Computer-Based Access to Patient Care Guidelines

PubMed Central

Oliver, Diane E.; Estey, Greg; Ford, Penny; Burke, Sheila M.; Teplick, Richard S.; Zielstorff, Rita D.; Barnett, G. Octo

1990-01-01

As health care becomes more complex and expensive, interest in the potential benefits of developing and implementing patient care guidelines has emerged. We propose that a hypertext-based system designed to deal with patient-specific problems can provide a valuable method of access to such guidelines. Because intensive care medicine is one area which has become extraordinarily complex in recent years, we have chosen this as an area in which the need exists for readily accessible expertise. More specifically, in this project we are focusing on the development and implementation of guidelines for troubleshooting problems associated with the of a pulmonary artery catheter.

Air Superiority And The Anti Access/Area Denial Environment In The Asia pacific In 2044

DTIC Science & Technology

2014-04-01

Ibid. 74 Ibid. 75 Ibid. 76 Ibid. 77 Lockheed Martin, “F-22 Raptor Specifications,” http://www.lockheedmartin.com/us/products/ f22 /f-22...Specifications.” http://www.lockheedmartin.com/us/products/ f22 /f-22-specifications.html (accessed 16 March 2014). Lockheed Martin. “F-35C Carrier Variant

78 FR 38227 - Connect America Fund

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... different per- location support amounts based on the existing level of Internet access ($550 for homes with low-speed Internet access and $775, as in the first round, for homes with only dial-up access), and... Internet access. We adopt a process for challenges to the eligibility of specific areas where price cap...

Evaluation of Advanced Reactive Surface Area Estimates for Improved Prediction of Mineral Reaction Rates in Porous Media

NASA Astrophysics Data System (ADS)

Beckingham, L. E.; Mitnick, E. H.; Zhang, S.; Voltolini, M.; Yang, L.; Steefel, C. I.; Swift, A.; Cole, D. R.; Sheets, J.; Kneafsey, T. J.; Landrot, G.; Anovitz, L. M.; Mito, S.; Xue, Z.; Ajo Franklin, J. B.; DePaolo, D.

2015-12-01

CO2 sequestration in deep sedimentary formations is a promising means of reducing atmospheric CO2 emissions but the rate and extent of mineral trapping remains difficult to predict. Reactive transport models provide predictions of mineral trapping based on laboratory mineral reaction rates, which have been shown to have large discrepancies with field rates. This, in part, may be due to poor quantification of mineral reactive surface area in natural porous media. Common estimates of mineral reactive surface area are ad hoc and typically based on grain size, adjusted several orders of magnitude to account for surface roughness and reactivity. This results in orders of magnitude discrepancies in estimated surface areas that directly translate into orders of magnitude discrepancies in model predictions. Additionally, natural systems can be highly heterogeneous and contain abundant nano- and micro-porosity, which can limit connected porosity and access to mineral surfaces. In this study, mineral-specific accessible surface areas are computed for a sample from the reservoir formation at the Nagaoka pilot CO2 injection site (Japan). Accessible mineral surface areas are determined from a multi-scale image analysis including X-ray microCT, SEM QEMSCAN, XRD, SANS, and SEM-FIB. Powder and flow-through column laboratory experiments are performed and the evolution of solutes in the aqueous phase is tracked. Continuum-scale reactive transport models are used to evaluate the impact of reactive surface area on predictions of experimental reaction rates. Evaluated reactive surface areas include geometric and specific surface areas (eg. BET) in addition to their reactive-site weighted counterparts. The most accurate predictions of observed powder mineral dissolution rates were obtained through use of grain-size specific surface areas computed from a BET-based correlation. Effectively, this surface area reflects the grain-fluid contact area, or accessible surface area, in the powder dissolution experiment. In the model of the flow-through column experiment, the accessible mineral surface area, computed from the multi-scale image analysis, is evaluated in addition to the traditional surface area estimates.

Healthcare Information Technology (HIT) in an Anti-Access (A2) and Area Denial (AD) Environment

DTIC Science & Technology

2014-03-01

OFFICE OF THE COMMAND SURGEON, AIR COMBAT COMMAND FELLOWSHIP PAPER HEALTHCARE INFORMATION TECHNOLOGY (HIT) IN AN ANTI-ACCESS (A2) AND AREA...expeditionary responses. A light and lean medical response that utilizes emerging technology , specifically HIT, enhances the AFMS’ readiness posture and...expeditionary medical capability. The new USAF reality in an A2/AD environment is impeded access, very little if any technological dominance

Spatial access disparities to primary health care in rural and remote Australia.

PubMed

McGrail, Matthew Richard; Humphreys, John Stirling

2015-11-04

Poor spatial access to health care remains a key issue for rural populations worldwide. Whilst geographic information systems (GIS) have enabled the development of more sophisticated access measures, they are yet to be adopted into health policy and workforce planning. This paper provides and tests a new national-level approach to measuring primary health care (PHC) access for rural Australia, suitable for use in macro-level health policy. The new index was constructed using a modified two-step floating catchment area method framework and the smallest available geographic unit. Primary health care spatial access was operationalised using three broad components: availability of PHC (general practitioner) services; proximity of populations to PHC services; and PHC needs of the population. Data used in its measurement were specifically chosen for accuracy, reliability and ongoing availability for small areas. The resultant index reveals spatial disparities of access to PHC across rural Australia. While generally more remote areas experienced poorer access than more populated rural areas, there were numerous exceptions to this generalisation, with some rural areas close to metropolitan areas having very poor access and some increasingly remote areas having relatively good access. This new index provides a geographically-sensitive measure of access, which is readily updateable and enables a fine granulation of access disparities. Such an index can underpin national rural health programmes and policies designed to improve rural workforce recruitment and retention, and, importantly, health service planning and resource allocation decisions designed to improve equity of PHC access.

CUTTING THE CORD: SUSTAINING UNTETHERED AIR SUPERIORITY OPERATIONS IN THE PACIFIC

DTIC Science & Technology

2016-06-01

designed to provide logistics support in an A2/AD environment. In the past the USAF has used sea-based sustainment effectively and could very well... pavement classification number that represents how much weight the runway can support.14 Once suitable airfields are identified, they will need to be...Anti-Access and Area Denial (A2/AD) Anti-access capabilities are designed to prevent an adversary from accessing specific target areas such as

Universal accessibility of "accessible" fitness and recreational facilities for persons with mobility disabilities.

