer journey. Indigenous cancer patients are likely to face greater unmet supportive care needs and more barriers to accessing cancer care and support. Other barriers include the higher proportion of Indigenous people who live remotely and in regional areas, a known difficulty for access to health services. This study describes the availability of cancer support services in Queensland for Indigenous patients and relevant location. Using a set criteria 121 services were selected from a pre-existing database (n = 344) of cancer services. These services were invited to complete an online questionnaire. ArcGIS (http://www.esri.com/software/arcgis/index.html) was used to map the services' location (using postcode) against Indigenous population by local government area. Services were classified as an 'Indigenous' or 'Indigenous friendly' service using set criteria. Eighty-three services (73.6%) completed the questionnaire. Mapping revealed services are located where there are relatively low percentages of Indigenous people compared with the whole population. No 'Indigenous-specific' services were identified; however, 11 services (13%) were classed 'Indigenous-friendly'. The primary support offered by these services was 'information'. Fewer referrals were received from Indigenous liaison officers compared with other health professionals. Only 8.6% of services reported frequently having contact with an Indigenous organisation; however, 44.6% of services reported that their staff participated in cultural training. Services also identified barriers to access which may exist for Indigenous clientele, including no Indigenous staff and the costs involved in accessing the service, but were unable to address these issues due to

  11. 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.

  12. 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

  13. Investigating socio-economic inequity in access to and expenditures on routine immunization services in Anambra state.

    PubMed

    Sibeudu, Florence T; Uzochukwu, Benjamin S C; Onwujekwe, Obinna E

    2017-02-01

    Addressing existing inequities in the utilization of priority health services such as routine immunization is a current public health priority. Increasing access to routine immunization from the current low levels amongst all socio-economic status groups in Nigeria is challenging. However, little is known on the level of SES inequity in utilization of routine immunization services and such information which will inform the development of strategies for ensuring equitable provision of routine immunization services in the country. The study was a cross sectional household survey, which was undertaken in two randomly selected communities in Anambra State, southeast Nigeria. A pre-tested interviewer administered questionnaire was used to collect data on levels of access to RI by children under-2 years from randomly selected households. In each household, data was collected from the primary care givers or their representative (in their absence). The relationship between access to routine immunization and socio-economic status of households and other key variables was explored in data analysis. Households from high socio-economic status (well-off) groups utilized routine immunization services more than those that belong to low socio-economic status (poor) groups (X 2  = 9.97, p < 0.002). It was found that higher percentage of low socio-economic status households compared to the high socio-economic status households received routine immunization services at public health facilities. Households that belong to low socio-economic status groups had to travel longer distance to get to health facilities consequently incurring some transportation cost. The mean expenditures on service charge for routine immunization services (mostly informal payments) and transportation were US$1.84 and US$1.27 respectively. Logistic regression showed that access to routine immunization was positively related to socio-economic status and negatively related to distant of a household to a

  14. Interactive, open source, travel time scenario modelling: tools to facilitate participation in health service access analysis.

    PubMed

    Fisher, Rohan; Lassa, Jonatan

    2017-04-18

    Modelling travel time to services has become a common public health tool for planning service provision but the usefulness of these analyses is constrained by the availability of accurate input data and limitations inherent in the assumptions and parameterisation. This is particularly an issue in the developing world where access to basic data is limited and travel is often complex and multi-modal. Improving the accuracy and relevance in this context requires greater accessibility to, and flexibility in, travel time modelling tools to facilitate the incorporation of local knowledge and the rapid exploration of multiple travel scenarios. The aim of this work was to develop simple open source, adaptable, interactive travel time modelling tools to allow greater access to and participation in service access analysis. Described are three interconnected applications designed to reduce some of the barriers to the more wide-spread use of GIS analysis of service access and allow for complex spatial and temporal variations in service availability. These applications are an open source GIS tool-kit and two geo-simulation models. The development of these tools was guided by health service issues from a developing world context but they present a general approach to enabling greater access to and flexibility in health access modelling. The tools demonstrate a method that substantially simplifies the process for conducting travel time assessments and demonstrate a dynamic, interactive approach in an open source GIS format. In addition this paper provides examples from empirical experience where these tools have informed better policy and planning. Travel and health service access is complex and cannot be reduced to a few static modeled outputs. The approaches described in this paper use a unique set of tools to explore this complexity, promote discussion and build understanding with the goal of producing better planning outcomes. The accessible, flexible, interactive and

  15. 28 CFR 115.282 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Mental Care § 115.282 Access to emergency medical and mental health services. (a) Resident victims of... intervention services, the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on...

  16. 28 CFR 115.282 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Mental Care § 115.282 Access to emergency medical and mental health services. (a) Resident victims of... intervention services, the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on...

  17. 28 CFR 115.282 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Mental Care § 115.282 Access to emergency medical and mental health services. (a) Resident victims of... intervention services, the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on...

  18. Using a service sector segmented approach to identify community stakeholders who can improve access to suicide prevention services for veterans.

    PubMed

    Matthieu, Monica M; Gardiner, Giovanina; Ziegemeier, Ellen; Buxton, Miranda

    2014-04-01

    Veterans in need of social services may access many different community agencies within the public and private sectors. Each of these settings has the potential to be a pipeline for attaining needed health, mental health, and benefits services; however, many service providers lack information on how to conceptualize where Veterans go for services within their local community. This article describes a conceptual framework for outreach that uses a service sector segmented approach. This framework was developed to aid recruitment of a provider-based sample of stakeholders (N = 70) for a study on improving access to the Department of Veterans Affairs and community-based suicide prevention services. Results indicate that although there are statistically significant differences in the percent of Veterans served by the different service sectors (F(9, 55) = 2.71, p = 0.04), exposure to suicidal Veterans and providers' referral behavior is consistent across the sectors. Challenges to using this framework include isolating the appropriate sectors for targeted outreach efforts. The service sector segmented approach holds promise for identifying and referring at-risk Veterans in need of services. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  19. 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.

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

    PubMed

    Dunn, Matthew; Henshaw, Richard; McKay, Fiona H

    2016-07-01

    To understand health service access and needs of people who use performance and image enhancing drugs (PIED) in regional Queensland. Semi-structured interviews were conducted with 21 people (n = 19 men) who reported the use of a range of PIEDs, including anabolic-androgenic steroids, human chorionic gonadotropin, growth hormone, clenbuterol, tamoxifen, insulin and peptides. Participants reported accessing a range of services, including needle and syringe programs and pharmacies, for sterile injecting equipment. While PIEDs users attributed some stigma to needle and syringe programs, they were seen as an important service for injecting equipment. Participants reported receiving either positive care from health-care providers, such as general practitioners (GP), or having negative experiences due to the stigma attached with PIED use. Few participants reported disclosing their PIED use to their GP not only because of the concerns that their GP would no longer see them but also because they felt their GP was not knowledgeable about these substances. Participants in the study reported no difficulty in accessing health services based on living in a regional area, with their concern focused more upon how they were viewed and treated by service staff. [Dunn M, Henshaw R, Mckay F. H. Do performance and image enhancing drug users in regional Queensland experience difficulty accessing health services? Drug Alcohol Rev 2016;35:377-382]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  1. Big Data Discovery and Access Services through NOAA OneStop

    NASA Astrophysics Data System (ADS)

    Casey, K. S.; Neufeld, D.; Ritchey, N. A.; Relph, J.; Fischman, D.; Baldwin, R.

    2017-12-01

    The NOAA OneStop Project was created as a pathfinder effort to to improve the discovery of, access to, and usability of NOAA's vast and diverse collection of big data. OneStop is led by the NOAA/NESDIS National Centers for Environmental Information (NCEI), and is seen as a key NESDIS contribution to NOAA's open data and data stewardship efforts. OneStop consists of an entire framework of services, from storage and interoperable access services at the base, through metadata and catalog services in the middle, to a modern user interface experience at the top. Importantly, it is an open framework where external tools and services can connect at whichever level is most appropriate. Since the beta release of the OneStop user interface at the 2016 Fall AGU meeting, significant progress has been made improving and modernizing many NOAA data collections to optimize their use within the framework. In addition, OneStop has made progress implementing robust metadata management and catalog systems at the collection and granule level and improving the user experience with the web interface. This progress will be summarized and the results of extensive user testing including professional usability studies will be reviewed. Key big data technologies supporting the framework will be presented and a community input sought on the future directions of the OneStop Project.

  2. Inequities in accessibility to and utilisation of maternal health services in Ghana after user-fee exemption: a descriptive study.

    PubMed

    Ganle, John K; Parker, Michael; Fitzpatrick, Raymond; Otupiri, Easmon

    2014-11-01

    Inequities in accessibility to, and utilisation of maternal healthcare services impede progress towards attainment of the maternal health-related Millennium Development Goals. The objective of this study is to examine the extent to which maternal health services are utilised in Ghana, and whether inequities in accessibility to and utilization of services have been eliminated following the implementation of a user-fee exemption policy, that aims to reduce financial barriers to access, reduce inequities in access, and improve access to and use of birthing services. We analyzed data from the 2007 Ghana Maternal Health Survey for inequities in access to and utilization of maternal health services. In measuring the inequities, frequency tables and cross-tabulations were used to compare rates of service utilization by region, residence and selected socio-demographic variables. Findings show marginal increases in accessibility to and utilisation of skilled antenatal, delivery and postnatal care services following the policy implementation (2003-2007). However, large gradients of inequities exist between geographic regions, urban and rural areas, and different socio-demographic, religious and ethnic groupings. More urban women (40%) than rural, 53% more women in the highest wealth quintile than women in the lowest, 38% more women in the best performing region (Central Region) than the worst (Upper East Region), and 48% more women with at least secondary education than those with no formal education, accessed and used all components of skilled maternal health services in the five years preceding the survey. Our findings raise questions about the potential equity and distributional benefits of Ghana's user-fee exemption policy, and the role of non-financial barriers or considerations. Exempting user-fees for maternal health services is a promising policy option for improving access to maternal health care, but might be insufficient on its own to secure equitable access to

  3. Scalable Active Optical Access Network Using Variable High-Speed PLZT Optical Switch/Splitter

    NASA Astrophysics Data System (ADS)

    Ashizawa, Kunitaka; Sato, Takehiro; Tokuhashi, Kazumasa; Ishii, Daisuke; Okamoto, Satoru; Yamanaka, Naoaki; Oki, Eiji

    This paper proposes a scalable active optical access network using high-speed Plumbum Lanthanum Zirconate Titanate (PLZT) optical switch/splitter. The Active Optical Network, called ActiON, using PLZT switching technology has been presented to increase the number of subscribers and the maximum transmission distance, compared to the Passive Optical Network (PON). ActiON supports the multicast slot allocation realized by running the PLZT switch elements in the splitter mode, which forces the switch to behave as an optical splitter. However, the previous ActiON creates a tradeoff between the network scalability and the power loss experienced by the optical signal to each user. It does not use the optical power efficiently because the optical power is simply divided into 0.5 to 0.5 without considering transmission distance from OLT to each ONU. The proposed network adopts PLZT switch elements in the variable splitter mode, which controls the split ratio of the optical power considering the transmission distance from OLT to each ONU, in addition to PLZT switch elements in existing two modes, the switching mode and the splitter mode. The proposed network introduces the flexible multicast slot allocation according to the transmission distance from OLT to each user and the number of required users using three modes, while keeping the advantages of ActiON, which are to support scalable and secure access services. Numerical results show that the proposed network dramatically reduces the required number of slots and supports high bandwidth efficiency services and extends the coverage of access network, compared to the previous ActiON, and the required computation time for selecting multicast users is less than 30msec, which is acceptable for on-demand broadcast services.

  4. A hybrid lightwave transmission system based on light injection/optoelectronic feedback techniques and fiber-VLLC integration

    NASA Astrophysics Data System (ADS)

    Tsai, Wen-Shing; Lu, Hai-Han; Li, Chung-Yi; Chen, Bo-Rui; Lin, Hung-Hsien; Lin, Dai-Hua

    2016-04-01

    A hybrid lightwave transmission system based on light injection/optoelectronic feedback techniques and fiber-visible laser light communication (VLLC) integration is proposed and experimentally demonstrated. To be the first one of its kind in employing light injection and optoelectronic feedback techniques in a fiber-VLLC integration lightwave transmission system, the light is successfully directly modulated with Community Access Television (CATV), 16-QAM, and 16-QAM-OFDM signals. Over a 40 km SMF and a 10 m free-space VLLC transport, good performances of carrier-to-noise ratio (CNR)/composite second-order (CSO)/composite triple-beat (CTB)/bit error rate (BER) are achieved for CATV/16-QAM/16-QAM-OFDM signals transmission. Such a hybrid lightwave transmission system would be very useful since it can provide broadband integrated services including CATV, Internet, and telecommunication services over both distribute fiber and in-building networks.

  5. The Mawson Centre: Access for All to Education Services

    ERIC Educational Resources Information Center

    Trimper, Kelvin

    2006-01-01

    In the knowledge society of the 21st century everyone--not only children but every person, enterprise and organisation--will need ongoing access to a full range of quality education and training services. This principle, often espoused by the OECD and endorsed by the ministers of education in its member countries, has driven the planning and…

  6. Community Consultation and Intervention: Supporting Students Who Do Not Access Counseling Services

    ERIC Educational Resources Information Center

    Mier, Sharon; Boone, Matthew; Shropshire, Sonya

    2009-01-01

    Although the severity of psychological problems among college students and the demand for campus counseling services has increased, many students who could benefit from mental health services still do not access them. This article describes Community Consultation and Intervention, a program designed to support students who are unlikely to access…

  7. Application of Fiber-Optical Techniques in the Access Transmission and Backbone Transport of Mobile Networks

    NASA Astrophysics Data System (ADS)

    Hilt, Attila; Pozsonyi, László

    2012-09-01

    Fixed access networks widely employ fiber-optical techniques due to the extremely wide bandwidth offered to subscribers. In the last decade, there has also been an enormous increase of user data visible in mobile systems. The importance of fiber-optical techniques within the fixed transmission/transport networks of mobile systems is therefore inevitably increasing. This article summarizes a few reasons and gives examples why and how fiber-optic techniques are employed efficiently in second-generation networks.

  8. 28 CFR 115.353 - Resident access to outside support services and legal representation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... provide residents with access to outside victim advocates for emotional support services related to sexual abuse, by providing, posting, or otherwise making accessible mailing addresses and telephone numbers... reports of abuse will be forwarded to authorities in accordance with mandatory reporting laws. (c) The...

  9. 28 CFR 115.353 - Resident access to outside support services and legal representation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... provide residents with access to outside victim advocates for emotional support services related to sexual abuse, by providing, posting, or otherwise making accessible mailing addresses and telephone numbers... reports of abuse will be forwarded to authorities in accordance with mandatory reporting laws. (c) The...

  10. 28 CFR 115.353 - Resident access to outside support services and legal representation.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... provide residents with access to outside victim advocates for emotional support services related to sexual abuse, by providing, posting, or otherwise making accessible mailing addresses and telephone numbers... reports of abuse will be forwarded to authorities in accordance with mandatory reporting laws. (c) The...

  11. Children's Access to Public Library Services: Prince George's County Memorial Public Library, Maryland, 1980.

    ERIC Educational Resources Information Center

    Gerhardt, Lillian N.

    1981-01-01

    Evaluates the Prince George's County Memorial Public Library's approach to providing access to its services for children, and examines policies, regulations, practices, and conditions that affect such access. Six references are cited. (FM)

  12. Access to HIV Services at Non-Governmental and Community-Based Organizations among Men Who Have Sex with Men (MSM) in Cameroon: An Integrated Biological and Behavioral Surveillance Analysis.

    PubMed

    Holland, Claire E; Papworth, Erin; Billong, Serge C; Kassegne, Sethson; Petitbon, Fanny; Mondoleba, Valentin; Moukam, Laure Vartan; Macauley, Isaac; Eyene Ntsama, Simon Pierre; Yomb, Yves Roger; Eloundou, Jules; Mananga, Franz; Tamoufe, Ubald; Baral, Stefan D

    2015-01-01

    Men who have sex with men (MSM) are more likely to be living with HIV than other adult men in low- and middle-income countries. MSM experience barriers to accessing HIV services including a lack of available specialized care, and community-level stigma and discrimination. This study aims to examine the uptake of HIV services at non-governmental and community-based organizations (NGOs/CBOs) to identify ways to improve coverage of HIV prevention and treatment among MSM. An Integrated Biological and Behavioral Surveillance (IBBS) survey was conducted in Yaoundé and Douala, Cameroon in 2011 using the respondent driven sampling (RDS) method to recruit and interview 239 MSM in Yaoundé and 272 MSM in Douala. MSM in Yaoundé were statistically significantly more likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months if they had any STI symptoms (aOR 2.17 CI 1.02-4.59. p=0.04), or if they had a larger MSM social network (aOR 1.02 CI 1.01-1.04. p<0.01). MSM in Douala were more likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months if they were living with HIV (aOR 3.60 CI 1.35-9.60. p=0.01), or if they reported higher numbers of male sexual partners (aOR 1.17 CI 1.00-1.36. p=0.046). Compared to men in Douala, MSM in Yaoundé were significantly less likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months (aOR 0.22 CI 0 .14-0.34. p=<0.01). With appropriate funding and resources, community-based organizations that provide care specifically for MSM can improve access to HIV prevention, treatment, and care services. Additionally, using social networks to reach MSM can connect greater numbers of the population to effective HIV interventions, which will improve health outcomes and decrease onward transmission of HIV.

  13. Secondary stroke prevention services in Canada: a cross-sectional survey and geospatial analysis of resources, capacity and geographic access

    PubMed Central

    Jewett, Lauren; Harroud, Adil; Hill, Michael D.; Côté, Robert; Wein, Theodore; Smith, Eric E.; Gubitz, Gord; Demchuk, Andrew M.; Sahlas, Demetrios J.; Gladstone, David J.; Lindsay, M. Patrice

    2018-01-01

    Background: Rapid assessment and management of transient ischemic attacks and nondisabling strokes by specialized stroke prevention services reduces the risk of recurrent stroke and improves outcomes. In Canada, with its vast geography and with 16.8% of the population living in rural areas, access to these services is challenging, and considerable variation in access to care exists. The purpose of this multiphase study was to identify sites across Canada providing stroke prevention services, evaluate resource capacity and determine geographic access for Canadians. Methods: We developed a Stroke Prevention Services Resource Inventory that contained 22 questions on the organization and delivery of stroke prevention services and quality monitoring. The inventory ran from November 2015 to January 2016 and was administered online. We conducted a geospatial analysis to estimate access by drive times. Considerations were made for hours of operation and access within and across provincial borders. Results: A total of 123 stroke prevention sites were identified, of which 119 (96.7%) completed the inventory. Most (95) are designated stroke prevention or rapid assessment clinics. Of the 119 sites, 68 operate full time, and 39 operate less than 2.5 days per week. A total of 87.3% of the Canadian population has access to a stroke prevention service within a 1-hour drive; however, only 69.2% has access to a service that operates 5-7 days a week. Allowing provincial border crossing improves access (< 6-h drive) for those who are beyond a 6-hour drive within their home province (3.4%). Interpretation: Most Canadians have reasonable geographic access to stroke prevention services. Allowing patients to cross borders improves the existing access for many, particularly some remote communities along the Ontario-Quebec and British Columbia-Alberta borders. PMID:29472251

  14. Pilot Evaluation of a Web-Based Intervention Targeting Sexual Health Service Access

    ERIC Educational Resources Information Center

    Brown, K. E.; Newby, K.; Caley, M.; Danahay, A.; Kehal, I.

    2016-01-01

    Sexual health service access is fundamental to good sexual health, yet interventions designed to address this have rarely been implemented or evaluated. In this article, pilot evaluation findings for a targeted public health behavior change intervention, delivered via a website and web-app, aiming to increase uptake of sexual health services among…

  15. A SOAP Web Service for accessing MODIS land product subsets

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

    SanthanaVannan, Suresh K; Cook, Robert B; Pan, Jerry Yun

    2011-01-01

    Remote sensing data from satellites have provided valuable information on the state of the earth for several decades. Since March 2000, the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor on board NASA s Terra and Aqua satellites have been providing estimates of several land parameters useful in understanding earth system processes at global, continental, and regional scales. However, the HDF-EOS file format, specialized software needed to process the HDF-EOS files, data volume, and the high spatial and temporal resolution of MODIS data make it difficult for users wanting to extract small but valuable amounts of information from the MODIS record. Tomore » overcome this usability issue, the NASA-funded Distributed Active Archive Center (DAAC) for Biogeochemical Dynamics at Oak Ridge National Laboratory (ORNL) developed a Web service that provides subsets of MODIS land products using Simple Object Access Protocol (SOAP). The ORNL DAAC MODIS subsetting Web service is a unique way of serving satellite data that exploits a fairly established and popular Internet protocol to allow users access to massive amounts of remote sensing data. The Web service provides MODIS land product subsets up to 201 x 201 km in a non-proprietary comma delimited text file format. Users can programmatically query the Web service to extract MODIS land parameters for real time data integration into models, decision support tools or connect to workflow software. Information regarding the MODIS SOAP subsetting Web service is available on the World Wide Web (WWW) at http://daac.ornl.gov/modiswebservice.« less

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

    PubMed

    Kattari, Shanna K; Walls, N Eugene; Speer, Stephanie Rachel

    2017-01-01

    Transgender and gender nonconforming (GNC) individuals frequently experience discrimination and potentially a lack of respect from service providers, suggesting they have decreased access to professionals with cultural competency. Similarly, people with disabilities experience higher levels of discrimination in social services than their nondisabled counterparts. From an intersectional perspective, this study examines rates of discrimination in accessing social services faced by transgender and GNC people, comparing across ability. Data indicate that although transgender and GNC individuals of all abilities experience gender-based discrimination when accessing social services, those with disabilities experience higher levels of antitransgender discrimination in mental health centers, rape crisis centers, and domestic violence shelters.

  17. Efficient Information Access for Location-Based Services in Mobile Environments

    ERIC Educational Resources Information Center

    Lee, Chi Keung

    2009-01-01

    The demand for pervasive access of location-related information (e.g., local traffic, restaurant locations, navigation maps, weather conditions, pollution index, etc.) fosters a tremendous application base of "Location Based Services (LBSs)". Without loss of generality, we model location-related information as "spatial objects" and the accesses…

  18. Challenges Women with Disability Face in Accessing and Using Maternal Healthcare Services in Ghana: A Qualitative Study.

    PubMed

    Ganle, John Kuumuori; Otupiri, Easmon; Obeng, Bernard; Edusie, Anthony Kwaku; Ankomah, Augustine; Adanu, Richard

    2016-01-01

    While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana. A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling's thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers' insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability. Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and patient-centred training for healthcare

  19. Differences in access to services in rural emergency departments of Quebec and Ontario.

    PubMed

    Fleet, Richard; Pelletier, Christina; Marcoux, Jérémie; Maltais-Giguère, Julie; Archambault, Patrick; Audette, Louis David; Plant, Jeff; Bégin, François; Tounkara, Fatoumata Korika; Poitras, Julien

    2015-01-01

    Rural emergency departments (EDs) are important safety nets for the 20% of Canadians who live there. A serious problem in access to health care services in these regions has emerged. However, there are considerable geographic disparities in access to trauma center in Canada. The main objective of this project was to compare access to local 24/7 support services in rural EDs in Quebec and Ontario as well as distances to Levels 1 and 2 trauma centers. Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities. There were 26 rural EDs in Quebec and 62 in Ontario meeting these criteria. Data were collected from ministries of health, local health authorities, and ED statistics. Fisher's exact test, the t-test or Wilcoxon-Mann-Whitney test, were performed to compare rural EDs of Quebec and Ontario. All selected EDs of Quebec and Ontario agreed to participate in the study. The number of EDs visits was higher in Quebec than in Ontario (19 322 ± 6 275 vs 13 446 ± 8 056, p = 0.0013). There were no significant differences between Quebec and Ontario's local population and small town population density. Quebec's EDs have better access to advance imaging services such as CT scanner (77% vs 15%, p < .0001) and most the consultant support and ICU (92% vs 31%, p < .0001). Finally, more than 40% of rural EDs in Quebec and Ontario are more than 300 km away from Levels 1 and 2 trauma centers. Considering that Canada has a Universal health care system, the discrepancies between Quebec and Ontario in access to support services are intriguing. A nationwide study is justified to address this issue.

  20. Differences in Access to Services in Rural Emergency Departments of Quebec and Ontario

    PubMed Central

    Archambault, Patrick; Audette, Louis David; Plant, Jeff; Bégin, François; Poitras, Julien

    2015-01-01

    Introduction Rural emergency departments (EDs) are important safety nets for the 20% of Canadians who live there. A serious problem in access to health care services in these regions has emerged. However, there are considerable geographic disparities in access to trauma center in Canada. The main objective of this project was to compare access to local 24/7 support services in rural EDs in Quebec and Ontario as well as distances to Levels 1 and 2 trauma centers. Materials and Methods Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities. There were 26 rural EDs in Quebec and 62 in Ontario meeting these criteria. Data were collected from ministries of health, local health authorities, and ED statistics. Fisher’s exact test, the t-test or Wilcoxon-Mann-Whitney test, were performed to compare rural EDs of Quebec and Ontario. Results All selected EDs of Quebec and Ontario agreed to participate in the study. The number of EDs visits was higher in Quebec than in Ontario (19 322 ± 6 275 vs 13 446 ± 8 056, p = 0.0013). There were no significant differences between Quebec and Ontario’s local population and small town population density. Quebec’s EDs have better access to advance imaging services such as CT scanner (77% vs 15%, p < .0001) and most the consultant support and ICU (92% vs 31%, p < .0001). Finally, more than 40% of rural EDs in Quebec and Ontario are more than 300 km away from Levels 1 and 2 trauma centers. Conclusions Considering that Canada has a Universal health care system, the discrepancies between Quebec and Ontario in access to support services are intriguing. A nationwide study is justified to address this issue. PMID:25874948

  1. Comparison of access to services in rural emergency departments in Quebec and British Columbia.

    PubMed

    Fleet, Richard; Audette, Louis-David; Marcoux, Jérémie; Villa, Julie; Archambault, Patrick; Poitras, Julien

    2014-11-01

    Although emergency departments (EDs) in Canada's rural areas serve approximately 20% of the population, a serious problem in access to health care services has emerged. The objective of this project was to compare access to support services in rural EDs between British Columbia and Quebec. Rural EDs were identified through the Canadian Healthcare Association's Guide to Canadian Healthcare Facilities. We selected hospitals with 24/7 ED physician coverage and hospitalization beds that were located in rural communities (using the rural and small town definition from Statistics Canada). Data were collected from ministries of health, local health authorities, and ED statistics. A telephone interview was administered to collect denominative user data statistics and determine the status of services. British Columbia has more rural EDs (n  =  34) than Quebec (n  =  26). EDs in Quebec have higher volumes (19,310 versus 7,793 annual visits). With respect to support services, 81% of Quebec rural EDs have a 24/7 on-call general surgeon compared to 12% for British Columbia. Nearly 75% of Quebec rural EDs have 24/7 access to computed tomography versus only 3% for British Columbia. Rural EDs in Quebec are also supported by a greater proportion of intensive care units (88% versus 15%); however, British Columbia appears to have more medevac aircraft/helicopters than Quebec. The results suggest that major differences exist in access to support services in rural EDs in British Columbia and Quebec. A nationwide study is justified to address this issue of variability in rural and remote health service delivery and its impact on interfacility transfers and patient outcomes.

  2. mORCA: ubiquitous access to life science web services.

    PubMed

    Diaz-Del-Pino, Sergio; Trelles, Oswaldo; Falgueras, Juan

    2018-01-16

    Technical advances in mobile devices such as smartphones and tablets have produced an extraordinary increase in their use around the world and have become part of our daily lives. The possibility of carrying these devices in a pocket, particularly mobile phones, has enabled ubiquitous access to Internet resources. Furthermore, in the life sciences world there has been a vast proliferation of data types and services that finish as Web Services. This suggests the need for research into mobile clients to deal with life sciences applications for effective usage and exploitation. Analysing the current features in existing bioinformatics applications managing Web Services, we have devised, implemented, and deployed an easy-to-use web-based lightweight mobile client. This client is able to browse, select, compose parameters, invoke, and monitor the execution of Web Services stored in catalogues or central repositories. The client is also able to deal with huge amounts of data between external storage mounts. In addition, we also present a validation use case, which illustrates the usage of the application while executing, monitoring, and exploring the results of a registered workflow. The software its available in the Apple Store and Android Market and the source code is publicly available in Github. Mobile devices are becoming increasingly important in the scientific world due to their strong potential impact on scientific applications. Bioinformatics should not fall behind this trend. We present an original software client that deals with the intrinsic limitations of such devices and propose different guidelines to provide location-independent access to computational resources in bioinformatics and biomedicine. Its modular design makes it easily expandable with the inclusion of new repositories, tools, types of visualization, etc.

  3. A Northern Territory Approach to Quantifying "Access Disadvantage" to Educational Services in Remote and Rural Australia.

    ERIC Educational Resources Information Center

    Griffith, D. A.

    The Griffith Service Access Frame (GSAF) is a model used for quantifying the access disadvantage to educational services of remote and rural areas in Australia. The model was specifically developed to assist policymakers and administrators in allocating resources. The problem with the current funding formula used by the Australian federal…

  4. Exploring health services accessibility by indigenous women in Asia and identifying actions to improve it: a scoping review.

    PubMed

    Thummapol, Onouma; Park, Tanya; Barton, Sylvia

    2018-05-03

    The aim of this scoping review was to uncover and summarize what is known in the literature about the experiences of Indigenous women in Asia regarding access to health services. The study was informed by the scoping review methodology proposed by Arksey and O'Malley [2005. "Scoping Studies: Towards a Methodological Framework." International Journal of Social Research Methodology 8 (1): 19-32. doi: 10.1080/1364557032000119616 ]. A comprehensive search of the databases for peer-reviewed studies and grey literature was conducted between January 2000 and December 2016. The data of selected papers and abstracts were analysed by three independent researchers through a protocol of data charting, descriptive numerical summary, and thematic analysis. Sixteen articles and two abstracts met the inclusion criteria for this scoping review. These 18 peer-reviewed documents consisted of eight qualitative studies, seven quantitative studies, and three mixed-method studies, which included the peer-reviewed poster and oral presentation abstracts from international conferences. The findings were sorted and grouped under the following themes: health care access for Indigenous women in Asia, facilitators to accessing healthcare services, barriers to accessing healthcare services, and cultural contexts impacting health and access. There is limited information about the experiences, facilitators, barriers, and cultural contexts faced by Indigenous women in Asia related to health services accessibility, and even less information related to improving health services accessibility and health outcomes. This scoping review in particular highlights the dearth of literature relating to Indigenous women's postpartum health and access to postnatal supports and services. Generally, it indicates that Indigenous women in Asia are more vulnerable to poor health in comparison to non-Indigenous women, and continue to face challenges and barriers in accessing quality and equitable health services. The

  5. Electromagnetic interference-aware transmission scheduling and power control for dynamic wireless access in hospital environments.

    PubMed

    Phunchongharn, Phond; Hossain, Ekram; Camorlinga, Sergio

    2011-11-01

    We study the multiple access problem for e-Health applications (referred to as secondary users) coexisting with medical devices (referred to as primary or protected users) in a hospital environment. In particular, we focus on transmission scheduling and power control of secondary users in multiple spatial reuse time-division multiple access (STDMA) networks. The objective is to maximize the spectrum utilization of secondary users and minimize their power consumption subject to the electromagnetic interference (EMI) constraints for active and passive medical devices and minimum throughput guarantee for secondary users. The multiple access problem is formulated as a dual objective optimization problem which is shown to be NP-complete. We propose a joint scheduling and power control algorithm based on a greedy approach to solve the problem with much lower computational complexity. To this end, an enhanced greedy algorithm is proposed to improve the performance of the greedy algorithm by finding the optimal sequence of secondary users for scheduling. Using extensive simulations, the tradeoff in performance in terms of spectrum utilization, energy consumption, and computational complexity is evaluated for both the algorithms.

  6. Gender Differences in Access to Extension Services and Agricultural Productivity

    ERIC Educational Resources Information Center

    Ragasa, Catherine; Berhane, Guush; Tadesse, Fanaye; Taffesse, Alemayehu Seyoum

    2013-01-01

    Purpose: This article contributes new empirical evidence and nuanced analysis on the gender difference in access to extension services and how this translates to observed differences in technology adoption and agricultural productivity. Approach: It looks at the case of Ethiopia, where substantial investments in the extension system have been…

  7. Language Barriers Impact Access to Services for Children with Autism Spectrum Disorders.

    PubMed

    St Amant, Helaine G; Schrager, Sheree M; Peña-Ricardo, Carolina; Williams, Marian E; Vanderbilt, Douglas L

    2018-02-01

    Racial and ethnic disparities in accessing health care have been described in children with autism spectrum disorder (ASD). In a retrospective chart review of 152 children with ASD, children of parents whose primary language was English were significantly more likely to have both social skills and communication goals within their individualized education plan (IEP) compared to children of parents whose primary language was not English. Additionally, children of primary English speakers received significantly more hours of direct services from their state disability program. After controlling for demographic covariates, findings suggest that language barriers may negatively affect parents' abilities to access health care services for their child with ASD. Acculturation factors must therefore be considered when analyzing disparities in autism.

  8. [Access to primary healthcare services: still a way to go].

    PubMed

    Mendes, Antônio da Cruz Gouveia; Miranda, Gabriella Morais Duarte; Figueiredo, Karla Erika Gouveia; Duarte, Petra Oliveira; Furtado, Betise Mery Alencar Sousa Macau

    2012-11-01

    This study seeks to evaluate accessibility to the Basic Units of the Family Health Strategy (ESF-UB) and Traditional Basic Units (BU-T) in the city of Recife in 2009. Data were collected through three instruments: a roadmap for systematic observation of the units and questionnaires for users and professional units. This is a descriptive cross-sectional study using a quantitative approach, and 1180 users, 61 doctors and 56 nurses were interviewed. The results showed good ties and recognition of users whereby primary healthcare is seen as the access portal to the health system. In the comparison between ESF-UB and UB-T, evaluations are always more favorable to the family healthcare strategy, though with relatively insignificant differences. The overall result revealed widespread dissatisfaction with the difficulty of obtaining drugs and taking tests, and also with the waiting times and access to specialized care. This showed the existence of organizational problems that may constitute barriers limiting accessibility to basic healthcare services for users.

  9. Patients’ Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice

    PubMed Central

    Mold, Freda; de Lusignan, Simon

    2015-01-01

    Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems. PMID:26690225

  10. Patients' Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice.

    PubMed

    Mold, Freda; de Lusignan, Simon

    2015-12-04

    Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.

  11. Practical Strategies for Making Online Library Services and Instruction Accessible to All Patrons

    ERIC Educational Resources Information Center

    Wray, Christina C.