PubMed

Arbour-Nicitopoulos, Kelly P; Ginis, Kathleen A Martin

2011-01-01

This study descriptively measured the universal accessibility of "accessible" fitness and recreational facilities for Ontarians living with mobility disabilities. The physical and social environments of 44 fitness and recreational facilities that identified as "accessible" were assessed using a modified version of the AIMFREE. None of the 44 facilities were completely accessible. Mean accessibility ratings ranged between 31 and 63 out of a possible 100. Overall, recreational facilities had higher accessibility scores than fitness centers, with significant differences found on professional support and training, entrance areas, and parking lot. A modest correlation was found between the availability of fitness programming and the overall accessibility of fitness-center specific facility areas. Overall, the physical and social environments of the 44 fitness and recreational facilities assessed were limited in their accessibility for persons with mobility disabilities. Future efforts should be directed at establishing and meeting universal accessibility guidelines for Canadian physical activity facilities.

Higher Education In Michigan: Overcoming Challenges to Expand Access

ERIC Educational Resources Information Center

Cunningham, Alisa F.; Erisman, Wendy; Looney, Shannon E.

2008-01-01

This report examines access to higher education in underserved regions of Michigan. This study focuses on specific concerns about postsecondary education access in three geographically diverse areas of the state: suburban Macomb County; the city of Saginaw; and six rural counties in the northeastern Lower Peninsula. The report provides a summary…

A Fiscal Analysis of Proposed Education Access Grants in Minneapolis. School Choice Issues in the State

ERIC Educational Resources Information Center

Maas, Ericca

2005-01-01

This study examines the fiscal impact of model legislation that would create Education Access Grants in Minnesota. The legislation would provide grants for low-income students to attend private schools. Specifically, this study examines the effect of implementing Education Access Grants in Minneapolis, the state's largest metropolitan area. It…

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…

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 significantly larger populations at every time interval while the ACFM calculated larger catchment area sizes. This trend is counterintuitive (i.e., larger catchment should mean higher populations), and it was found to be most disparate at the shortest time intervals (under 60 minutes). Through critical evaluation of the differences, the authors elucidated that the ACFM could calculate road access in areas with no roads and overestimates access in low-density areas compared to the RM, potentially affecting delivery of care decisions. Based on these results, the authors believe that future methodologies for calculating EMS ground transport access must incorporate a continuous and valid route through the road network as well as use travel speeds appropriate to the road segments traveled; alternatively, we feel that variation in methods for calculating road distances would have little effect on realized access. Overall, as more complex models for calculating EMS ground transport access become used, there needs to be a standard methodology to improve and to compare it to. Based on these findings, the authors believe that this should be the RM. © 2012 by the Society for Academic Emergency Medicine.

Interactive access to forest inventory data for the South Central United States

Treesearch

William H. McWilliams

1990-01-01

On-line access to USDA, Forest Service successive forest inventory data for the South Central United States is provided by two computer systems. The Easy Access to Forest Inventory and Analysis Tables program (EZTAB) produces a set of tables for specific geographic areas. The Interactive Graphics and Retrieval System (INGRES) is a database management system that...

Accessibility of health clubs for people with mobility disabilities and visual impairments.

PubMed

Rimmer, James H; Riley, Barth; Wang, Edward; Rauworth, Amy

2005-11-01

We sought to examine the accessibility of health clubs to persons with mobility disabilities and visual impairments. We assessed 35 health clubs and fitness facilities as part of a national field trial of a new instrument, Accessibility Instruments Measuring Fitness and Recreation Environments (AIMFREE), designed to assess accessibility of fitness facilities in the following domains: (1) built environment, (2) equipment, (3) swimming pools, (4) information, (5) facility policies, and (6) professional behavior. All facilities had a low to moderate level of accessibility. Some of the deficiencies concerned specific Americans with Disabilities Act guidelines pertaining to the built environment, whereas other deficiency areas were related to aspects of the facilities' equipment, information, policies, and professional staff. Persons with mobility disabilities and visual impairments have difficulty accessing various areas of fitness facilities and health clubs. AIMFREE is an important tool for increasing awareness of these accessibility barriers for people with disabilities.

Accessibility of Health Clubs for People with Mobility Disabilities and Visual Impairments

PubMed Central

Rimmer, James H.; Riley, Barth; Wang, Edward; Rauworth, Amy

2005-01-01

Objective. We sought to examine the accessibility of health clubs to persons with mobility disabilities and visual impairments. Methods. We assessed 35 health clubs and fitness facilities as part of a national field trial of a new instrument, Accessibility Instruments Measuring Fitness and Recreation Environments (AIMFREE), designed to assess accessibility of fitness facilities in the following domains: (1) built environment, (2) equipment, (3) swimming pools, (4) information, (5) facility policies, and (6) professional behavior. Results. All facilities had a low to moderate level of accessibility. Some of the deficiencies concerned specific Americans with Disabilities Act guidelines pertaining to the built environment, whereas other deficiency areas were related to aspects of the facilities’ equipment, information, policies, and professional staff. Conclusions. Persons with mobility disabilities and visual impairments have difficulty accessing various areas of fitness facilities and health clubs. AIMFREE is an important tool for increasing awareness of these accessibility barriers for people with disabilities. PMID:16254234

Settlement Relocation Modeling: Reacting to Merapi’s Eruption Incident

NASA Astrophysics Data System (ADS)

Pramitasari, A.; Buchori, I.

2018-02-01

Merapi eruption has made severe damages in Central Java Province. Klaten was one of the most affected area, specifically in Balerante Village. This research is made to comprehend GIS model on finding alternative locations for impacted settlement in hazardous zones of eruption. The principal objective of the research study is to identify and analyze physical condition, community characteristics, and local government regulation related to settlements relocation plan for impacted area of eruption. The output is location map which classified into four categories, i.e. not available, available with low accessibility, available with medium accessibility, and available with high accessibility.

Energy-efficient process-stacking multiplexing access for 60-GHz mm-wave wireless personal area networks.

PubMed

Estevez, Claudio; Kailas, Aravind

2012-01-01

Millimeter-wave technology shows high potential for future wireless personal area networks, reaching over 1 Gbps transmissions using simple modulation techniques. Current specifications consider dividing the spectrum into effortlessly separable spectrum ranges. These low requirements open a research area in time and space multiplexing techniques for millimeter-waves. In this work a process-stacking multiplexing access algorithm is designed for single channel operation. The concept is intuitive, but its implementation is not trivial. The key to stacking single channel events is to operate while simultaneously obtaining and handling a-posteriori time-frame information of scheduled events. This information is used to shift a global time pointer that the wireless access point manages and uses to synchronize all serviced nodes. The performance of the proposed multiplexing access technique is lower bounded by the performance of legacy TDMA and can significantly improve the effective throughput. Work is validated by simulation results.