    2013-01-01

    Providing accessible library services and instruction to distance users with disabilities can seem daunting. This article, which grew out of a webinar presented by the author to the Health Science Special Interest Group of ACRL, provides practical strategies to help content creators utilize built-in accessibility features and provides a resources…

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

    PubMed

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

    2016-10-22

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

  13. Changing access to mental health care and social support when people living with HIV/AIDS become service providers.

    PubMed

    Li, Alan Tai-Wai; Wales, Joshua; Wong, Josephine Pui-Hing; Owino, Maureen; Perreault, Yvette; Miao, Andrew; Maseko, Precious; Guiang, Charlie

    2015-01-01

    As people living with HIV/AIDS (PHAs) achieve more stable health, many have taken on active peer support and professional roles within AIDS service organizations. Although the increased engagement has been associated with many improved health outcomes, emerging program and research evidence have identified new challenges associated with such transition. This paper reports on the results of a qualitative interpretive study that explored the effect of this role transition on PHA service providers' access to mental health support and self care. A total of 27 PHA service providers of diverse ethno-racial backgrounds took part in the study. Results show that while role transition often improves access to financial and health-care benefits, it also leads to new stress from workload demands, emotional triggers from client's narratives, feeling of burnout from over-immersion in HIV at both personal and professional levels, and diminished self care. Barriers to seeking support included: concerns regarding confidentiality; self-imposed and enacted stigma associated with accessing mental health services; and boundary issues resulting from changes in relationships with peers and other service providers. Evolving support mechanisms included: new formal and informal peer support networks amongst colleagues or other PHA service providers to address both personal and professional challenges, and having access to professional support offered through the workplace. The findings suggest the need for increased organizational recognition of HIV support work as a form of emotional labor that places complex demands on PHA service providers. Increased access to employer-provided mental health services, supportive workplace policies, and adequate job-specific training will contribute to reduced work-related stress. Community level strategies that support expansion of social networks amongst PHA service providers would reduce isolation. Systemic policies to increase access to insurance

  14. From the voices of women: facilitating survivor access to IPV services.

    PubMed

    Simmons, Catherine A; Farrar, Melissa; Frazer, Kitty; Thompson, Mary Jane

    2011-10-01

    This mixed-method study investigated perceptions women domestic violence survivors/victims have about why women do not seek help from formal support structures and actions domestic helping agencies can take to facilitate survivor access to services. Congruent with previous research, quantitative analysis identified 17 reasons women do not seek help from formal support structures. Expanding current knowledge, concept mapping revealed six ways family violence programs can better reach women in abusive relationships, including (1) remove barriers to services, (2) improve comfort with services, (3) "talk about it," (4) improve community awareness, (5) victim-targeted marketing, and (6) "I honestly don't know."

  15. A descriptive study of access to services in a random sample of Canadian rural emergency departments.

    PubMed

    Fleet, Richard; Poitras, Julien; Maltais-Giguère, Julie; Villa, Julie; Archambault, Patrick

    2013-11-27

    To examine 24/7 access to services and consultants in a sample of Canadian rural emergency departments (EDs). Cross-sectional study-mixed methods (structured interview, survey and government data bases) with random sampling of hospitals. Canadian rural EDs (rural small town (RST) definition-Statistics Canada). 28% (95/336) of Canadian rural EDs providing 24/7 physician coverage located in hospitals with acute care hospitalisation beds. General characteristics of the rural EDs, information about 24/7 access to consultants, equipment and services, and the proportion of rural hospitals more than 300 km from levels 1 and 2 trauma centres. Of the 336 rural EDs identified, 122 (36%) were randomly selected and contacted. Overall, 95 EDs participated in the study (participation rate, 78%). Hospitals had, on an average, 23 acute care beds, 7 ED stretchers and 13 500 annual ED visits. The proportion of rural hospitals with local access to the following 24/7 services was paediatrician, 5%; obstetrician, 10%; psychiatrist, 11%; internist, 12%; intensive care unit, 17%; CT scanner, 20%; surgeon, 26%; ultrasound, 28%; basic X-ray, 97% and laboratory services, 99%. Forty-four per cent and 54% of the RST EDs were more than 300 km from a level 1 and level 2 trauma centre, respectively. This is the first study describing the services available in Canadian rural EDs. Apart from basic laboratory and X-ray services, most rural EDs have limited access to consultants, advanced imaging and critical care services. A detailed study is needed to evaluate the impact of these limited services on patient outcomes, costs and interfacility transport demands.

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

    PubMed Central

    2012-01-01

    Background Coordinated, interdisciplinary services, supported by self-management underpin effective management for chronic low back pain (CLBP). However, a combination of system, provider and consumer-based barriers exist which limit the implementation of such models into practice, particularly in rural areas where unique access issues exist. In order to improve health service delivery for consumers with CLBP, policymakers and service providers require a more in depth understanding of these issues. The objective of this qualitative study was to explore barriers experienced by consumers in rural settings in Western Australia (WA) to accessing information and services and implementing effective self-management behaviours for CLBP. Methods Fourteen consumers with a history of CLBP from three rural sites in WA participated. Maximum variation sampling was employed to ensure a range of experiences were captured. An interviewer, blinded to quantitative pain history data, conducted semi-structured telephone interviews using a standardised schedule to explore individuals’ access to information and services for CLBP, and self-management behaviours. Interviews were digitally recorded and transcribed verbatim. Inductive analysis techniques were used to derive and refine key themes. Results Five key themes were identified that affected individuals’ experiences of managing CLBP in a rural setting, including: 1) poor access to information and services in rural settings; 2) inadequate knowledge and skills among local practitioners; 3) feelings of isolation and frustration; 4) psychological burden associated with CLBP; and 5) competing lifestyle demands hindering effective self-management for CLBP. Conclusions Consumers in rural WA experienced difficulties in knowing where to access relevant information for CLBP and expressed frustration with the lack of service delivery options to access interdisciplinary and specialist services for CLBP. Competing lifestyle demands such as

  17. The relation between community bans of self-service tobacco displays and store environment and between tobacco accessibility and merchant incentives.

    PubMed

    Lee, R E; Feighery, E C; Schleicher, N C; Halvorson, S

    2001-12-01

    These studies investigated (1) the effect of community bans of self-service tobacco displays on store environment and (2) the effect of consumer tobacco accessibility on merchants. We counted cigarette displays (self-service, clerk-assisted, clear acrylic case) in 586 California stores. Merchant interviews (N = 198) identified consumer tobacco accessibility, tobacco company incentives, and shoplifting. Stores in communities with self-service tobacco display bans had fewer self-service displays and more acrylic displays but an equal total number of displays. The merchants who limited consumer tobacco accessibility received fewer incentives and reported lower shoplifting losses. In contrast, consumer access to tobacco was unrelated to the amount of monetary incentives. Community bans decreased self-service tobacco displays; however, exposure to tobacco advertising in acrylic displays remained high. Reducing consumer tobacco accessibility may reduce shoplifting.

  18. Being Single as a Social Barrier to Access Reproductive Healthcare Services by Iranian Girls.

    PubMed

    Kohan, Shahnaz; Mohammadi, Fatemeh; Mostafavi, Firoozeh; Gholami, Ali

    2016-08-17

    Iranian single women are deprived of reproductive healthcare services, though the provision of such services to the public has increased. This study aimed to explore the experiences of Iranian single women on their access to reproductive health services. A qualitative design using a conventional content analysis method was used. Semi-structured interviews were held with 17 single women and nine health providers chosen using the purposive sampling method. Data analysis resulted in the development of three categories: 'family's attitudes and performance about single women's reproductive healthcare,' 'socio-cultural factors influencing reproductive healthcare,' and 'cultural factors influencing being a single woman.' Cultural and contextual factors affect being a single woman in every society. Therefore, healthcare providers need to identify such factors during the designing of strategies for improving the facilitation of access to reproductive healthcare services. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  19. Multiradio Resource Management: Parallel Transmission for Higher Throughput?

    NASA Astrophysics Data System (ADS)

    Bazzi, Alessandro; Pasolini, Gianni; Andrisano, Oreste

    2008-12-01

    Mobile communication systems beyond the third generation will see the interconnection of heterogeneous radio access networks (UMTS, WiMax, wireless local area networks, etc.) in order to always provide the best quality of service (QoS) to users with multimode terminals. This scenario poses a number of critical issues, which have to be faced in order to get the best from the integrated access network. In this paper, we will investigate the issue of parallel transmission over multiple radio access technologies (RATs), focusing the attention on the QoS perceived by final users. We will show that the achievement of a real benefit from parallel transmission over multiple RATs is conditioned to the fulfilment of some requirements related to the kind of RATs, the multiradio resource management (MRRM) strategy, and the transport-level protocol behaviour. All these aspects will be carefully considered in our investigation, which will be carried out partly adopting an analytical approach and partly by means of simulations. In this paper, in particular, we will propose a simple but effective MRRM algorithm, whose performance will be investigated in IEEE802.11a-UMTS and IEEE802.11a-IEEE802.16e heterogeneous networks (adopted as case studies).

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

    PubMed

    McCann, Terence V; Lubman, Dan I

    2012-08-01

    Despite the emergence of mental health problems during adolescence and early adulthood, many young people encounter difficulties accessing appropriate services. In response to this gap, the Australian Government recently established new enhanced primary care services (headspace) that target young people with emerging mental health problems. In this study, we examine the experience of young people with depression accessing one of these services, with a focus on understanding how they access the service and the difficulties they encounter in the process. Individual, in-depth, audio-recorded interviews were used to collect data. Twenty-six young people with depression were recruited from a headspace site in Melbourne, Australia. Interpretative phenomenological analysis was used to analyse the data. Four overlapping themes were identified in the data. First, school counsellors as access mediators, highlights the prominent role school counsellors have in facilitating student access to the service. Second, location as an access facilitator and inhibitor. Although the service is accessible by public transport, it is less so to those who do not live near public transport. Third, encountering barriers accessing the service initially. Two main service access barriers were experienced: unfamiliarity with the service, and delays in obtaining initial appointments for ongoing therapy. Finally, the service's funding model acts as an access facilitator and barrier. While the model provides a low or no cost services initially, it limits the number of funded sessions, and this can be problematic. Young people have contrasting experiences accessing the service. School counsellors have an influential role in facilitating access, and its close proximity to public transport enhances access. The service needs to become more prominent in young people's consciousness, while the appointment system would benefit from providing more timely appointments with therapists. The service's funding

  1. A framework for improving access and customer service times in health care: application and analysis at the UCLA Medical Center.

    PubMed

    Duda, Catherine; Rajaram, Kumar; Barz, Christiane; Rosenthal, J Thomas

    2013-01-01

    There has been an increasing emphasis on health care efficiency and costs and on improving quality in health care settings such as hospitals or clinics. However, there has not been sufficient work on methods of improving access and customer service times in health care settings. The study develops a framework for improving access and customer service time for health care settings. In the framework, the operational concept of the bottleneck is synthesized with queuing theory to improve access and reduce customer service times without reduction in clinical quality. The framework is applied at the Ronald Reagan UCLA Medical Center to determine the drivers for access and customer service times and then provides guidelines on how to improve these drivers. Validation using simulation techniques shows significant potential for reducing customer service times and increasing access at this institution. Finally, the study provides several practice implications that could be used to improve access and customer service times without reduction in clinical quality across a range of health care settings from large hospitals to small community clinics.

  2. Applying human rights to improve access to reproductive health services.

    PubMed

    Shaw, Dorothy; Cook, Rebecca J

    2012-10-01

    Universal access to reproductive health is a target of Millennium Development Goal (MDG) 5B, and along with MDG 5A to reduce maternal mortality by three-quarters, progress is currently too slow for most countries to achieve these targets by 2015. Critical to success are increased and sustainable numbers of skilled healthcare workers and financing of essential medicines by governments, who have made political commitments in United Nations forums to renew their efforts to reduce maternal mortality. National essential medicine lists are not reflective of medicines available free or at cost in facilities or in the community. The WHO Essential Medicines List indicates medicines required for maternal and newborn health including the full range of contraceptives and emergency contraception, but there is no consistent monitoring of implementation of national lists through procurement and supply even for basic essential drugs. Health advocates are using human rights mechanisms to ensure governments honor their legal commitments to ensure access to services essential for reproductive health. Maternal mortality is recognized as a human rights violation by the United Nations and constitutional and human rights are being used, and could be used more effectively, to improve maternity services and to ensure access to drugs essential for reproductive health. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  3. Access to and use of infertility services in the United States: framing the challenges.

    PubMed

    Adashi, Eli Y; Dean, Laura A

    2016-05-01

    An overview of access to and use of general infertility and assisted reproductive technology (ART) services in the United States (U.S.) shows a declining trend for the ever-use of infertility services. Moreover, the use of ART services lags relative to other member nations of the Organization for Economic Co-operation and Development (OECD). Access to and use of general infertility and ART services is primarily undermined by a severely constrained underwriting universe dominated by self-insured employers and by a finite number of state infertility insurance mandates. The contribution of traditional public and private payers to the underwriting of ART is limited. As compared with OECD member nations wherein the access to and underwriting of general infertility and ART services is universal, the current status quo in the U.S. can only be characterized as dismal. Further, the current state of affairs is socially unjust in that the right to build a family in the face of infertility appears to have become a function of economic prowess. Given the dominance of the self-insured employers as underwriters of general infertility and ART services, advocacy directed at this interest group is likely to prove most productive. Improving the state of underwriting of general infertility and ART services in the U.S. must be embraced as a central moral imperative and as an unwavering strategic goal of the professional societies entrusted with the reproductive health of women and men. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Patients' online access to their electronic health records and linked online services: a systematic review in primary care.

    PubMed

    Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley

    2015-03-01

    Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King's Fund, Nuffield Health, PsycINFO, OpenGrey (1999-2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of record access and use by specific ethnic and socioeconomic groups

  5. Patients’ online access to their electronic health records and linked online services: a systematic review in primary care

    PubMed Central

    Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley

    2015-01-01

    Background Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. Aim To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. Design and setting A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Method Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King’s Fund, Nuffield Health, PsycINFO, OpenGrey (1999–2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. Results A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. Conclusion While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of

  6. Accessibility and spatial distribution of general practice services in an Australian city by levels of social disadvantage.

    PubMed

    Hyndman, J C; Holman, C D

    2001-12-01

    The accessibility and spatial distribution of health services provided by the main source of primary medical care in Australia--the general practice surgery--was investigated by level of social disadvantage of local catchment areas. All 459 general practice surgeries in Perth, an Australian city of 1.2 million residents, were surveyed with a 94% response. Amount of service provision was measured using weekly doctor-hours, available from consulting rooms during opening hours, and associated nurse-hours of service. Access factors were defined as the distance to the nearest surgery, provision of Sunday and evening services, ease of making a same day appointment, bulk-billing, and whether the surgery offered a choice of gender of doctor. There were relatively more surgeries in disadvantaged areas and doctor-hours of service provision were also greater (41.0 h/1,000 most disadvantaged vs. 37.9 h/1000 least disadvantaged). Bulk-billing care, at no direct cost to the patient, was more likely to be provided in most disadvantaged areas compared with least disadvantaged areas (61 vs. 38%). However, populations living in the most disadvantaged areas were less likely to be able to see the local GP at short notice (91 vs. 95%), to have access to a local female GP (56 vs. 62%) or a local service in the evenings (42 vs. 51%). While the overall picture of accessibility was favourable, there was considerable variation in the type of services provided to different socioeconomic groups. Health care planners should investigate the reasons for these differences and advise Government to ensure that access factors affecting publicly funded services are equitably distributed.

  7. A survey of access to medical services in nursing and residential homes in England.

    PubMed

    Glendinning, Caroline; Jacobs, Sally; Alborz, Alison; Hann, Mark

    2002-07-01

    Residential and nursing homes make major demands on NHS services. To investigate patterns of access to medical services for residents in homes for older people. Telephone survey. All nursing and dual registered homes and one in four residential homes located in a stratified random sample of 72 English primary care group/trust (PCG/T) areas. A structured questionnaire investigating home characteristics, numbers of general practitioners (GPs) or practices per home, homes' policies for registering new residents with GPs, existence of payments to GPs, GP services provided to homes, and access to specialist medical care. There were wide variations in the numbers of GPs providing services to individual homes; this was not entirely dependent on home size. Eight percent of homes paid local GPs for their services to residents; these were more likely to be nursing homes (33%) than residential homes (odds ratio [OR] = 10.82, [95% CI = 4.48 to 26.13], P<0.001) and larger homes (OR for a ten-bed increase = 1.51 [95% CI = 1.28 to 1.79], P<0.001). Larger homes were more likely to encourage residents to register with a 'home' GP (OR for a ten-bed increase = 1.16 [95% CI = 1.04 to 1.31], P = 0.009). Homes paying local GPs were more likely to receive one or more additional services, over and above GPs' core contractual obligations. Few homes had direct access to specialist clinicians. Extensive variations in homes' policies and local GP services raise serious questions about patient choice, levels of GP services and, above all, about equity between residents within homes, between homes and between those in homes and in the community.

  8. Human rights and access to healthcare services for indigenous peoples in Africa.

    PubMed

    Durojaye, Ebenezer

    2017-09-20

    In September 2015, the United Nations adopted the sustainable development goals (SDGs) to address among others poverty and inequality within and among countries of the world. In particular, the SDGs aim at ameliorating the position of disadvantaged and vulnerable groups in societies. One of the over-arching goals of the SDGs is to ensure that no one is left behind in the realisation of their access to health care. African governments are obligated under international and regional human rights law to ensure access to healthcare services for everyone, including indigenous populations, on a non-discriminatory basis. This requires the governments to adopt appropriate measures that will remove barriers to healthcare services for disadvantaged and marginalised groups such as indigenous peoples.

  9. Ability to pay and equity in access to Italian and British National Health Services.

    PubMed

    Domenighetti, Gianfranco; Vineis, Paolo; De Pietro, Carlo; Tomada, Angelo

    2010-10-01

    Equity in delivery and distribution of health care is an important determinant of health and a cornerstone in the long way to social justice. We performed a comparative analysis of the prevalence of Italian and British residents who have fully paid out-of-pocket for health services which they could have obtained free of charge or at a lower cost from their respective National Health Services. Cross-sectional study based on a standardized questionnaire survey carried out in autumn 2006 among two representative samples (n = 1000) of the general population aged 20-74 years in each of the two countries. 78% (OR 19.9; 95% CI 15.5-25.6) of Italian residents have fully paid out-of-pocket for at least one access to health services in their lives, and 45% (OR 18.1; 95% CI 12.9-25.5) for more than five accesses. Considering only the last 2 years, 61% (OR 16.5; 95% CI 12.6-21.5) of Italians have fully paid out-of-pocket for at least one access. The corresponding pattern for British residents is 20 and 4% for lifelong prevalence, and 10% for the last 2 years. Opening the public health facilities to a privileged private access to all hospital physicians based on patient's ability to pay, as Italy does, could be a source of social inequality in access to care and could probably represent a major obstacle to decreasing waiting times for patients in the standard formal 'free of charge' way of access.

  10. Challenges Women with Disability Face in Accessing and Using Maternal Healthcare Services in Ghana: A Qualitative Study

    PubMed Central

    Ganle, John Kuumuori; Otupiri, Easmon; Obeng, Bernard; Edusie, Anthony Kwaku; Ankomah, Augustine; Adanu, Richard

    2016-01-01

    Background While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana. Methods and Findings A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling’s thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers’ insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability. Conclusions Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and

  11. Quantum key distribution in multicore fibre for secure radio access networks

    NASA Astrophysics Data System (ADS)

    Llorente, Roberto; Provot, Antoine; Morant, Maria

    2018-01-01

    Broadband access in optical domain usually focuses in providing a pervasive cost-effective high bitrate communication in a given area. Nowadays, it is of utmost interest also to be able to provide a secure communication to the costumers in the area. Wireless access networks rely on optical domain for both fronthaul and backhaul of the radio access network (C-RAN). Multicore fiber (MCF) has been proposed as a promising candidate for the optical media of choice in nextgeneration wireless. The capacity demand of next-generation 5G networks makes interesting the use of high-capacity optical solutions as space-division multiplexing of different signals over MCF media. This work addresses secure MCF communication supporting C-RAN architectures. The paper proposes the use of one core in the MCF to transport securely an optical quantum key encoding altogether with end-to-end wireless signal transmitted in the remaining cores in radio-over-fiber (RoF). The RoF wireless signals are suitable for radio access fronthaul and backhaul. The theoretical principle and simulation analysis of quantum key distribution (QKD) are presented in this paper. The potential impact of optical RoF transmission crosstalk impairments is assessed experimentally considering different cellular signals on the remaining optical cores in the MCF. The experimental results report fronthaul performance over a four-core optical fiber with RoF transmission of full-standard CDMA signals providing 3.5G services in one core, HSPA+ signals providing 3.9G services in the second core and 3GPP LTEAdvanced signals providing 4G services in the third core, considering that the QKD signal is allocated in the fourth core.

  12. A Seamless Handoff Scheme with Access Point Load Balance for Real-Time Services Support in 802.11 Wireless LANs

    NASA Astrophysics Data System (ADS)

    Manodham, Thavisak; Loyola, Luis; Miki, Tetsuya

    IEEE 802.11 wirelesses LANs (WLANs) have been rapidly deployed in enterprises, public areas, and households. Voice-over-IP (VoIP) and similar applications are now commonly used in mobile devices over wireless networks. Recent works have improved the quality of service (QoS) offering higher data rates to support various kinds of real-time applications. However, besides the need for higher data rates, seamless handoff and load balancing among APs are key issues that must be addressed in order to continue supporting real-time services across wireless LANs and providing fair services to all users. In this paper, we introduce a novel access point (AP) with two transceivers that improves network efficiency by supporting seamless handoff and traffic load balancing in a wireless network. In our proposed scheme, the novel AP uses the second transceiver to scan and find neighboring STAs in the transmission range and then sends the results to neighboring APs, which compare and analyze whether or not the STA should perform a handoff. The initial results from our simulations show that the novel AP module is more effective than the conventional scheme and a related work in terms of providing a handoff process with low latency and sharing traffic load with neighbor APs.

  13. Managed Care for Children: Effect on Access to Care and Utilization of Health Services.

    ERIC Educational Resources Information Center

    Szilagyi, Peter G.

    1998-01-01

    Reviews what is known about the effect of managed care on access to health services, as well as utilization of hospital care, emergency department visits, primary care services, and specialty pediatric services. The effect of managed care appears dependent on several factors and, thus, is likely to vary according to the population served. (SLD)

  14. Barriers to uptake of prevention of mother-to-child transmission of HIV services among mothers of vertically infected HIV-seropositive infants in Makurdi, Nigeria

    PubMed Central

    Anígilájé, Emmanuel Ademola; Ageda, Bem Ruben; Nweke, Nnamdi Okechukwu

    2016-01-01

    Background Perinatal transmission of human immunodeficiency virus (HIV) continues in Nigeria because of the poor use of prevention of mother-to-child transmission of HIV (PMTCT) services. This study reports on the barriers preventing mothers of vertically infected HIV-seropositive infants to use the PMTCT services at the Federal Medical Centre, Makurdi, Nigeria. Methods This is a descriptive study conducted between January and April, 2014. A quantitative survey was applied to detect barriers along the PMTCT services cascade among 52 mothers of vertically infected HIV-seropositive infants. This includes 22 women who attended antenatal care at the Federal Medical Centre (designated as Group A mothers) and 30 women who did not receive any form of PMTCT service (Group B mothers). The study was supplemented with a focused group discussion involving 12 discussants from the two groups. Results In the quantitative assessment: among the Group A mothers, falling asleep was the most common reason (n=22, 100%) for missing therapeutic/prophylactic antiretroviral medicine; financial constraint (n=22, 100%) was the most common reason for antenatal care visit defaults; and a lot of the mothers (n=11, 50.0%) did not give nevirapine to their newborns because they delivered at home. Among Group B mothers, unawareness of HIV-seropositive status was the most common reason (n=28, 93.3%) given for not accessing PMTCT services. In the qualitative study: noninvolvement of male partners, stigma and discrimination experienced by HIV-seropositive mothers, financial constraints in couples, involvement of traditional birth attendants in antenatal care and delivery of HIV-infected women, unawareness of HIV-seropositive status by pregnant women, poor health system, and the lack of funding for PMTCT services at private and rural health facilities were the major barriers preventing the use of PMTCT services. Conclusion In order to reduce the missed opportunities for PMTCT interventions in Makurdi

  15. On-the-field performance of quintuple-play long-reach OFDM-based WDM-PON optical access networks.

    PubMed

    Llorente, Roberto; Morant, Maria; Pellicer, Eloy; Herman, Milan; Nagy, Zsolt; Alves, Tiago; Cartaxo, Adolfo; Herrera, Javier; Correcher, Jose; Quinlan, Terence; Walker, Stuart; Rodrigues, Cláudio; Cluzeaud, Pierre; Schmidt, Axel; Piesiewicz, Radoslaw; Sambaraju, Rakesh

    2014-03-24

    In this paper the on-the-field performance of a WDM-PON optical access providing quintuple-play services using orthogonal frequency division multiplexing (OFDM) modulation is evaluated in a real fiber-to-the-home (FTTH) network deployed by Towercom operator in Bratislava (Slovakia). A bundle of quintuple-play services comprising full-standard OFDM-based signals (LTE, WiMAX, UWB and DVB-T) and an ad-hoc OFDM-GbE signal is transmitted in coexistence per single user. Both downstream and upstream transmission performances are evaluated in different on-the-field long-reach optical link distance configurations. Four wavelength multi-user transmission of quintuple-play OFDM services is demonstrated exceeding 60.8 km reach in standard single mode fiber.

  16. Access Patterns of ADHD Students Utilizing Campus Disability Services Supports

    ERIC Educational Resources Information Center

    Jackson, Meribeth L.

    2013-01-01

    Source of initial access to disability services, accommodations received as supports on campus, and the rate of continuous enrollment data was measured and compared for students diagnosed with ADHD prior to age eighteen and those diagnosed with ADHD after age eighteen. These two groups were compared to analyze the assumption that students who were…

  17. Investigating the accessibility factors that influence antenatal care services utilisation in Mangwe district, Zimbabwe

    PubMed Central

    Tugli, Augustine K.; Mpofu, Molyn

    2017-01-01

    Background Maternal and infant mortality remains a huge public health problem in developing countries. One of the strategies to minimise the risks of both maternal and infant mortality is access to and utilisation of antenatal care (ANC) services. Aim This study aimed to investigate the accessibility factors that influence the use of ANC services in Mangwe district. Methods A qualitative approach using explorative design was adopted to target women who have babies under 1 year of age. The study was conducted in Mangwe district, Matabeleland South province, Zimbabwe. Data were collected through semi-structured interviews and observations. Data saturation was reached after 15 women who were conveniently sampled were interviewed. Field notes were analysed thematically using Tech’s steps. Lincoln and Guba’s criteria ensured trustworthiness of the study findings. Results Accessibility factors such as lack of transport, high transport costs and long distances to health care facilities, health care workers’ attitudes, type and quality of services as well as delays in receiving care influence women’s utilisation of ANC services in Mangwe district, Zimbabwe. Conclusion The study concluded that women were still facing problems of unavailability of nearby clinics; therefore, it was recommended that the government should avail resources for women to use. Recommendations Mangwe District Health Department should provide mobile clinics rendering ANC services in distant rural areas. PMID:28697619

  18. [Factors associated with difficulty of access of the elderly with disabilities to the health services].

    PubMed

    Amaral, Fabienne Louise Juvêncio dos Santos; Motta, Márcia Heloyse Alves; da Silva, Laíla Pereira Gomes; Alves, Simone Bezerra

    2012-11-01

    This study seeks to analyze which are the variables associated with the difficulty of elderly people with disabilities gaining access to the health services. This is an observational study of an analytical cross-sectional nature, with a sample of 244 elderly people with disabilities. Data relating to socio-economic profile, the nature of the disability, and the conditions of access to health services were gathered. Version 11.0 of the Statistical Package for the Social Sciences software was used for descriptive, statistical and analytical assessment of the data. The protection variables for difficulties in being treated in the health services were: the lack of drains, culverts, trash, bags of refuse, or irregular floor surfaces; the absence of ramps on sidewalks and pavements; the availability of transport; ease in scheduling appointments; and the length of the waiting period to be attended. The number of factors listed shows that the architectonic barriers and the current situation of healthcare need to be adequate in order to ensure full access and use by the elderly with disabilities to the health services.

  19. A descriptive study of access to services in a random sample of Canadian rural emergency departments

    PubMed Central

    Fleet, Richard; Poitras, Julien; Maltais-Giguère, Julie; Villa, Julie; Archambault, Patrick

    2013-01-01

    Objective To examine 24/7 access to services and consultants in a sample of Canadian rural emergency departments (EDs). Design Cross-sectional study—mixed methods (structured interview, survey and government data bases) with random sampling of hospitals. Setting Canadian rural EDs (rural small town (RST) definition—Statistics Canada). Participants 28% (95/336) of Canadian rural EDs providing 24/7 physician coverage located in hospitals with acute care hospitalisation beds. Main outcome measures General characteristics of the rural EDs, information about 24/7 access to consultants, equipment and services, and the proportion of rural hospitals more than 300 km from levels 1 and 2 trauma centres. Results Of the 336 rural EDs identified, 122 (36%) were randomly selected and contacted. Overall, 95 EDs participated in the study (participation rate, 78%). Hospitals had, on an average, 23 acute care beds, 7 ED stretchers and 13 500 annual ED visits. The proportion of rural hospitals with local access to the following 24/7 services was paediatrician, 5%; obstetrician, 10%; psychiatrist, 11%; internist, 12%; intensive care unit, 17%; CT scanner, 20%; surgeon, 26%; ultrasound, 28%; basic X-ray, 97% and laboratory services, 99%. Forty-four per cent and 54% of the RST EDs were more than 300 km from a level 1 and level 2 trauma centre, respectively. Conclusions This is the first study describing the services available in Canadian rural EDs. Apart from basic laboratory and X-ray services, most rural EDs have limited access to consultants, advanced imaging and critical care services. A detailed study is needed to evaluate the impact of these limited services on patient outcomes, costs and interfacility transport demands. PMID:24285633

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

    PubMed Central

    2012-01-01

    Background Despite the emergence of mental health problems during adolescence and early adulthood, many young people encounter difficulties accessing appropriate services. In response to this gap, the Australian Government recently established new enhanced primary care services (headspace) that target young people with emerging mental health problems. In this study, we examine the experience of young people with depression accessing one of these services, with a focus on understanding how they access the service and the difficulties they encounter in the process. Method Individual, in-depth, audio-recorded interviews were used to collect data. Twenty-six young people with depression were recruited from a headspace site in Melbourne, Australia. Interpretative phenomenological analysis was used to analyse the data. Results Four overlapping themes were identified in the data. First, school counsellors as access mediators, highlights the prominent role school counsellors have in facilitating student access to the service. Second, location as an access facilitator and inhibitor. Although the service is accessible by public transport, it is less so to those who do not live near public transport. Third, encountering barriers accessing the service initially. Two main service access barriers were experienced: unfamiliarity with the service, and delays in obtaining initial appointments for ongoing therapy. Finally, the service’s funding model acts as an access facilitator and barrier. While the model provides a low or no cost services initially, it limits the number of funded sessions, and this can be problematic. Conclusions Young people have contrasting experiences accessing the service. School counsellors have an influential role in facilitating access, and its close proximity to public transport enhances access. The service needs to become more prominent in young people’s consciousness, while the appointment system would benefit from providing more timely

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

    PubMed Central

    2012-01-01

    Background Immigration is not a new phenomenon but, rather, has deep roots in human history. Documents from every era detail individuals who left their homelands and struggled to reestablish their lives in other countries. The aim of this study was to explore and understand the experience of Iranian immigrants who accessed Canadian health care services. Research with immigrants is useful for learning about strategies that newcomers develop to access health care services. Methods The research question guiding this study was, “What are the processes by which Iranian immigrants learn to access health care services in Canada?” To answer the question, a constructivist grounded theory approach was applied. Initially, unstructured interviews were conducted with 17 participants (11 women and six men) who were adults (at least 18 years old) and had immigrated to Canada within the past 15 years. Eight participants took part in a second interview, and four participants took part in a third interview. Results Using a constructivist grounded theory approach, “tackling the stumbling blocks of access” emerged as the core category. The basic social process (BSP), becoming self-sufficient, was a transitional process and had five stages: becoming a stranger; feeling helpless; navigating/seeking information; employing strategies; and becoming integrated and self-sufficient. We found that “tackling the stumbling blocks of access” was the main struggle throughout this journey. Some of the immigrants were able to overcome these challenges and became proficient in accessing health care services, but others were unable to make the necessary changes and thus stayed in earlier stages/phases of transition, and sometimes returned to their country of origin. Conclusion During the course of this journey a substantive grounded theory was developed that revealed the challenges and issues confronted by this particular group of immigrants. This process explains why some Iranian

  2. Interference-Assisted Techniques for Transmission and Multiple Access in Optical Communications

    NASA Astrophysics Data System (ADS)

    Guan, Xun

    Optical communications can be in wired or wireless form. Fiber optics communication (FOC) connects transmitters and receivers with optical fiber. Benefiting from its high bandwidth, low cost per volume and stability, it gains a significant market share in long-haul networks, access networks and data centers. Meanwhile, optical wireless communication (OWC) is also emerging as a crucial player in the communication market. In OWC, free-space optical communication (FSO) and visible light communication (VLC) are being studied and commercially deployed extensively. Interference is a common phenomenon in multi-user communication systems. In both FOC and OWC, interference has long been treated as a detrimental effect. However, it could also be beneficial to system applications. The effort of harnessing interference has spurred numerous innovations. Interesting examples are physical-layer network coding (PNC) and non-orthogonal multiple access (NOMA). The first part of this thesis in on the topic of PNC. PNC was firstly proposed in wireless communication to improve the throughput of a two-way relay network (TWRN). As a variation of network coding (NC), PNC turns the common channel interference (CCI) as a natural network coding operation. In this thesis, PNC is introduced into optical communication. Three schemes are proposed in different scenarios. Firstly, PNC is applied to a coherent optical orthogonal frequency division multiplexing (CO-OFDM) system so as to improve the throughput of the multicast network. The optical signal to noise ratio (OSNR) penalty is quite low. Secondly, we investigate the application of PNC in an OFDM passive optical network (OFDM-PON) supporting heterogeneous services. It is found that only minor receiver power penalties are observed to realize PNC-based virtual private networks (VPN), both in the wired service part and the wireless service part in an OFDM-PON with heterogeneous services. Thirdly, we innovate relay-based visible light

  3. Cultural barriers in access to healthcare services for people with disability in Iran: A qualitative study.

    PubMed

    Soltani, Shahin; Takian, Amirhossein; Akbari Sari, Ali; Majdzadeh, Reza; Kamali, Mohammad

    2017-01-01

    Background: People with disability experience various problems to access to healthcare services. This study aimed to identify cultural barriers in access to healthcare services for people with disability in Iran. Methods: We conducted a qualitative study using content analysis to identify the cultural barriers. We used semi-structured interviews to collect data. Participants were selected through purposeful sampling with maximum variation. 50 individual interviews were conducted with three groups of people with disability, healthcare services providers and policy makers, September to May 2015, at different locations in Tehran, Iran. Results: We identified a number of different cultural barriers in access to health services for people with disability in Iran. These related to health service providers, namely reluctance to provide health services and disrespect; related to People with disability, namely denial of disability, disproportionate expectation, shame and insufficient sociocultural supports; and related to policy makers, namely lack of concern, little attention to the culture of disability and discrimination. We categorized misconception as a barrier that was observed at all levels of the society. Conclusion: Disability is a reality that some human being may experience and live with it. The negative attitude towards people with disability has a close relationship with the cultural norms of a society. The culture of disability in different dimensions should be a priority for all policy makers. Removing cultural barriers in access to healthcare for people with a disability needs collective efforts and collaborations among all stakeholders.

  4. Access to HIV Services at Non-Governmental and Community-Based Organizations among Men Who Have Sex with Men (MSM) in Cameroon: An Integrated Biological and Behavioral Surveillance Analysis

    PubMed Central

    Holland, Claire E.; Papworth, Erin; Billong, Serge C.; Kassegne, Sethson; Petitbon, Fanny; Mondoleba, Valentin; Moukam, Laure Vartan; Macauley, Isaac; Eyene Ntsama, Simon Pierre; Yomb, Yves Roger; Eloundou, Jules; Mananga, Franz; Tamoufe, Ubald; Baral, Stefan D.

    2015-01-01

    Background Men who have sex with men (MSM) are more likely to be living with HIV than other adult men in low- and middle-income countries. MSM experience barriers to accessing HIV services including a lack of available specialized care, and community-level stigma and discrimination. This study aims to examine the uptake of HIV services at non-governmental and community-based organizations (NGOs/CBOs) to identify ways to improve coverage of HIV prevention and treatment among MSM. Methods An Integrated Biological and Behavioral Surveillance (IBBS) survey was conducted in Yaoundé and Douala, Cameroon in 2011 using the respondent driven sampling (RDS) method to recruit and interview 239 MSM in Yaoundé and 272 MSM in Douala. Results MSM in Yaoundé were statistically significantly more likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months if they had any STI symptoms (aOR 2.17 CI 1.02-4.59. p=0.04), or if they had a larger MSM social network (aOR 1.02 CI 1.01-1.04. p<0.01). MSM in Douala were more likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months if they were living with HIV (aOR 3.60 CI 1.35-9.60. p=0.01), or if they reported higher numbers of male sexual partners (aOR 1.17 CI 1.00-1.36. p=0.046). Compared to men in Douala, MSM in Yaoundé were significantly less likely to have accessed NGO/CBO services or been reached by an outreach worker in the past 12 months (aOR 0.22 CI 0 .14-0.34. p=<0.01). Conclusions With appropriate funding and resources, community-based organizations that provide care specifically for MSM can improve access to HIV prevention, treatment, and care services. Additionally, using social networks to reach MSM can connect greater numbers of the population to effective HIV interventions, which will improve health outcomes and decrease onward transmission of HIV. PMID:25906046

  5. Diffraction and Transmission Synchrotron Imaging at the German Light Source ANKA--Potential Industrial Applications

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

    Rack, Alexander; Weitkamp, Timm; European Synchrotron Radiation Facility, BP 220, F-38043 Grenoble Cedex

    2009-03-10

    Diffraction and transmission synchrotron imaging methods have proven to be highly suitable for investigations in materials research and non-destructive evaluation. The high flux and spatial coherence of X-rays from modern synchrotron light sources allows one to work using high resolution and different contrast modalities. This article gives a short overview of different transmission and diffraction imaging methods with high potential for industrial applications, now available for commercial access via the German light source ANKA (Forschungszentrum Karlsruhe) and its new department ANKA Commercial Service (ANKA COS, http://www.anka-cos.de)

  6. Being Single as a Social Barrier to Access Reproductive Healthcare Services by Iranian Girls

    PubMed Central

    Kohan, Shahnaz; Mohammadi, Fatemeh; Mostafavi, Firoozeh; Gholami, Ali

    2017-01-01

    Background: Iranian single women are deprived of reproductive healthcare services, though the provision of such services to the public has increased. This study aimed to explore the experiences of Iranian single women on their access to reproductive health services. Methods: A qualitative design using a conventional content analysis method was used. Semi-structured interviews were held with 17 single women and nine health providers chosen using the purposive sampling method. Results: Data analysis resulted in the development of three categories: ‘family’s attitudes and performance about single women’s reproductive healthcare,’ ‘socio-cultural factors influencing reproductive healthcare,’ and ‘cultural factors influencing being a single woman.’ Conclusion: Cultural and contextual factors affect being a single woman in every society. Therefore, healthcare providers need to identify such factors during the designing of strategies for improving the facilitation of access to reproductive healthcare services. PMID:28812794

  7. A survey of access to medical services in nursing and residential homes in England.

    PubMed Central

    Glendinning, Caroline; Jacobs, Sally; Alborz, Alison; Hann, Mark

    2002-01-01

    BACKGROUND: Residential and nursing homes make major demands on NHS services. AIM: To investigate patterns of access to medical services for residents in homes for older people. DESIGN OF STUDY: Telephone survey. SETTING: All nursing and dual registered homes and one in four residential homes located in a stratified random sample of 72 English primary care group/trust (PCG/T) areas. METHOD: A structured questionnaire investigating home characteristics, numbers of general practitioners (GPs) or practices per home, homes' policies for registering new residents with GPs, existence of payments to GPs, GP services provided to homes, and access to specialist medical care. RESULTS: There were wide variations in the numbers of GPs providing services to individual homes; this was not entirely dependent on home size. Eight percent of homes paid local GPs for their services to residents; these were more likely to be nursing homes (33%) than residential homes (odds ratio [OR] = 10.82, [95% CI = 4.48 to 26.13], P<0.001) and larger homes (OR for a ten-bed increase = 1.51 [95% CI = 1.28 to 1.79], P<0.001). Larger homes were more likely to encourage residents to register with a 'home' GP (OR for a ten-bed increase = 1.16 [95% CI = 1.04 to 1.31], P = 0.009). Homes paying local GPs were more likely to receive one or more additional services, over and above GPs' core contractual obligations. Few homes had direct access to specialist clinicians. CONCLUSION: Extensive variations in homes' policies and local GP services raise serious questions about patient choice, levels of GP services and, above all, about equity between residents within homes, between homes and between those in homes and in the community. PMID:12120725

  8. Prevention of mother-to-child transmission (PMTCT) of HIV services in Adama town, Ethiopia: clients' satisfaction and challenges experienced by service providers.

    PubMed

    Asefa, Anteneh; Mitike, Getnet

    2014-02-01

    The coverage and uptake of prevention of mother-to-child transmission (PMTCT) of HIV services has remained very low in Ethiopia. One of the pillars of improving quality of health services is measuring and addressing client satisfaction. In Ethiopia, information about the quality of PMTCT services regarding client satisfaction is meager. A facility-based cross-sectional study using quantitative methods was conducted in Adama town. We interviewed 423 pregnant women and 31 health providers from eight health facilities. Satisfaction of clients was measured using a standard questionnaire adapted from the UNAIDS best practices collection on HIV/AIDS. Bivariate and multivariate logistic regression analyses were used to identify factors associated with clients' satisfaction. About three-fourth (74.7%) of clients reported that they were satisfied with the PMTCT services provided by the health facilities. However, a much lower proportion (39%) of the total respondents (pregnant women who underwent an ANC follow-up session), said they received and understood the messages related to mother-to-child transmission (MTCT) of HIV and PMTCT. The main challenges reported by service providers were lack of training, lack of feedback on job performance and inadequate pay. Clients' satisfaction with PMTCT service was found to be associated with liking the discussion they had with their counselor, non-preference to a different counselor with regards to sex and/or age and not seeing the same ANC counselor before and after HIV test. Although 74.7% of clients were satisfied, the majority did not have a good understanding of the counseling on MTCT and PMTCT. We recommend more efforts to be exerted on improving provider-client communication, devising ways of increasing clients' satisfaction and designing an effective motivation strategy for service providers to enhance the status of PMTCT services.

  9. Web Services Provide Access to SCEC Scientific Research Application Software

    NASA Astrophysics Data System (ADS)

    Gupta, N.; Gupta, V.; Okaya, D.; Kamb, L.; Maechling, P.

    2003-12-01

    Web services offer scientific communities a new paradigm for sharing research codes and communicating results. While there are formal technical definitions of what constitutes a web service, for a user community such as the Southern California Earthquake Center (SCEC), we may conceptually consider a web service to be functionality provided on-demand by an application which is run on a remote computer located elsewhere on the Internet. The value of a web service is that it can (1) run a scientific code without the user needing to install and learn the intricacies of running the code; (2) provide the technical framework which allows a user's computer to talk to the remote computer which performs the service; (3) provide the computational resources to run the code; and (4) bundle several analysis steps and provide the end results in digital or (post-processed) graphical form. Within an NSF-sponsored ITR project coordinated by SCEC, we are constructing web services using architectural protocols and programming languages (e.g., Java). However, because the SCEC community has a rich pool of scientific research software (written in traditional languages such as C and FORTRAN), we also emphasize making existing scientific codes available by constructing web service frameworks which wrap around and directly run these codes. In doing so we attempt to broaden community usage of these codes. Web service wrapping of a scientific code can be done using a "web servlet" construction or by using a SOAP/WSDL-based framework. This latter approach is widely adopted in IT circles although it is subject to rapid evolution. Our wrapping framework attempts to "honor" the original codes with as little modification as is possible. For versatility we identify three methods of user access: (A) a web-based GUI (written in HTML and/or Java applets); (B) a Linux/OSX/UNIX command line "initiator" utility (shell-scriptable); and (C) direct access from within any Java application (and with the

  10. Ethernet access network based on free-space optic deployment technology

    NASA Astrophysics Data System (ADS)

    Gebhart, Michael; Leitgeb, Erich; Birnbacher, Ulla; Schrotter, Peter

    2004-06-01

    The satisfaction of all communication needs from single households and business companies over a single access infrastructure is probably the most challenging topic in communications technology today. But even though the so-called "Last Mile Access Bottleneck" is well known since more than ten years and many distribution technologies have been tried out, the optimal solution has not yet been found and paying commercial access networks offering all service classes are still rare today. Conventional services like telephone, radio and TV, as well as new and emerging services like email, web browsing, online-gaming, video conferences, business data transfer or external data storage can all be transmitted over the well known and cost effective Ethernet networking protocol standard. Key requirements for the deployment technology driven by the different services are high data rates to the single customer, security, moderate deployment costs and good scalability to number and density of users, quick and flexible deployment without legal impediments and high availability, referring to the properties of optical and wireless communication. We demonstrate all elements of an Ethernet Access Network based on Free Space Optic distribution technology. Main physical parts are Central Office, Distribution Network and Customer Equipment. Transmission of different services, as well as configuration, service upgrades and remote control of the network are handled by networking features over one FSO connection. All parts of the network are proven, the latest commercially available technology. The set up is flexible and can be adapted to any more specific need if required.

  11. Access to oral health care services among adults with learning disabilities: a scoping review.

    PubMed

    Naseem, Mustafa; Shah, Altaf H; Khiyani, Muhammad Faheem; Khurshid, Zohaib; Zafar, Muhammad Sohail; Gulzar, Shabnam; AlJameel, AlBandary H; Khalil, Hesham S

    2016-01-01

    The prevalence of oral diseases including dental caries and periodontal conditions is remarkably higher in people with disabilities. The provision of accessible oral health services for people with learning disabilities may be challenging. The objectives of the review were to identify barriers in accessing oral health care that persists within society, enabling or disabling people with learning disabilities. Using the Arksey O'Malley framework, a scoping review was conducted on PubMed/Medline, OVIDSP, and EMBASE. Studies were evaluated and short-listed based on the inclusion criteria, which consisted of: (1) study participants or population with learning disabilities, (2) aged 16 years or over, (3) reporting on access to oral health services, (4) published in the English language. Those that justified the inclusion criteria were carefully chosen after a blind peer-reviewed process when relevance and quality were debated. Nine studies were eventually included from searches. Tabulation of data was done under the heading of study type, outcomes, the year of publication and patient selection. The majority of studies provided a biomedical overview of access for adults with learning disabilities. The concept of access for people with disability is still ill-defined and obscure. Access to oral health care and needs of people with learning disabilities are complex and multi-facet.

  12. A model for identifying and ranking need for trauma service in nonmetropolitan regions based on injury risk and access to services.

    PubMed

    Schuurman, Nadine; Bell, Nathaniel; Hameed, Morad S; Simons, Richard

    2008-07-01

    Timely access to definitive trauma care has been shown to improve survival rates after severe injury. Unfortunately, despite development of sophisticated trauma systems, prompt, definitive trauma care remains unavailable to over 50 million North Americans, particularly in rural areas. Measures to quantify social and geographic isolation may provide important insights for the development of health policy aimed at reducing the burden of injury and improving access to trauma care in presently under serviced populations. Indices of social deprivation based on census data, and spatial analyses of access to trauma centers based on street network files were combined into a single index, the Population Isolation Vulnerability Amplifier (PIVA) to characterize vulnerability to trauma in socioeconomically and geographically diverse rural and urban communities across British Columbia. Regions with a sufficient core population that are more than one hour travel time from existing services were ranked based on their level of socioeconomic vulnerability. Ten regions throughout the province were identified as most in need of trauma services based on population, isolation and vulnerability. Likewise, 10 communities were classified as some of the least isolated areas and were simultaneously classified as least vulnerable populations in province. The model was verified using trauma services utilization data from the British Columbia Trauma Registry. These data indicate that including vulnerability in the model provided superior results to running the model based only on population and road travel time. Using the PIVA model we have shown that across Census Urban Areas there are wide variations in population dependence on and distances to accredited tertiary/district trauma centers throughout British Columbia. Many of the factors that influence access to definitive trauma care can be combined into a single quantifiable model that researchers in the health sector can use to predict

  13. Access and acceptability of community-based services for older Greek migrants in Australia: user and provider perspectives.

    PubMed

    Hurley, Catherine; Panagiotopoulos, Georgia; Tsianikas, Michael; Newman, Lareen; Walker, Ruth

    2013-03-01

    In most developed nations, ageing migrants represent a growing proportion of the older population. Policies that emphasise care in the community depend on older migrants having access to formal services along with informal support, yet little is known about how older migrants experience community-based formal services. By examining the views of both Greek elders in Australia and those of formal service providers, this research fills an important gap in the literature around access to and acceptability of formal community-based services for older migrants. A research team including two Greek background researchers used existing social groups and a snowball sampling method to conduct face-to-face interviews and focus groups with seventy older Greeks in Adelaide, Australia. In addition, 22 community-based service providers were interviewed over the telephone. Results from users and providers showed that while many older Greeks experience service access issues, they also relied heavily on family for support and assistance at home. Reliance on family was both in preference to formal services or where formal services were used, to locate, negotiate and monitor such services. Common barriers identified by both groups included cost, transport and availability, but additional challenges were posed by language, literacy and cultural attitudes. Demographic changes including greater employment mobility and female workforce participation among adult children will have implications for both formal and informal care providers. Formal service providers need to ensure that services are promoted and delivered to take account of the important role of family in informal support while also addressing the access challenges posed by language and literacy. Research conducted by researchers from the same cultural background in the respondent's native language can further advance knowledge in this area. © 2012 Blackwell Publishing Ltd.

  14. Frame Transmission Efficiency-Based Cross-Layer Congestion Notification Scheme in Wireless Ad Hoc Networks.

    PubMed

    He, Huaguang; Li, Taoshen; Feng, Luting; Ye, Jin

    2017-07-15

    Different from the traditional wired network, the fundamental cause of transmission congestion in wireless ad hoc networks is medium contention. How to utilize the congestion state from the MAC (Media Access Control) layer to adjust the transmission rate is core work for transport protocol design. However, recent works have shown that the existing cross-layer congestion detection solutions are too complex to be deployed or not able to characterize the congestion accurately. We first propose a new congestion metric called frame transmission efficiency (i.e., the ratio of successful transmission delay to the frame service delay), which describes the medium contention in a fast and accurate manner. We further present the design and implementation of RECN (ECN and the ratio of successful transmission delay to the frame service delay in the MAC layer, namely, the frame transmission efficiency), a general supporting scheme that adjusts the transport sending rate through a standard ECN (Explicit Congestion Notification) signaling method. Our method can be deployed on commodity switches with small firmware updates, while making no modification on end hosts. We integrate RECN transparently (i.e., without modification) with TCP on NS2 simulation. The experimental results show that RECN remarkably improves network goodput across multiple concurrent TCP flows.

  15. Rural access to clinical pharmacy services.

    PubMed

    Patterson, Brandon J; Kaboli, Peter J; Tubbs, Traviss; Alexander, Bruce; Lund, Brian C

    2014-01-01

    To examine the impact of rural residence and primary care site on use of clinical pharmacy services (CPS) and to describe the use of clinical telepharmacy within the Veterans Health Administration (VHA) health care system. Using 2011 national VHA data, the frequency of patients with CPS encounters was compared across patient residence (urban or rural) and principal site of primary care (medical center, urban clinic, or rural clinic). The likelihood of CPS utilization was estimated with random effects logistic regression. Individual service types (e.g., anticoagulation clinics) and delivery modes (e.g., telehealth) were also examined. Of 3,040,635 patients, 711,348 (23.4%) received CPS. Service use varied by patient residence (urban: 24.9%; rural: 19.7%) and principal site of primary care (medical center: 25.9%; urban clinic: 22.5%; rural clinic: 17.6%). However, in adjusted analyses, urban-rural differences were explained primarily by primary care site and less so by patient residence. Similar findings were observed for individual CPS types. Telehealth encounters were common, accounting for nearly one-half of patients receiving CPS. Video telehealth was infrequent (<0.2%), but more common among patients of rural clinics than those receiving CPS at medical centers (odds ratio [OR] = 9.7; 95% CI 9.0-10.5). We identified a potential disparity between rural and urban patients' access to CPS, which was largely explained by greater reliance on community clinics for primary care than on medical centers. Future research is needed to determine if this disparity will be alleviated by emerging organizational changes, including expanding telehealth capacity and integrating pharmacists into primary care teams, and whether lessons learned at VHA translate to other settings.

  16. Are social franchises contributing to universal access to reproductive health services in low-income countries?

    PubMed

    Sundari Ravindran, T K; Fonn, Sharon

    2011-11-01

    A social franchise in health is a network of for-profit private health practitioners linked through contracts to provide socially beneficial services under a common brand. The early 21st century has seen considerable donor enthusiasm for promoting social franchises for the provision of reproductive health services. Based on a compendium of descriptive information on 45 clinical social franchises, located in 27 countries of Africa, Asia and Latin America, this paper examines their contribution to universal access to comprehensive reproductive health services. It finds that these franchises have not widened the range of reproductive health services, but have mainly focused on contraceptive services, and to a lesser extent, maternal health care and abortion. In many instances, coverage had not been extended to new areas. Measures taken to ensure sustainability ran counter to the objective of access for low-income groups. In almost two-thirds of the franchises, the full cost of all services had to be paid out of pocket and was unaffordable for low-income women. While standards and protocols for quality assurance were in place in all franchises, evidence on adherence to these was limited. Informal interviews with patients indicated satisfaction with services. However, factors such as difficulties in recruiting franchisees and significant attrition, franchisees' inability to attend training programmes, use of lay health workers to deliver services without support or supervision, and logistical problems with applying quality assurance tools, all raise concerns. The contribution of social franchises to universal access to reproductive health services appears to be uncertain. Continued investment in them for the provision of reproductive health services does not appear to be justified until and unless further evidence of their value is forthcoming. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  17. Investigation of Priority Needs in Terms of Museum Service Accessibility for Visually Impaired Visitors

    ERIC Educational Resources Information Center

    Handa, Kozue; Dairoku, Hitoshi; Toriyama, Yoshiko

    2010-01-01

    This study investigates the priority needs of museum service accessibility for visually impaired visitors. For this purpose, conjoint analysis was utilized. Four conjoint attributes of museum services were selected: A--facilities for wayfinding; B--exhibitions and collections including objects for touching, hearing, smelling, etc.; C--information…

  18. How far will they go? Assessing the travel distance of current and former drug users to access harm reduction services.

    PubMed

    Allen, Sean; Ruiz, Monica; O'Rourke, Allison

    2015-03-01

    Prior research has explored spatial access to syringe exchange programs (SEPs) among people who inject drugs (PWID), but little is known about service utilization by former PWID who continue to access services (e.g., HIV screenings and referrals for social services) at harm reduction providers. The purpose of this research is to examine differences in access to SEPs between current and former PWID seeking services at a mobile SEP in Washington, DC. A geometric point distance estimation technique was applied to data collected as part of a PWID population estimation study that took place in Washington, DC, in March and April 2014. We calculated the walking distance from the centroid point of home residence zip code to the mobile exchange site where PWID presented for services. An independent samples t-test was used to examine differences in walking distance measures between current and former PWID. Differences in mean walking distance were statistically significant with current and former PWID having mean walking distances of 2.75 and 1.80 miles, respectively. The results of this study suggest that former PWID who are engaging with SEPs primarily for non-needle exchange services (e.g., medical or social services) may have decreased access to SEPs than their counterparts who are active injectors. This research provides support for expanding SEP operations such that both active and former PWID have increased access to harm reduction providers and associated health and social services. Increasing service accessibility may help resolve unmet needs among current and former PWID.

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

    PubMed

    White, Kari; deMartelly, Victoria; Grossman, Daniel; Turan, Janet M

    2016-01-01

    In Alabama, more than one-half of reproductive-aged women live in counties without an abortion provider. State regulations require in-person counseling (or confirmed receipt of materials sent by certified mail) followed by a 48-hour waiting period. We explored the impact of this service and policy environment on experiences accessing abortion care for women traveling long distances to clinics. We conducted in-depth interviews with 25 women who traveled more than 30 miles to an Alabama clinic providing abortion care between July and September 2014. Women were interviewed by telephone at least 1 day after their consultation, procedure, or follow-up visit. We used content analysis methods to code and analyze interview transcripts. Almost all women found a clinic by searching online or talking to others in their social networks who had abortions. These strategies did not always direct women to the closest clinic, and some described searches that yielded inaccurate information. The majority of women did not believe an in-person consultation visit was necessary and found it to be burdensome because of the extra travel required and long waits at the clinic. Two-thirds of the women were unable to schedule their abortion 48 hours later owing to work schedules or because appointments were offered only once a week, and four women were delayed until their second trimester even though they sought services earlier in pregnancy. It is often difficult for women in communities without an abortion provider to find and access timely abortion care. Efforts are needed to make abortion more accessible and prevent further restrictions on services. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  20. Onsite provision of specialized contraceptive services: does Title X funding enhance access?

    PubMed

    Thiel de Bocanegra, Heike; Cross Riedel, Julie; Menz, Mary; Darney, Philip D; Brindis, Claire D

    2014-05-01

    This article presents the extent to which providers enrolled in California's Family Planning, Access, Care, and Treatment (Family PACT) program offer contraceptive methods onsite, thus eliminating one important access barrier. Family PACT has a diverse provider network, including public-sector providers receiving Title X funding, public-sector providers not receiving Title X funding, and private-sector providers. We explored whether Title X funding enhances providers' ability to offer contraceptive methods that require specialized skills onsite. Data were derived from 1,072 survey responses to a 2010 provider-capacity survey matched by unique identifier to administrative claims data. A significantly greater proportion of Title X-funded providers compared to non-Title X public and private providers offered onsite services for the following studied methods: intrauterine contraceptives (90% Title X, 51% public non-Title X, 38% private); contraceptive implants (58% Title X, 19% public non-Title X, 7% private); vasectomy (8% Title X, 4% public non-Title X, 1% private); and fertility-awareness methods (69% Title X, 55% public non-Title X, 49% private) (all p<0.0001). The association between onsite provision and Title X funding remained after stratifying individually by clinic specialty, facility capacity to provide reproductive health services (based on staffing), and rural/urban location. Extra funding for publicly funded family-planning programs, through mechanisms such as Title X, appears to be associated with increased onsite access to a wide range of contraceptive services, including those that require special skills and training.

  1. Limited access to special education services for school-aged children with developmental delay.

    PubMed

    Twardzik, Erica; Smit, Ellen; Hatfield, Bridget; Odden, Michelle C; Dixon-Ibarra, Alicia; MacDonald, Megan

    2018-01-01

    Current policy in Oregon limits eligibility of children diagnosed with developmental delay for school-based services. Due to eligibility definitions, children with developmental delay may face additional barriers transitioning from early intervention/early childhood special education into school-based special education services. Examine the relationship between enrollment in school-based special education programs given a change in primary disability diagnosis. Logistic regression models were fit for children who enrolled in early intervention/early childhood special education services with a primary disability diagnosis of developmental delay and changed primary disability diagnosis before third grade (n=5076). Odds of enrollment in future special education were greater in children with a change in primary disability diagnosis after the age of five in comparison to children that had a change in primary disability diagnosis before the age of five, while adjusting for demographic characteristics (adjusted odds ratio: 2.37, 95% CI 1.92, 2.92). Results suggest that children who are diagnosed with a developmental delay and exit early childhood special education due to maximum age of eligibility are more likely to enroll in special education compared to children without a gap in service access. Gaps in service access during early development are associated with the need for supportive services later on in life. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Politics, policies, pronatalism, and practice: availability and accessibility of abortion and reproductive health services in Turkey.

    PubMed

    MacFarlane, Katrina A; O'Neil, Mary Lou; Tekdemir, Deniz; Çetin, Elvin; Bilgen, Barış; Foster, Angel M

    2016-11-01

    Turkey has maintained liberal contraception and abortion policies since the 1980s. In 2012, the government proposed to restrict abortion; a bill limiting abortion was later drafted but never passed into law. Since the proposed restriction, women have reported difficulty accessing abortion services across Turkey. We aimed to better understand the current availability of abortion and reproductive health services in Istanbul and explore whether access to services has changed since 2012. In 2015, we completed 14 in-depth interviews with women and 11 semi-structured interviews with key informants. We transcribed all interviews and completed content and thematic analyses of the data. Key informants had good knowledge about the political discourse and the current abortion law. In contrast, women were familiar with the political discourse but had mixed information about the current status of abortion and were unsure about the legality of their own abortions. There was consensus that access to services has become more limited in the last five years due to the political climate, thus advocacy to prioritize reproductive health services, and abortion care in particular, in the public health system are needed. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Increasing Access to Tuberculosis Services in Ethiopia: Findings From a Patient-Pathway Analysis.

    PubMed

    Fekadu, Lelisa; Hanson, Christy; Osberg, Mike; Makayova, Julia; Mingkwan, Pia; Chin, Daniel

    2017-11-06

    In Ethiopia, extensive scale-up of the availability of health extension workers (HEWs) at the community level has been credited with increased identification and referral of patients with presumptive tuberculosis, which has contributed to increased tuberculosis case notification and better treatment outcomes. However, nearly 30% of Ethiopia's estimated 191000 patients with tuberculosis remained unnotified in 2015. A better understanding of patient care-seeking practices may inform future government action to reach all patients with tuberculosis. A patient-pathway analysis was completed to assess the alignment between patient care initiation and the availability of diagnostic and treatment services at the national level. More than one third of patients initiated care with HEWs, who refer patients to health centers for diagnosis. An additional one third of patients initiated care at health centers. Of those health centers, >80% had microscopy services, but few had access to Xpert. Despite an extensive microscopy and radiography network at middle levels of the health system, a quarter of all notified patients with tuberculosis had no bacteriological confirmation of disease. While 30% of patients reported receiving some form of care from the private sector, private-sector facilities, especially pharmacies, were not widely accessed for tuberculosis diagnosis. The availability of HEWs can increase access to tuberculosis diagnostic and treatment support services, particularly for rural populations. Continued strengthening of referral systems from HEWs and health posts are needed to enable consistent and timely access to Xpert as an initial diagnostic test and to drug resistance screening. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  4. Cost-effectiveness of an improving access to psychological therapies service.

    PubMed

    Mukuria, Clara; Brazier, John; Barkham, Michael; Connell, Janice; Hardy, Gillian; Hutten, Rebecca; Saxon, Dave; Dent-Brown, Kim; Parry, Glenys

    2013-03-01

    Effective psychological therapies have been recommended for common mental health problems, such as depression and anxiety, but provision has been poor. Improving Access to Psychological Therapies (IAPT) may provide a cost-effective solution to this problem. To determine the cost-effectiveness of IAPT at the Doncaster demonstration site (2007-2009). An economic evaluation comparing costs and health outcomes for patients at the IAPT demonstration site with those for comparator sites, including a separate assessment of lost productivity. Sensitivity analyses were undertaken. The IAPT site had higher service costs and was associated with small additional gains in quality-adjusted life-years (QALYs) compared with its comparator sites, resulting in a cost per QALY gained of £29 500 using the Short Form (SF-6D). Sensitivity analysis using predicted EQ-5D scores lowered this to £16 857. Costs per reliable and clinically significant (RCS) improvement were £9440 per participant. Improving Access to Psychological Therapies provided a service that was probably cost-effective within the usual National Institute for Health and Clinical Excellence (NICE) threshold range of £20 000-30 000, but there was considerable uncertainty surrounding the costs and outcome differences.

  5. Domestic Violence Survivors' Access of Career Counseling Services: A Qualitative Investigation

    ERIC Educational Resources Information Center

    Chronister, Krista M.; Linville, Deanna; Kaag, Kristi Palmer

    2008-01-01

    The present study was a qualitative investigation of the impact of domestic violence on women's career development and the contextual barriers and supports that affect women's ability to access career counseling services. Our sample included 11 women who completed various stages of a community-based career counseling intervention program. The…

  6. [Gender, equality, and health services access: an empirical approximation].

    PubMed

    Gómez Gómez, Elsa

    2002-01-01

    This piece describes the conceptual framework and the objectives that guided a research initiative in the Region of the Americas that was called "Gender, Equity, and Access to Health Services" and that was sponsored in 2001 by the Pan American Health Organization. The piece does not summarize the results of the six projects that were carried under the initiative, whose analyses have not all been completed. Instead, the piece discusses some of the foundations of the initiative and provides a general introduction to the country studies that were done. The six studies were done in Barbados/Jamaica, Brazil, Chile, Colombia, Ecuador, and Peru. The primary objective of the initiative was to stimulate the use of existing quantitative information in the countries, with the goal of starting a process of systematically documenting two things: 1) the unfair, unnecessary, and avoidable inequalities between men and women in their access to health care and 2) the linkages between those inequalities and other socioeconomic factors. The concept of gender equity that guided this examination of health care was not the usual one calling for the equal distribution of resources. Rather, it was the notion that resources should be allocated differentially, according to the particular needs of men and of women, and that persons should pay for health services according to their economic ability rather than their risk level. The starting point for the initiative was the premise that gender inequities in utilizing and paying for health care result from gender differences in the macroeconomic and microeconomic distribution of resources. The piece concludes that achieving equity in health care access will require a better understanding of the gender needs and gender barriers that are linked to social structures and health systems.

  7. A study of HIV positive undocumented African migrants' access to health services in the UK.

    PubMed

    Whyte, James; Whyte, Maria D; Hires, Kimberly

    2015-01-01

    Newly immigrated persons, whatever their origin, tend to fall in the lower socioeconomic levels. In fact, failure of an asylum application renders one destitute in a large proportion of cases, often resulting in a profound lack of access to basic necessities. With over a third of HIV positive failed asylum seekers reporting no income, and the remainder reporting highly limited resources, poverty is a reality for the vast majority. The purpose of the study was to determine the basic social processes that guide HIV positive undocumented migrant's efforts to gain health services in the UK. The study used the Grounded Theory Approach. Theoretical saturation occurred after 16 participants were included in the study. The data included reflections of the prominent factors related to the establishment of a safe and productive life and the ability of individuals to remain within the UK. The data reflected heavily upon the ability of migrants to enter the medical care system during their asylum period, and on an emerging pattern of service denial after loss on immigration appeal. The findings of this study are notable in that they have demonstrated sequence of events along a timeline related to the interaction between the asylum process and access to health-related services. The results reflect that African migrants maintain a degree of formal access to health services during the period that they possess legal access to services and informal access after the failure of their asylum claim. The purpose of this paper is to examine the basic social processes that characterize efforts to gain access to health services among HIV positive undocumented African migrants to the UK. The most recent estimates indicate that there are a total of 618,000 migrants who lack legal status within the UK. Other studies have placed the number of undocumented migrants within the UK in the range of 525,000-950,000. More than 442,000 are thought to dwell in the London metropolitan area. Even in

  8. Accessing Suomi NPP OMPS Products Through the GES DISC Online Data Services

    NASA Astrophysics Data System (ADS)

    Johnson, J. E.; Wei, J. C.; Garasimov, I.; Vollmer, B.

    2017-12-01

    The NASA Goddard Earth Sciences Data and Information Services Center (GES DISC) is the primary archive of the latest versions of atmospheric composition data from the Suomi National Polar-orbiting Partnership (NPP) Ozone Mapping Profiler Suite (OMPS) mission. OMPS consists of three spectrometers: a Nadir Mapper (300-420 nm) with 50×50 km2 resolution and 2600 km wide swath, a Nadir Profiler (250-310 nm) with 250×250 km2 footprint, and a three-slit Limb Profiler (290-1000 nm) making 3 vertical profiles spaced about 250 km apart with 1-2 km vertical resolution up to 65 km altitude. OMPS measures primarily ozone, both total column and vertical profiles, but also includes measurements of NO2 and SO2 total and tropospheric columns, aerosol extinction profiles. Also available from OMPS are the Level-1B calibrated and geolocated radiances. All data products are generated at the OMPS Science Investigator Processing System (SIPS) at NASA/GSFC. This presentation will provide an overview of the OMPS products available at the GES DISC archive, as well as demonstrate the various data services provided by the GES DISC. Traditionally users have accessed data by downloading data files using anonymous FTP. Although one may still download the full OMPS data products from the archive (using HTTPS instead), the GES DISC now also offers online data services that allow users to not have to physically download the full data files to their desktop computer. Users can access the data through a desktop client tool (such as IDL, Matlab or Panoply) using OPeNDAP. Other data services include file subsetters (spatially, temporally, and/or by variable), as well as data visualization and exploration services for users to preview or quickly analyze the data. Since TOMS and EOS Aura data products are also available from the GES DISC archive, these can be easily accessed and compared with the OMPS data.

  9. Access to primary healthcare services for the Roma population in Serbia: a secondary data analysis

    PubMed Central

    2011-01-01

    Background Serbia has proclaimed access to healthcare as a human right. In a context wherein the Roma population are disadvantaged, the aim of this study was to assess whether the Roma population are able to effectively access primary care services, and if not, what barriers prevent them from doing so. The history of the Roma in Serbia is described in detail so as to provide a context for their current vulnerable position. Methods Disaggregated data were analyzed from three population groups in Serbia; the general population, the Roma population, and the poorest quintile of the general population not including the Roma. The effective coverage framework, which incorporates availability, affordability, accessibility, acceptability, and effectiveness of health services, was used to structure the secondary data analysis. Acute respiratory infection (ARI) in children less than five years of age was used as an example as this is the leading cause of death in children under 5 years old in Serbia. Results Roma children were significantly more likely to experience an ARI than either the general population or the poorest quintile of the general population, not including the Roma. All three population groups were equally likely to not receive the correct treatment regime of antibiotics. An analysis of the factors that affect quality of access to health services reveal that personal documentation is a statistically significant problem; availability of health services is not an issue that disproportionately affects the Roma; however the geographical accessibility and affordability are substantive issues that disproportionately affect the Roma population. Affordability of services affected the Roma and the poorest quintile and affordability of medications significantly affected all three population groups. With regards to acceptability, mothers from all three population groups are equally likely to recognize the importance of seeking treatment. Conclusions The Roma should be

  10. Comparing Methodologies for Evaluating Emergency Medical Services Ground Transport Access to Time-critical Emergency Services: A Case Study Using Trauma Center Care.

    PubMed

    Doumouras, Aristithes G; Gomez, David; Haas, Barbara; Boyes, Donald M; Nathens, Avery B

    2012-09-01

    The regionalization of medical services has resulted in improved outcomes and greater compliance with existing guidelines. For certain "time-critical" conditions intimately associated with emergency medicine, early intervention has demonstrated mortality benefits. For these conditions, then, appropriate triage within a regionalized system at first diagnosis is paramount, ideally occurring in the field by emergency medical services (EMS) personnel. Therefore, EMS ground transport access is an important metric in the ongoing evaluation of a regionalized care system for time-critical emergency services. To our knowledge, no studies have demonstrated how methodologies for calculating EMS ground transport access differ in their estimates of access over the same study area for the same resource. This study uses two methodologies to calculate EMS ground transport access to trauma center care in a single study area to explore their manifestations and critically evaluate the differences between the methodologies. Two methodologies were compared in their estimations of EMS ground transport access to trauma center care: a routing methodology (RM) and an as-the-crow-flies methodology (ACFM). These methodologies were adaptations of the only two methodologies that had been previously used in the literature to calculate EMS ground transport access to time-critical emergency services across the United States. The RM and ACFM were applied to the nine Level I and Level II trauma centers within the province of Ontario by creating trauma center catchment areas at 30, 45, 60, and 120 minutes and calculating the population and area encompassed by the catchments. Because the methodologies were identical for measuring air access, this study looks specifically at EMS ground transport access. Catchments for the province were created for each methodology at each time interval, and their populations and areas were significantly different at all time periods. Specifically, the RM calculated

  11. Access to oral health care services among adults with learning disabilities: a scoping review

    PubMed Central

    Naseem, Mustafa; Shah, Altaf H; Khiyani, Muhammad Faheem; Khurshid, Zohaib; Zafar, Muhammad Sohail; Gulzar, Shabnam; AlJameel, AlBandary H.; Khalil, Hesham S.