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.

US cardiologist workforce from 1995 to 2007: modest growth, lasting geographic maldistribution, especially in rural areas

PubMed Central

Aneja, Sanjay; Ross, Joseph S.; Wang, Yongfei; Matsumoto, Masatoshi; Rodgers, George P.; Bernheim, Susannah M.; Rathore, Saif S.; Krumholz, Harlan M.

2012-01-01

A sufficient cardiology workforce is necessary to ensure access to cardiovascular care. Specifically, access to cardiologists is important in the management and treatment of chronic cardiovascular disease. Previous workforce analyses focused narrowly on the total numbers necessary to care for the entire population and not the geographic distribution of the workforce. To examine the supply and distribution of the cardiologist workforce, we mapped the ratios of cardiologists, primary care physicians, and total physicians to the population aged 65 years or older within different Hospital Referral Regions from the years 1995 and 2007. We found within the 12-year span of our study growth in the cardiology workforce was modest compared to the primary care physician and total physician workforces. Also we found a persistent geographic misdistribution of cardiologists associated with socioeconomic population characteristics. Our results suggest that large segments of our population, specifically in rural areas, continue to have decreased access to cardiologists despite a modest growth in the overall workforce. Policy initiatives focused upon increasing the cardiologist workforces in these areas in necessary to provide adequate cardiovascular care. PMID:22147857

Characterizing Rural Food Access in Remote Areas.

PubMed

Bardenhagen, Chris J; Pinard, Courtney A; Pirog, Rich; Yaroch, Amy Lazarus

2017-10-01

Residents of rural areas may have limited access to healthy foods, leading to higher incidence of diet related health issues. Smaller grocers in rural areas experience challenges in maintaining fresh produce and other healthy foods available for customers. This study assessed the rural food environment in northeast Lower Michigan in order to inform healthy food financing projects such as the Michigan Good Food Fund. The area's retail food businesses were categorized using secondary licensing, business, and nutrition program databases. Twenty of these stores were visited in person to verify the validity of the categories created, and to assess the availability of healthy foods in their aisles. In-depth interviews with key informants were carried out with store owners, economic development personnel, and other food system stakeholders having knowledge about food access, in order to learn more about the specific challenges that the area faces. Out-shopping, seasonality, and economic challenges were found to affect healthy food availability. Mid-sized independent stores were generally found to have a larger selection of healthy foods, but smaller rural groceries also have potential to provide fresh produce and increase food access. Potential healthy food financing projects are described and areas in need of further research are identified.

Mobilizing Curriculum Studies in a (Virtual) World: Open Access, Edupunks, and the Public Good

ERIC Educational Resources Information Center

Corrigan, Julie Ann; Ng-A-Fook, Nicholas

2012-01-01

Despite societal imperatives for equity--whether espoused by nation states or transnational agencies like UNESCO--current models of higher education are unequivocally failing to provide universal access. This paper seeks to explore the (cyber)spaces (un)occupied by higher education, specifically in the area of curriculum studies, arguing that the…

SIMON: Integration of mobility and parking solutions for people with disabilities.

PubMed

Ferreras, Alberto; Barberà, Ricard; Durá-Gil, Juan Vicente; Solaz, José; Muñoz, Eva María; Serrano, Manuel; Marqués, Antonio

2015-01-01

Mobility and parking in urban areas are often difficult for people with disabilities. Obstacles include lack of accessible information on routes, transport alternatives and parking availability, as well as fraud in the use of the specific services intended for these citizens. The SIMON project aims to improve this situation through the integration of different ICT solutions. SIMON is enhancing the European Parking Card for disable people with contactless technologies and integrates mobile solutions to support user unique identification in existing parking areas whilst preserving privacy. SIMON will also promote better mobility solutions for mobility including information, navigation and access to restricted areas.

ERLN Radiation Focus Area

EPA Pesticide Factsheets

As part of the Environmental Response Laboratory Network, the National Air and Radiation Environmental Laboratory (NAREL) here provides your laboratory with access to radiation-specific laboratory guidance documents and training courses.

49 CFR 38.83 - Mobility aid accessibility.

Code of Federal Regulations, 2013 CFR

2013-10-01

... wheelchair or mobility aid users to reach areas, each with a minimum clear floor space of 48 inches by 30 inches, which do not unduly restrict passenger flow. Space to accommodate wheelchairs and mobility aids may be provided within the normal area used by standees and designation of specific spaces is not...

49 CFR 38.83 - Mobility aid accessibility.

Code of Federal Regulations, 2014 CFR

2014-10-01

... wheelchair or mobility aid users to reach areas, each with a minimum clear floor space of 48 inches by 30 inches, which do not unduly restrict passenger flow. Space to accommodate wheelchairs and mobility aids may be provided within the normal area used by standees and designation of specific spaces is not...

36 CFR 1192.83 - Mobility aid accessibility.

Code of Federal Regulations, 2014 CFR

2014-07-01

... areas, each with a minimum clear floor space of 48 inches by 30 inches, which do not unduly restrict passenger flow. Space to accommodate wheelchairs and mobility aids may be provided within the normal area used by standees and designation of specific spaces is not required. (2) Exception. If lifts, ramps or...

49 CFR 38.83 - Mobility aid accessibility.

Code of Federal Regulations, 2012 CFR

2012-10-01

... wheelchair or mobility aid users to reach areas, each with a minimum clear floor space of 48 inches by 30 inches, which do not unduly restrict passenger flow. Space to accommodate wheelchairs and mobility aids may be provided within the normal area used by standees and designation of specific spaces is not...

36 CFR 1192.83 - Mobility aid accessibility.

Code of Federal Regulations, 2012 CFR

2012-07-01

... areas, each with a minimum clear floor space of 48 inches by 30 inches, which do not unduly restrict passenger flow. Space to accommodate wheelchairs and mobility aids may be provided within the normal area used by standees and designation of specific spaces is not required. (2) Exception. If lifts, ramps or...

Land-Use-Planning Writing Assignment for an Environmental-Geology Course.