    2016-01-01

    Summary Background The prevalence of oral diseases including dental caries and periodontal conditions is remarkably higher in people with disabilities. The provision of accessible oral health services for people with learning disabilities may be challenging. Objectives The objectives of the review were to identify barriers in accessing oral health care that persists within society, enabling or disabling people with learning disabilities. Methods Using the Arksey O’Malley framework, a scoping review was conducted on PubMed/Medline, OVIDSP, and EMBASE. Studies were evaluated and short-listed based on the inclusion criteria, which consisted of: (1) study participants or population with learning disabilities, (2) aged 16 years or over, (3) reporting on access to oral health services, (4) published in the English language. Those that justified the inclusion criteria were carefully chosen after a blind peer-reviewed process when relevance and quality were debated. Results Nine studies were eventually included from searches. Tabulation of data was done under the heading of study type, outcomes, the year of publication and patient selection. The majority of studies provided a biomedical overview of access for adults with learning disabilities. Conclusions The concept of access for people with disability is still ill-defined and obscure. Access to oral health care and needs of people with learning disabilities are complex and multi-facet. PMID:28149451

  12. 28 CFR 16.99 - Exemption of the Immigration and Naturalization Service Systems-limited access.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Exemption of the Immigration and....99 Exemption of the Immigration and Naturalization Service Systems-limited access. (a) The following systems of records of the Immigration and Naturalization Service are exempt from 5 U.S.C. 552a (c) (3) and...

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

    PubMed

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

    2014-01-01

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

  14. Internet tool box for rural GPs to access mental health services information.

    PubMed

    Ollerenshaw, Alison

    2009-01-01

    Rural GPs play a significant role in the mental health care of their patients. It is therefore crucial that they have access to reputable support and advice that enhances their existing knowledge. This article outlines a recent project initiated by the Australian rural Ballarat and District Division of General Practice (BDDGP) to develop and implement an online resource to facilitate local implementation and delivery of the 'Better Access to Mental Health Care' (BAMHC) program. This 12 month project was initiated in response to a request from local GPs for additional information about and support in using the BAMHC program. The project is the culmination of significant collaboration among key stakeholders that includes local GPs, GP advisors from BDDGP, BDDGP staff, and two University of Ballarat research centres (the Centre for Health Research and Practice, and the Centre for Electronic Commerce and Communication). This article documents the key stages involved in the project from initiation to implementation, and reports on the use of this resource 12 months after its launch. The BDDGP represents 107 GPs and six GP registrars and covers a large rural/semi-rural area of 7300 km2 and a catchment population of more than 120,000. The format and design of the project entailed four distinct but interrelated stages of development: (1) developing the program specifications and localising it to the BDDGP catchment; (2) constructing a decision-making support tool with 7 sequential steps comprising key questions and links to detailed answers; (3) developing and populating an online service directory of local allied health professionals; and (4) constructing the website for easy access and navigation for GPs and other service providers. The website was publicly launched in December 2007 and is hosted by BDDGP. Since then it has received strong support. In the 12 months since its launch the website received regular and continuous visits (2847 visits/11,500 pages accessed). In

  15. Matrix Management in Practice in Access Services at the NCSU Libraries

    ERIC Educational Resources Information Center

    Harris, Colleen S.

    2010-01-01

    The former Associate Head of Access and Delivery Services of the North Carolina State University Libraries reports on successful use of matrix management techniques for the Circulation and Reserves unit of the department. Despite their having fallen out of favor in much of the management literature, matrix management principles are useful for…

  16. Inequities in access to HIV prevention services for transgender men: results of a global survey of men who have sex with men.

    PubMed

    Scheim, Ayden I; Santos, Glenn-Milo; Arreola, Sonya; Makofane, Keletso; Do, Tri D; Hebert, Patrick; Thomann, Matthew; Ayala, George

    2016-01-01

    Free or low-cost HIV testing, condoms, and lubricants are foundational HIV prevention strategies, yet are often inaccessible for men who have sex with men (MSM). In the global context of stigma and poor healthcare access, transgender (trans) MSM may face additional barriers to HIV prevention services. Drawing on data from a global survey of MSM, we aimed to describe perceived access to prevention services among trans MSM, examine associations between stigma and access, and compare access between trans MSM and cisgender (non-transgender) MSM. The 2014 Global Men's Health and Rights online survey was open to MSM (inclusive of trans MSM) from any country and available in seven languages. Baseline data (n=3857) were collected from July to October 2014. Among trans MSM, correlations were calculated between perceived service accessibility and anti-transgender violence, healthcare provider stigma, and discrimination. Using a nested matched-pair study design, trans MSM were matched 4:1 to cisgender MSM on age group, region, and HIV status, and conditional logistic regression models compared perceived access to prevention services by transgender status. About 3.4% of respondents were trans men, of whom 69 were included in the present analysis. The average trans MSM participant was 26 to 35 years old (56.5%); lived in western Europe, North America, or Oceania (75.4%); and reported being HIV-negative (98.6%). HIV testing, condoms, and lubricants were accessible for 43.5, 53.6, and 26.1% of trans MSM, respectively. Ever having been arrested or convicted due to being trans and higher exposure to healthcare provider stigma in the past six months were associated with less access to some prevention services. Compared to matched cisgender controls, trans MSM reported significantly lower odds of perceived access to HIV testing (OR=0.57, 95% CI=0.33, 0.98) and condom-compatible lubricants (OR=0.54, 95% CI=0.30, 0.98). This first look at access to HIV prevention services for trans MSM

  17. New Web Services for Broader Access to National Deep Submergence Facility Data Resources Through the Interdisciplinary Earth Data Alliance

    NASA Astrophysics Data System (ADS)

    Ferrini, V. L.; Grange, B.; Morton, J. J.; Soule, S. A.; Carbotte, S. M.; Lehnert, K.

    2016-12-01

    The National Deep Submergence Facility (NDSF) operates the Human Occupied Vehicle (HOV) Alvin, the Remotely Operated Vehicle (ROV) Jason, and the Autonomous Underwater Vehicle (AUV) Sentry. These vehicles are deployed throughout the global oceans to acquire sensor data and physical samples for a variety of interdisciplinary science programs. As part of the EarthCube Integrative Activity Alliance Testbed Project (ATP), new web services were developed to improve access to existing online NDSF data and metadata resources. These services make use of tools and infrastructure developed by the Interdisciplinary Earth Data Alliance (IEDA) and enable programmatic access to metadata and data resources as well as the development of new service-driven user interfaces. The Alvin Frame Grabber and Jason Virtual Van enable the exploration of frame-grabbed images derived from video cameras on NDSF dives. Metadata available for each image includes time and vehicle position, data from environmental sensors, and scientist-generated annotations, and data are organized and accessible by cruise and/or dive. A new FrameGrabber web service and service-driven user interface were deployed to offer integrated access to these data resources through a single API and allows users to search across content curated in both systems. In addition, a new NDSF Dive Metadata web service and service-driven user interface was deployed to provide consolidated access to basic information about each NDSF dive (e.g. vehicle name, dive ID, location, etc), which is important for linking distributed data resources curated in different data systems.

  18. A proxy of DICOM services

    NASA Astrophysics Data System (ADS)

    Ribeiro, Luís S.; Costa, Carlos; Oliveira, José Luís

    2010-03-01

    Diagnostic tools supported by digital medical images have increasingly become an essential aid to medical decisions. However, despite its growing importance, Picture Archiving and Communication Systems (PACS) are typically oriented to support a single healthcare institution, and the sharing of medical data across institutions is still a difficult process. This paper describes a proposal to publish and control Digital Imaging Communications in Medicine (DICOM) services in a wide domain composed of several healthcare institutions. The system creates virtual bridges between intranets enabling the exchange, search and store of the medical data within the wide domain. The service provider publishes the DICOM services following a token-based strategy. The token advertisements are public and known by all system users. However, access to the DICOM service is controlled through a role association between an access key and the service. Furthermore, in medical diagnoses, time is a crucial factor. Therefore, our system is a turnkey solution, capable of exchanging medical data across firewalls and Network Address Translation (NAT), avoiding bureaucratic issues with local network security. Security is also an important concern - in any transmission across different domains, data is encrypted by Transport Layer Security (TLS).

  19. Factors determining access to oral health services among children aged less than 12 years in Peru

    PubMed Central

    Azañedo, Diego; Hernández-Vásquez, Akram; Casas-Bendezú, Mixsi; Gutiérrez, César; Agudelo-Suárez, Andrés A.; Cortés, Sandra

    2017-01-01

    Background: Understanding problems of access to oral health services requires knowledge of factors that determine access. This study aimed to evaluate factors that determine access to oral health services among children aged <12 years in Peru between 2014 and 2015. Methods: We performed a secondary data analysis of 71,614 Peruvian children aged <12 years and their caregivers. Data were obtained from the Survey on Demography and Family Health 2014-2015 (Encuesta Demográfica y de Salud Familiar - ENDES). Children’s access to oral health services within the previous 6 months was used as the dependent variable (i.e. Yes/No), and the Andersen and col model was used to select independent variables. Predisposing (e.g., language spoken by  tutor or guardian, wealth level, caregivers’ educational level, area of residence, natural region of residence, age, and sex) and enabling factors (e.g. type of health insurance) were considered. Descriptive statistics were calculated, and multivariate analysis was performed using generalized linear models (Poisson family). Results: Of all the children, 51% were males, 56% were aged <5 years, and 62.6% lived in urban areas. The most common type of health insurance was Integral Health Insurance (57.8%), and most respondents were in the first quintile of wealth (31.6%). Regarding caregivers, the most common educational level was high school (43.02%) and the most frequently spoken language was Spanish (88.4%). Univariate analysis revealed that all variables, except sex and primary educational level, were statistically significant. After adjustment, sex, area of residence, and language were insignificant, whereas the remaining variables were statistically significant. Conclusions: Wealth index, caregivers’ education level, natural region of residence, age, and type of health insurance are factors that determine access to oral health services among children aged <12 years in Peru. These factors should be considered when devising

  20. Factors determining access to oral health services among children aged less than 12 years in Peru.

    PubMed

    Azañedo, Diego; Hernández-Vásquez, Akram; Casas-Bendezú, Mixsi; Gutiérrez, César; Agudelo-Suárez, Andrés A; Cortés, Sandra

    2017-01-01

    Background: Understanding problems of access to oral health services requires knowledge of factors that determine access. This study aimed to evaluate factors that determine access to oral health services among children aged <12 years in Peru between 2014 and 2015. Methods: We performed a secondary data analysis of 71,614 Peruvian children aged <12 years and their caregivers. Data were obtained from the Survey on Demography and Family Health 2014-2015 (Encuesta Demográfica y de Salud Familiar - ENDES). Children's access to oral health services within the previous 6 months was used as the dependent variable (i.e. Yes/No), and the Andersen and col model was used to select independent variables. Predisposing (e.g., language spoken by  tutor or guardian, wealth level, caregivers' educational level, area of residence, natural region of residence, age, and sex) and enabling factors (e.g. type of health insurance) were considered. Descriptive statistics were calculated, and multivariate analysis was performed using generalized linear models (Poisson family). Results: Of all the children, 51% were males, 56% were aged <5 years, and 62.6% lived in urban areas. The most common type of health insurance was Integral Health Insurance (57.8%), and most respondents were in the first quintile of wealth (31.6%). Regarding caregivers, the most common educational level was high school (43.02%) and the most frequently spoken language was Spanish (88.4%). Univariate analysis revealed that all variables, except sex and primary educational level, were statistically significant. After adjustment, sex, area of residence, and language were insignificant, whereas the remaining variables were statistically significant. Conclusions: Wealth index, caregivers' education level, natural region of residence, age, and type of health insurance are factors that determine access to oral health services among children aged <12 years in Peru. These factors should be considered when devising strategies

  1. 18 CFR 2.22 - Pricing policy for transmission services provided under the Federal Power Act.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Pricing policy for transmission services provided under the Federal Power Act. 2.22 Section 2.22 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES GENERAL POLICY AND...

  2. 18 CFR 2.22 - Pricing policy for transmission services provided under the Federal Power Act.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Pricing policy for transmission services provided under the Federal Power Act. 2.22 Section 2.22 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES GENERAL POLICY AND...

  3. 18 CFR 2.22 - Pricing policy for transmission services provided under the Federal Power Act.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Pricing policy for transmission services provided under the Federal Power Act. 2.22 Section 2.22 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES GENERAL POLICY AND...

  4. 18 CFR 2.22 - Pricing policy for transmission services provided under the Federal Power Act.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Pricing policy for transmission services provided under the Federal Power Act. 2.22 Section 2.22 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES GENERAL POLICY AND...

  5. Emergency intraosseous access in a helicopter emergency medical service: a retrospective study.

    PubMed

    Sunde, Geir A; Heradstveit, Bård E; Vikenes, Bjarne H; Heltne, Jon K

    2010-10-07

    Intraosseous access (IO) is a method for providing vascular access in out-of-hospital resuscitation of critically ill and injured patients when traditional intravenous access is difficult or impossible. Different intraosseous techniques have been used by our Helicopter Emergency Medical Services (HEMS) since 2003. Few articles document IO use by HEMS physicians. The aim of this study was to evaluate the use of intraosseous access in pre-hospital emergency situations handled by our HEMS. We reviewed all medical records from the period May 2003 to April 2010, and compared three different techniques: Bone Injection Gun (B.I.G® - Waismed), manual bone marrow aspiration needle (Inter V - Medical Device Technologies) and EZ-IO® (Vidacare), used on both adults and paediatric patients. During this seven-year period, 78 insertion attempts were made on 70 patients. Overall success rates were 50% using the manual needle, 55% using the Bone Injection Gun, and 96% using the EZ-IO®. Rates of success on first attempt were significantly higher using the EZ-IO® compared to the manual needle/Bone Injection Gun (p < 0.01/p < 0.001). Fifteen failures were due to insertion-related problems (19.2%), with four technical problems (5.1%) and three extravasations (3.8%) being the most frequent causes. Intraosseous access was primarily used in connection with 53 patients in cardiac arrest (75.7%), including traumatic arrest, drowning and SIDS. Other diagnoses were seven patients with multi-trauma (10.0%), five with seizures/epilepsy (7.1%), three with respiratory failure (4.3%) and two others (2.9%). Nearly one third of all insertions (n = 22) were made in patients younger than two years. No cases of osteomyelitis or other serious complications were documented on the follow-up. Newer intraosseous techniques may enable faster and more reliable vascular access, and this can lower the threshold for intraosseous access on both adult and paediatric patients in critical situations. We believe

  6. Emergency intraosseous access in a helicopter emergency medical service: a retrospective study

    PubMed Central

    2010-01-01

    Background Intraosseous access (IO) is a method for providing vascular access in out-of-hospital resuscitation of critically ill and injured patients when traditional intravenous access is difficult or impossible. Different intraosseous techniques have been used by our Helicopter Emergency Medical Services (HEMS) since 2003. Few articles document IO use by HEMS physicians. The aim of this study was to evaluate the use of intraosseous access in pre-hospital emergency situations handled by our HEMS. Methods We reviewed all medical records from the period May 2003 to April 2010, and compared three different techniques: Bone Injection Gun (B.I.G® - Waismed), manual bone marrow aspiration needle (Inter V - Medical Device Technologies) and EZ-IO® (Vidacare), used on both adults and paediatric patients. Results During this seven-year period, 78 insertion attempts were made on 70 patients. Overall success rates were 50% using the manual needle, 55% using the Bone Injection Gun, and 96% using the EZ-IO®. Rates of success on first attempt were significantly higher using the EZ-IO® compared to the manual needle/Bone Injection Gun (p < 0.01/p < 0.001). Fifteen failures were due to insertion-related problems (19.2%), with four technical problems (5.1%) and three extravasations (3.8%) being the most frequent causes. Intraosseous access was primarily used in connection with 53 patients in cardiac arrest (75.7%), including traumatic arrest, drowning and SIDS. Other diagnoses were seven patients with multi-trauma (10.0%), five with seizures/epilepsy (7.1%), three with respiratory failure (4.3%) and two others (2.9%). Nearly one third of all insertions (n = 22) were made in patients younger than two years. No cases of osteomyelitis or other serious complications were documented on the follow-up. Conclusions Newer intraosseous techniques may enable faster and more reliable vascular access, and this can lower the threshold for intraosseous access on both adult and paediatric

  7. Providing Data Access for Interdisciplinary Research

    NASA Astrophysics Data System (ADS)

    Hooper, R. P.; Couch, A.

    2012-12-01

    Developing an interdisciplinary understanding of human and environmental interactions with water requires access to a variety of data kinds collected by various organizations. The CUAHSI Hydrologic Information System (HIS) is a standards-based, services-oriented architecture designed for time-series data. Such data represents an important type of data in water studies. Through the efforts of HIS, a standard transmission language, WaterML2, has been adopted by the Open Geospatial Consortium and is under consideration by the World Meteorologic Organization as an international standards. Web services have also been developed to retrieve data and metadata. HIS is completed with a metadata catalog, hosted by San Diego Supercomputing Center, which indexes more than 20 million time series provided from over 90 different services. This catalog is supported through a hierarchically organized controlled vocabulary that is open for community input and mediation. Data publishers include federal agencies, universities, state agencies, and non-profit organizations such as watershed associations. Accessing data from such a broad spectrum of sources through a uniform service standard promises to truly transform the way in which hydrologic research is done. CUAHSI HIS is a large-scale prototype at this time, but a proposal is under consideration by the National Science Foundation to operationalize HIS through a data facility, tentatively called the CUAHSI Water Data Center. Establishing HIS is an important step to enable research into human-environment interactions with water, but it is only one step. Other data structures will need to be made accessible and interoperable to support this research. Some data—such as two-dimensional GIS coverages—already have widely used standards for transmission and sharing. The US Federal government has long operated a clearinghouse for federal geographic data that is now being augmented with other services such as ArcGIS OnLine. Other data

  8. The NASA Reanalysis Ensemble Service - Advanced Capabilities for Integrated Reanalysis Access and Intercomparison

    NASA Astrophysics Data System (ADS)

    Tamkin, G.; Schnase, J. L.; Duffy, D.; Li, J.; Strong, S.; Thompson, J. H.

    2017-12-01

    NASA's efforts to advance climate analytics-as-a-service are making new capabilities available to the research community: (1) A full-featured Reanalysis Ensemble Service (RES) comprising monthly means data from multiple reanalysis data sets, accessible through an enhanced set of extraction, analytic, arithmetic, and intercomparison operations. The operations are made accessible through NASA's climate data analytics Web services and our client-side Climate Data Services Python library, CDSlib; (2) A cloud-based, high-performance Virtual Real-Time Analytics Testbed supporting a select set of climate variables. This near real-time capability enables advanced technologies like Spark and Hadoop-based MapReduce analytics over native NetCDF files; and (3) A WPS-compliant Web service interface to our climate data analytics service that will enable greater interoperability with next-generation systems such as ESGF. The Reanalysis Ensemble Service includes the following: - New API that supports full temporal, spatial, and grid-based resolution services with sample queries - A Docker-ready RES application to deploy across platforms - Extended capabilities that enable single- and multiple reanalysis area average, vertical average, re-gridding, standard deviation, and ensemble averages - Convenient, one-stop shopping for commonly used data products from multiple reanalyses including basic sub-setting and arithmetic operations (e.g., avg, sum, max, min, var, count, anomaly) - Full support for the MERRA-2 reanalysis dataset in addition to, ECMWF ERA-Interim, NCEP CFSR, JMA JRA-55 and NOAA/ESRL 20CR… - A Jupyter notebook-based distribution mechanism designed for client use cases that combines CDSlib documentation with interactive scenarios and personalized project management - Supporting analytic services for NASA GMAO Forward Processing datasets - Basic uncertainty quantification services that combine heterogeneous ensemble products with comparative observational products (e

  9. Combining survey data, GIS and qualitative interviews in the analysis of health service access for persons with disabilities.

    PubMed

    Eide, Arne H; Dyrstad, Karin; Munthali, Alister; Van Rooy, Gert; Braathen, Stine H; Halvorsen, Thomas; Persendt, Frans; Mvula, Peter; Rød, Jan Ketil

    2018-06-26

    Equitable access to health services is a key ingredient in reaching health for persons with disabilities and other vulnerable groups. So far, research on access to health services in low- and middle-income countries has largely relied on self-reported survey data. Realizing that there may be substantial discrepancies between perceived and actual access, other methods are needed for more precise knowledge to guide health policy and planning. The objective of this article is to describe and discuss an innovative methodological triangulation where statistical and spatial analysis of perceived distance and objective measures of access is combined with qualitative evidence. The data for the study was drawn from a large household and individual questionnaire based survey carried out in Namibia and Malawi. The survey data was combined with spatial data of respondents and health facilities, key informant interviews and focus group discussions. To analyse access and barriers to access, a model is developed that takes into account both measured and perceived access. The geo-referenced survey data is used to establish four outcome categories of perceived and measured access as either good or poor. Combined with analyses of the terrain and the actual distance from where the respondents live to the health facility they go to, the data allows for categorising areas and respondents according to the four outcome categories. The four groups are subsequently analysed with respect to variation in individual characteristics and vulnerability factors. The qualitative component includes participatory map drawing and is used to gain further insight into the mechanisms behind the different combinations of perceived and actual access. Preliminary results show that there are substantial discrepancies between perceived and actual access to health services and the qualitative study provides insight into mechanisms behind such divergences. The novel combination of survey data, geographical

  10. 47 CFR 101.207 - Suspension of transmission.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 5 2012-10-01 2012-10-01 false Suspension of transmission. 101.207 Section 101.207 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Operational Requirements § 101.207 Suspension of transmission. Transmission...

  11. 47 CFR 101.207 - Suspension of transmission.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Suspension of transmission. 101.207 Section 101.207 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Operational Requirements § 101.207 Suspension of transmission. Transmission...

  12. 47 CFR 101.207 - Suspension of transmission.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 5 2014-10-01 2014-10-01 false Suspension of transmission. 101.207 Section 101.207 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Operational Requirements § 101.207 Suspension of transmission. Transmission...

  13. 47 CFR 101.207 - Suspension of transmission.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 5 2013-10-01 2013-10-01 false Suspension of transmission. 101.207 Section 101.207 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Operational Requirements § 101.207 Suspension of transmission. Transmission...

  14. 47 CFR 101.207 - Suspension of transmission.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 5 2011-10-01 2011-10-01 false Suspension of transmission. 101.207 Section 101.207 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO SERVICES FIXED MICROWAVE SERVICES Operational Requirements § 101.207 Suspension of transmission. Transmission...

  15. [How do immigrant women access health services in the Basque Country? Perceptions of health professionals].

    PubMed

    Pérez-Urdiales, Iratxe; Goicolea, Isabel

    2017-09-12

    To determine the perception of health professionals working in alternative health centres on the barriers and facilitators in the access by immigrant women to general public health services and sexual and reproductive health in the Basque Country. Basque Country. Analysis of qualitative content based on 11 individual interviews. Health professionals working in alternative health centres of Primary Care and sexual and reproductive health. Data collection was performed between September and December 2015 in four alternative health centres. After transcription, the units of meaning, codes and categories were identified. Four categories emerged from the analysis, which represented how the characteristics of immigrant women (Tell me how you are and I will tell you how to access), the attitude of the administrative and health staff ("When they are already taken care of"), the functioning of the health system (Inflexible, passive and needs-responsive health system), and health policies ("If you do not meet the requirements, you do not go in. The law is the law") influence access to health services of immigrant women. This study shows that there are a considerable number of barriers and few facilitators to the access by immigrant women to public health and sexual and reproductive health services in the Basque Country. The alternative health centres were presented as favouring the improvement of the health of the immigrant population and in their access. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  16. Improving Access to Behavioral Health Care for Remote Service Members and Their Families

    DTIC Science & Technology

    2015-01-01

    that drive times exceeding 30 minutes are associated with marked decrements in utilization of care.6 The researchers find that remote service members...location, the location of behavioral health services, and information on insurance coverage and regulations surrounding access. A drive time of 30...geographic and health insurance data; how- ever, the data are somewhat limited due to their sensitive nature and availability. Third, the team considered

  17. Equity in Access to Health Promotion and Risk Reduction Services: Implications for Elder Health.

    ERIC Educational Resources Information Center

    Smith, Nancy H.; Howze, Elizabeth Harper

    Although there is a national emphasis on health promotion and preventive practices, questions remain regarding the equity of access to these services by low income and minority groups, and the implications of inequities for elder health. Data from a systematic survey of 500 public and private providers of health promotion services in northern…

  18. Universal access to HIV treatment versus universal 'test and treat': transmission, drug resistance & treatment costs.

    PubMed

    Wagner, Bradley G; Blower, Sally

    2012-01-01

    In South Africa (SA) universal access to treatment for HIV-infected individuals in need has yet to be achieved. Currently ~1 million receive treatment, but an additional 1.6 million are in need. It is being debated whether to use a universal 'test and treat' (T&T) strategy to try to eliminate HIV in SA; treatment reduces infectivity and hence transmission. Under a T&T strategy all HIV-infected individuals would receive treatment whether in need or not. This would require treating 5 million individuals almost immediately and providing treatment for several decades. We use a validated mathematical model to predict impact and costs of: (i) a universal T&T strategy and (ii) achieving universal access to treatment. Using modeling the WHO has predicted a universal T&T strategy in SA would eliminate HIV within a decade, and (after 40 years) cost ~$10 billion less than achieving universal access. In contrast, we predict a universal T&T strategy in SA could eliminate HIV, but take 40 years and cost ~$12 billion more than achieving universal access. We determine the difference in predictions is because the WHO has under-estimated survival time on treatment and ignored the risk of resistance. We predict, after 20 years, ~2 million individuals would need second-line regimens if a universal T&T strategy is implemented versus ~1.5 million if universal access is achieved. Costs need to be realistically estimated and multiple evaluation criteria used to compare 'treatment as prevention' with other prevention strategies. Before implementing a universal T&T strategy, which may not be sustainable, we recommend striving to achieve universal access to treatment as quickly as possible. We predict achieving universal access to treatment would be a very effective 'treatment as prevention' approach and bring the HIV epidemic in SA close to elimination, preventing ~4 million infections after 20 years and ~11 million after 40 years.

  19. Contextualising renal patient routines: Everyday space-time contexts, health service access, and wellbeing.

    PubMed

    McQuoid, Julia; Jowsey, Tanisha; Talaulikar, Girish

    2017-06-01

    Stable routines are key to successful illness self-management for the growing number of people living with chronic illness around the world. Yet, the influence of chronically ill individuals' everyday contexts in supporting routines is poorly understood. This paper takes a space-time geographical approach to explore the everyday space-time contexts and routines of individuals with chronic kidney disease (CKD). We ask: what is the relationship between renal patients' space-time contexts and their ability to establish and maintain stable routines, and, what role does health service access play in this regard? We draw from a qualitative case study of 26 individuals with CKD in Australia. Data comprised self-reported two day participant diaries and semi-structured interviews. Thematic analysis of interview transcripts was guided by an inductive-deductive approach. We examined the embeddedness of routines within the space-time contexts of participants' everyday lives. We found that participants' everyday space-time contexts were highly complex, especially for those receiving dialysis and/or employed, making routines difficult to establish and vulnerable to disruption. Health service access helped shape participants' everyday space-time contexts, meaning that incidences of unpredictability in accessing health services set-off 'ripple effects' within participants' space-time contexts, disrupting routines and making everyday life negotiation more difficult. The ability to absorb ripple effects from unpredictable health services without disrupting routines varied by space-time context. Implications of these findings for the deployment of the concept of routine in health research, the framing of patient success in self-managing illness, and health services design are discussed. In conclusion, efforts to understand and support individuals in establishing and maintaining routines that support health and wellbeing can benefit from approaches that contextualise and de

  20. Contextualising renal patient routines: Everyday space-time contexts, health service access, and wellbeing

    PubMed Central

    McQuoid, Julia; Jowsey, Tanisha; Talaulikar, Girish

    2017-01-01

    Stable routines are key to successful illness self-management for the growing number of people living with chronic illness around the world. Yet, the influence of chronically ill individuals’ everyday contexts in supporting routines is poorly understood. This paper takes a space-time geographical approach to explore the everyday space-time contexts and routines of individuals with chronic kidney disease (CKD). We ask: what is the relationship between renal patients’ space-time contexts and their ability to establish and maintain stable routines, and, what role does health service access play in this regard? We draw from a qualitative case study of 26 individuals with CKD in Australia. Data comprised self-reported two day participant diaries and semi-structured interviews. Thematic analysis of interview transcripts was guided by an inductive-deductive approach. We examined the embeddedness of routines within the space-time contexts of participants’ everyday lives. We found that participants’ everyday space-time contexts were highly complex, especially for those receiving dialysis and/or employed, making routines difficult to establish and vulnerable to disruption. Health service access helped shape participants’ everyday space-time contexts, meaning that incidences of unpredictability in accessing health services set-off ‘ripple effects’ within participants’ space-time contexts, disrupting routines and making everyday life negotiation more difficult. The ability to absorb ripple effects from unpredictable health services without disrupting routines varied by space-time context. Implications of these findings for the deployment of the concept of routine in health research, the framing of patient success in self-managing illness, and health services design are discussed. In conclusion, efforts to understand and support individuals in establishing and maintaining routines that support health and wellbeing can benefit from approaches that contextualise

  1. Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management.

    PubMed

    Kuupiel, Desmond; Bawontuo, Vitalis; Mashamba-Thompson, Tivani P

    2017-11-29

    Access to point-of-care (POC) diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs) and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings.

  2. Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management

    PubMed Central

    Kuupiel, Desmond; Bawontuo, Vitalis

    2017-01-01

    Access to point-of-care (POC) diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs) and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings. PMID:29186013

  3. Access of Hispanics to health care and cuts in services: a state-of-the-art overview.

    PubMed

    Andersen, R M; Giachello, A L; Aday, L A

    1986-01-01

    The most current research literature on the access of Hispanics to medical care is reviewed, and data from a 1982 national survey by Louis Harris and Associates on access to health care are presented to document current levels of access to health care of the Hispanic population. Through telephone interviews, 4,800 families were contacted, yielding a total sample of 6,610 persons. According to the survey's data, the ability of Hispanics to obtain health services is hampered by relatively low incomes, lack of health insurance coverage, and ties to a particular physician. However, Hispanics do not differ significantly from whites in their use of hospitals, physicians, or outpatient departments and emergency rooms. Hispanics are less satisfied than whites on a host of measures describing the most recent medical visit. These levels of dissatisfaction with the visit are similar to those of blacks. The recession and public care service cutbacks did not appear to result in a substantial reduction in the volume of medical care received by Hispanics and blacks. Still, the services available to minorities are viewed by them as less effective in meeting their needs in comparison with how whites view the services they receive. Further, the 1982 survey reveals particular difficulties and barriers for Hispanics in obtaining needed medical services. More than one-fifth of the Hispanic families had one or more significant problems in obtaining needed services.

  4. Research on Rural Residence and Access to Drug Abuse Services: Where Are We and where Do We Go?

    ERIC Educational Resources Information Center

    Borders, Tyrone F.; Booth, Brenda M.

    2007-01-01

    Context: Illicit drug use is common in rural areas, but very little research has investigated rural populations' access to drug abuse services. Purpose: To describe the current state of the scientific literature on access to drug abuse services in rural areas and suggest directions for future research. Methods: We performed a literature review of…

  5. Living conditions and access to health services by Bolivian immigrants in the city of São Paulo, Brazil.

    PubMed

    Silveira, Cássio; Carneiro Junior, Nivaldo; Ribeiro, Manoel Carlos Sampaio de Almeida; Barata, Rita de Cássia Barradas

    2013-10-01

    Bolivian immigrants in Brazil experience serious social problems: precarious work conditions, lack of documents and insufficient access to health services. The study aimed to investigate inequalities in living conditions and access to health services among Bolivian immigrants living in the central area of São Paulo, Brazil, using a cross-sectional design and semi-structured interviews with 183 adults. According to the data, the immigrants tend to remain in Brazil, thus resulting in an aging process in the group. Per capita income increases the longer the immigrants stay in the country. The majority have secondary schooling. Work status does not vary according to time since arrival in Brazil. The immigrants work and live in garment sweatshops and speak their original languages. Social networks are based on ties with family and friends. Access to health services shows increasing inclusion in primary care. The authors conclude that the immigrants' social exclusion is decreasing due to greater access to documentation, work (although precarious), and the supply of health services from the public primary care system.

  6. ‘Doing the hard yards’: carer and provider focus group perspectives of accessing Aboriginal childhood disability services

    PubMed Central

    2013-01-01

    Background Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability. Methods Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community. Results Seventeen health and social service providers representing local area government and non-government-funded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people. Conclusions Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a number of

  7. Experimental demonstration of large capacity WSDM optical access network with multicore fibers and advanced modulation formats.

    PubMed

    Li, Borui; Feng, Zhenhua; Tang, Ming; Xu, Zhilin; Fu, Songnian; Wu, Qiong; Deng, Lei; Tong, Weijun; Liu, Shuang; Shum, Perry Ping

    2015-05-04

    Towards the next generation optical access network supporting large capacity data transmission to enormous number of users covering a wider area, we proposed a hybrid wavelength-space division multiplexing (WSDM) optical access network architecture utilizing multicore fibers with advanced modulation formats. As a proof of concept, we experimentally demonstrated a WSDM optical access network with duplex transmission using our developed and fabricated multicore (7-core) fibers with 58.7km distance. As a cost-effective modulation scheme for access network, the optical OFDM-QPSK signal has been intensity modulated on the downstream transmission in the optical line terminal (OLT) and it was directly detected in the optical network unit (ONU) after MCF transmission. 10 wavelengths with 25GHz channel spacing from an optical comb generator are employed and each wavelength is loaded with 5Gb/s OFDM-QPSK signal. After amplification, power splitting, and fan-in multiplexer, 10-wavelength downstream signal was injected into six outer layer cores simultaneously and the aggregation downstream capacity reaches 300 Gb/s. -16 dBm sensitivity has been achieved for 3.8 × 10-3 bit error ratio (BER) with 7% Forward Error Correction (FEC) limit for all wavelengths in every core. Upstream signal from ONU side has also been generated and the bidirectional transmission in the same core causes negligible performance degradation to the downstream signal. As a universal platform for wired/wireless data access, our proposed architecture provides additional dimension for high speed mobile signal transmission and we hence demonstrated an upstream delivery of 20Gb/s per wavelength with QPSK modulation formats using the inner core of MCF emulating a mobile backhaul service. The IQ modulated data was coherently detected in the OLT side. -19 dBm sensitivity has been achieved under the FEC limit and more than 18 dB power budget is guaranteed.

  8. Onsite Provision of Specialized Contraceptive Services: Does Title X Funding Enhance Access?

    PubMed Central

    Riedel, Julie Cross; Menz, Mary; Darney, Philip D.; Brindis, Claire D.

    2014-01-01

    Abstract Background: This article presents the extent to which providers enrolled in California's Family Planning, Access, Care, and Treatment (Family PACT) program offer contraceptive methods onsite, thus eliminating one important access barrier. Family PACT has a diverse provider network, including public-sector providers receiving Title X funding, public-sector providers not receiving Title X funding, and private-sector providers. We explored whether Title X funding enhances providers' ability to offer contraceptive methods that require specialized skills onsite. Methods: Data were derived from 1,072 survey responses to a 2010 provider-capacity survey matched by unique identifier to administrative claims data. Results: A significantly greater proportion of Title X–funded providers compared to non–Title X public and private providers offered onsite services for the following studied methods: intrauterine contraceptives (90% Title X, 51% public non–Title X, 38% private); contraceptive implants (58% Title X, 19% public non–Title X, 7% private); vasectomy (8% Title X, 4% public non–Title X, 1% private); and fertility-awareness methods (69% Title X, 55% public non–Title X, 49% private) (all p<0.0001). The association between onsite provision and Title X funding remained after stratifying individually by clinic specialty, facility capacity to provide reproductive health services (based on staffing), and rural/urban location. Conclusions: Extra funding for publicly funded family-planning programs, through mechanisms such as Title X, appears to be associated with increased onsite access to a wide range of contraceptive services, including those that require special skills and training. PMID:24405313

  9. Patients’ online access to their electronic health records and linked online services: a systematic interpretative review

    PubMed Central

    de Lusignan, Simon; Mold, Freda; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Gronlund, Toto Anne; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Barker, Fiona; Ellis, Beverley; Koczan, Phil; Arvanitis, Theodoros N; McCarthy, Mary; Jones, Simon; Rafi, Imran

    2014-01-01

    Objectives To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Setting Primary care. Participants A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Primary and secondary outcome measures Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. Results No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Conclusions Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of

  10. Universal access to ambulance does not increase overall demand for ambulance services in Queensland, Australia.

    PubMed

    Tippett, Vivienne C; Toloo, Ghasem Sam; Eeles, David; Ting, Joseph Y S; Aitken, Peter J; Fitzgerald, Gerard J

    2013-02-01

    To determine the impact of the introduction of universal access to ambulance services via the implementation of the Community Ambulance Cover (CAC) program in Queensland in 2003-04. The study involved a 10-year (2000-01 to 2009-10) retrospective analysis of routinely collected data reported by the Queensland Ambulance Service (QAS) and by the Council of Ambulance Authorities. The data were analysed for the impact of policy changes that resulted in universal access to ambulance services in Queensland. QAS is a statewide, publically funded ambulance service. In Queensland, ambulance utilisation rate (AUR) per 1000 persons grew by 41% over the decade or 3.9% per annum (10-year mean=149.8, 95% CI: 137.3-162.3). The AUR mean after CAC was significantly higher for urgent incidents than for non-urgent ones. However projection modelling demonstrates that URs after the introduction of CAC were significantly lower than the projected utilisation for the same period. The introduction of universal access under the Community Ambulance Cover program in Queensland has not had any significant independent long-term impact on demand overall. There has been a reduction in the long-term growth rate, which may have been contributed to by an 'appropriate use' public awareness program.

  11. Perspectives of resettled African refugees on accessing medicines and pharmacy services in Queensland, Australia.

    PubMed

    Bellamy, Kim; Ostini, Remo; Martini, Nataly; Kairuz, Therese

    2017-10-01

    The aim of this study was to explore the barriers to accessing medicines and pharmacy services among refugees in Queensland, Australia, from the perspectives of resettled African refugees. A generic qualitative approach was used in this study. Resettled African refugees were recruited via a purposive snowball sampling method. The researcher collected data from different African refugee communities, specifically those from Sudanese, Congolese and Somalian communities. Participants were invited by a community health leader to participate in the study; a community health leader is a trained member of the refugee community who acts as a 'health information conduit' between refugees and the health system. Invitations were done either face-to-face, telephonically or by email. The focus groups were digitally recorded in English and transcribed verbatim by the researcher. Transcripts were entered into NVIVO© 11 and the data were analysed using inductive thematic analysis. Four focus groups were conducted between October and November 2014 in the city of Brisbane with African refugees, one with five Somali refugees, one with five Congolese refugees, one with three refugee community health leaders from South Sudan, Liberia and Eritrea and one with three refugee community health leaders from Uganda, Burundi and South Sudan. Eleven sub-themes emerged through the coding process, which resulted in four overarching themes: health system differences, navigating the Australian health system, communication barriers and health care-seeking behaviour. With regard to accessing medicines and pharmacy services, this study has shown that there is a gap between resettled refugees' expectations of health services and the reality of the Australian health system. Access barriers identified included language barriers, issues with the Translating and Interpreter Service, a lack of professional communication and cultural beliefs affecting health care-seeking behaviour. This exploratory study has

  12. Protocol independent transmission method in software defined optical network

    NASA Astrophysics Data System (ADS)

    Liu, Yuze; Li, Hui; Hou, Yanfang; Qiu, Yajun; Ji, Yuefeng

    2016-10-01

    With the development of big data and cloud computing technology, the traditional software-defined network is facing new challenges (e.i., ubiquitous accessibility, higher bandwidth, more flexible management and greater security). Using a proprietary protocol or encoding format is a way to improve information security. However, the flow, which carried by proprietary protocol or code, cannot go through the traditional IP network. In addition, ultra- high-definition video transmission service once again become a hot spot. Traditionally, in the IP network, the Serial Digital Interface (SDI) signal must be compressed. This approach offers additional advantages but also bring some disadvantages such as signal degradation and high latency. To some extent, HD-SDI can also be regard as a proprietary protocol, which need transparent transmission such as optical channel. However, traditional optical networks cannot support flexible traffics . In response to aforementioned challenges for future network, one immediate solution would be to use NFV technology to abstract the network infrastructure and provide an all-optical switching topology graph for the SDN control plane. This paper proposes a new service-based software defined optical network architecture, including an infrastructure layer, a virtualization layer, a service abstract layer and an application layer. We then dwell on the corresponding service providing method in order to implement the protocol-independent transport. Finally, we experimentally evaluate that proposed service providing method can be applied to transmit the HD-SDI signal in the software-defined optical network.

  13. Access and Use of FIA Data Through FIA Spatial Data Services

    Treesearch

    Elizabeth LaPoint

    2005-01-01

    Forest Inventory and Analysis (FIA) Spatial Data Services (SDS) was established in May 2002 to facilitate outside access to FIA data and allow use of georeferenced plot data while protecting the confidentiality of plot locations. Modification of the Food Security Act of 1985 legislated the protection of information on plot location and ownership. Penalties were put in...

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

    PubMed

    Arulogun, Oyedunni S; Titiloye, Musibau A; Afolabi, Nathanael B; Oyewole, Oyediran E; Nwaorgu, Onyekwere G B

    2013-03-01

    Delivery of health services to people with hearing impairment is poorly understood in Nigeria and limited research has been done to throw more light on the process involved. This study described experiences of 167 girls with hearing impairment in accessing reproductive health services in Ibadan using a validated questionnaire. Descriptive statistics and binary logistic regression were used to analyze the data. Almost 95.0% of respondents had ever visited health facility for reproductive health issues. Of these 6.2% and 4.6% went for treatment of STIs and pregnancy termination respectively; 36.7% were embarrassed to ask questions in the presence of an interpreter, communication (40.5%) and cost (10.8%) were key barriers to access and 85.6% would use facility if hearing impairment-friendly services are provided. Respondents who were currently working were 20 times more likely to receive services they wanted (OR = 20.29, CI = 1.05-392.16). Availability of certified interpreters and ensuring confidentiality are key to effective service delivery for the hearing impaired.

  15. Essays on the Impacts of Geography and Institutions on Access to Energy and Public Infrastructure Services

    NASA Astrophysics Data System (ADS)

    Archibong, Belinda

    While previous literature has emphasized the importance of energy and public infrastructure services for economic development, questions surrounding the implications of unequal spatial distribution in access to these resources remain, particularly in the developing country context. This dissertation provides evidence on the nature, origins and implications of this distribution uniting three strands of research from the development and political economy, regional science and energy economics fields. The dissertation unites three papers on the nature of spatial inequality of access to energy and infrastructure with further implications for conflict risk , the historical institutional and biogeographical determinants of current distribution of access to energy and public infrastructure services and the response of households to fuel price changes over time. Chapter 2 uses a novel survey dataset to provide evidence for spatial clustering of public infrastructure non-functionality at schools by geopolitical zone in Nigeria with further implications for armed conflict risk in the region. Chapter 3 investigates the drivers of the results in chapter 2, exploiting variation in the spatial distribution of precolonial institutions and geography in the region, to provide evidence for the long-term impacts of these factors on current heterogeneity of access to public services. Chapter 4 addresses the policy implications of energy access, providing the first multi-year evidence on firewood demand elasticities in India, using the spatial variation in prices for estimation.

  16. Estimation and Evaluation of Future Demand and Supply of Healthcare Services Based on a Patient Access Area Model

    PubMed Central

    Doi, Shunsuke; Ide, Hiroo; Takeuchi, Koichi; Fujita, Shinsuke; Takabayashi, Katsuhiko

    2017-01-01

    Accessibility to healthcare service providers, the quantity, and the quality of them are important for national health. In this study, we focused on geographic accessibility to estimate and evaluate future demand and supply of healthcare services. We constructed a simulation model called the patient access area model (PAAM), which simulates patients’ access time to healthcare service institutions using a geographic information system (GIS). Using this model, to evaluate the balance of future healthcare services demand and supply in small areas, we estimated the number of inpatients every five years in each area and compared it with the number of hospital beds within a one-hour drive from each area. In an experiment with the Tokyo metropolitan area as a target area, when we assumed hospital bed availability to be 80%, it was predicted that over 78,000 inpatients would not receive inpatient care in 2030. However, this number would decrease if we lowered the rate of inpatient care by 10% and the average length of the hospital stay. Using this model, recommendations can be made regarding what action should be undertaken and by when to prevent a dramatic increase in healthcare demand. This method can help plan the geographical resource allocation in healthcare services for healthcare policy. PMID:29125585

  17. HIV-positive mothers in Viet Nam: using their status to build support groups and access essential services.

    PubMed

    Oosterhoff, Pauline; Anh, Nguyen Thu; Yen, Pham Ngoc; Wright, Pamela; Hardon, Anita

    2008-11-01

    Various support and self-help groups for people living with HIV and their families have developed in Viet Nam in recent years. This paper reports on a case study of Sunflowers, the first support group for HIV positive mothers in Hanoi, begun in 2004, and a sister group begun in 2005 in Thai Nguyen province. From April 2004 to early 2007, we carried out semi-structured interviews with 275 health care workers and 153 HIV-positive women and members of their families, as well as participant observation of group meetings and activities. Sunflowers have successfully organised themselves to access vital social, medical and economic support and services for themselves, their children and partners. They gained self-confidence, and learned to communicate with their peers and voice their needs to service providers. Based on personal development plans, they have accessed other state services, such as loans, job counselling and legal advice. They have also gained access to school and treatment for their children, who had previously been excluded. Although the women were vulnerable to HIV as wives and mothers, motherhood also provided them with social status and an identity they used to help build organisations and develop strategies to access the essential services that they and their families need.

  18. 34 CFR 370.7 - What shall the designated agency do to make its services accessible?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false What shall the designated agency do to make its services accessible? 370.7 Section 370.7 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION...

  19. 76 FR 75542 - Rail Splitter Wind Farm, LLC v. Ameren Services Company Midwest Independent Transmission, System...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-02

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL12-11-000] Rail Splitter Wind Farm, LLC v. Ameren Services Company Midwest Independent Transmission, System Operator, Inc...) Rules of Practice and Procedures, 18 CFR 385.206, Rail Splitter Wind Farm, LLC (Rail Splitter or...

  20. Social Capital, Acculturation, Mental Health, and Perceived Access to Services among Mexican American Women

    PubMed Central

    Valencia-Garcia, Dellanira; Simoni, Jane M.; Alegría, Margarita; Takeuchi, David T.

    2012-01-01

    Objective We examined whether individual-level social capital--the intangible resources in a community available through membership in social networks or other social structures and perceived trust in the community—was associated with acculturation; depression and anxiety symptoms; and perceived access to services among women of Mexican ancestry. Method Recruited through venue-based targeted sampling in King County, WA, 205 women of Mexican descent age 18 to 64 years who differed in socioeconomic status and nativity completed a cross-sectional survey. Half completed the survey in Spanish and half in English. Structural equation modeling was used for model testing. Results Social capital increased with level of acculturation and was negatively related to depression and anxiety; it had no direct association with perceived access to services. Social capital mediated the relation between acculturation and both depression and anxiety symptoms. Acculturation had no direct association with psychological distress but was directly associated with perceived access to services. This community sample of women reported high levels of psychological distress, with 20–26% of women meeting diagnostic criteria for depression or anxiety. Conclusions Social capital can be assessed at the individual level, increases with acculturation, and may be a potential target for interventions to improve mental health among Mexican American women residing in the U.S. PMID:22329824

  1. A five-year review of vertical HIV transmission in a specialized service: cross-sectional study.

    PubMed

    Hoffmann, Izabel Cristina; Santos, Wendel Mombaque Dos; Padoin, Stela Maris de Mello; Barros, Sonia Maria Oliveira de

    2016-01-01

    Healthcare professionals need to instill the process of prevention, control and treatment of people infected with HIV into care practice. Through maintaining preventive treatment among HIV-infected pregnant women, it has been demonstrated that prophylactic antiretroviral therapy, scheduled cesarean section and the prohibition of breastfeeding significantly reduce vertical HIV transmission. This study aimed to assess the rates of vertical HIV transmission in a specialized service and identify the factors associated with it. Cross-sectional study developed at the University Hospital of Santa Maria (RS), Brazil. A cross-sectional study was conducted on a sample of 198 notification forms and medical records of HIV-positive pregnant women and exposed children. The vertical transmission rate was 2.4%, and three children had been infected by vertical HIV transmission. The statistically significant risk factor was the use of injectable drugs. Delayed reporting of pregnancy, absence of antiretroviral therapy during pregnancy, lack of proper prenatal care, incapacity to perform viral load detection tests and CD4+ T cell counts and obstetric and maternal clinical complications were reported. The vertical transmission rate was high and the recommended intervention measures were not adopted in full. Adequate prophylactic measures need to be implemented in HIV-positive pregnant women prenatally and during the antenatal, delivery and postpartum periods.

  2. 75 FR 37883 - Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-30

    ... Planning and Cost Allocation by Transmission Owning and Operating Public Utilities; Proposed Rule #0;#0...] Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities Issued June 17... Transmission Services by Public Utilities; Recovery of Stranded Costs by Public Utilities and Transmitting...

  3. Inequality in access to cultural ecosystem services from protected areas in the Chilean biodiversity hotspot.

    PubMed

    Martinez-Harms, Maria Jose; Bryan, Brett A; Wood, Spencer A; Fisher, David M; Law, Elizabeth; Rhodes, Jonathan R; Dobbs, Cynnamon; Biggs, Duan; Wilson, Kerrie A

    2018-09-15

    Experiences with nature through visits to protected areas provide important cultural ecosystem services that have the potential to strengthen pro-environmental attitudes and behavior. Understanding accessibility to protected areas and likely preferences for enjoying the benefits of nature visits are key factors in identifying ways to reduce inequality in access and inform the planning and management for future protected areas. We develop, at a regional scale, a novel social media database of visits to public protected areas in part of the Chilean biodiversity hotspot using geotagged photographs and assess the inequality of access using the home locations of the visitors and socio-economic data. We find that 20% of the population of the region make 87% of the visits to protected areas. The larger, more biodiverse protected areas were the most visited and provided most cultural ecosystem services. Wealthier people tend to travel further to visit protected areas while people with lower incomes tend to visit protected areas that are closer to home. By providing information on the current spatial flows of people to protected areas, we demonstrate the need to expand the protected area network, especially in lower income areas, to reduce inequality in access to the benefits from cultural ecosystem services provided by nature to people. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Barriers to the Accessibility and Continuity of Health-Care Services in People with Multiple Sclerosis

    PubMed Central

    Bishop, Malachy; Pionke, J.J.; Strauser, David; Santens, Ryan L.

    2017-01-01

    Background: Individuals with multiple sclerosis (MS) face a range of barriers to accessing and using health-care services. The aim of this review was to identify specific barriers to accessing and using health-care services based on a continuum of the health-care delivery system. Methods: Literature searches were conducted in the PubMed, PsycINFO, CINAHL, and Web of Science databases. The following terms were searched as subject headings, key words, or abstracts: health care, access, barriers, physical disability, and multiple sclerosis. The literature search produced 361 potentially relevant citations. After screening titles, abstracts, and citations, eight citations were selected for full-text review. Results: Health-care barriers were divided into three continuous phases of receiving health care. In the before-visit phase, the most commonly identified barrier was transportation. In the during-visit phase, communication quality was the major concern. In the after-visit phase, discontinued referral was the major barrier encountered. Conclusions: There are multiple interrelated barriers to accessing and using health-care services along the health-care delivery continuum for people with MS and its associated physical disabilities, ranging from complex and long-recognized barriers that will likely require extended advocacy to create policy changes to issues that can and should be addressed through relatively minor changes in health-care delivery practices, improved care coordination, and increased provider awareness, education, and responsiveness to patients' needs. PMID:29270089

  5. Barriers to access and minority ethnic carers' satisfaction with social care services in the community: a systematic review of qualitative and quantitative literature.

    PubMed

    Greenwood, Nan; Habibi, Ruth; Smith, Raymond; Manthorpe, Jill

    2015-01-01

    As populations age, the numbers of carers overall and numbers of carers from minority ethnic groups in particular are rising. Evidence suggests that carers from all sections of the community and particularly carers from minority groups often fail to access care services. This may relate to barriers in accessing services and service dissatisfaction. The aim of this systematic review was to identify and summarise minority ethnic carers' perceptions of barriers to accessing community social care services and their satisfaction with these services if accessed. The following databases were searched from their start until July 2013: Social Care Online, Social Policy and Research, Scopus, PsychINFO, HMIC, ASSIA, MEDLINE, Embase, CINAHL Plus and AMED. Thirteen studies met the inclusion criteria. Most investigated either barriers to access or satisfaction levels, although three explored both. Only 4 studies investigated minority ethnic carers' satisfaction with social care, although 12 studies reported perceived barriers to accessing services. Few studies compared minority ethnic carers' perceptions with majority ethnic groups, making it difficult to identify issues specific to minority groups. Most barriers described were potentially relevant to all carers, irrespective of ethnic group. They included attitudinal barriers such as not wanting to involve outsiders or not seeing the need for services and practical barriers such as low awareness of services and service availability. Issues specific to minority ethnic groups included language barriers and concerns about services' cultural or religious appropriateness. Studies investigating satisfaction with services reported a mixture of satisfaction and dissatisfaction. Barriers common to all groups should not be underestimated and a better understanding of the relationship between perceived barriers to accessing services and dissatisfaction with services is needed before the experiences of all carers can be improved. © 2014

  6. Barriers to access and minority ethnic carers' satisfaction with social care services in the community: a systematic review of qualitative and quantitative literature

    PubMed Central

    Greenwood, Nan; Habibi, Ruth; Smith, Raymond; Manthorpe, Jill

    2015-01-01

    As populations age, the numbers of carers overall and numbers of carers from minority ethnic groups in particular are rising. Evidence suggests that carers from all sections of the community and particularly carers from minority groups often fail to access care services. This may relate to barriers in accessing services and service dissatisfaction. The aim of this systematic review was to identify and summarise minority ethnic carers' perceptions of barriers to accessing community social care services and their satisfaction with these services if accessed. The following databases were searched from their start until July 2013: Social Care Online, Social Policy and Research, Scopus, PsychINFO, HMIC, ASSIA, MEDLINE, Embase, CINAHL Plus and AMED. Thirteen studies met the inclusion criteria. Most investigated either barriers to access or satisfaction levels, although three explored both. Only 4 studies investigated minority ethnic carers' satisfaction with social care, although 12 studies reported perceived barriers to accessing services. Few studies compared minority ethnic carers' perceptions with majority ethnic groups, making it difficult to identify issues specific to minority groups. Most barriers described were potentially relevant to all carers, irrespective of ethnic group. They included attitudinal barriers such as not wanting to involve outsiders or not seeing the need for services and practical barriers such as low awareness of services and service availability. Issues specific to minority ethnic groups included language barriers and concerns about services' cultural or religious appropriateness. Studies investigating satisfaction with services reported a mixture of satisfaction and dissatisfaction. Barriers common to all groups should not be underestimated and a better understanding of the relationship between perceived barriers to accessing services and dissatisfaction with services is needed before the experiences of all carers can be improved. PMID

  7. 28 CFR 115.82 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... § 115.82 Access to emergency medical and mental health services. (a) Inmate victims of sexual abuse..., the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at...

  8. 28 CFR 115.82 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... § 115.82 Access to emergency medical and mental health services. (a) Inmate victims of sexual abuse..., the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at...

  9. 28 CFR 115.82 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... § 115.82 Access to emergency medical and mental health services. (a) Inmate victims of sexual abuse..., the nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at...

  10. The impact of programs for prevention of mother-to-child transmission of HIV on health care services and systems in sub-Saharan Africa - A review.

    PubMed

    Mutabazi, Jean Claude; Zarowsky, Christina; Trottier, Helen

    2017-01-01

    The global scale-up of Prevention of mother-to-child transmission (PMTCT) services is credited for a 52% worldwide decline in new HIV infections among children between 2001 and 2012. However, the epidemic continues to challenge maternal and paediatric HIV control efforts in Sub Saharan Africa (SSA), with repercussions on other health services beyond those directly addressing HIV and AIDS. This systematised narrative review describes the effects of PMTCT programs on other health care services and the implications for improving health systems in SSA as reported in the existing articles and scientific literature. The following objectives framed our review:To describe the effects of PMTCT on health care services and systems in SSA and assess whether the PMTCT has strengthened or weakened health systems in SSATo describe the integration of PMTCT and its extent within broader programs and health systems. Articles published in English and French over the period 1st January 2007 (the year of publication of WHO/UNICEF guidelines on global scale-up of the PMTCT) to 31 November 2016 on PMTCT programs in SSA were sought through searches of electronic databases (Medline and Google Scholar). Articles describing the impact (positive and negative effects) of PMTCT on other health care services and those describing its integration in health systems in SSA were eligible for inclusion. We assessed 6223 potential papers, reviewed 225, and included 57. The majority of selected articles offered arguments for increased health services utilisation, notably of ante-natal care, and some evidence of beneficial synergies between PMTCT programs and other health services especially maternal health care, STI prevention and early childhood immunisation. Positive and negative impact of PMTCT on other health care services and health systems are suggested in thirty-two studies while twenty-five papers recommend more integration and synergies. However, the empirical evidence of impact of PMTCT

  11. Ensuring Rights: Improving Access to Sexual and Reproductive Health Services for Female International Students in Australia

    ERIC Educational Resources Information Center

    Poljski, Carolyn; Quiazon, Regina; Tran, Chau

    2014-01-01

    Drawing on the research and advocacy work being conducted by the Multicultural Centre for Women's Health (MCWH), a national community-based organization in Victoria, Australia, the paper analyzes female international students' experiences with accessing sexual and reproductive health information and services. Accessibility of sexual and…

  12. Adolescent health care: improving access by school-based service.

    PubMed

    Gonzales, C; Mulligan, D; Kaufman, A; Davis, S; Hunt, K; Kalishman, N; Wallerstein, N

    1985-10-01

    Participants in this discussion of the potential of school-based health care services for adolescents included family medicine physicians, school health coordinators, a school nurse, and a community worker. It was noted that health care for adolescents tends to be either inaccessible or underutilized, largely because of a lack of sensitivity to adolescent culture and values. An ideal service for adolescents would offer immediate services for crises, strict confidentiality, ready access to prescribed medications, a sliding-scale scheme, and a staff that is tolerant of divergent values and life-styles. School-based pilot adolescent clinics have been established by the University of New Mexico's Department of Family, Community, and Emergency Medicine to test the community-oriented health care model. On-site clinics provide urgent medical care, family planning, pregnancy testing, psychological counseling, alcohol and drug counseling, and classroom health education. Experience with these programs has demonstrated the necessity for an alliance among the health team and the school administration, parents, and students. Financial, ethical, and political factors can serve as constraints to school-based programs. In some cases, school administrators have been resistant to the provision of contraception to students on school grounds and parents have been unwilling to accept the adolescent's right to confidentiality. These problems in part stem from having 2 separate systems, each with its own values, orientation, and responsibilities, housed in 1 facility. In addition, there have been problems generating awareness of the school-based clinic among students. Health education theater groups, peer counseling, and student-run community services have been effective, however, in increasing student participation. It has been helpful to mold clinic services to meet the needs identified by teenagers themselves. There is an interest not only in curative services, but in services focused

  13. Availability and acceptability of HIV counselling and testing services. A qualitative study comparing clients' experiences of accessing HIV testing at public sector primary health care facilities or non-governmental mobile services in Cape Town, South Africa.

    PubMed

    Meehan, Sue-Ann; Leon, Natalie; Naidoo, Pren; Jennings, Karen; Burger, Ronelle; Beyers, Nulda

    2015-09-02

    The South African government is striving for universal access to HIV counselling and testing (HCT), a fundamental component of HIV care and prevention. In the Cape Town district, Western Cape Province of South Africa, HCT is provided free of charge at publically funded primary health care (PHC) facilities and through non-governmental organizations (NGOs). This study investigated the availability and accessibility of HCT services; comparing health seeking behaviour and client experiences of HCT across public PHC facilities (fixed sites) and NGO mobile services. This qualitative study used semi-structured interviews. Systematic sampling was used to select 16 participants who accessed HCT in either a PHC facility (8) or a NGO mobile service (8). Interviews, conducted between March and June 2011, were digitally recorded, transcribed and where required, translated into English. Constant comparative and thematic analysis was used to identify common and divergent responses and themes in relation to the key questions (reasons for testing, choice of service provider and experience of HCT). The sample consisted of 12 females and 4 males with an age range of 19-60 years (median age 28 years). Motivations for accessing health facilities and NGO services were similar; opportunity to test, being affected by HIV and a perceived personal risk for contracting HIV. Participants chose a particular service provider based on accessibility, familiarity with and acceptability of that service. Experiences of both services were largely positive, though instances of poor staff attitude and long waiting times were reported at PHC facilities. Those attending NGO services reported shorter waiting times and overall positive testing experiences. Concerns about lack of adequate privacy and associated stigma were expressed about both services. Realised access to HCT is dependent on availability and acceptability of HCT services. Those who utilised either a NGO mobile service or a public PHC

  14. Long-Term Impacts of Precolonial Institutions, Geography and Ecological Diversity on Access to Public Infrastructure Services in Nigeria

    NASA Astrophysics Data System (ADS)

    Archibong, B.

    2014-12-01

    Do precolonial institutions, geography and ecological diversity affect population access to public infrastructure services over a century later? Can local leaders from historically centralized or 'conqueror' groups still influence access to public goods today? Do precolonial states located in ecologically diverse environments have better access to water, power and sanitation resources today? A growing body of literature examining the sources of the current state of African economic development has cited the enduring impacts of precolonial institutions and geography on contemporary African economic development using large sample cross-sectional analysis. In this paper, I focus on within country effects of local ethnic and political state institutions on access to public infrastructure services in present day Nigeria. Specifically, I combine information on the spatial distribution of ethnic states and ecological diversity in Nigeria circa mid 19th century and political states in Nigeria circa 1785 and 1850 with information, from a novel geocoded survey dataset, on access to public infrastructure at the local government level in present day Nigeria to examine the impact of precolonial state centralization on the current unequal access to public infrastructure services in Nigeria, accounting for the effects of ecological diversity and other geographic covariates. Some preliminary results show evidence for the long-term impacts of institutions, geography and ecological diversity on access to public infrastructure in Nigeria.

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

    PubMed

    Lyons, Tara; Krüsi, Andrea; Pierre, Leslie; Smith, Adrienne; Small, Will; Shannon, Kate

    2016-10-01

    Little is known about trans womens' experiences accessing gender-segregated health and housing services, particularly services for marginalized individuals living in poverty. As such, we conducted a qualitative investigation into experiences of accessing women-specific health and housing services among trans women and two-spirit persons in a downtown neighborhood of Vancouver, Canada. Between June 2012 and May 2013 interviews were conducted with 32 trans women and two-spirit individuals who had accessed women-specific health and/or housing services. Participants were recruited from four open prospective cohorts of sex workers and individuals who use drugs. Interview data were analyzed using a participatory analysis approach with two participants who were hired as research assistants. Participants were generally able to access women-specific services in the neighborhood. However, there were reports of discrimination related to gender identity, discrimination based on gender expression (e.g., requirement of a feminine gender expression), and lack of staff intervention in harassment from other service users. Trans women and two-spirit persons in our study relied upon services for their health and safety and, therefore, exclusion from women-specific services had potentially severe adverse consequences such as homelessness and sexual violence. Recommendations to improve accessibility, including policy development and procedural recommendations, are put forth.

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

    PubMed Central

    Krüsi, Andrea; Pierre, Leslie; Smith, Adrienne; Small, Will; Shannon, Kate

    2016-01-01

    Abstract Purpose: Little is known about trans womens' experiences accessing gender-segregated health and housing services, particularly services for marginalized individuals living in poverty. As such, we conducted a qualitative investigation into experiences of accessing women-specific health and housing services among trans women and two-spirit persons in a downtown neighborhood of Vancouver, Canada. Methods: Between June 2012 and May 2013 interviews were conducted with 32 trans women and two-spirit individuals who had accessed women-specific health and/or housing services. Participants were recruited from four open prospective cohorts of sex workers and individuals who use drugs. Interview data were analyzed using a participatory analysis approach with two participants who were hired as research assistants. Results: Participants were generally able to access women-specific services in the neighborhood. However, there were reports of discrimination related to gender identity, discrimination based on gender expression (e.g., requirement of a feminine gender expression), and lack of staff intervention in harassment from other service users. Conclusion: Trans women and two-spirit persons in our study relied upon services for their health and safety and, therefore, exclusion from women-specific services had potentially severe adverse consequences such as homelessness and sexual violence. Recommendations to improve accessibility, including policy development and procedural recommendations, are put forth. PMID:27575593

  17. 75 FR 57805 - Part D Grant for Coordinated HIV Services and Access to Research for Women, Infants, Children...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-22

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Part D Grant for Coordinated HIV Services and Access to Research for Women, Infants, Children, and Youth Part D Funds Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services Administration (HRSA...

  18. AccessMod 3.0: computing geographic coverage and accessibility to health care services using anisotropic movement of patients

    PubMed Central

    Ray, Nicolas; Ebener, Steeve

    2008-01-01

    Background Access to health care can be described along four dimensions: geographic accessibility, availability, financial accessibility and acceptability. Geographic accessibility measures how physically accessible resources are for the population, while availability reflects what resources are available and in what amount. Combining these two types of measure into a single index provides a measure of geographic (or spatial) coverage, which is an important measure for assessing the degree of accessibility of a health care network. Results This paper describes the latest version of AccessMod, an extension to the Geographical Information System ArcView 3.×, and provides an example of application of this tool. AccessMod 3 allows one to compute geographic coverage to health care using terrain information and population distribution. Four major types of analysis are available in AccessMod: (1) modeling the coverage of catchment areas linked to an existing health facility network based on travel time, to provide a measure of physical accessibility to health care; (2) modeling geographic coverage according to the availability of services; (3) projecting the coverage of a scaling-up of an existing network; (4) providing information for cost effectiveness analysis when little information about the existing network is available. In addition to integrating travelling time, population distribution and the population coverage capacity specific to each health facility in the network, AccessMod can incorporate the influence of landscape components (e.g. topography, river and road networks, vegetation) that impact travelling time to and from facilities. Topographical constraints can be taken into account through an anisotropic analysis that considers the direction of movement. We provide an example of the application of AccessMod in the southern part of Malawi that shows the influences of the landscape constraints and of the modes of transportation on geographic coverage

  19. 28 CFR 115.382 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ....382 Access to emergency medical and mental health services. (a) Resident victims of sexual abuse shall... nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at the time a...

  20. 28 CFR 115.382 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ....382 Access to emergency medical and mental health services. (a) Resident victims of sexual abuse shall... nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at the time a...

  1. 28 CFR 115.382 - Access to emergency medical and mental health services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ....382 Access to emergency medical and mental health services. (a) Resident victims of sexual abuse shall... nature and scope of which are determined by medical and mental health practitioners according to their professional judgment. (b) If no qualified medical or mental health practitioners are on duty at the time a...

  2. Ethical conflicts over access to services: patient effects and worker influence in home health.

    PubMed

    Egan, Marcia; Kadushin, Goldie

    2002-01-01

    A survey of home health social workers (N = 51) explored the effects on patients of ethical conflicts over access to services. The findings suggest that patients were as likely to be discharged or not receive services as they were to receive the services without paying a fee. Social workers rated themselves as moderately influential in the resolution of the conflict. Their influence was significantly correlated with patients more often receiving services and less often being discharged. Social work influence was enhanced by recognition of professional expertise and/or through informal networking within the agency. Implications for practice and education are discussed.

  3. Investing in HIV services while building Kenya's health system: PEPFAR's support to prevent mother-to-child HIV transmission.

    PubMed

    Dutta, Arin; Wallace, Nathan; Savosnick, Peter; Adungosi, John; Kioko, Urbanus Mutuku; Stewart, Scott; Hijazi, Mai; Gichanga, Bedan

    2012-07-01

    Trade-offs may exist between investments to promote health system strengthening, such as investments in facilities and training, and the rapid scale-up of HIV/AIDS services. We analyzed trends in expenditures to support the prevention of mother-to-child transmission of HIV in Kenya under the President's Emergency Plan for AIDS Relief (PEPFAR) from 2005 to 2010. We examined how expenditures changed over time, considering health system strengthening alongside direct treatment of patients. We focused on two organizations carrying out contracts under PEPFAR: the Elizabeth Glaser Pediatric AIDS Foundation and FHI360 (formerly Family Health International), a nonprofit health and development organization. We found that the average unit expenditure, or the spending on goods and services per mother living with HIV who was provided with antiretroviral drugs, declined by 52 percent, from $567 to $271, during this time period. The unit expenditure per mother-to-infant transmission averted declined by 66 percent, from $7,117 to $2,440. Meanwhile, the health system strengthening proportion of unit expenditure increased from 12 percent to 33 percent during the same time period. The analysis suggests that PEPFAR investments in prevention of mother-to-child transmission of HIV in Kenya became more efficient over time, and that there was no strong evidence of a trade-off between scaling up services and investing in health systems.

  4. Community Impact of Pharmacy-Randomized Intervention to Improve Access to Syringes and Services for Injection Drug Users

    ERIC Educational Resources Information Center

    Crawford, Natalie D.; Amesty, Silvia; Rivera, Alexis V.; Harripersaud, Katherine; Turner, Alezandria; Fuller, Crystal M.

    2014-01-01

    Objectives: In an effort to reduce HIV transmission among injection drug users (IDUs), New York State deregulated pharmacy syringe sales in 2001 through the Expanded Syringe Access Program by removing the requirement of a prescription. With evidence suggesting pharmacists' ability to expand their public health role, a structural, pharmacy-based…

  5. A mobile school-based HCT service - is it youth friendly?

    PubMed

    Lawrence, Estelle; Struthers, Patricia; Van Hove, Geert

    2016-12-01

    Despite an increase in HIV Counselling and Testing (HCT), few young people have been tested. It has been suggested that they do not test because formal health services (where HCT is provided) are often not youth friendly. The World Health Organisation describes a youth-friendly health service (YFHS) as one which is accessible, equitable, acceptable, appropriate, and effective. A mobile school-based model has been implemented by a non-governmental organisation in Cape Town in an attempt to make HCT more youth friendly and accessible to young people. The objective of this study was to explore whether this mobile school-based HCT service is youth friendly. The study was descriptive, using three qualitative data collection methods: observation of the HCT site at two secondary schools; interviews with six service providers; and direct observation of 21 HCT counselling sessions. The mobile school-based HCT service fulfilled some of the criteria for being a YFHS. The service was equitable in that all students, irrespective of race, gender, age, or socio-economic status, were free to use the service. It was accessible in terms of location and cost, but students were not well informed to make decisions about using the service. The service was acceptable in that confidentiality was guaranteed and the service providers were friendly and non-judgemental, but it was not considered acceptable in that there was limited privacy. The service was appropriate in that HCT is recommended as an intervention for decreasing the transmission of HIV, based on evidence and expert opinion; however, in this case, HCT was provided as a stand-alone service rather than part of a full package of services. Moreover, studies have suggested that young people want to know their HIV status. The service was ineffective in that it identified students who are HIV positive; however, these students were not assisted to access care. Providing HCT in the school setting may make HCT more accessible for

  6. Characteristics of clients who access mobile compared to clinic HIV counselling and testing services: a matched study from Cape Town, South Africa.