ERIC Educational Resources Information Center

Carson, Robert James; Sadd, James Lester

1991-01-01

Describes writing environmental impact statement concerning land use as assignment in geology courses. Students select area, propose land-use project, analyze available literature, choose specific site within map area for project, and write report addressing site access, water supply, liquid and solid waste disposal, mitigation of environmental…

Charting the Functional Relevance of Broca's Area for Visual Word Recognition and Picture Naming in Dutch Using fMRI-Guided TMS

ERIC Educational Resources Information Center

Wheat, Katherine L.; Cornelissen, Piers L.; Sack, Alexander T.; Schuhmann, Teresa; Goebel, Rainer; Blomert, Leo

2013-01-01

Magnetoencephalography (MEG) has shown pseudohomophone priming effects at Broca's area (specifically pars opercularis of left inferior frontal gyrus and precentral gyrus; LIFGpo/PCG) within [approximately]100 ms of viewing a word. This is consistent with Broca's area involvement in fast phonological access during visual word recognition. Here we…

NASA's UAS NAS Access Project

NASA Technical Reports Server (NTRS)

Johnson, Charles W.

2011-01-01

The vision of the Unmanned Aircraft System (UAS) Integration in the National Airspace System (NAS) Project is "A global transportation system which allows routine access for all classes of UAS." The goal of the UAS Integration in the NAS Project is to "contribute capabilities that reduce technical barriers related to the safety and operational challenges associated with enabling routine UAS access to the NAS." This goal will be accomplished through a two-phased approach based on development of system-level integration of key concepts, technologies and/or procedures, and demonstrations of integrated capabilities in an operationally relevant environment. Phase 1 will take place the first two years of the Project and Phase 2 will take place the following three years. The Phase 1 and 2 technical objectives are: Phase 1: Developing a gap analysis between current state of the art and the Next Generation Air Transportation System (NextGen) UAS Concept of Operations . Validating the key technical areas identified by this Project . Conducting initial modeling, simulation, and flight testing activities . Completing Sub-project Phase 1 deliverables (spectrum requirements, comparative analysis of certification methodologies, etc.) and continue Phase 2 preparation (infrastructure, tools, etc.) Phase 2: Providing regulators with a methodology for developing airworthiness requirements for UAS, and data to support development of certifications standards and regulatory guidance . Providing systems-level, integrated testing of concepts and/or capabilities that address barriers to routine access to the NAS. Through simulation and flight testing, address issues including separation assurance, communications requirements, and human systems integration in operationally relevant environments. The UAS in the NAS Project will demonstrate solutions in specific technology areas, which will address operational/safety issues related to UAS access to the NAS. Since the resource allocation for this Project is limited ($150M over the five years), the focus is on reducing the technical barriers where NASA has unique capabilities. As a result, technical areas, such as Sense and Avoid (SAA) and beyond line of sight command and control will not be addressed. While these are critical barriers to UAS access, currently, there is a great deal of global effort being exercised to address these challenge areas. Instead, specific technology development in areas where there is certainty that NASA can advance the research to high technology readiness levels will be the Project's focus. Specific sub-projects include Separation Assurance, Human Systems Integration, Communications, Certification, and Integrated Test and Evaluation. Each sub-project will transfer technologies to relevant key stakeholders and decision makers through research transition teams, technology forums, or through other analogous means.

36 CFR § 1192.83 - Mobility aid accessibility.

Code of Federal Regulations, 2013 CFR

2013-07-01

... users to reach areas, each with a minimum clear floor space of 48 inches by 30 inches, which do not unduly restrict passenger flow. Space to accommodate wheelchairs and mobility aids may be provided within the normal area used by standees and designation of specific spaces is not required. (2) Exception. If...

Communications Management at the Parks Reserve Forces Training Area, Camp Parks, California

DTIC Science & Technology

1994-10-31

The overall objective of the audit was to evaluate DoD management of circuit configurations for Defense Switched Network access requirements. The specific objective for this segment of the audit was to determine whether the Army used the most cost effective configuration of base and long haul telecommunications equipment and services at Camp Parks to access the Defense Switched Network.

Spatial accessibility to specific sport facilities and corresponding sport practice: the RECORD Study.

PubMed

Karusisi, Noëlla; Thomas, Frédérique; Méline, Julie; Chaix, Basile

2013-04-20

Physical activity is considered as a major component of a healthy lifestyle. However, few studies have examined the relationships between the spatial accessibility to sport facilities and sport practice with a sufficient degree of specificity. The aim of this study was to investigate the associations between the spatial accessibility to specific types of sports facilities and the practice of the corresponding sports after carefully controlling for various individual socio-demographic characteristics and neighborhood socioeconomic variables. Data from the RECORD Study involving 7290 participants recruited in 2007-2008, aged 30-79 years, and residing in the Paris metropolitan area were analyzed. Four categories of sports were studied: team sports, racket sports, swimming and related activities, and fitness. Spatial accessibility to sport facilities was measured with two complementary approaches that both take into account the street network (distance to the nearest facility and count of facilities around the dwelling). Associations between the spatial accessibility to sport facilities and the practice of the corresponding sports were assessed using multilevel logistic regression after adjusting for individual and contextual characteristics. High individual education and high household income were associated with the practice of racket sports, swimming or related activities, and fitness over the previous 7 days. The spatial accessibility to swimming pools was associated with swimming and related sports, even after adjustment for individual/contextual factors. The spatial accessibility to facilities was not related to the practice of other sports. High neighborhood income was associated with the practice of a racket sport and fitness. Accessibility is a multi-dimensional concept that integrates educational, financial, and geographical aspects. Our work supports the evidence that strategies to increase participation in sport activities should improve the spatial and financial access to specific facilities, but also address educational disparities in sport practice.

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

Aleman, S.E.

This report documents a series of capture zone analyses performed to access the expected overall performance of two (of the twelve) vertical airlift recirculation wells (ARWs) (specifically, SSR-011 and SRR-012) located in the Southern Sector of A/M Area.

Listening to the Patient: Women Veterans' Insights About Health Care Needs, Access, and Quality in Rural Areas.

PubMed

Brooks, Elizabeth; Dailey, Nancy K; Bair, Byron D; Shore, Jay H

2016-09-01

Many work to ensure that women veterans receive appropriate and timely health care, yet the needs of those living in rural areas are often ignored. This is a critical oversight given the multitude of reports documenting rural access problems and health disparities. Lacking this, we are unable to plan for and evaluate appropriate care for this specific group. In this project, we spoke with rural women veterans to document service needs and quality of care from their perspective. Rural women veterans' views about health care access and quality were ascertained in a series of five, semistructured focus groups (n = 35) and completion of a demographic questionnaire. Content analysis documented focus-group themes. Participants said that local dental, mental health, and gender-specific care options were needed, as well as alternative healing options. Community-based support for women veterans and interaction with female peers were absent. Participants' support for telehealth was mixed, as were requests for gender-specific care. Personal experiences in the military impacted participants' current service utilization. Action by both Veterans Affairs and the local community is vital to improving the health of women veterans. Service planning should consider additional Veterans Affairs contracts, mobile health vans, peer support, and enhanced outreach. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

TRI.NET Tutorial with Examples

EPA Pesticide Factsheets

This tutorial walks users through some sample TRI.NET searches to illustrate some of the ways this application can be used to access TRI data and answer basic questions about toxic chemical releases in a specific geographic area.