    PubMed

    Meehan, Sue-Ann; Naidoo, Pren; Claassens, Mareli M; Lombard, Carl; Beyers, Nulda

    2014-12-20

    Studies within sub-Saharan African countries have shown that mobile services increase uptake of HIV counselling and testing (HCT) services when compared to clinics and are able to access different populations, but these have included provider-initiated HCT in clinics. This study aimed to compare the characteristics of clients who self-initiated HCT at either a mobile or a clinic service in terms of demographic and socio-economic variables, also comparing reasons for accessing a particular health service provider. This study took place in eight areas around Cape Town. A matched design was used with one mobile HCT service matched with one or more clinics (offering routine HCT services) within each of the eight areas. Adult clients who self-referred for an HIV test within a specified time period at either a mobile or clinic service were invited to participate in the study. Data were collected between February and April 2011 using a questionnaire. Summary statistics were calculated for each service type within a matched pair and differences of outcomes from pairs were used to calculate effect sizes and 95% confidence intervals. 1063 participants enrolled in the study with 511 from mobile and 552 from clinic HCT services. The proportion of males accessing mobile HCT significantly exceeded that of clinic HCT (p < 0.001). The mean age of participants attending mobile HCT was higher than clinic participants (p = 0.023). No significant difference was found for socio-economic variables between participants, with the exception of access to own piped water (p = 0.029). Participants who accessed mobile HCT were significantly more likely to report that they were just passing, deemed an "opportunistic" visit (p = 0.014). Participants who accessed clinics were significantly more likely to report the service being close to home or work (p = 0.035). An HCT strategy incorporating a mobile HCT service, has a definite role to play in reaching those population groups who do

  7. Patients' online access to their electronic health records and linked online services: a systematic interpretative review.

    PubMed

    de Lusignan, Simon; Mold, Freda; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Gronlund, Toto Anne; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Barker, Fiona; Ellis, Beverley; Koczan, Phil; Arvanitis, Theodoros N; McCarthy, Mary; Jones, Simon; Rafi, Imran

    2014-09-08

    To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. Primary care. A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of access to a wider group of patients. A1 SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO

  8. The Role of Maternal Depression in Accessing Early Intervention Services for Children with Developmental Delay

    ERIC Educational Resources Information Center

    Colgan, Siobhan Eileen

    2012-01-01

    This study investigated the relationship between maternal depression and children's access to early intervention services among a sample of children with developmental delay at age two who were determined to be eligible for early intervention services, were full term and of normal birth weight, and were not previously identified with any special…

  9. Timeliness and access to healthcare services via telemedicine for adolescents in state correctional facilities.

    PubMed

    Fox, Karen C; Somes, Grant W; Waters, Teresa M

    2007-08-01

    The aim of this study was to examine the effectiveness of a telemedicine program in improving timeliness of and access to healthcare services in adolescent correctional facilities. This study is a pre/post quasi-experimental design comparing time to treatment and healthcare use in the year preceding and the 2 years after the implementation of a telemedicine program in four facilities housing adolescents from 12 to 19. Timeliness of care is measured by time from referral to date of service (for behavioral healthcare only). Access to care is measured by use of outpatient care, emergency department (ED) visits, and inpatient visits. Two of the four state correctional facilities had a significant decrease (24%) in time from referral to treatment after the implementation of the telemedicine intervention. The facilities not showing significant improvements in timeliness experienced difficulty implementing the telemedicine program. The telemedicine program was also associated with significant improvements in access to care. Outpatient visits increased by 40% in the 2 years after implementation of telemedicine. For each 1% increase in telemedicine usage, outpatient visits increased by 1%, whereas emergency room visits decreased by 7%. Telemedicine can have a positive impact on timeliness of and access to care for youth in correctional facilities.

  10. Adult College Career Employment Support Services: ACCESS. Emeritus Career and Vocational Exploration.

    ERIC Educational Resources Information Center

    McGrew, Lee

    A part of the Adult College Career Employment Support Services (ACCESS), the minicourse entitled Emeritus Career and Vocational Exploration has been designed to facilitate the entry or reentry of older persons into the work force as paid or volunteer workers. Organized into two four-week modules, the course offers participants assistance in…

  11. Towards equity and sustainability of rural and remote health services access: supporting social capital and integrated organisational and professional development.

    PubMed

    Schoo, Adrian; Lawn, Sharon; Carson, Dean

    2016-04-02

    Access to rural health services is compromised in many countries including Australia due to workforce shortages. The issues that consequently impact on equity of access and sustainability of rural and remote health services are complex. The purpose of this paper is to describe a number of approaches from the literature that could form the basis of a more integrated approach to health workforce and rural health service enhancement that can be supported by policy. A case study is used to demonstrate how such an approach could work. Disjointed health services are common in rural areas due to the 'tyranny of distance.' Recruitment and retention of health professionals in rural areas and access to and sustainability of rural health services is therefore compromised. Strategies to address these issues tend to have a narrow focus. An integrated approach is needed to enhance rural workforce and health services; one that develops, acknowledges and accounts for social capital and social relations within the rural community.

  12. 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…

  13. Social capital, acculturation, mental health, and perceived access to services among Mexican American women.

    PubMed

    Valencia-Garcia, Dellanira; Simoni, Jane M; Alegría, Margarita; Takeuchi, David T

    2012-04-01

    We examined whether individual-level social capital-the intangible resources in a community available through membership in social networks or other social structures and perceived trust in the community-was associated with acculturation, depression and anxiety symptoms, and perceived access to services among women of Mexican ancestry. Recruited through venue-based targeted sampling in King County, Washington, 205 women of Mexican descent ages 18 to 64 years who differed in socioeconomic status and nativity completed a cross-sectional survey. Half completed the survey in Spanish and half in English. Structural equation modeling was used for model testing. Social capital increased with level of acculturation and was negatively related to depression and anxiety; it had no direct association with perceived access to services. Social capital mediated the relation between acculturation and both depression and anxiety symptoms. Acculturation had no direct association with psychological distress but was directly associated with perceived access to services. This community sample of women reported high levels of psychological distress, with 20% to 26% of women meeting diagnostic criteria for depression or anxiety. Social capital can be assessed at the individual level, increases with acculturation, and may be a potential target for interventions to improve mental health among Mexican American women residing in the United States. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  14. Policies of access to healthcare services for accompanied asylum-seeking children in the Nordic countries.

    PubMed

    Sandahl, Hinuga; Norredam, Marie; Hjern, Anders; Asher, Henry; Nielsen, Signe Smith

    2013-08-01

    Asylum-seeking children constitute a vulnerable group with high prevalence and risk for mental health problems. The aim of this study was to compare policies of access to healthcare services, including physical examination and screening for mental health problems on arrival, for accompanied asylum-seeking children in the Nordic countries. This study was based on the national reports "Reception of refugee children in the Nordic countries" written by independent national experts for the Nordic Network for Research on Refugee Children, supplemented by information from relevant authorities. In Sweden, Norway and Iceland, asylum-seeking children had access to healthcare services equal to children in the general population. On a policy level, Denmark imposed restrictions on non-acute hospitalisations and prolonged specialist treatments. Regarding health examinations, Sweden deviated from the Nordic pattern by not performing these systematically. In Denmark, Iceland, and some counties in Sweden, but not in Norway, screening for mental health problems was offered to asylum-seeking children. Access to healthcare services for asylum-seeking children differs in the Nordic countries; the consequences of these systematic differences for the individual asylum-seeking child are unknown. For asylum-seeking children, access to healthcare has to be considered in a wider context that includes the core conditions of being an asylum-seeker. A comparative study at policy level needs to be supplemented with empirical follow-up studies of the well-being of the study population to document potential consequences of policies in practice.

  15. Frequency and Correlates of Service Access among Youth with Autism Transitioning to Adulthood

    PubMed Central

    Taylor, Julie Lounds; Henninger, Natalie A.

    2014-01-01

    This study examined service receipt and unmet service needs among youth with autism spectrum disorders (ASD) in their last year of high school, as well as the youth (intellectual disability, race/ethnicity, autism severity, comorbid psychiatric diagnoses, behavior problems, adaptive behavior) and family (income, parental health, parental depressive symptoms, parental anxiety) correlates of service access. Thirty-nine families of youth with ASD participated. Data were collected via parental interview/questionnaire and youth psychological evaluation. Results suggested that this sample was underserved relative to a nationally-representative cohort. Those with a comorbid psychiatric diagnosis and lower levels of adaptive behavior received more services. Greater unmet needs were reported for youth who were racial/ethnic minorities, who had more behavior problems, and whose parents had greater anxiety. PMID:25081594

  16. Barriers and facilitators of access to maternal services for women with disabilities: scoping review protocol.

    PubMed

    Mheta, Doreen; Mashamba-Thompson, Tivani P

    2017-05-16

    The Sustainable Development Goals (SDGs) emphasises the increasing equitable coverage of quality health care and provision of integrated services as means of reducing maternal mortality. Despite so much effort being placed on improved access to maternity health care, studies show that women with disabilities are being systemically excluded from the mainstream maternal health services. The proposed scoping review aims to map literature on the barriers and facilitators of access to maternal services for women with disabilities. The search strategy for this scoping review study will involve electronic databases including Pubmed, MEDLINE via EBSCOhost, CINAHL Plus with full text via EBSCOhost, Africa-Wide Info via EBSCOhost, JSTOR and Proquest Health and Medical Complete. Articles will also be searched through the "Cited by" search as well as citations included in the reference lists of included articles. A two-stage mapping strategy would be conducted. Stage 1 would be to screen studies through examining their titles. Furthermore, we will screen abstracts of the identified studies descriptively and by focus and method as stipulated by the inclusion and exclusion criteria. In stage 2, we will extract data from the included studies. A parallel screening and data extraction will be undertaken by two reviewers. We will access the quality of the included studies using the mixed methods appraisal tool (MMAT). We will use NVIVO version 10 to extract the relevant outcomes and thematic analysis of the studies. We anticipate to find relevant studies reporting evidence on the barriers and facilitators of access to maternal health services in Sub-Saharan Africa. The evidence obtained from the included studies when summarised will help guide future research. The study findings will be disseminated electronically and in print. In addition, it will be presented at conferences related to sexual reproductive health, maternal health care and reproductive health.

  17. Multi-Instrument Tools and Services to Access NASA Earth Science Data from the GSFC Earth Sciences Data and Information Services Center

    NASA Technical Reports Server (NTRS)

    Kempler, Steve; Leptoukh, Greg; Lynnes, Chris

    2010-01-01

    The presentation purpose is to describe multi-instrument tools and services that facilitate access and usability of NASA Earth science data at Goddard Space Flight Center (GSFC). NASA's Earth observing system includes 14 satellites. Topics include EOSDIS facilities and system architecture, and overview of GSFC Earth Science Data and Information Services Center (GES DISC) mission, Mirador data search, Giovanni, multi-instrument data exploration, Google Earth[TM], data merging, and applications.

  18. Accessing Electronic Journals.

    ERIC Educational Resources Information Center

    McKay, Sharon Cline

    1999-01-01

    Discusses issues librarians need to consider when providing access to electronic journals. Topics include gateways; index and abstract services; validation and pay-per-view; title selection; integration with OPACs (online public access catalogs)or Web sites; paper availability; ownership versus access; usage restrictions; and services offered…

  19. Association of Access to Publicly Funded Family Planning Services With Adolescent Birthrates in California Counties

    PubMed Central

    Chabot, Marina J.; Navarro, Sandy; Swann, Diane; Darney, Philip; Thiel de Bocanegra, Heike

    2014-01-01

    Objectives. We examined the association of adolescent birthrates (ABRs) with access to and receipt of publicly funded family planning services in California counties provided through 2 state programs: Medi-Cal, California’s Medicaid program, and the Family Planning, Access, Care, and Treatment (Family PACT) program. Methods. Our key data sources included the California Health Interview Survey and California Women’s Health Survey, Medi-Cal and Family PACT claims data, and the Birth Statistical Master File. We constructed a linear regression analysis measuring the relationship of access to and receipt of family planning services with ABRs when controlling for counties’ select covariates. Results. The regression analysis indicated that a higher access rate to Family PACT in a county was associated with a lower ABR (B = −0.19; P < .01) when controlling for unemployment rate, percentage of foreign-born adolescents, and percentage of adult low-income births. Conclusions. Efforts to reduce ABRs, specifically in counties that had persistently high rates are critical to achieving a healthy future for the state and the nation. Family PACT played a crucial role in helping adolescents avoid unintended and early childbearing. PMID:24354841

  20. An energy-efficient transmission scheme for real-time data in wireless sensor networks.

    PubMed

    Kim, Jin-Woo; Barrado, José Ramón Ramos; Jeon, Dong-Keun

    2015-05-20

    The Internet of things (IoT) is a novel paradigm where all things or objects in daily life can communicate with other devices and provide services over the Internet. Things or objects need identifying, sensing, networking and processing capabilities to make the IoT paradigm a reality. The IEEE 802.15.4 standard is one of the main communication protocols proposed for the IoT. The IEEE 802.15.4 standard provides the guaranteed time slot (GTS) mechanism that supports the quality of service (QoS) for the real-time data transmission. In spite of some QoS features in IEEE 802.15.4 standard, the problem of end-to-end delay still remains. In order to solve this problem, we propose a cooperative medium access scheme (MAC) protocol for real-time data transmission. We also evaluate the performance of the proposed scheme through simulation. The simulation results demonstrate that the proposed scheme can improve the network performance.

  1. An Energy-Efficient Transmission Scheme for Real-Time Data in Wireless Sensor Networks

    PubMed Central

    Kim, Jin-Woo; Barrado, José Ramón Ramos; Jeon, Dong-Keun

    2015-01-01

    The Internet of things (IoT) is a novel paradigm where all things or objects in daily life can communicate with other devices and provide services over the Internet. Things or objects need identifying, sensing, networking and processing capabilities to make the IoT paradigm a reality. The IEEE 802.15.4 standard is one of the main communication protocols proposed for the IoT. The IEEE 802.15.4 standard provides the guaranteed time slot (GTS) mechanism that supports the quality of service (QoS) for the real-time data transmission. In spite of some QoS features in IEEE 802.15.4 standard, the problem of end-to-end delay still remains. In order to solve this problem, we propose a cooperative medium access scheme (MAC) protocol for real-time data transmission. We also evaluate the performance of the proposed scheme through simulation. The simulation results demonstrate that the proposed scheme can improve the network performance. PMID:26007722

  2. Access to and utilisation of GP services among Burmese migrants in London: a cross-sectional descriptive study.

    PubMed

    Aung, Nyein Chan; Rechel, Bernd; Odermatt, Peter

    2010-10-12

    An estimated 10,000 Burmese migrants are currently living in London. No studies have been conducted on their access to health services. Furthermore, most studies on migrants in the United Kingdom (UK) have been conducted at the point of service provision, carrying the risk of selection bias. Our cross-sectional study explored access to and utilisation of General Practice (GP) services by Burmese migrants residing in London. We used a mixed-method approach: a quantitative survey using self-administered questionnaires was complemented by qualitative in-depth interviews for developing the questionnaire and triangulating the findings of the survey. Overall, 137 questionnaires were received (a response rate of 57%) and 11 in-depth interviews conducted. The main outcome variables of the study included GP registration, barriers towards registration, GP consultations, barriers towards consultations, and knowledge on entitlements to health care. Quantitative data were analysed using descriptive statistics, association tests, and a multivariate analysis using logistic regression. The qualitative information was analysed using content analysis. The respondents were young, of roughly equal gender (51.5% female), well educated, and had a fair level of knowledge on health services in the UK. Although the GP registration rate was relatively high (80%, 109 out of 136), GP service utilisation during the last episode of illness, at 56.8% (54 out of 95), was low. The statistical analysis showed that age being younger than 35 years, lacking prior overseas experience, having an unstable immigration status, having a shorter duration of stay, and resorting to self-medication were the main barriers hindering Burmese migrants from accessing primary health care services. These findings were corroborated by the in-depth interviews. Our study found that having formal access to primary health care was not sufficient to ensure GP registration and health care utilisation. Some respondents faced

  3. WDM-PON access network with lightwave source centralized full-duplex link based on SSB-OOFDM for wired and 60 GHz band wireless alternative accesses

    NASA Astrophysics Data System (ADS)

    Ma, Jianxin; Wang, Zhao; Zheng, Guoli

    2014-04-01

    A novel lightwave centralized full-duplex WDM-PON access network based on single sideband optical orthogonal frequency-division multiplexing (SSB-OOFDM) is proposed for providing wired and 60-GHz band wireless accesses alternately. At the OLT, the multi-channels with 10-Gb/s 4-QAM-RF-OFDM signals are SSB modulated on the optical local oscillators (OLOs). At the RN, one OOFDM signal along with two OLOs is abstracted and switched to the corresponding HONU, where the signal can be downconverted to the 10-GHz or 60-GHz band RF-OFDM signal by one OLO for wired or wireless access, while the other one is used to bear the uplink signal. Since the HONU is free from the light sources, the system complexity and cost are reduced. Full duplex transmission over 25 km fiber have been demonstrated that the error vector magnitude (EVM) of the down- and up-link signals are much below the FEC limit for both the wired and 60-GHz band wireless access services.

  4. Equitable access to elective hospital services: the introduction of patient choice in a decentralised healthcare system.

    PubMed

    Ringard, Ånen

    2012-02-01

    During the 1980s and 1990s, increased waiting times for elective surgery was perceived to be a major accessibility problem in many countries. In an attempt to improve access, hospital choice reforms were introduced in a number of countries. In Norway, a nationwide reform to improve access came into effect in 2001. At the same time, renewed support was expressed for the long-standing political aim of ensuring equal access to healthcare services for all citizens regardless of their social position. The current aim is to analyse the relationship of the hospital choice reform and the goal of equitable access to hospital services. A survey conducted among Norwegian patients in 2004 provided information about whether a choice of hospital had been made. Information from the survey was merged with administrative data from the hospital that performed the treatment. The survey provided data on patients' socioeconomic position. Demographics, medical need, and prior use of healthcare services were controlled for to determine the effect of socioeconomic position on hospital choice. The patient's socioeconomic position, measured by education, was found to be significantly associated with hospital choice. The relationship resembled that of a social gradient. Patients with a primary education were less likely to have made a choice, followed by those with secondary education or a lower university degree. Patients with higher university education were most likely to have chosen. Hospital selection is a demanding task for many patients. Policymakers should therefore focus on crafting and implementing tools necessary for supporting uptake of choice in disadvantaged groups.

  5. IEEE 802.15.4 MAC with GTS transmission for heterogeneous devices with application to wheelchair body-area sensor networks.

    PubMed

    Shrestha, Bharat; Hossain, Ekram; Camorlinga, Sergio

    2011-09-01

    In wireless personal area networks, such as wireless body-area sensor networks, stations or devices have different bandwidth requirements and, thus, create heterogeneous traffics. For such networks, the IEEE 802.15.4 medium access control (MAC) can be used in the beacon-enabled mode, which supports guaranteed time slot (GTS) allocation for time-critical data transmissions. This paper presents a general discrete-time Markov chain model for the IEEE 802.15.4-based networks taking into account the slotted carrier sense multiple access with collision avoidance and GTS transmission phenomena together in the heterogeneous traffic scenario and under nonsaturated condition. For this purpose, the standard GTS allocation scheme is modified. For each non-identical device, the Markov model is solved and the average service time and the service utilization factor are analyzed in the non-saturated mode. The analysis is validated by simulations using network simulator version 2.33. Also, the model is enhanced with a wireless propagation model and the performance of the MAC is evaluated in a wheelchair body-area sensor network scenario.

  6. A mobile school-based HCT service – is it youth friendly?

    PubMed Central

    Lawrence, Estelle; Struthers, Patricia; Van Hove, Geert

    2016-01-01

    Abstract Background: Despite an increase in HIV Counselling and Testing (HCT), few young people have been tested. It has been suggested that they do not test because formal health services (where HCT is provided) are often not youth friendly. The World Health Organisation describes a youth-friendly health service (YFHS) as one which is accessible, equitable, acceptable, appropriate, and effective. A mobile school-based model has been implemented by a non-governmental organisation in Cape Town in an attempt to make HCT more youth friendly and accessible to young people. The objective of this study was to explore whether this mobile school-based HCT service is youth friendly. Methods: The study was descriptive, using three qualitative data collection methods: observation of the HCT site at two secondary schools; interviews with six service providers; and direct observation of 21 HCT counselling sessions. Key Results: The mobile school-based HCT service fulfilled some of the criteria for being a YFHS. The service was equitable in that all students, irrespective of race, gender, age, or socio-economic status, were free to use the service. It was accessible in terms of location and cost, but students were not well informed to make decisions about using the service. The service was acceptable in that confidentiality was guaranteed and the service providers were friendly and non-judgemental, but it was not considered acceptable in that there was limited privacy. The service was appropriate in that HCT is recommended as an intervention for decreasing the transmission of HIV, based on evidence and expert opinion; however, in this case, HCT was provided as a stand-alone service rather than part of a full package of services. Moreover, studies have suggested that young people want to know their HIV status. The service was ineffective in that it identified students who are HIV positive; however, these students were not assisted to access care. Conclusion: Providing HCT in the

  7. Apollo: Giving application developers a single point of access to public health models using structured vocabularies and Web services

    PubMed Central

    Wagner, Michael M.; Levander, John D.; Brown, Shawn; Hogan, William R.; Millett, Nicholas; Hanna, Josh

    2013-01-01

    This paper describes the Apollo Web Services and Apollo-SV, its related ontology. The Apollo Web Services give an end-user application a single point of access to multiple epidemic simulators. An end user can specify an analytic problem—which we define as a configuration and a query of results—exactly once and submit it to multiple epidemic simulators. The end user represents the analytic problem using a standard syntax and vocabulary, not the native languages of the simulators. We have demonstrated the feasibility of this design by implementing a set of Apollo services that provide access to two epidemic simulators and two visualizer services. PMID:24551417

  8. Apollo: giving application developers a single point of access to public health models using structured vocabularies and Web services.

    PubMed

    Wagner, Michael M; Levander, John D; Brown, Shawn; Hogan, William R; Millett, Nicholas; Hanna, Josh

    2013-01-01

    This paper describes the Apollo Web Services and Apollo-SV, its related ontology. The Apollo Web Services give an end-user application a single point of access to multiple epidemic simulators. An end user can specify an analytic problem-which we define as a configuration and a query of results-exactly once and submit it to multiple epidemic simulators. The end user represents the analytic problem using a standard syntax and vocabulary, not the native languages of the simulators. We have demonstrated the feasibility of this design by implementing a set of Apollo services that provide access to two epidemic simulators and two visualizer services.

  9. Understanding the Voice of the Customer: Practical, Data-Driven Planning and Decision Making for Access Services

    ERIC Educational Resources Information Center

    Huff-Eibl, Robyn; Miller-Wells, John; Begay, Wendy

    2014-01-01

    This article describes the process and role frontline access and public service staff play in needs assessment and evaluation of user services, specifically in understanding the voice of the customer. Information includes how the University of Arizona Libraries have incorporated daily data collection into the strategic planning process, resources…

  10. Disparities in mobile phone access and maternal health service utilization in Nigeria: a population-based survey.

    PubMed

    Jennings, Larissa; Omoni, Adetayo; Akerele, Akunle; Ibrahim, Yisa; Ekanem, Ekpenyong

    2015-05-01

    Mobile communication technologies may reduce maternal health disparities related to cost, distance, and infrastructure. However, the ability of mHealth initiatives to accelerate maternal health goals requires in part that women with the greatest health needs have access to mobile phones. This study examined if women with limited mobile phone access have differential odds of maternal knowledge and health service utilization as compared to female mobile phone users who are currently eligible to participate in maternal mHealth programs. Using household survey data from Nigeria, multivariable logistic regressions were used to examine the odds of maternal knowledge and service utilization by mobile phone strata. Findings showed that in settings with unequal access to mobile phones, mHealth interventions may not reach women who have the poorest maternal knowledge and care-seeking as these women often lacked mobile connectivity. As compared to mobile users, women without mobile phone access had significantly lower odds of antenatal care utilization (OR=0.48, 95%CI: 0.36-0.64), skilled delivery (OR=0.56, 95%CI: 0.45-0.70), and modern contraceptive use (OR=0.50, 95%CI: 0.33-0.76) after adjusting for demographic characteristics. They also had significantly lower knowledge of maternal danger signs (OR=0.69, 95%CI: 0.53-0.90) and knowledge of antenatal (OR=0.46, 95%CI: 0.36-0.59) and skilled delivery care benefits (OR=0.62, 95%CI: 0.47-0.82). No differences were observed by mobile phone strata in uptake of emergency obstetric care, postnatal services, or breastfeeding. As maternal mHealth strategies are increasingly utilized, more efforts are needed to improve women's access to mobile phones and minimize potential health inequities brought on by health systems and technological barriers in access to care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Can innovative health financing policies increase access to MDG-related services? Evidence from Rwanda.

    PubMed

    Sekabaraga, Claude; Diop, Francois; Soucat, Agnes

    2011-11-01

    Ensuring financial access to health services is a critical challenge for poor countries if they are to reach the health Millennium Development Goals (MDGs). This article examines the case of Rwanda, a country which has championed innovative health care financing policies. Between 2000 and 2007, Rwanda has improved financial access for the poor, increased utilization of health services and reduced out-of-pocket payments for health care. Poor groups' utilization has increased for all health services, sometimes dramatically. Use of assisted deliveries, for example, increased from 12.1% to 42.7% among the poorest quintile; payments at the point of delivery have also been reduced; and catastrophic expenditures have declined. Part of these achievements is likely linked to innovative health financing policies, particularly the expansion of micro-insurance ('mutuelles') and performance-based financing. The paper concludes that the Rwanda experience provides a useful example of effective implementation of policies that reduce the financial barrier to health services, hereby contributing to the health MDGs. Today's main challenge is to build the sustainability of this system. Finally, the paper proposes a simple set of rigorous metrics to assess the impact of health financing policies and calls for implementing rigorous impact evaluation of health care financing policies in low-income countries.

  12. Accessing near real-time Antarctic meteorological data through an OGC Sensor Observation Service (SOS)

    NASA Astrophysics Data System (ADS)

    Kirsch, Peter; Breen, Paul

    2013-04-01

    We wish to highlight outputs of a project conceived from a science requirement to improve discovery and access to Antarctic meteorological data in near real-time. Given that the data was distributed in both spatial and temporal domains and is to be accessed across several science disciplines, the creation of an interoperable, OGC compliant web service was deemed the most appropriate approach. We will demonstrate an implementation of the OGC SOS Interface Standard to discover, browse, and access Antarctic meteorological data-sets. A selection of programmatic (R, Perl) and web client interfaces utilizing open technologies ( e.g. jQuery, Flot, openLayers ) will be demonstrated. In addition we will show how high level abstractions can be constructed to allow the users flexible and straightforward access to SOS retrieved data.

  13. A SOA broker solution for standard discovery and access services: the GI-cat framework

    NASA Astrophysics Data System (ADS)

    Boldrini, Enrico

    2010-05-01

    GI-cat ideal users are data providers or service providers within the geoscience community. The former have their data already available through an access service (e.g. an OGC Web Service) and would have it published through a standard catalog service, in a seamless way. The latter would develop a catalog broker and let users query and access different geospatial resources through one or more standard interfaces and Application Profiles (AP) (e.g. OGC CSW ISO AP, CSW ebRIM/EO AP, etc.). GI-cat actually implements a broker components (i.e. a middleware service) which carries out distribution and mediation functionalities among "well-adopted" catalog interfaces and data access protocols. GI-cat also publishes different discovery interfaces: the OGC CSW ISO and ebRIM Application Profiles (the latter coming with support for the EO and CIM extension packages) and two different OpenSearch interfaces developed in order to explore Web 2.0 possibilities. An extended interface is also available to exploit all available GI-cat features, such as interruptible incremental queries and queries feedback. Interoperability tests performed in the context of different projects have also pointed out the importance to enforce compatibility with existing and wide-spread tools of the open source community (e.g. GeoNetwork and Deegree catalogs), which was then achieved. Based on a service-oriented framework of modular components, GI-cat can effectively be customized and tailored to support different deployment scenarios. In addition to the distribution functionality an harvesting approach has been lately experimented, allowing the user to switch between a distributed and a local search giving thus more possibilities to support different deployment scenarios. A configurator tool is available in order to enable an effective high level configuration of the broker service. A specific geobrowser was also naturally developed, for demonstrating the advanced GI-cat functionalities. This client

  14. Providing accessible medical abortion services in a Victorian rural community: A description and audit of service delivery and contraception follow up.

    PubMed

    Tomnay, Jane E; Coelli, Lauren; Davidson, Ange; Hulme-Chambers, Alana; Orr, Catherine; Hocking, Jane S

    2018-06-01

    To describe how a nurse led, MToP service is run in primary care in regional Victoria and investigate the characteristics and contraceptive choices of the women who have attended. Descriptive study of the development and implementation of a rural MToP service and a retrospective chart audit of patients attending between January 2015 and September 2016. Characteristics and clinical outcomes for women attending an MToP service in a primary care setting in rural Victoria. Contraceptive usage pre and post attending a rural service for MToP. There were 229 presentations, representing 223 women, of which 172 women (75.1%; 95%CI: 69.0%, 80.6%) had a successful MToP and for two further women, MToP failed, requiring a surgical termination (0.9%; 95%CI: 0.1%, 3.1%). At the time of presentation, the mean age of women was 25 years, the median length of gestation was 49 days and 171 (75%) had not had a previous termination. Data about contraceptive use was available for 195 women, 143 (73.3%) reported no contraception, 2 reported emergency contraceptive pill (1.0%), 10 used condoms (2.1%) and 39 (20.0%) reported hormonal contraception. Among the 156 women using no contraception, condoms or emergency contraception at the time of pregnancy, 113 (72.4%) initiated a reliable form of contraception post presentation to the MToP service. Provision of accessible, affordable MToP through an integrated primary health service is one strategy to address access inequity in regional areas. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Poverty, food security and universal access to sexual and reproductive health services: a call for cross-movement advocacy against neoliberal globalisation.

    PubMed

    Sundari Ravindran, T K

    2014-05-01

    Universal access to sexual and reproductive health services is one of the goals of the International Conference on Population and Development of 1994. The Millennium Development Goals were intended above all to end poverty. Universal access to health and health services are among the goals being considered for the post-2015 agenda, replacing or augmenting the MDGs. Yet we are not only far from reaching any of these goals but also appear to have lost our way somewhere along the line. Poverty and lack of food security have, through their multiple linkages to health and access to health care, deterred progress towards universal access to health services, including for sexual and reproductive health needs. A more insidious influence is neoliberal globalisation. This paper describes neoliberal globalisation and the economic policies it has engendered, the ways in which it influences poverty and food security, and the often unequal impact it has had on women as compared to men. It explores the effects of neoliberal economic policies on health, health systems, and universal access to health care services, and the implications for access to sexual and reproductive health. To be an advocate for universal access to health and health care is to become an advocate against neoliberal globalisation. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  16. Ethnic minority, young onset, rare dementia type, depression: A case study of a Muslim male accessing UK dementia health and social care services.

    PubMed

    Regan, Jemma L

    2016-07-01

    A case study comprised of formal interviews, formal observations and informal discussions investigated the motivations and experiences accessing dementia care health and social care services for a Muslim, Pakistani male with dementia. Motivations derived from 'desperation' and an inability to access support from family or religious community. Experiences of accessing services were mostly negative. Dementia services were ill-informed about how to support persons with young onset dementia, with pre-existing mental health conditions, from an ethnic minority. Education and training to remove barriers to all dementia care services is required for persons with dementia, their families and within dementia services and religious communities. © The Author(s) 2014.

  17. Applying the Earth System Grid Security System in a Heterogeneous Environment of Data Access Services

    NASA Astrophysics Data System (ADS)

    Kershaw, Philip; Lawrence, Bryan; Lowe, Dominic; Norton, Peter; Pascoe, Stephen

    2010-05-01

    CEDA (Centre for Environmental Data Archival) based at STFC Rutherford Appleton Laboratory is host to the BADC (British Atmospheric Data Centre) and NEODC (NERC Earth Observation Data Centre) with data holdings of over half a Petabyte. In the coming months this figure is set to increase by over one Petabyte through the BADC's role as one of three data centres to host the CMIP5 (Coupled Model Intercomparison Project Phase 5) core archive of climate model data. Quite apart from the problem of managing the storage of such large volumes there is the challenge of collating the data together from the modelling centres around the world and enabling access to these data for the user community. An infrastructure to support this is being developed under the US Earth System Grid (ESG) and related projects bringing together participating organisations together in a federation. The ESG architecture defines Gateways, the web interfaces that enable users to access data and data serving applications organised into Data Nodes. The BADC has been working in collaboration with US Earth System Grid team and other partners to develop a security system to restrict access to data. This provides single sign-on via both OpenID and PKI based means and uses role based authorisation facilitated by SAML and OpenID based interfaces for attribute retrieval. This presentation will provide an overview of the access control architecture and look at how this has been implemented for CEDA. CEDA has developed an expertise in data access and information services over several years through a number of projects to develop and enhance these capabilities. Participation in CMIP5 comes at a time when a number of other software development activities are coming to fruition. New services are in the process of being deployed alongside services making up the system for ESG. The security system must apply access control across this heterogeneous environment of different data services and technologies. One strand

  18. Access to the NCAR Research Data Archive via the Globus Data Transfer Service

    NASA Astrophysics Data System (ADS)

    Cram, T.; Schuster, D.; Ji, Z.; Worley, S. J.

    2014-12-01

    The NCAR Research Data Archive (RDA; http://rda.ucar.edu) contains a large and diverse collection of meteorological and oceanographic observations, operational and reanalysis outputs, and remote sensing datasets to support atmospheric and geoscience research. The RDA contains greater than 600 dataset collections which support the varying needs of a diverse user community. The number of RDA users is increasing annually, and the most popular method used to access the RDA data holdings is through web based protocols, such as wget and cURL based scripts. In the year 2013, 10,000 unique users downloaded greater than 820 terabytes of data from the RDA, and customized data products were prepared for more than 29,000 user-driven requests. In order to further support this increase in web download usage, the RDA is implementing the Globus data transfer service (www.globus.org) to provide a GridFTP data transfer option for the user community. The Globus service is broadly scalable, has an easy to install client, is sustainably supported, and provides a robust, efficient, and reliable data transfer option for RDA users. This paper highlights the main functionality and usefulness of the Globus data transfer service for accessing the RDA holdings. The Globus data transfer service, developed and supported by the Computation Institute at The University of Chicago and Argonne National Laboratory, uses the GridFTP as a fast, secure, and reliable method for transferring data between two endpoints. A Globus user account is required to use this service, and data transfer endpoints are defined on the Globus web interface. In the RDA use cases, the access endpoint is created on the RDA data server at NCAR. The data user defines the receiving endpoint for the data transfer, which can be the main file system at a host institution, a personal work station, or laptop. Once initiated, the data transfer runs as an unattended background process by Globus, and Globus ensures that the transfer is

  19. Data Access and Web Services at the EarthScope Plate Boundary Observatory

    NASA Astrophysics Data System (ADS)

    Matykiewicz, J.; Anderson, G.; Henderson, D.; Hodgkinson, K.; Hoyt, B.; Lee, E.; Persson, E.; Torrez, D.; Smith, J.; Wright, J.; Jackson, M.

    2007-12-01

    The EarthScope Plate Boundary Observatory (PBO) at UNAVCO, Inc., part of the NSF-funded EarthScope project, is designed to study the three-dimensional strain field resulting from deformation across the active boundary zone between the Pacific and North American plates in the western United States. To meet these goals, PBO will install 880 continuous GPS stations, 103 borehole strainmeter stations, and five laser strainmeters, as well as manage data for 209 previously existing continuous GPS stations and one previously existing laser strainmeter. UNAVCO provides access to data products from these stations, as well as general information about the PBO project, via the PBO web site (http://pboweb.unavco.org). GPS and strainmeter data products can be found using a variety of access methods, incuding map searches, text searches, and station specific data retrieval. In addition, the PBO construction status is available via multiple mapping interfaces, including custom web based map widgets and Google Earth. Additional construction details can be accessed from PBO operational pages and station specific home pages. The current state of health for the PBO network is available with the statistical snap-shot, full map interfaces, tabular web based reports, and automatic data mining and alerts. UNAVCO is currently working to enhance the community access to this information by developing a web service framework for the discovery of data products, interfacing with operational engineers, and exposing data services to third party participants. In addition, UNAVCO, through the PBO project, provides advanced data management and monitoring systems for use by the community in operating geodetic networks in the United States and beyond. We will demonstrate these systems during the AGU meeting, and we welcome inquiries from the community at any time.

  20. Perspectives on providing good access to dental services for elderly people: patient selection, dentists' responsibility and budget management.

    PubMed

    Grytten, Jostein; Holst, Dorthe

    2013-06-01

    To suggest a model for organizing and financing dental services for elderly people so that they have good access to services. There are few studies on how dental services for elderly people should be organized and financed. This is surprising if we take into consideration the fact that the proportion of elderly people is growing faster than any other group in the population, and that elderly people have more dental diseases and poorer access to dental services than the rest of the adult population. In several countries, dental services are characterized by private providers who often operate in a market with competition and free price-setting. Private dentists have no community responsibility, and they are free to choose which patients they treat. Literature review and critical reasoning. In order to avoid patient selection, a patient list system for elderly people is recommended, with per capita remuneration for the patients that the dentist is given responsibility for. The patient list system means that the dentist assumes responsibility for a well-defined list of elderly people. Our model will lead to greater security in the dentist/patient relationship, and patients with great treatment needs will be ensured access to dental services. © 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

  1. Linking women who test HIV-positive in pregnancy-related services to long-term HIV care and treatment services: a systematic review.

    PubMed

    Ferguson, Laura; Grant, Alison D; Watson-Jones, Deborah; Kahawita, Tanya; Ong'ech, John O; Ross, David A

    2012-05-01

    To quantify attrition between women testing HIV-positive in pregnancy-related services and accessing long-term HIV care and treatment services in low- or middle-income countries and to explore the reasons underlying client drop-out by synthesising current literature on this topic. A systematic search in Medline, EMBASE, Global Health and the International Bibliography of the Social Sciences of literature published 2000-2010. Only studies meeting pre-defined quality criteria were included. Of 2543 articles retrieved, 20 met the inclusion criteria. Sixteen (80%) drew on data from sub-Saharan Africa. The pathway between testing HIV-positive in pregnancy-related services and accessing long-term HIV-related services is complex, and attrition was usually high. There was a failure to initiate highly active antiretroviral therapy (HAART) among 38-88% of known-eligible women. Providing 'family-focused care', and integrating CD4 testing and HAART provision into prevention of mother-to-child HIV transmission services appear promising for increasing women's uptake of HIV-related services. Individual-level factors that need to be addressed include financial constraints and fear of stigma. Too few women negotiate the many steps between testing HIV-positive in pregnancy-related services and accessing HIV-related services for themselves. Recent efforts to stem patient drop-out, such as the MTCT-Plus Initiative, hold promise. Addressing barriers and enabling factors both within health facilities and at the levels of the individual woman, her family and society will be essential to improve the uptake of services. © 2012 Blackwell Publishing Ltd.

  2. 18 CFR 2.20 - Good faith requests for transmission services and good faith responses by transmitting utilities.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Good faith requests for transmission services and good faith responses by transmitting utilities. 2.20 Section 2.20 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES...

  3. 18 CFR 2.20 - Good faith requests for transmission services and good faith responses by transmitting utilities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Good faith requests for transmission services and good faith responses by transmitting utilities. 2.20 Section 2.20 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES...

  4. 18 CFR 2.20 - Good faith requests for transmission services and good faith responses by transmitting utilities.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Good faith requests for transmission services and good faith responses by transmitting utilities. 2.20 Section 2.20 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES...

  5. Accessing Suomi NPP OMPS Products through the GES DISC Online Data Services

    NASA Technical Reports Server (NTRS)

    Johnson, J.; Wei, J.; Gerasimov, I.; Vollmer, Bruce E.

    2017-01-01

    This presentation will provide an overview of the OMPS products available at the GES DISC archive, as well as demonstrate the various data services provided by the GES DISC. Since the TOMS, SBUV, and EOS Aura (OMI, MLS, HIRDLS) data products are also available from the GES DISC archive, these can be easily accessed and compared with the OMPS data.

  6. Impact of Medicare payment reductions on access to surgical services.

    PubMed Central

    Mitchell, J B; Cromwell, J

    1995-01-01

    OBJECTIVE. This study evaluates the impact of surgical fee reductions under Medicare on the utilization of surgical services. DATA SOURCES. Medicare physician claims data were obtained from 11 states for a five-year time period (1985-1989). STUDY DESIGN. Under OBRA-87, Medicare reduced payments for 11 surgical procedures. A fixed effects regression method was used to determine the impact of these payment reductions on access to care for potentially vulnerable Medicare beneficiaries: joint Medicaid-eligibles, blacks, and the very old. DATA COLLECTION/EXTRACTION METHODS. Medicare claims and enrollment data were used to construct a cross-section time-series of population-based surgical rates from 1985 through 1989. PRINCIPAL FINDINGS. Reductions in surgical fees led to small but significant increases in use for three procedures, small decreases in use for two procedures, and no impact on the remaining six procedures. There was little evidence that access to surgery was impaired for potentially vulnerable enrollees; in fact, declining fees often led to greater rates of increases for some subgroups. CONCLUSIONS. Our results suggest that volume responses by surgeons to payment changes under the Medicare Fee Schedule may be smaller than HCFA's original estimates. Nevertheless, both access and quality of care should continue to be closely monitored. PMID:8537224

  7. Access Control in Location-Based Services

    NASA Astrophysics Data System (ADS)

    Ardagna, Claudio A.; Cremonini, Marco; de Capitani di Vimercati, Sabrina; Samarati, Pierangela

    Recent enhancements in location technologies reliability and precision are fostering the development of a new wave of applications that make use of the location information of users. Such applications introduces new aspects of access control which should be addressed. On the one side, precise location information may play an important role and can be used to develop Location-based Access Control (LBAC) systems that integrate traditional access control mechanisms with conditions based on the physical position of users. On the other side, location information of users can be considered sensitive and access control solutions should be developed to protect it against unauthorized accesses and disclosures. In this chapter, we address these two aspects related to the use and protection of location information, discussing existing solutions, open issues, and some research directions.

  8. Increased access to palliative care and hospice services: opportunities to improve value in health care.

    PubMed

    Meier, Diane E

    2011-09-01

    A small proportion of patients with serious illness or multiple chronic conditions account for the majority of health care spending. Despite the high cost, evidence demonstrates that these patients receive health care of inadequate quality, characterized by fragmentation, overuse, medical errors, and poor quality of life. This article examines data demonstrating the impact of the U.S. health care system on clinical care outcomes and costs for the sickest and most vulnerable patients. It also defines palliative care and hospice, synthesizes studies of the outcomes of palliative care and hospice services, reviews variables predicting access to palliative care and hospice services, and identifies those policy priorities necessary to strengthen access to high-quality palliative care. Palliative care and hospice services improve patient-centered outcomes such as pain, depression, and other symptoms; patient and family satisfaction; and the receipt of care in the place that the patient chooses. Some data suggest that, compared with the usual care, palliative care prolongs life. By helping patients get the care they need to avoid unnecessary emergency department and hospital stays and shifting the locus of care to the home or community, palliative care and hospice reduce health care spending for America's sickest and most costly patient populations. Policies focused on enhancing the palliative care workforce, investing in the field's science base, and increasing the availability of services in U.S. hospitals and nursing homes are needed to ensure equitable access to optimal care for seriously ill patients and those with multiple chronic conditions. © 2011 Milbank Memorial Fund. Published by Wiley Periodicals Inc.

  9. Increased Access to Palliative Care and Hospice Services: Opportunities to Improve Value in Health Care

    PubMed Central

    Meier, Diane E

    2011-01-01

    Context: A small proportion of patients with serious illness or multiple chronic conditions account for the majority of health care spending. Despite the high cost, evidence demonstrates that these patients receive health care of inadequate quality, characterized by fragmentation, overuse, medical errors, and poor quality of life. Methods: This article examines data demonstrating the impact of the U.S. health care system on clinical care outcomes and costs for the sickest and most vulnerable patients. It also defines palliative care and hospice, synthesizes studies of the outcomes of palliative care and hospice services, reviews variables predicting access to palliative care and hospice services, and identifies those policy priorities necessary to strengthen access to high-quality palliative care. Findings: Palliative care and hospice services improve patient-centered outcomes such as pain, depression, and other symptoms; patient and family satisfaction; and the receipt of care in the place that the patient chooses. Some data suggest that, compared with the usual care, palliative care prolongs life. By helping patients get the care they need to avoid unnecessary emergency department and hospital stays and shifting the locus of care to the home or community, palliative care and hospice reduce health care spending for America's sickest and most costly patient populations. Conclusions: Policies focused on enhancing the palliative care workforce, investing in the field's science base, and increasing the availability of services in U.S. hospitals and nursing homes are needed to ensure equitable access to optimal care for seriously ill patients and those with multiple chronic conditions. PMID:21933272

  10. PKI-based secure mobile access to electronic health services and data.

    PubMed

    Kambourakis, G; Maglogiannis, I; Rouskas, A

    2005-01-01

    Recent research works examine the potential employment of public-key cryptography schemes in e-health environments. In such systems, where a Public Key Infrastructure (PKI) is established beforehand, Attribute Certificates (ACs) and public key enabled protocols like TLS, can provide the appropriate mechanisms to effectively support authentication, authorization and confidentiality services. In other words, mutual trust and secure communications between all the stakeholders, namely physicians, patients and e-health service providers, can be successfully established and maintained. Furthermore, as the recently introduced mobile devices with access to computer-based patient record systems are expanding, the need of physicians and nurses to interact increasingly with such systems arises. Considering public key infrastructure requirements for mobile online health networks, this paper discusses the potential use of Attribute Certificates (ACs) in an anticipated trust model. Typical trust interactions among doctors, patients and e-health providers are presented, indicating that resourceful security mechanisms and trust control can be obtained and implemented. The application of attribute certificates to support medical mobile service provision along with the utilization of the de-facto TLS protocol to offer competent confidentiality and authorization services is also presented and evaluated through experimentation, using both the 802.11 WLAN and General Packet Radio Service (GPRS) networks.

  11. Extending access to essential services against constraints: the three-tier health service delivery system in rural China (1949-1980).

    PubMed

    Feng, Xing Lin; Martinez-Alvarez, Melisa; Zhong, Jun; Xu, Jin; Yuan, Beibei; Meng, Qingyue; Balabanova, Dina

    2017-05-23

    China has made remarkable progress in scaling up essential services during the last six decades, making health care increasingly available in rural areas. This was partly achieved through the building of a three-tier health system in the 1950s, established as a linked network with health service facilities at county, township and village level, to extend services to the whole population. We developed a Theory of Change to chart the policy context, contents and mechanisms that may have facilitated the establishment of the three-tier health service delivery system in rural China. We systematically synthesized the best available evidence on how China achieved universal access to essential services in resource-scarce rural settings, with a particular emphasis on the experiences learned before the 1980s, when the country suffered a particularly acute lack of resources. The search identified only three peered-reviewed articles that fit our criteria for scientific rigor. We therefore drew extensively on government policy documents, and triangulated them with other publications and key informant interviews. We found that China's three-tier health service delivery system was established in response to acute health challenges, including high fertility and mortality rates. Health system resources were extremely low in view of the needs and insufficient to extend access to even basic care. With strong political commitment to rural health and a "health-for-all" policy vision underlying implementation, a three-tier health service delivery model connecting villages, townships and counties was quickly established. We identified several factors that contributed to the success of the three-tier system in China: a realistic health human resource development strategy, use of mass campaigns as a vehicle to increase demand, an innovative financing mechanisms, public-private partnership models in the early stages of scale up, and an integrated approach to service delivery. An

  12. Interventions to significantly improve service uptake and retention of HIV-positive pregnant women and HIV-exposed infants along the prevention of mother-to-child transmission continuum of care: systematic review.

    PubMed

    Vrazo, Alexandra C; Firth, Jacqueline; Amzel, Anouk; Sedillo, Rebecca; Ryan, Julia; Phelps, B Ryan

    2018-02-01

    Despite the success of Prevention of Mother-to-Child Transmission of HIV (PMTCT) programmes, low uptake of services and poor retention pose a formidable challenge to achieving the elimination of vertical HIV transmission in low- and middle-income countries. This systematic review summarises interventions that demonstrate statistically significant improvements in service uptake and retention of HIV-positive pregnant and breastfeeding women and their infants along the PMTCT cascade. Databases were systematically searched for peer-reviewed studies. Outcomes of interest included uptake of services, such as antiretroviral therapy (ART) such as initiation, early infant diagnostic testing, and retention of HIV-positive pregnant and breastfeeding women and their infants. Interventions that led to statistically significant outcomes were included and mapped to the PMTCT cascade. An eight-item assessment tool assessed study rigour. CRD42017063816. Of 686 citations reviewed, 11 articles met inclusion criteria. Ten studies detailed maternal outcomes and seven studies detailed infant outcomes in PMTCT programmes. Interventions to increase access to antenatal care (ANC) and ART services (n = 4) and those using lay cadres (n = 3) were most common. Other interventions included quality improvement (n = 2), mHealth (n = 1), and counselling (n = 1). One study described interventions in an Option B+ programme. Limitations included lack of HIV testing and counselling and viral load monitoring outcomes, small sample size, geographical location, and non-randomized assignment and selection of participants. Interventions including ANC/ART integration, family-centred approaches, and the use of lay healthcare providers are demonstrably effective in increasing service uptake and retention of HIV-positive mothers and their infants in PMTCT programmes. Future studies should include control groups and assess whether interventions developed in the context of earlier 'Options' are

  13. Assessment of strategies for male involvement in the prevention of mother-to-child transmission of HIV services in Blantyre, Malawi.

    PubMed

    Nyondo, Alinane Linda; Muula, Adamson Sinjani; Chimwaza, Angela Faith

    2013-12-16

    Despite the documented benefits of prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) services, the uptake remains low in sub-Saharan Africa. The lack of male involvement (MI) may be one of the reasons for this. However, there are limited data on strategies for MI in PMTCT. The objective of this study was to identify strategies that may promote MI in PMTCT services in antenatal care (ANC) services in Blantyre, Malawi. An exploratory qualitative study was conducted from December 2012 to January 2013 at South Lunzu Health Centre (SLHC) in Blantyre, Malawi. It consisted of six face-to-face key informant interviews (KIIs) with healthcare workers and four focus group discussions (FGDs) with 18 men and 17 pregnant women attending ANC at SLHC. The FGDs were divided according to sex and age. All FGDs and KIIs were digitally recorded and simultaneously transcribed and translated verbatim into English. Data were analyzed using thematic content analysis. Three major themes with several subcategories emerged. Theme 1 was a gatekeeping strategy with two subcategories: (1) healthcare workers refusing service provision to women accessing antenatal clinic without their partners and (2) women refusing ANC attention in the absence of a partner. Theme 2 comprised extending invitations and had six subcategories: (1) word of mouth, (2) card invites, (3) woman's health passport book invites, (4) telephonic invites, (5) use of influential people, and (6) home visits. Theme 3 was information education and communication, such as health education forums and advertisements. Of all the strategies, an invitation card addressed to the male partner was most preferred by study participants. There are several strategies by which men may be involved in PMTCT. Healthcare workers should offer a pregnant woman all strategies available for MI for her to select the appropriate one. Further research and consultations with men should continue to achieve higher levels

  14. Ensuring Access and Inclusion for Marginalised Children in Extended Services: Identifying the Barriers and Promoting Choice

    ERIC Educational Resources Information Center

    Frost, Nick; Elmer, Sue; Best, Lesly; Mills, Sue

    2010-01-01

    This article by Nick Frost of Leeds Metropolitan University, Sue Elmer of Leeds Trinity University, and Lesly Best and Sue Mills, who are both Independent Researchers, looks at the experience of marginalised children in extended services. The authors conducted research into access to, and inclusion in, extended services based within schools and…

  15. Livestock producers' views on accessing food-animal veterinary services: implications for student recruitment, training, and practice management.

    PubMed

    Jensen, Kimberly L; English, Burton C; Menard, R Jamey; Holland, Robert E

    2009-01-01

    Nationally, shortages of food-animal veterinary practitioners have been projected over the next several years. The purpose of this study was to ascertain livestock producers' perceptions on access to veterinary services and to measure opinions on potential solutions to access problems. Data for the study were from a 2006 survey of livestock producers in Tennessee. The study found that the majority of livestock producers had not perceived problems in obtaining veterinary services during the past year. Among those who had, the problems most commonly cited were a delay in obtaining services; that the veterinarian would treat the animal only if the producer transported it to the veterinary facility; and that the cost of the veterinary service was too high relative to the value of the animal. While it was hypothesized that producers who experienced a problem would have smaller farms on average and would reside in counties with lower numbers of large- or food-animal veterinarians, the results did not support this hypothesis. Among those who perceived a problem, scholarship programs to encourage veterinary students to specialize in large- or food-animal care and greater availability of veterinary technicians to perform health care services were viewed as effective ways to alleviate access problems. Financial incentives for veterinarians to locate in rural areas were also viewed as effective. While shortages have been predicted nationally, data from this survey do not suggest a perceived shortage in Tennessee. Problems in obtaining services appear to be more closely related to practice management and availability of large-animal practitioners in dairy and equine medicine.

  16. Trends in the location of the HIV-positive population in Australia: implications for access to healthcare services and delivery.

    PubMed

    Carman, Marina; Grierson, Jeffrey; Pitts, Marian; Hurley, Michael; Power, Jennifer

    2010-06-01

    Examining existing and potential trends in the HIV-positive population in Australia is important for current and future healthcare service development and delivery. A new analysis of existing data on this population from the HIV Futures 5 survey was based on linking a geographic breakdown of respondents based on 'area type'--capital city or inner suburban, outer suburban, regional centre and rural--with patterns of healthcare service access. In addition, the distance between the postcode of the respondent's residence and the postcode of the doctor seen for HIV-related treatment was calculated. An analysis of 'area type' by income and age was also conducted. The 'area type' analysis showed important differences in patterns of access to antiretroviral prescriptions and choice of provider for HIV-related and general healthcare. The median distance travelled to see a doctor for HIV-related treatment was higher for those living in outer suburbs than those living in regional centres. Differences in service use appear to be related to geographic accessibility of different service types. However, there may be other important social, economic and cultural factors involved. Ageing and socio-economic pressures may be influencing a move away from inner suburban areas where most HIV-specific care is located. This new analysis assists in finding the right balance between increasing the accessibility of HIV-specific services and 'mainstreaming'. Longitudinal data collection would further assist in tracking trends in geographic location, and how often and at what intervals people living with HIV utilise healthcare services.

  17. A national survey of UK health libraries investigating the cost of interlibrary loan services and assessing the accessibility to key orthopaedic journals.

    PubMed

    Tahim, Arpan; Stokes, Oliver; Vedi, Vikas

    2012-06-01

     NHS Library Services are utilised by NHS staff and junior trainees to locate scientific papers that provide them with the evidence base required for modern medical practice. The cost of accessing articles can be considerable particularly for junior trainees.  This survey looks at variations in cost of journal article loans and investigates access to particular orthopaedic journals across the country.  A national survey of UK Health Libraries was performed. Access to and costs of journals and interlibrary loan services were assessed. Availability of five wide-reaching orthopaedic journals was investigated.  Seven hundred and ten libraries were identified. One hundred and ten libraries completed the questionnaire (16.7%). Of these, 96.2% reported free access to scientific journals for users. 99.1% of libraries used interlibrary loan services with 38.2% passing costs on to the user at an average of £2.99 per article. 72.7% of libraries supported orthopaedic services. Journal of Bone and Joint Surgery (British) had greatest onsite availability.  The study demonstrates fluctuations in cost of access to interlibrary loan services and variation in access to important orthopaedic journals. It provides a reflection of current policy of charging for the acquisition of medical evidence by libraries in the UK. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

  18. Data Access Services that Make Remote Sensing Data Easier to Use

    NASA Technical Reports Server (NTRS)

    Lynnes, Christopher

    2010-01-01

    This slide presentation reviews some of the processes that NASA uses to make the remote sensing data easy to use over the World Wide Web. This work involves much research into data formats, geolocation structures and quality indicators, often to be followed by coding a preprocessing program. Only then are the data usable within the analysis tool of choice. The Goddard Earth Sciences Data and Information Services Center is deploying a variety of data access services that are designed to dramatically shorten the time consumed in the data preparation step. On-the-fly conversion to the standard network Common Data Form (netCDF) format with Climate-Forecast (CF) conventions imposes a standard coordinate system framework that makes data instantly readable through several tools, such as the Integrated Data Viewer, Gridded Analysis and Display System, Panoply and Ferret. A similar benefit is achieved by serving data through the Open Source Project for a Network Data Access Protocol (OPeNDAP), which also provides subsetting. The Data Quality Screening Service goes a step further in filtering out data points based on quality control flags, based on science team recommendations or user-specified criteria. Further still is the Giovanni online analysis system which goes beyond handling formatting and quality to provide visualization and basic statistics of the data. This general approach of automating the preparation steps has the important added benefit of enabling use of the data by non-human users (i.e., computer programs), which often make sub-optimal use of the available data due to the need to hard-code data preparation on the client side.

  19. Caregiver perspectives in oral healthcare in an institutionalised elderly population without access to dental services: a pilot study.

    PubMed

    Matear, David; Barbaro, John

    2006-01-01

    The provision of dental services to elderly populations is a complicated area. When clients are cognitively impaired, a new set of variables are introduced as care can be influenced by designated family members, caregivers or administrators, who are responsible for the oral health care of the client and may influence the types of treatment the client will receive. Differences in attitudes and perceptions, with respect to oral health, may lead to better or worse access to care. The goals of this study are: (a) to gain a better understanding of the perceptions which may govern access and barriers to care within the institutionalised elderly population; and (b) to improve information on where and how to target educational and service resources, in order to reduce barriers to care. A convenience (non-randomised) sample of 100 residents with caregivers was selected from nursing homes without organised access to oral healthcare services. A structured interview was conducted with 40 family members. Questions explored the importance and priorities of dental services for elderly people in institutions. Services which family members deemed of highest importance were dentures (both to replace teeth and adjustments on existing dentures), pain relief, emergency dentistry, fillings, cleanings, check-ups, tooth removal and treatment for advanced gum disease. Services that family members felt were less important were complex restorations, cleaning instruction to caregivers and seniors, and services by a specialist. Services considered to be of least importance were root canal treatment and implants. The top service priorities identified by the sample of family members included: cleanings to prevent mouth disease; check-ups including X-rays; fillings; dentures to replace teeth; and dental treatment to relieve pain. This study found that family members and caregivers would like a basic dental service including check-ups and preventive care, with restorative, denture and surgical

  20. Barriers and Enablers to Accessing Mental Health Services for People with Intellectual Disability: A Scoping Review

    ERIC Educational Resources Information Center

    Whittle, Erin Louise; Fisher, Karen R.; Reppermund, Simone; Lenroot, Rhoshel; Trollor, Julian

    2018-01-01

    Background: It is well established that people with an intellectual disability have high rates of mental health problems, yet rates of uptake of services do not match need. Aim: To identify the current literature pertaining to the barriers and facilitators to access to mental health services for people with an intellectual disability. Method: A…

  1. Speed control system for an access gate

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

    Bzorgi, Fariborz M

    2012-03-20

    An access control apparatus for an access gate. The access gate typically has a rotator that is configured to rotate around a rotator axis at a first variable speed in a forward direction. The access control apparatus may include a transmission that typically has an input element that is operatively connected to the rotator. The input element is generally configured to rotate at an input speed that is proportional to the first variable speed. The transmission typically also has an output element that has an output speed that is higher than the input speed. The input element and the outputmore » element may rotate around a common transmission axis. A retardation mechanism may be employed. The retardation mechanism is typically configured to rotate around a retardation mechanism axis. Generally the retardation mechanism is operatively connected to the output element of the transmission and is configured to retard motion of the access gate in the forward direction when the first variable speed is above a control-limit speed. In many embodiments the transmission axis and the retardation mechanism axis are substantially co-axial. Some embodiments include a freewheel/catch mechanism that has an input connection that is operatively connected to the rotator. The input connection may be configured to engage an output connection when the rotator is rotated at the first variable speed in a forward direction and configured for substantially unrestricted rotation when the rotator is rotated in a reverse direction opposite the forward direction. The input element of the transmission is typically operatively connected to the output connection of the freewheel/catch mechanism.« less

  2. Comparing private and public transport access to diabetic health services across inner, middle, and outer suburbs of Melbourne, Australia.

    PubMed

    Madill, Rebecca; Badland, Hannah; Mavoa, Suzanne; Giles-Corti, Billie

    2018-04-13

    Melbourne, Australia is experiencing rapid population growth, with much of this occurring in metropolitan outer suburban areas, also known as urban growth areas. Currently little is known about differences in travel times when using private and public transport to access primary and secondary services across Melbourne's urban growth areas. Plan Melbourne Refresh, a recent strategic land use document has called for a 20 min city, which is where essential services including primary health care, can be accessed within a 20 min journey. Type 2 diabetes mellitus (T2DM) is a major chronic condition in Australia, with some of Melbourne's growth areas having some of the highest prevalence across Australia. This study explores travel times to diabetic health care services for populations residing in inner, middle and outer suburbs of metropolitan Melbourne. Geographic information systems (GIS) software were used to map the location of selected diabetic primary and secondary health care service providers across metropolitan inner, middle, outer established, outer urban growth and outer fringe areas of Melbourne. An origin-destination matrix was used to estimate travel distances from point of origin (using a total of approximately 50,000 synthetic residential addresses) to the closest type of each diabetic health care service provider (destinations) across Melbourne. ArcGIS was used to estimate travel times for private transport and public transport; comparisons were made by area. Our study indicated increased travel times to diabetic health services for people living in Melbourne's outer growth and outer fringe areas compared with the rest of Melbourne (inner, middle and outer established). Compared with those living in inner city areas, the median time spent travelling to diabetic services was between 2.46 and 23.24 min (private motor vehicle) and 12.01 and 43.15 min (public transport) longer for those living in outer suburban areas. Irrespective of travel mode used

  3. Playing the Catch-Up Game: Accelerating the Scale-Up of Prevention of Mother-To-Child Transmission of HIV (PMTCT) Services to Eliminate New Pediatric HIV Infection in Nigeria.

    PubMed

    Oladele, Edward Adekola; Khamofu, Hadiza; Asala, Seun; Saleh, Mariya; Ralph-Opara, Uche; Nwosisi, Charles; Anyaike, Chukwuma; Gana, Catherine; Adedokun, Oluwasanmi; Dirks, Rebecca; Adebayo, Olufunsho; Oduwole, Modupe; Mandala, Justin; Torpey, Kwasi

    2017-01-01

    As the world is making progress towards elimination of mother-to-child transmission of HIV, poor coverage of PMTCT services in Nigeria remains a major challenge. In order to address this, scale-up was planned with activities organized into 3 phases. This paper describes the process undertaken in eight high burden Nigerian states to rapidly close PMTCT coverage gaps at facility and population levels between February 2013 and March 2014. Activities were grouped into three phases-pre-assessment phase (engagement of a wide range of stakeholders), assessment (rapid health facility assessment, a cross sectional survey using mixed methods conducted in the various states between Feb and May 2013 and impact modelling), and post-assessment (drawing up costed state operational plans to achieve eMTCT by 2015, data-driven smart scale-up). Over a period of 10 months starting June 2013, 2044 facilities were supported to begin provision of PMTCT services. This increased facility coverage from 8% to 50%. A 246% increase was also recorded in the number of pregnant women and their families who have access to HIV testing and counselling in the context of PMTCT. Similarly, access to antiretrovirals for PMTCT has witnessed a 152% increase in these eight states between October 2013 and October 2014. A data-driven and participatory approach can be used to rapidly scale-up PMTCT services at community and facility levels in this region. These results present us with hope for real progress in Nigeria. We are confident that the efforts described here will contribute significantly to eliminating new pediatric HIV infection in Nigeria.

  4. Design mobile satellite system architecture as an integral part of the cellular access digital network

    NASA Technical Reports Server (NTRS)

    Chien, E. S. K.; Marinho, J. A.; Russell, J. E., Sr.

    1988-01-01

    The Cellular Access Digital Network (CADN) is the access vehicle through which cellular technology is brought into the mainstream of the evolving integrated telecommunications network. Beyond the integrated end-to-end digital access and per call network services provisioning of the Integrated Services Digital Network (ISDN), the CADN engenders the added capability of mobility freedom via wireless access. One key element of the CADN network architecture is the standard user to network interface that is independent of RF transmission technology. Since the Mobile Satellite System (MSS) is envisioned to not only complement but also enhance the capabilities of the terrestrial cellular telecommunications network, compatibility and interoperability between terrestrial cellular and mobile satellite systems are vitally important to provide an integrated moving telecommunications network of the future. From a network standpoint, there exist very strong commonalities between the terrestrial cellular system and the mobile satellite system. Therefore, the MSS architecture should be designed as an integral part of the CADN. This paper describes the concept of the CADN, the functional architecture of the MSS, and the user-network interface signaling protocols.

  5. Gender and care: access to HIV testing, care, and treatment.

    PubMed

    Remien, Robert H; Chowdhury, Jenifar; Mokhbat, Jacques E; Soliman, Cherif; Adawy, Maha El; El-Sadr, Wafaa

    2009-07-01

    HIV transmission and occurrence of AIDS in the Middle East and North Africa region (MENA) is increasing, while access to ART in the region lags behind most low to middle-income countries. Like in other parts of the world, there is a growing feminization of the epidemic, and men and women each confront unique barriers to adequate HIV prevention and treatment services, while sharing some common obstacles as well. This paper focuses on important gender dimensions of access to HIV testing, care and treatment in the MENA region, including issues related to stigma, religion and morality, gender power imbalances, work status, and migration. Culturally specific policy and programmatic recommendations for improving HIV prevention and treatment in the MENA region are offered.

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

    ERIC Educational Resources Information Center

    Littlefield, Lyn; Giese, Jill

    2008-01-01

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

  7. The effect of poverty and caregiver education on perceived need and access to health services among children with special health care needs.

    PubMed

    Porterfield, Shirley L; McBride, Timothy D

    2007-02-01

    We examined the association between several variables and the use of specialist physician services, developmental therapies, and prescription medications among children with special health care needs (N=38866). We used a bivariate probit model to estimate whether a given child needed specialized services and whether that child accessed those services; we controlled for activity limitations and severity of special needs. Variables included family income, mother's (or other caregiver's) educational level, health insurance coverage, and perceived need for specialized services. We used data from the 2001 National Survey of Children with Special Health Care Needs. Lower-income and less-educated parents were less likely than higher-income and more-educated parents to say their special needs children needed specialized health services. The probability of accessing specialized health services-when needed-increased with both higher family income and insurance coverage. Children with special health care needs have less access to health services because their parents do not recognize the need for those services. An intervention in the form of information at the family level may be an appropriate policy response.

  8. Disability in post-earthquake Haiti: prevalence and inequality in access to services.

    PubMed

    Danquah, Lisa; Polack, Sarah; Brus, Aude; Mactaggart, Islay; Houdon, Claire Perrin; Senia, Patrick; Gallien, Pierre; Kuper, Hannah

    2015-01-01

    To assess the prevalence of disability and service needs in post-earthquake Haiti, and to compare the inclusion and living conditions of people with disabilities to those without disabilities. A population-based prevalence survey of disability was undertaken in 2012 in Port-au-Prince region, which was at the centre of the earthquake in 2010. Sixty clusters of 50 people aged 5 + years were selected with probability proportionate to size sampling and screened for disability (Washington Group short set questionnaire). A case-control study was undertaken, nested within the survey, matching cases to controls by age, gender and cluster. There was additional case finding to identify further children with disabilities. Information was collected on: socioeconomic status, education, livelihood, health, activities, participation and barriers. The prevalence of disability was 4.1% (3.4-4.7%) across 3132 eligible individuals. The earthquake was the second leading cause of disability. Disability was more common with increasing age, but unrelated to poverty. Large gaps existed in access of services for people with disabilities. Adults with disabilities were less likely to be literate or work and more likely to visit health services than adults without disabilities. Children with disabilities were less likely to be currently enrolled at school compared to controls. Children and adults with disabilities reported more activity limitations and participation restriction. Further focus is needed to improve inclusion of people with disabilities in post-earthquake Haiti to ensure that their rights are fulfilled. Almost one in six households in this region of Haiti included a person with a disability, and the earthquake was the second leading cause of disability. Fewer than half of people who reported needing medical rehabilitation had received this service. The leading reported barriers to the uptake of health services included financial constraints (50%) and difficulties with

  9. Accessing and Utilizing Remote Sensing Data for Vectorborne Infectious Diseases Surveillance and Modeling

    NASA Technical Reports Server (NTRS)

    Kiang, Richard; Adimi, Farida; Kempler, Steven

    2008-01-01

    Background: The transmission of vectorborne infectious diseases is often influenced by environmental, meteorological and climatic parameters, because the vector life cycle depends on these factors. For example, the geophysical parameters relevant to malaria transmission include precipitation, surface temperature, humidity, elevation, and vegetation type. Because these parameters are routinely measured by satellites, remote sensing is an important technological tool for predicting, preventing, and containing a number of vectorborne infectious diseases, such as malaria, dengue, West Nile virus, etc. Methods: A variety of NASA remote sensing data can be used for modeling vectorborne infectious disease transmission. We will discuss both the well known and less known remote sensing data, including Landsat, AVHRR (Advanced Very High Resolution Radiometer), MODIS (Moderate Resolution Imaging Spectroradiometer), TRMM (Tropical Rainfall Measuring Mission), ASTER (Advanced Spaceborne Thermal Emission and Reflection Radiometer), EO-1 (Earth Observing One) ALI (Advanced Land Imager), and SIESIP (Seasonal to Interannual Earth Science Information Partner) dataset. Giovanni is a Web-based application developed by the NASA Goddard Earth Sciences Data and Information Services Center. It provides a simple and intuitive way to visualize, analyze, and access vast amounts of Earth science remote sensing data. After remote sensing data is obtained, a variety of techniques, including generalized linear models and artificial intelligence oriented methods, t 3 can be used to model the dependency of disease transmission on these parameters. Results: The processes of accessing, visualizing and utilizing precipitation data using Giovanni, and acquiring other data at additional websites are illustrated. Malaria incidence time series for some parts of Thailand and Indonesia are used to demonstrate that malaria incidences are reasonably well modeled with generalized linear models and artificial

  10. Availability, spatial accessibility, utilisation and the role of telehealth for multi-disciplinary paediatric cerebral palsy services in Queensland.