33 CFR 165.808 - Corpus Christi Ship Channel, Corpus Christi, TX, safety zone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Corpus Christi Ship Channel, Corpus Christi, TX, safety zone. 165.808 Section 165.808 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PORTS AND WATERWAYS SAFETY REGULATED NAVIGATION AREAS AND LIMITED ACCESS AREAS Specific Regulated Navigatio...

33 CFR 165.835 - Security Zone; Port of Mobile, Mobile Ship Channel, Mobile, AL.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Security Zone; Port of Mobile, Mobile Ship Channel, Mobile, AL. 165.835 Section 165.835 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PORTS AND WATERWAYS SAFETY REGULATED NAVIGATION AREAS AND LIMITED ACCESS AREAS Specific Regulated...

Teaching Assistants Managing Behaviour--Who Knows How They Do It? A Review of Literature

ERIC Educational Resources Information Center

Clarke, Emma; Visser, John

2016-01-01

This article reflects on the specific challenges facing teaching assistants (TAs) when managing behaviour. It considers the variety of existing research into this area, and why the paucity of specific research is problematic. It discusses how difficulties in access to training, its availability, the levels of preparation for lessons, the lack of…

Hospitals in rural or remote areas: An exploratory review of policies in 8 high-income countries.

PubMed

Rechel, Bernd; Džakula, Aleksandar; Duran, Antonio; Fattore, Giovanni; Edwards, Nigel; Grignon, Michel; Haas, Marion; Habicht, Triin; Marchildon, Gregory P; Moreno, Antonio; Ricciardi, Walter; Vaughan, Louella; Smith, Tina Anderson

2016-07-01

Our study reviewed policies in 8 high-income countries (Australia, Canada, United States, Italy, Spain, United Kingdom, Croatia and Estonia) in Europe, Australasia and North America with regard to hospitals in rural or remote areas. We explored whether any specific policies on hospitals in rural or remote areas are in place, and, if not, how countries made sure that the population in remote or rural areas has access to acute inpatient services. We found that only one of the eight countries (Italy) had drawn up a national policy on hospitals in rural or remote areas. In the United States, although there is no singular comprehensive national plan or vision, federal levers have been used to promote access in rural or remote areas and provide context for state and local policy decisions. In Australia and Canada, intermittent policies have been developed at the sub-national level of states and provinces respectively. In those countries where access to hospital services in rural or remote areas is a concern, common challenges can be identified, including the financial sustainability of services, the importance of medical education and telemedicine and the provision of quick transport to more specialized services. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Airport Choice in Sao Paulo Metropolitan Area: An Application of the Conditional Logit Model

NASA Technical Reports Server (NTRS)

Moreno, Marcelo Baena; Muller, Carlos

2003-01-01

Using the conditional LOGIT model, this paper addresses the airport choice in the Sao Paulo Metropolitan Area. In this region, Guarulhos International Airport (GRU) and Congonhas Airport (CGH) compete for passengers flying to several domestic destinations. The airport choice is believed to be a result of the tradeoff passengers perform considering airport access characteristics, airline level of service characteristics and passenger experience with the analyzed airports. It was found that access time to the airports better explain the airport choice than access distance, whereas direct flight frequencies gives better explanation to the airport choice than the indirect (connections and stops) and total (direct plus indirect) flight frequencies. Out of 15 tested variables, passenger experience with the analyzed airports was the variable that best explained the airport choice in the region. Model specifications considering 1, 2 or 3 variables were tested. The model specification most adjusted to the observed data considered access time, direct flight frequencies in the travel period (morning or afternoon peak) and passenger experience with the analyzed airports. The influence of these variables was therefore analyzed across market segments according to departure airport and flight duration criteria. The choice of GRU (located neighboring Sao Paulo city) is not well explained by the rationality of access time economy and the increase of the supply of direct flight frequencies, while the choice of CGH (located inside Sao Paulo city) is. Access time was found to be more important to passengers flying shorter distances while direct flight frequencies in the travel period were more significant to those flying longer distances. Keywords: Airport choice, Multiple airport region, Conditional LOGIT model, Access time, Flight frequencies, Passenger experience with the analyzed airports, Transportation planning

Associations of supermarket accessibility with obesity and fruit and vegetable consumption in the conterminous United States.

PubMed

Michimi, Akihiko; Wimberly, Michael C

2010-10-08

Limited access to supermarkets may reduce consumption of healthy foods, resulting in poor nutrition and increased prevalence of obesity. Most studies have focused on accessibility of supermarkets in specific urban settings or localized rural communities. Less is known, however, about how supermarket accessibility is associated with obesity and healthy diet at the national level and how these associations differ in urban versus rural settings. We analyzed data on obesity and fruit and vegetable (F/V) consumption from the Behavioral Risk Factor Surveillance System for 2000-2006 at the county level. We used 2006 Census Zip Code Business Patterns data to compute population-weighted mean distance to supermarket at the county level for different sizes of supermarket. Multilevel logistic regression models were developed to test whether population-weighted mean distance to supermarket was associated with both obesity and F/V consumption and to determine whether these relationships varied for urban (metropolitan) versus rural (nonmetropolitan) areas. Distance to supermarket was greater in nonmetropolitan than in metropolitan areas. The odds of obesity increased and odds of consuming F/V five times or more per day decreased as distance to supermarket increased in metropolitan areas for most store size categories. In nonmetropolitan areas, however, distance to supermarket had no associations with obesity or F/V consumption for all supermarket size categories. Obesity prevalence increased and F/V consumption decreased with increasing distance to supermarket in metropolitan areas, but not in nonmetropolitan areas. These results suggest that there may be a threshold distance in nonmetropolitan areas beyond which distance to supermarket no longer impacts obesity and F/V consumption. In addition, obesity and food environments in nonmetropolitan areas are likely driven by a more complex set of social, cultural, and physical factors than a single measure of supermarket accessibility. Future research should attempt to more precisely quantify the availability and affordability of foods in nonmetropolitan areas and consider alternative sources of healthy foods besides supermarkets.