    PubMed

    Edirippulige, Sisira; Reyno, John; Armfield, Nigel R; Bambling, Matthew; Lloyd, Owen; McNevin, Elizabeth

    2016-10-01

    The purpose of this study was to understand the methods of current delivery of health care services to cerebral palsy (CP) patients in Queensland, Australia. The study also examines the current use of telehealth by clinicians and their perceptions about telehealth use. Patient records during July 2013-July 2014 were accessed from the Queensland Paediatric Rehabilitation Service (QPRS) to collect information relating to the service delivery for CP patients. Analysis was carried out to examine the patient locations and travel distances using ArcMap geoprocessing software. In addition, 13 face-to-face semi structured interviews were conducted with clinicians from the QPRS and the Cerebral Palsy Health Service (CPHS) to understand the perceptions of clinicians relating to the current level of health care delivery. We also examined the clinicians' current use of telehealth and their opinions about this method. Records of 329 paediatric CP patients were accessed and reviewed. The majority of patients (96%, n = 307) who attended the clinics at the Royal Children's Hospital (RCH), Brisbane, were from remote, rural or regional areas of Queensland. Only 4% of patients (n = 13) were from major cities. During 12 months, patients had attended nine outreach programmes that were conducted by the QPRS and CPHS. The study found that non-local patients were required to travel an average distance of 836 km to access QPRS and CPHS services in Brisbane. The average distance for receiving a consultation at an outreach clinic was 173 km. Clinicians perceived that access to health care services to CP patients in Queensland is inadequate. Nearly all clinicians interviewed had some experience in using telehealth. They had high satisfaction levels with the method. Traditional methods of delivering services to CP patients do not meet their needs. Clinicians have found telehealth is a feasible and satisfactory delivery method. However, the use of telehealth is still limited. © The

  11. Changing landscapes, changing practice: negotiating access to sleeping sickness services in a post-conflict society.

    PubMed

    Palmer, Jennifer J; Kelly, Ann H; Surur, Elizeous I; Checchi, Francesco; Jones, Caroline

    2014-11-01

    For several decades, control programmes for human African trypanosomiasis (HAT, or sleeping sickness) in South Sudan have been delivered almost entirely as humanitarian interventions: large, well-organised, externally-funded but short-term programmes with a strategic focus on active screening. When attempts to hand over these programmes to local partners fail, resident populations must actively seek and negotiate access to tests at hospitals via passive screening. However, little is known about the social impact of such humanitarian interventions or the consequences of withdrawal on access to and utilisation of remaining services by local populations. Based on qualitative and quantitative fieldwork in Nimule, South Sudan (2008-2010), where passive screening necessarily became the predominant strategy, this paper investigates the reasons why, among two ethnic groups (Madi returnees and Dinka displaced populations), service uptake was so much higher among the latter. HAT tests were the only form of clinical care for which displaced Dinka populations could self-refer; access to all other services was negotiated through indigenous area workers. Because of the long history of conflict, these encounters were often morally and politically fraught. An open-door policy to screening supported Dinka people to 'try' HAT tests in the normal course of treatment-seeking, thereby empowering them to use HAT services more actively. This paper argues that in a context like South Sudan, where HAT control increasingly depends upon patient-led approaches to case-detection, it is imperative to understand the cultural values and political histories associated with the practice of testing and how medical humanitarian programmes shape this landscape of care, even after they have been scaled down. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Predictors of patient non-attendance at Improving Access to Psychological Therapy services demonstration sites

    PubMed Central

    Di Bona, Laura; Saxon, David; Barkham, Michael; Dent-Brown, Kim; Parry, Glenys

    2014-01-01

    Background Improving Access to Psychological Therapy (IAPT) services have increased the number of people with common mental health disorders receiving psychological therapy in England, but concerns remain about how equitably these services are accessed. Method Using cohort patient data (N=363) collected as part of the independent evaluation of the two demonstration sites, logistic regression was utilised to identify socio-demographic, clinical and service factors predictive of IAPT non-attendance. Results Significant predictors of IAPT first session non-attendance by patients were: lower non-risk score on the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM); more frequent thoughts of “being better off dead” (derived from the CORE-OM); either a very recent onset of common mental health disorder (1 month or less) or a long term condition (more than 2 years); and site. Limitations The small sample and low response rate are limitations, as the sample may not be representative of all those referred to IAPT services. The predictive power of the logistic regression model is limited and suggests other variables not available in the dataset may also be important predictors. Conclusions The clinical characteristics of risk to self, severity of emotional distress, and illness duration, along with site, were more predictive of IAPT non-attendance than socio-demographic characteristics. Further testing of the relationship between these variables and IAPT non-attendance is recommended. Clinicians should monitor IAPT uptake in those they refer and implement strategies to increase their engagement with services, particularly when referring people presenting with suicidal ideation or more chronic illness. PMID:25194784

  13. Indicators of Access to Early Childhood Services in the Mississippi Delta. Rural Early Childhood Report No. 5

    ERIC Educational Resources Information Center

    Shores, Elizabeth F.; Barbaro, Erin; Barbaro, Michael C.; Flenner, Michelle; Bell, Lynn

    2007-01-01

    The Early Childhood Atlas facilitates spatial analysis in early childhood services research for the promotion of greater quality and accessibility of early care and education. The Atlas team collects and geocodes federal, state and nongovernmental datasets about early childhood services, integrating selected data elements into its online mapmaking…

  14. Progressive segmented health insurance: Colombian health reform and access to health services.

    PubMed

    Ruiz, Fernando; Amaya, Liliana; Venegas, Stella

    2007-01-01

    Equal access for poor populations to health services is a comprehensive objective for any health reform. The Colombian health reform addressed this issue through a segmented progressive social health insurance approach. The strategy was to assure universal coverage expanding the population covered through payroll linked insurance, and implementing a subsidized insurance program for the poorest populations, those not affiliated through formal employment. A prospective study was performed to follow-up health service utilization and out-of-pocket expenses using a cohort design. It was representative of four Colombian cities (Cendex Health Services Use and Expenditure Study, 2001). A four part econometric model was applied. The model related medical service utilization and medication with different socioeconomic, geographic, and risk associated variables. Results showed that subsidized health insurance improves health service utilization and reduces the financial burden for the poorest, as compared to those non-insured. Other social health insurance schemes preserved high utilization with variable out-of-pocket expenditures. Family and age conditions have significant effect on medical service utilization. Geographic variables play a significant role in hospital inpatient service utilization. Both, geographic and income variables also have significant impact on out-of-pocket expenses. Projected utilization rates and a simulation favor a dual policy for two-stage income segmented insurance to progress towards the universal insurance goal. Copyright (c) 2006 John Wiley & Sons, Ltd.

  15. Health Service Accessibility and Risk in Cervical Cancer Prevention: Comparing Rural Versus Nonrural Residence in New Mexico.

    PubMed

    McDonald, Yolanda J; Goldberg, Daniel W; Scarinci, Isabel C; Castle, Philip E; Cuzick, Jack; Robertson, Michael; Wheeler, Cosette M

    2017-09-01

    Multiple intrapersonal and structural barriers, including geography, may prevent women from engaging in cervical cancer preventive care such as screening, diagnostic colposcopy, and excisional precancer treatment procedures. Geographic accessibility, stratified by rural and nonrural areas, to necessary services across the cervical cancer continuum of preventive care is largely unknown. Health care facility data for New Mexico (2010-2012) was provided by the New Mexico Human Papillomavirus Pap Registry (NMHPVPR), the first population-based statewide cervical cancer screening registry in the United States. Travel distance and time between the population-weighted census tract centroid to the nearest facility providing screening, diagnostic, and excisional treatment services were examined using proximity analysis by rural and nonrural census tracts. Mann-Whitney test (P < .05) was used to determine if differences were significant and Cohen's r to measure effect. Across all cervical cancer preventive health care services and years, women who resided in rural areas had a significantly greater geographic accessibility burden when compared to nonrural areas (4.4 km vs 2.5 km and 4.9 minutes vs 3.0 minutes for screening; 9.9 km vs 4.2 km and 10.4 minutes vs 4.9 minutes for colposcopy; and 14.8 km vs 6.6 km and 14.4 minutes vs 7.4 minutes for precancer treatment services, all P < .001). Improvements in cervical cancer prevention should address the potential benefits of providing the full spectrum of screening, diagnostic and precancer treatment services within individual facilities. Accessibility, assessments distinguishing rural and nonrural areas are essential when monitoring and recommending changes to service infrastructures (eg, mobile versus brick and mortar). © 2016 National Rural Health Association.

  16. Health Service Accessibility and Risk in Cervical Cancer Prevention: Comparing Rural Versus Nonrural Residence in New Mexico

    PubMed Central

    McDonald, Yolanda J.; Goldberg, Daniel W.; Scarinci, Isabel C.; Castle, Philip E.; Cuzick, Jack; Robertson, Michael; Wheeler, Cosette M.

    2018-01-01

    Purpose Multiple intrapersonal and structural barriers, including geography, may prevent women from engaging in cervical cancer preventive care such as screening, diagnostic colposcopy, and excisional precancer treatment procedures. Geographic accessibility, stratified by rural and nonrural areas, to necessary services across the cervical cancer continuum of preventive care is largely unknown. Methods Health care facility data for New Mexico (2010-2012) was provided by the New Mexico Human Papillomavirus Pap Registry (NMHPVPR), the first population-based statewide cervical cancer screening registry in the United States. Travel distance and time between the population-weighted census tract centroid to the nearest facility providing screening, diagnostic, and excisional treatment services were examined using proximity analysis by rural and nonrural census tracts. Mann-Whitney test (P < .05) was used to determine if differences were significant and Cohen's r to measure effect. Findings Across all cervical cancer preventive health care services and years, women who resided in rural areas had a significantly greater geographic accessibility burden when compared to nonrural areas (4.4 km vs 2.5 km and 4.9 minutes vs 3.0 minutes for screening; 9.9 km vs 4.2 km and 10.4 minutes vs 4.9 minutes for colposcopy; and 14.8 km vs 6.6 km and 14.4 minutes vs 7.4 minutes for precancer treatment services, all P < .001). Conclusion Improvements in cervical cancer prevention should address the potential benefits of providing the full spectrum of screening, diagnostic and precancer treatment services within individual facilities. Accessibility, assessments distinguishing rural and nonrural areas are essential when monitoring and recommending changes to service infrastructures (eg, mobile versus brick and mortar). PMID:27557124

  17. Defining equity in physical access to clinical services using geographical information systems as part of malaria planning and monitoring in Kenya

    PubMed Central

    Noor, A. M.; Zurovac, D.; Hay, S. I.; Ochola, S. A.; Snow, R. W.

    2010-01-01

    Summary Distance is a crucial feature of health service use and yet its application and utility to health care planning have not been well explored, particularly in the light of large-scale international and national efforts such as Roll Back Malaria. We have developed a high-resolution map of population-to-service access in four districts of Kenya. Theoretical physical access, based upon national targets, developed as part of the Kenyan health sector reform agenda, was compared with actual health service usage data among 1668 paediatric patients attending 81 sampled government health facilities. Actual and theoretical use were highly correlated. Patients in the larger districts of Kwale and Makueni, where access to government health facilities was relatively poor, travelled greater mean distances than those in Greater Kisii and Bondo. More than 60% of the patients in the four districts attended health facilities within a 5-km range. Interpolated physical access surfaces across districts highlighted areas of poor access and large differences between urban and rural settings. Users from rural communities travelled greater distances to health facilities than those in urban communities. The implications of planning and monitoring equitable delivery of clinical services at national and international levels are discussed. PMID:14516303

  18. 47 CFR 64.402 - Policies and procedures for the provision of priority access service by commercial mobile radio...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 3 2011-10-01 2011-10-01 false Policies and procedures for the provision of... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) MISCELLANEOUS... National Security and Emergency Preparedness personnel shall provide priority access service in accordance...

  19. Privacy-Aware Relevant Data Access with Semantically Enriched Search Queries for Untrusted Cloud Storage Services.

    PubMed

    Pervez, Zeeshan; Ahmad, Mahmood; Khattak, Asad Masood; Lee, Sungyoung; Chung, Tae Choong

    2016-01-01

    Privacy-aware search of outsourced data ensures relevant data access in the untrusted domain of a public cloud service provider. Subscriber of a public cloud storage service can determine the presence or absence of a particular keyword by submitting search query in the form of a trapdoor. However, these trapdoor-based search queries are limited in functionality and cannot be used to identify secure outsourced data which contains semantically equivalent information. In addition, trapdoor-based methodologies are confined to pre-defined trapdoors and prevent subscribers from searching outsourced data with arbitrarily defined search criteria. To solve the problem of relevant data access, we have proposed an index-based privacy-aware search methodology that ensures semantic retrieval of data from an untrusted domain. This method ensures oblivious execution of a search query and leverages authorized subscribers to model conjunctive search queries without relying on predefined trapdoors. A security analysis of our proposed methodology shows that, in a conspired attack, unauthorized subscribers and untrusted cloud service providers cannot deduce any information that can lead to the potential loss of data privacy. A computational time analysis on commodity hardware demonstrates that our proposed methodology requires moderate computational resources to model a privacy-aware search query and for its oblivious evaluation on a cloud service provider.

  20. Privacy-Aware Relevant Data Access with Semantically Enriched Search Queries for Untrusted Cloud Storage Services

    PubMed Central

    Pervez, Zeeshan; Ahmad, Mahmood; Khattak, Asad Masood; Lee, Sungyoung; Chung, Tae Choong

    2016-01-01

    Privacy-aware search of outsourced data ensures relevant data access in the untrusted domain of a public cloud service provider. Subscriber of a public cloud storage service can determine the presence or absence of a particular keyword by submitting search query in the form of a trapdoor. However, these trapdoor-based search queries are limited in functionality and cannot be used to identify secure outsourced data which contains semantically equivalent information. In addition, trapdoor-based methodologies are confined to pre-defined trapdoors and prevent subscribers from searching outsourced data with arbitrarily defined search criteria. To solve the problem of relevant data access, we have proposed an index-based privacy-aware search methodology that ensures semantic retrieval of data from an untrusted domain. This method ensures oblivious execution of a search query and leverages authorized subscribers to model conjunctive search queries without relying on predefined trapdoors. A security analysis of our proposed methodology shows that, in a conspired attack, unauthorized subscribers and untrusted cloud service providers cannot deduce any information that can lead to the potential loss of data privacy. A computational time analysis on commodity hardware demonstrates that our proposed methodology requires moderate computational resources to model a privacy-aware search query and for its oblivious evaluation on a cloud service provider. PMID:27571421

  1. Differentiated optical services: a quality of optical service model for WDM networks

    NASA Astrophysics Data System (ADS)

    Ndousse, Thomas D.; Golmie, Nada

    1999-08-01

    This paper addresses the issues of guaranteed and scalable end-to-end QoS in Metropolitan DWDM networks serving as transit networks for IP access networks. DWDM offering few wavelengths have in the past been deployed in backbone networks to upgrade point-to-point transmission where sharing is based on coarse granularity. This type of DWDM backbone networks, offering few lightpaths, provides no support for QoS services traversing the network. As DWDM networks with larger numbers of wavelengths penetrate the data-centric Metro environment, specific IP service requirements such as priority restoration, scalability, dynamic provisioning of capacity and routes, and support for coarse-grain QoS capabilities will have to be addressed in the optical domain in order to support end-to-end Service- Level Agreements. In this paper, we focus on the support of QoS in the optical domain in order to achieve end-to-end QoS over a DWDM network. We propose a QoS service model in the optical domain called Differentiated Optical Services (DOS). Service classification in DOS is based on a set of optical parameters that captures the quality and reliability of the optical lightpath.

  2. Spatial accessibility to healthcare services in Shenzhen, China: improving the multi-modal two-step floating catchment area method by estimating travel time via online map APIs.

    PubMed

    Tao, Zhuolin; Yao, Zaoxing; Kong, Hui; Duan, Fei; Li, Guicai

    2018-05-09

    Shenzhen has rapidly grown into a megacity in the recent decades. It is a challenging task for the Shenzhen government to provide sufficient healthcare services. The spatial configuration of healthcare services can influence the convenience for the consumers to obtain healthcare services. Spatial accessibility has been widely adopted as a scientific measurement for evaluating the rationality of the spatial configuration of healthcare services. The multi-modal two-step floating catchment area (2SFCA) method is an important advance in the field of healthcare accessibility modelling, which enables the simultaneous assessment of spatial accessibility via multiple transport modes. This study further develops the multi-modal 2SFCA method by introducing online map APIs to improve the estimation of travel time by public transit or by car respectively. As the results show, the distribution of healthcare accessibility by multi-modal 2SFCA shows significant spatial disparity. Moreover, by dividing the multi-modal accessibility into car-mode and transit-mode accessibility, this study discovers that the transit-mode subgroup is disadvantaged in the competition for healthcare services with the car-mode subgroup. The disparity in transit-mode accessibility is the main reason of the uneven pattern of healthcare accessibility in Shenzhen. The findings suggest improving the public transit conditions for accessing healthcare services to reduce the disparity of healthcare accessibility. More healthcare services should be allocated in the eastern and western Shenzhen, especially sub-districts in Dapeng District and western Bao'an District. As these findings cannot be drawn by the traditional single-modal 2SFCA method, the advantage of the multi-modal 2SFCA method is significant to both healthcare studies and healthcare system planning.

  3. Social Capital, Acculturation, Mental Health, and Perceived Access to Services among Mexican American Women

    ERIC Educational Resources Information Center

    Valencia-Garcia, Dellanira; Simoni, Jane M.; Alegria, Margarita; Takeuchi, David T.

    2012-01-01

    Objective: We examined whether individual-level social capital--the intangible resources in a community available through membership in social networks or other social structures and perceived trust in the community--was associated with acculturation, depression and anxiety symptoms, and perceived access to services among women of Mexican…

  4. Restructuring to Promote Collaboration and Exceed User Needs: The Blackwell Library Access Services Experience

    ERIC Educational Resources Information Center

    Chakraborty, Mou; English, Michael; Payne, Sharon

    2013-01-01

    Through vision, leadership, and creativity, Salisbury University's Blackwell Library transformed its access services department structurally and philosophically to better position itself to meet, and strive to exceed, today's user needs and expectations. Restructuring and the introduction of new leadership and new ideas provided the foundation for…

  5. Access to dental care-parents' and caregivers' views on dental treatment services for people with disabilities.

    PubMed

    Prabhu, Neeta T; Nunn, June H; Evans, D J; Girdler, N M

    2010-01-01

    The goal of this study was to elicit the views of patients or parents/caregivers of patients with disabilities regarding access to dental care. A questionnaire was generated both from interviews with patients/parents/caregivers already treated under sedation or general anesthesia as well as by use of the Delphi technique with other stakeholders. One hundred thirteen patients from across six community dental clinics and one dental hospital were included. Approximately, 38% of the subjects used a general dental practitioner and 35% used the community dental service for their dental care, with only 27% using the hospital dental services. Overall waiting time for an appointment at the secondary care setting was longer than for the primary care clinics. There was a high rate of parent/caregiver satisfaction with dental services and only five patients reported any difficulty with travel and access to clinics. This study highlights the need for a greater investment in education and training to improve skills in the primary dental care sector.

  6. Uniform Data Management and Access to Near Real-Time Seismic Data (Invited)

    NASA Astrophysics Data System (ADS)

    Casey, R.; Ahern, T. K.; Benson, R. B.; Karstens, R.; Stromme, S.; Trabant, C. M.; Weertman, B. R.

    2010-12-01

    The IRIS Data Management Center has its ears to the ground, receiving relayed seismic telemetry from all parts of the globe with delay times as little as a few seconds from sensor to data center. This immediacy of always-on geophysical information has spawned a demand for ready access to persistent data streams, quality assurance metrics, and automatic production of data products based on specific triggers. For the last ten years, IRIS DMC has developed an effective near real-time data pipeline that serves the needs of seismic networks needing a central data management system as well as the scientific community that need the ability to monitor and respond to events that occurred only moments before. A number of accessible applications have been developed that provide useful data both through the web and through freely available software. Metrics and products of the raw data are cataloged and managed as a chain of events that occur in near-real time. The technical challenges faced with such a system are general to the data management community. Delayed transmission of packetized data, out of order data transmissions, verification of complete data transmission, and data flow concurrency have all been areas of focus in order to provide the best possible level of service to scientists and educators.

  7. Fertility decline and social service access: reconciling behavioral and medical models.

    PubMed

    Weinstein, J

    1978-01-01

    In this summary of fertility literature the author attempts to differentiate between the effects of behavioral and medical models of family planning programs on the fertility rate. This is done by determining the effects of access to social welfare services by assessment of: the function of children within the family life survey conducted in the Cameroons are also used. It was found that 7 interdependent elements of social service are involved: 1) general health care; 2) social security for sick and aged; 3) employment training and opportunities for adults; 4) literacy and education; 5) communication and transportation systems; 6) housing and infrastructure; 7) child care and welfare. The presence of these elements is shown to accompany low fertility while their absence is expressed in high rates of child bearing. These elements are major variables in both the nomological and public policy senses. 2 additional components are knowledge of and favorable attitudes towards effective means of fertility control plus effective mechanical, chemical, or natural means of limiting fertility. The concept of fertility norm and its impact on the fertility rate is explained as being the result of the collective force which social affiliations exert on people to reproduce in a certain way. The "stopping rule" is that which will fulfill the fertility norm. An example of this is a culture which continues child bearing until a son has been born and then controls reproduction after this has happened. Such factors must be considered for family planning programs to succeed in these cultures. Therefore fertility levels are found to be the product of prevailing norms and technical ability to achieve these norms. Improvement in levels of access to social services can bring about the lowering of these norms.

  8. Correlates of Strengthening Lessons from HIV/AIDS Treatment and Care Services in Ethiopia Perceived Access and Implications for Health System.

    PubMed

    Yakob, Bereket; Ncama, Busisiwe Purity

    2016-01-01

    Access to healthcare is an important public health concept and has been traditionally measured by using population level parameters, such as availability, distribution and proximity of the health facilities in relation to the population. However, client based factors such as their expectations, experiences and perceptions which impact their evaluations of health care access were not well studied and integrated into health policy frameworks and implementation programs. This study aimed to investigate factors associated with perceived access to HIV/AIDS Treatment and care services in Wolaita Zone, Ethiopia. A cross-sectional survey was conducted on 492 people living with HIV, with 411 using ART and 81 using pre-ART services accessed at six public sector health facilities from November 2014 to March 2015. Data were analyzed using the ologit function of STATA. The variables explored consisted of socio-demographic and health characteristics, type of health facility, type of care, distance, waiting time, healthcare responsiveness, transportation convenience, satisfaction with service, quality of care, financial fairness, out of pocket expenses and HIV disclosure. Of the 492 participants, 294 (59.8%) were females and 198 (40.2%) were males, with a mean age of 38.8 years. 23.0% and 12.2% believed they had 'good' or 'very good' access respectively, and 64.8% indicated lower ratings. In the multivariate analysis, distance from the health facility, type of care, HIV clinical stage, out of pocket expenses, employment status, type of care, HIV disclosure and perceived transportation score were not associated with the perceived access (PA). With a unit increment in satisfaction, perceived quality of care, health system responsiveness, transportation convenience and perceived financial fairness scores, the odds of providing higher rating of PA increased by 29.0% (p<0.001), 6.0%(p<0.01), 100.0% (p<0.001), 9.0% (p<0.05) and 6.0% (p<0.05) respectively. Perceived quality of care

  9. Understanding structural barriers to accessing HIV testing and prevention services among black men who have sex with men (BMSM) in the United States.

    PubMed

    Levy, Matthew E; Wilton, Leo; Phillips, Gregory; Glick, Sara Nelson; Kuo, Irene; Brewer, Russell A; Elliott, Ayana; Watson, Christopher; Magnus, Manya

    2014-05-01

    Structural-level factors have contributed to the substantial disproportionate rates of HIV among Black men who have sex with men (BMSM) in the United States. Despite insufficient HIV testing patterns, however, there is a void in research investigating the relationship between structural factors and access to HIV testing and prevention services among BMSM. Building on previous scholarly work and incorporating a dynamic social systems conceptual framework, we conducted a comprehensive review of the literature on structural barriers to HIV testing and prevention services among BMSM across four domains: healthcare, stigma and discrimination, incarceration, and poverty. We found that BMSM experience inadequate access to culturally competent services, stigma and discrimination that impede access to services, a deficiency of services in correctional institutions, and limited services in areas where BMSM live. Structural interventions that eliminate barriers to HIV testing and prevention services and provide BMSM with core skills to navigate complex systems are needed.

  10. Understanding Structural Barriers to Accessing HIV Testing and Prevention Services Among Black Men Who Have Sex with Men (BMSM) in the United States

    PubMed Central

    Wilton, Leo; Phillips, Gregory; Glick, Sara Nelson; Kuo, Irene; Brewer, Russell A.; Elliott, Ayana; Watson, Christopher; Magnus, Manya

    2015-01-01

    Structural-level factors have contributed to the substantial disproportionate rates of HIV among Black men who have sex with men (BMSM) in the United States. Despite insufficient HIV testing patterns, however, there is a void in research investigating the relationship between structural factors and access to HIV testing and prevention services among BMSM. Building on previous scholarly work and incorporating a dynamic social systems conceptual framework, we conducted a comprehensive review of the literature on structural barriers to HIV testing and prevention services among BMSM across four domains: healthcare, stigma and discrimination, incarceration, and poverty. We found that BMSM experience inadequate access to culturally competent services, stigma and discrimination that impede access to services, a deficiency of services in correctional institutions, and limited services in areas where BMSM live. Structural interventions that eliminate barriers to HIV testing and prevention services and provide BMSM with core skills to navigate complex systems are needed. PMID:24531769

  11. Dynamic Network Selection for Multicast Services in Wireless Cooperative Networks

    NASA Astrophysics Data System (ADS)

    Chen, Liang; Jin, Le; He, Feng; Cheng, Hanwen; Wu, Lenan

    In next generation mobile multimedia communications, different wireless access networks are expected to cooperate. However, it is a challenging task to choose an optimal transmission path in this scenario. This paper focuses on the problem of selecting the optimal access network for multicast services in the cooperative mobile and broadcasting networks. An algorithm is proposed, which considers multiple decision factors and multiple optimization objectives. An analytic hierarchy process (AHP) method is applied to schedule the service queue and an artificial neural network (ANN) is used to improve the flexibility of the algorithm. Simulation results show that by applying the AHP method, a group of weight ratios can be obtained to improve the performance of multiple objectives. And ANN method is effective to adaptively adjust weight ratios when users' new waiting threshold is generated.

  12. Multi-service small-cell cloud wired/wireless access network based on tunable optical frequency comb

    NASA Astrophysics Data System (ADS)

    Xiang, Yu; Zhou, Kun; Yang, Liu; Pan, Lei; Liao, Zhen-wan; Zhang, Qiang

    2015-11-01

    In this paper, we demonstrate a novel multi-service wired/wireless integrated access architecture of cloud radio access network (C-RAN) based on radio-over-fiber passive optical network (RoF-PON) system, which utilizes scalable multiple- frequency millimeter-wave (MF-MMW) generation based on tunable optical frequency comb (TOFC). In the baseband unit (BBU) pool, the generated optical comb lines are modulated into wired, RoF and WiFi/WiMAX signals, respectively. The multi-frequency RoF signals are generated by beating the optical comb line pairs in the small cell. The WiFi/WiMAX signals are demodulated after passing through the band pass filter (BPF) and band stop filter (BSF), respectively, whereas the wired signal can be received directly. The feasibility and scalability of the proposed multi-service wired/wireless integrated C-RAN are confirmed by the simulations.

  13. Channel access schemes and fiber optic configurations for integrated-services local area networks

    NASA Astrophysics Data System (ADS)

    Nassehi, M. Mehdi

    1987-03-01

    Local Area Networks are in common use for data communications and have enjoyed great success. Recently, there is a growing interest in using a single network to support many applications in addition to traditional data traffic. These additional applications introduce new requirements in terms of volume of traffic and real-time delivery of data which are not met by existing networks. To satisfy these requirements, a high-bandwidth tranmission medium, such as fiber optics, and a distributed channel access scheme for the efficient sharing of the bandwidth among the various applications are needed. As far as the throughput-delay requirements of the various application are concerned, a network structure along with a distributed channel access are proposed which incorporate appropriate scheduling policies for the transmission of outstanding messages on the network. A dynamic scheduling policy was devised which outperforms all existing policies in terms of minimizing the expected cost per message. A broadcast mechanism was devised for the efficient dissemination of all relevant information. Fiber optic technology is considered for the high-bandwidth transmisison medium.

  14. Access barriers to and unmet needs for home- and community-based services among older Korean Americans.

    PubMed

    Casado, Banghwa Lee; Lee, Sang E

    2012-01-01

    This cross-sectional survey study of 146 caregivers of older Korean Americans explored access barriers to and unmet needs for home- and community-based services (HCBS) programs (respite care, adult day care, personal care, home health, housekeeping, and transportation). Most often reported access barriers were lack of awareness and care recipient refusal. Predictors of unmet needs varied depending on the type of service, but included caregiver gender, relationship, education, caregiving duration, Medicaid coverage, English proficiency, caregiver self-efficacy, care recipient functional dependency, cognitive impairment, and caregiving hours. This study highlighted unmet needs for HCBS in Korean American communities, pointing to the pressing need for a collaborative effort to develop plans that modify and expand HCBS programs for older Korean Americans.

  15. 47 CFR 73.6023 - Distributed transmission systems.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Distributed transmission systems. 73.6023... distributed transmission system. [73 FR 74064, Dec. 5, 2008] ... RADIO BROADCAST SERVICES Class A Television Broadcast Stations § 73.6023 Distributed transmission...

  16. Variation in geographic access to chemotherapy by definitions of providers and service locations: a population-based observational study.

    PubMed

    Schroeder, Mary C; Chapman, Cole G; Nattinger, Matthew C; Halfdanarson, Thorvardur R; Abu-Hejleh, Taher; Tien, Yu-Yu; Brooks, John M

    2016-07-18

    An aging population, with its associated rise in cancer incidence and strain on the oncology workforce, will continue to motivate patients, healthcare providers and policy makers to better understand the existing and growing challenges of access to chemotherapy. Administrative data, and SEER-Medicare data in particular, have been used to assess patterns of healthcare utilization because of its rich information regarding patients, their treatments, and their providers. To create measures of geographic access to chemotherapy, patients and oncologists must first be identified. Others have noted that identifying chemotherapy providers from Medicare claims is not always straightforward, as providers may report multiple or incorrect specialties and/or practice in multiple locations. Although previous studies have found that specialty codes alone fail to identify all oncologists, none have assessed whether various methods of identifying chemotherapy providers and their locations affect estimates of geographic access to care. SEER-Medicare data was used to identify patients, physicians, and chemotherapy use in this population-based observational study. We compared two measures of geographic access to chemotherapy, local area density and distance to nearest provider, across two definitions of chemotherapy provider (identified by specialty codes or billing codes) and two definitions of chemotherapy service location (where chemotherapy services were proven to be or possibly available) using descriptive statistics. Access measures were mapped for three representative registries. In our sample, 57.2 % of physicians who submitted chemotherapy claims reported a specialty of hematology/oncology or medical oncology. These physicians were associated with 91.0 % of the chemotherapy claims. When providers were identified through billing codes instead of specialty codes, an additional 50.0 % of beneficiaries (from 23.8 % to 35.7 %) resided in the same ZIP code as a chemotherapy

  17. Antiretroviral interventions to reduce mother-to-child transmission of human immunodeficiency virus: challenges for health systems, communities and society.

    PubMed Central

    Baggaley, R.; van Praag, E.

    2000-01-01

    This paper examines the ethical, economic and social issues that should be considered when antiretroviral interventions are being planned to reduce mother-to-child transmission of the human immunodeficiency virus. Interventions aiming to reduce mother-to-child transmission should be concerned with the rights of both the child and the mother. Women should not be seen as vectors of transmission but as people entitled to adequate health care and social services in their own right. For women accepting mother-to-child transmission interventions it is important to consider their medical and emotional needs and to ensure that they are not stigmatized or subjected to abuse or abandonment following voluntary counselling and testing. Seropositive women who do not wish to continue with pregnancy should have access to facilities for safe termination if this is legal in the country concerned. Problems arise in relation to the basic requirements for introducing such interventions via the health services in developing countries. A framework is given for making decisions about implementation of interventions in health care systems with limited resources where there is a relatively high prevalence of human immunodeficiency virus infection among pregnant women. PMID:10994287

  18. Sustainable access to data, products, services and software from the European seismological Research Infrastructures: the EPOS TCS Seismology

    NASA Astrophysics Data System (ADS)

    Haslinger, Florian; Dupont, Aurelien; Michelini, Alberto; Rietbrock, Andreas; Sleeman, Reinoud; Wiemer, Stefan; Basili, Roberto; Bossu, Rémy; Cakti, Eser; Cotton, Fabrice; Crawford, Wayne; Diaz, Jordi; Garth, Tom; Locati, Mario; Luzi, Lucia; Pinho, Rui; Pitilakis, Kyriazis; Strollo, Angelo

    2016-04-01

    Easy, efficient and comprehensive access to data, data products, scientific services and scientific software is a key ingredient in enabling research at the frontiers of science. Organizing this access across the European Research Infrastructures in the field of seismology, so that it best serves user needs, takes advantage of state-of-the-art ICT solutions, provides cross-domain interoperability, and is organizationally and financially sustainable in the long term, is the core challenge of the implementation phase of the Thematic Core Service (TCS) Seismology within the EPOS-IP project. Building upon the existing European-level infrastructures ORFEUS for seismological waveforms, EMSC for seismological products, and EFEHR for seismological hazard and risk information, and implementing a pilot Computational Earth Science service starting from the results of the VERCE project, the work within the EPOS-IP project focuses on improving and extending the existing services, aligning them with global developments, to at the end produce a well coordinated framework that is technically, organizationally, and financially integrated with the EPOS architecture. This framework needs to respect the roles and responsibilities of the underlying national research infrastructures that are the data owners and main providers of data and products, and allow for active input and feedback from the (scientific) user community. At the same time, it needs to remain flexible enough to cope with unavoidable challenges in the availability of resources and dynamics of contributors. The technical work during the next years is organized in four areas: - constructing the next generation software architecture for the European Integrated (waveform) Data Archive EIDA, developing advanced metadata and station information services, fully integrate strong motion waveforms and derived parametric engineering-domain data, and advancing the integration of mobile (temporary) networks and OBS deployments in

  19. What does 'access to health care' mean?

    PubMed

    Gulliford, Martin; Figueroa-Munoz, Jose; Morgan, Myfanwy; Hughes, David; Gibson, Barry; Beech, Roger; Hudson, Meryl

    2002-07-01

    Facilitating access is concerned with helping people to command appropriate health care resources in order to preserve or improve their health. Access is a complex concept and at least four aspects require evaluation. If services are available and there is an adequate supply of services, then the opportunity to obtain health care exists, and a population may 'have access' to services. The extent to which a population 'gains access' also depends on financial, organisational and social or cultural barriers that limit the utilisation of services. Thus access measured in terms of utilisation is dependent on the affordability, physical accessibility and acceptability of services and not merely adequacy of supply. Services available must be relevant and effective if the population is to 'gain access to satisfactory health outcomes'. The availability of services, and barriers to access, have to be considered in the context of the differing perspectives, health needs and material and cultural settings of diverse groups in society. Equity of access may be measured in terms of the availability, utilisation or outcomes of services. Both horizontal and vertical dimensions of equity require consideration. Copyright The Royal Society of Medicine Press Ltd 2002.

  20. Can contracted out health facilities improve access, equity, and quality of maternal and newborn health services? Evidence from Pakistan.

    PubMed

    Zaidi, Shehla; Riaz, Atif; Rabbani, Fauziah; Azam, Syed Iqbal; Imran, Syeda Nida; Pradhan, Nouhseen Akber; Khan, Gul Nawaz

    2015-11-25

    The case of contracting out government health services to non-governmental organizations (NGOs) has been weak for maternal, newborn, and child health (MNCH) services, with documented gains being mainly in curative services. We present an in-depth assessment of the comparative advantages of contracting out on MNCH access, quality, and equity, using a case study from Pakistan. An end-line, cross-sectional assessment was conducted of government facilities contracted out to a large national NGO and government-managed centres serving as controls, in two remote rural districts of Pakistan. Contracting out was specific for augmenting MNCH services but without contractual performance incentives. A household survey, a health facility survey, and focus group discussions with client and spouses were used for assessment. Contracted out facilities had a significantly higher utilization as compared to control facilities for antenatal care, delivery, postnatal care, emergency obstetric care, and neonatal illness. Contracted facilities had comparatively better quality of MNCH services but not in all aspects. Better household practices were also seen in the district where contracting involved administrative control over outreach programs. Contracting was also faced with certain drawbacks. Facility utilization was inequitably higher amongst more educated and affluent clients. Contracted out catchments had higher out-of-pocket expenses on MNCH services, driven by steeper transport costs and user charges for additional diagnostics. Contracting out did not influence higher MNCH service coverage rates across the catchment. Physical distances, inadequate transport, and low demand for facility-based care in non-emergency settings were key client-reported barriers. Contracting out MNCH services at government health facilities can improve facility utilization and bring some improvement in  quality of services. However, contracting out of health facilities is insufficient to increase