Associations of supermarket accessibility with obesity and fruit and vegetable consumption in the conterminous United States

PubMed Central

2010-01-01

Background Limited access to supermarkets may reduce consumption of healthy foods, resulting in poor nutrition and increased prevalence of obesity. Most studies have focused on accessibility of supermarkets in specific urban settings or localized rural communities. Less is known, however, about how supermarket accessibility is associated with obesity and healthy diet at the national level and how these associations differ in urban versus rural settings. We analyzed data on obesity and fruit and vegetable (F/V) consumption from the Behavioral Risk Factor Surveillance System for 2000-2006 at the county level. We used 2006 Census Zip Code Business Patterns data to compute population-weighted mean distance to supermarket at the county level for different sizes of supermarket. Multilevel logistic regression models were developed to test whether population-weighted mean distance to supermarket was associated with both obesity and F/V consumption and to determine whether these relationships varied for urban (metropolitan) versus rural (nonmetropolitan) areas. Results Distance to supermarket was greater in nonmetropolitan than in metropolitan areas. The odds of obesity increased and odds of consuming F/V five times or more per day decreased as distance to supermarket increased in metropolitan areas for most store size categories. In nonmetropolitan areas, however, distance to supermarket had no associations with obesity or F/V consumption for all supermarket size categories. Conclusions Obesity prevalence increased and F/V consumption decreased with increasing distance to supermarket in metropolitan areas, but not in nonmetropolitan areas. These results suggest that there may be a threshold distance in nonmetropolitan areas beyond which distance to supermarket no longer impacts obesity and F/V consumption. In addition, obesity and food environments in nonmetropolitan areas are likely driven by a more complex set of social, cultural, and physical factors than a single measure of supermarket accessibility. Future research should attempt to more precisely quantify the availability and affordability of foods in nonmetropolitan areas and consider alternative sources of healthy foods besides supermarkets. PMID:20932312

33 CFR 165.T01-0519 - Safety zone; ship repair in Penobscot Bay, ME.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Safety zone; ship repair in Penobscot Bay, ME. 165.T01-0519 Section 165.T01-0519 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) PORTS AND WATERWAYS SAFETY REGULATED NAVIGATION AREAS AND LIMITED ACCESS AREAS Specific Regulated Navigation...

I Never Left a Place that I didn’t Clean up. The Legacy of Historic Settlement on Lands Administered by Holloman Air Force Base.

DTIC Science & Technology

1994-10-01

these two sites. Extensive artifact analyses would contribute to studies concerning consumer behavior , and archaeological testing would help determine...Specific research areas to be considered especially from the artifact assemblages are: subsistence patterns, consumer behavior , market accessibility...to provide archaeological information which could be used in various studies, such as subsistence patterns, consumer behavior , market accessibility

Identifying areas of need relative to liver disease: geographic clustering within a health service district.

PubMed

El-Atem, Nathan; Irvine, Katharine M; Valery, Patricia C; Wojcik, Kyle; Horsfall, Leigh; Johnson, Tracey; Janda, Monika; McPhail, Steven M; Powell, Elizabeth E

2017-08-01

Background Many people with chronic liver disease (CLD) are not detected until they present to hospital with advanced disease, when opportunities for intervention are reduced and morbidity is high. In order to build capacity and liver expertise in the community, it is important to focus liver healthcare resources in high-prevalence disease areas and specific populations with an identified need. The aim of the present study was to examine the geographic location of people seen in a tertiary hospital hepatology clinic, as well as ethnic and sociodemographic characteristics of these geographic areas. Methods The geographic locations of hepatology out-patients were identified via the out-patient scheduling database and grouped into statistical area (SA) regions for demographic analysis using data compiled by the Australian Bureau of Statistics. Results During the 3-month study period, 943 individuals from 71 SA Level 3 regions attended clinic. Nine SA Level 3 regions accounted for 55% of the entire patient cohort. Geographic clustering was seen especially for people living with chronic hepatitis B virus. There was a wide spectrum of socioeconomic advantage and disadvantage in areas with high liver disease prevalence. Conclusions The geographic area from which people living with CLD travel to access liver health care is extensive. However, the greatest demand for tertiary liver disease speciality care is clustered within specific geographic areas. Outreach programs targeted to these areas may enhance liver disease-specific health service resourcing. What is known about the topic? The demand for tertiary hospital clinical services in CLD is rising. However, there is limited knowledge about the geographic areas from which people living with CLD travel to access liver services, or the ethnic, socioeconomic and education characteristics of these areas. What does this paper add? The present study demonstrates that a substantial proportion of people living with CLD and accessing tertiary hospital liver services are clustered within specific geographic areas. The most striking geographic clustering was seen for people living with chronic hepatitis B, in regions with a relatively high proportion of people born in Vietnam and China. In addition to ethnicity, the data show an apparent ecological association between liver disease and both socioeconomic and educational and/or occupational disadvantage. What are the implications for practitioners? Identifying where demand for clinical services arises is an important step for service planning and preparing for potential outreach programs to optimise community-based care. It is likely that outreach programs to engage and enhance primary care services in geographic areas from which the greatest demand for tertiary liver disease speciality care arises would yield greater relative return on investment than non-targeted outreach programs.

The Role of Remote Sensing in Assessing Forest Biomass in Appalachian South Carolina

NASA Technical Reports Server (NTRS)

Shain, W.; Nix, L.

1982-01-01

Information is presented on the use of color infrared aerial photographs and ground sampling methods to quantify standing forest biomass in Appalachian South Carolina. Local tree biomass equations are given and subsequent evaluation of stand density and size classes using remote sensing methods is presented. Methods of terrain analysis, environmental hazard rating, and subsequent determination of accessibility of forest biomass are discussed. Computer-based statistical analyses are used to expand individual cover-type specific ground sample data to area-wide cover type inventory figures based on aerial photographic interpretation and area measurement. Forest biomass data are presented for the study area in terms of discriminant size classes, merchantability limits, accessibility (as related to terrain and yield/harvest constraints), and potential environmental impact of harvest.

Guiding Future Research on the Community College Transfer Function: Summary of a National Seminar (Washington, D.C., September 21-22, 1992).

ERIC Educational Resources Information Center

Ludwig, Meredith J.; Palmer, James C.

1993-01-01

In September 1992, a small group of experienced researchers met to identify areas of research and specific research hypotheses to guide further inquiry into transfer. Specifically, participants examined transfer as it relates to institutional mission, institutional organization, and access to education and identified various premises upon which…

Shopping center wheelchair accessibility: ongoing advocacy to implement the Americans with Disabilities Act of 1990.

PubMed

McClain, L

2000-01-01

Although the regulations of the Americans with Disabilities Act (ADA) of 1990 were phased in by 1992, monitoring and enforcement continue to be problematic. This study of three large shopping centers in the Southwest included one mall that was opened in the mid-1990s, and two malls that were constructed prior to the law (but have undergone recent renovations). Use of the ADA Accessibility Guidelines Checklist for Buildings and Facilities (Architectural and Transportation Barriers Compliance Board [ATBCB], 1992) generated data which were analyzed descriptively to determine the frequency and percent compliance in: parking lots, entrances, ramps, elevators, telephones, restrooms, food courts, and 12 specific store-types. No mall was fully compliant in any area, other than telephone specifications. In other areas, compliance ranged from 0% (ramp slopes in the newer mall) to many areas of 100% compliance (for example, outdoor curb ramps and food court seating spaces and aisles). The implications are that shoppers who are wheelchair mobile cannot count on complete compliance and cannot predict which physical architectural barriers they will find in shopping centers.

Beyond the visual word form area: the orthography-semantics interface in spelling and reading.

PubMed

Purcell, Jeremy J; Shea, Jennifer; Rapp, Brenda

2014-01-01

Lexical orthographic information provides the basis for recovering the meanings of words in reading and for generating correct word spellings in writing. Research has provided evidence that an area of the left ventral temporal cortex, a subregion of what is often referred to as the visual word form area (VWFA), plays a significant role specifically in lexical orthographic processing. The current investigation goes beyond this previous work by examining the neurotopography of the interface of lexical orthography with semantics. We apply a novel lesion mapping approach with three individuals with acquired dysgraphia and dyslexia who suffered lesions to left ventral temporal cortex. To map cognitive processes to their neural substrates, this lesion mapping approach applies similar logical constraints to those used in cognitive neuropsychological research. Using this approach, this investigation: (a) identifies a region anterior to the VWFA that is important in the interface of orthographic information with semantics for reading and spelling; (b) determines that, within this orthography-semantics interface region (OSIR), access to orthography from semantics (spelling) is topographically distinct from access to semantics from orthography (reading); (c) provides evidence that, within this region, there is modality-specific access to and from lexical semantics for both spoken and written modalities, in both word production and comprehension. Overall, this study contributes to our understanding of the neural architecture at the lexical orthography-semantic-phonological interface within left ventral temporal cortex.

Nano- to Formation-Scale Estimates of Mineral-Specific Reactive Surface Area

NASA Astrophysics Data System (ADS)

Cole, D. R.; Swift, A.; Sheets, J.; Anovitz, L. M.

2017-12-01

Predictions of changes in fluid composition, coupled with the evolution of the solid matrix, include the generation and testing of reactive transport models. However, translating a heterogeneous natural system into physical and chemical model parameters, including the critical but poorly-constrained metric of fluid-accessible surface area, continues to challenge Earth scientists. Studies of carbon storage capacity, permeability, rock strain due to mineral dissolution and precipitation, or the prediction of rock evolution through diagenesis and weathering each consider macroscale outcomes of processes that often are critically impacted by rock surface geometry at the nanoscale. The approach taken here is to consider the whole vertical extent of a saline reservoir and then to address two questions. First, what is the accessible surface area for each major mineral, and for all adjacent pore sizes from <2 nm on up, within each major lithofacies in that formation? Second, with the formation thus divided into units of analysis, parameterized, and placed into geologic context, what constraints can be placed on reactive surface area as a function of mineral composition? A complex sandstone covering a substantial fraction of the quartz-K-feldspar-illite ternary is selected and mineral-specific surface area quantified using neutron scattering, nitrogen and mercury porosimetry, multi-signal high-resolution mineral mapping, and other techniques. For neutron scattering, scale-specific pore geometries enable more accurate translation of volume into surface area. By applying this workflow to all end-member lithologies of this reservoir formation, equations and maps of surface area as a function of position on a quartz-feldspar-clay ternary plot are developed for each major mineral. Results from this work therefore advance our ability to parameterize models not just for the particular formation studied, but for similar geologic units as well.

Spatial accessibility to specific sport facilities and corresponding sport practice: the RECORD Study

PubMed Central

2013-01-01

Background Physical activity is considered as a major component of a healthy lifestyle. However, few studies have examined the relationships between the spatial accessibility to sport facilities and sport practice with a sufficient degree of specificity. The aim of this study was to investigate the associations between the spatial accessibility to specific types of sports facilities and the practice of the corresponding sports after carefully controlling for various individual socio-demographic characteristics and neighborhood socioeconomic variables. Methods Data from the RECORD Study involving 7290 participants recruited in 2007–2008, aged 30–79 years, and residing in the Paris metropolitan area were analyzed. Four categories of sports were studied: team sports, racket sports, swimming and related activities, and fitness. Spatial accessibility to sport facilities was measured with two complementary approaches that both take into account the street network (distance to the nearest facility and count of facilities around the dwelling). Associations between the spatial accessibility to sport facilities and the practice of the corresponding sports were assessed using multilevel logistic regression after adjusting for individual and contextual characteristics. Results High individual education and high household income were associated with the practice of racket sports, swimming or related activities, and fitness over the previous 7 days. The spatial accessibility to swimming pools was associated with swimming and related sports, even after adjustment for individual/contextual factors. The spatial accessibility to facilities was not related to the practice of other sports. High neighborhood income was associated with the practice of a racket sport and fitness. Conclusions Accessibility is a multi-dimensional concept that integrates educational, financial, and geographical aspects. Our work supports the evidence that strategies to increase participation in sport activities should improve the spatial and financial access to specific facilities, but also address educational disparities in sport practice. PMID:23601332

Geospatial Authentication

NASA Technical Reports Server (NTRS)

Lyle, Stacey D.

2009-01-01

A software package that has been designed to allow authentication for determining if the rover(s) is/are within a set of boundaries or a specific area to access critical geospatial information by using GPS signal structures as a means to authenticate mobile devices into a network wirelessly and in real-time. The advantage lies in that the system only allows those with designated geospatial boundaries or areas into the server.

33 CFR 165.1404 - Apra Harbor, Guam-security zone.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) PORTS AND WATERWAYS SAFETY REGULATED NAVIGATION AREAS AND LIMITED ACCESS AREAS Specific Regulated... surrounding Naval Mooring Buoy No. 702 (Located at 13°27′30.1″ N and 144°38′12.9″ E. Based on World Geodetic... unless authorized by the Captain of the Port, Guam. [COTP Guam Reg. 89-001, 55 FR 18725, May 4, 1990] ...

Geographical accessibility to community pharmacies by the elderly in metropolitan Lisbon.

PubMed

Padeiro, Miguel

2018-07-01

In ageing societies, community pharmacies play an important role in delivering medicines, responsible advising, and other targeted services. Elderly people are among their main consumers, as they use more prescription drugs, need more specific health care, and experience more mobility issues than other age groups. This makes geographical accessibility a relevant concern for them. To measure geographical pedestrian accessibility to community pharmacies by elderly people in the Lisbon Metropolitan Area (LMA). The number of elderly people living within a 10- and 15-min walk was estimated based on the exploitation of population census data, the address-based location of 801 community pharmacies, and a Google Maps Application Programming Interface (API) method for calculating distances between pharmacies and the centroids of census statistical subsections. Results were compared to figures attained via traditional methods. In the LMA, 61.2% of the elderly live less than a 10 min walk from the nearest pharmacy and 76.9% live less than 15 min away. This opposes the common view that pharmacies are highly accessible in urban areas. In addition, results show a high spatial variability of proximity to pharmacies. Despite the illusion of good coverage suggested at the metropolitan scale, accessibility measures demonstrate the existence of pharmaceutical deprivation areas for the elderly. The findings indicate the need for more accuracy in both access measurements and redistribution policies. Measurement methods and population targets should be reconsidered. Copyright © 2017 Elsevier Inc. All rights reserved.

A research agenda for a people-centred approach to energy access in the urbanizing global south

NASA Astrophysics Data System (ADS)

Broto, Vanesa Castán; Stevens, Lucy; Ackom, Emmanuel; Tomei, Julia; Parikh, Priti; Bisaga, Iwona; To, Long Seng; Kirshner, Joshua; Mulugetta, Yacob

2017-10-01

Energy access is typically viewed as a problem for rural areas, but people living in urban settings also face energy challenges that have not received sufficient attention. A revised agenda in research and practice that puts the user and local planning complexities centre stage is needed to change the way we look at energy access in urban areas, to understand the implications of the concentration of vulnerable people in slums and to identify opportunities for planned management and innovation that can deliver urban energy transitions while leaving no one behind. Here, we propose a research agenda focused on three key issues: understanding the needs of urban energy users; enabling the use of context-specific, disaggregated data; and engaging with effective modes of energy and urban governance. This agenda requires interdisciplinary scholarship across the social and physical sciences to support local action and deliver large-scale, inclusive transformations.

Measuring geographic access to health care: raster and network-based methods

PubMed Central

2012-01-01

Background Inequalities in geographic access to health care result from the configuration of facilities, population distribution, and the transportation infrastructure. In recent accessibility studies, the traditional distance measure (Euclidean) has been replaced with more plausible measures such as travel distance or time. Both network and raster-based methods are often utilized for estimating travel time in a Geographic Information System. Therefore, exploring the differences in the underlying data models and associated methods and their impact on geographic accessibility estimates is warranted. Methods We examine the assumptions present in population-based travel time models. Conceptual and practical differences between raster and network data models are reviewed, along with methodological implications for service area estimates. Our case study investigates Limited Access Areas defined by Michigan’s Certificate of Need (CON) Program. Geographic accessibility is calculated by identifying the number of people residing more than 30 minutes from an acute care hospital. Both network and raster-based methods are implemented and their results are compared. We also examine sensitivity to changes in travel speed settings and population assignment. Results In both methods, the areas identified as having limited accessibility were similar in their location, configuration, and shape. However, the number of people identified as having limited accessibility varied substantially between methods. Over all permutations, the raster-based method identified more area and people with limited accessibility. The raster-based method was more sensitive to travel speed settings, while the network-based method was more sensitive to the specific population assignment method employed in Michigan. Conclusions Differences between the underlying data models help to explain the variation in results between raster and network-based methods. Considering that the choice of data model/method may substantially alter the outcomes of a geographic accessibility analysis, we advise researchers to use caution in model selection. For policy, we recommend that Michigan adopt the network-based method or reevaluate the travel speed assignment rule in the raster-based method. Additionally, we recommend that the state revisit the population assignment method. PMID:22587023

Techniques for the Detection of Faulty Packet Header Modifications

DTIC Science & Technology

2014-03-12

layer approaches to check if packets are being altered by middleboxes and were primarily developed as network neutrality analysis tools. Switzerland works...local and metropolitan area networks –specific requirements part 11: Wireless LAN medium access control (MAC) and physical layer (PHY) specifications...policy or position of the Department of Defense or the U.S. Government. Understanding, measuring, and debugging IP networks , particularly across

Methodologies and Methods for User Behavioral Research.

ERIC Educational Resources Information Center

Wang, Peiling

1999-01-01

Discusses methodological issues in empirical studies of information-related behavior in six specific research areas: information needs and uses; information seeking; relevance judgment; online searching (including online public access catalog, online database, and the Web); human-system interactions; and reference transactions. (Contains 191…

Health Disparities in Women

PubMed Central

Hornbuckle, Lyndsey M; Amutah-Onukagha, Ndidiamaka; Bryan, Alicia; Skidmore Edwards, Elizabeth; Madzima, Takudzwa; Massey, Kelly; May, Linda; Robinson, Leah E

2017-01-01

AIMS AND SCOPE Clinical Medicine Insights: Women’s Health is an international, open-access, peer-reviewed journal which considers manuscripts on all aspects of the diagnosis, management, and prevention of disorders specific to women, in addition to related genetic, pathophysiological, and epidemiological topics. Clinical Medicine Insights: Women’s Health aims to provide researchers working in this complex, quickly developing field with online, open access to highly relevant scholarly articles by leading international researchers. In a field where the literature is ever-expanding, researchers increasingly need access to up-to-date, high-quality scholarly articles on areas of specific contemporary interest. This supplement is on Health Disparities in Women. This supplement aims to address this by presenting high-quality articles that allow readers to distinguish the signal from the noise. The editor in chief hopes that through this effort, practitioners and researchers will be aided in finding answers to some of the most complex and pressing issues of our time. PMID:28579867

Science information systems: Archive, access, and retrieval

NASA Technical Reports Server (NTRS)

Campbell, William J.

1991-01-01

The objective of this research is to develop technology for the automated characterization and interactive retrieval and visualization of very large, complex scientific data sets. Technologies will be developed for the following specific areas: (1) rapidly archiving data sets; (2) automatically characterizing and labeling data in near real-time; (3) providing users with the ability to browse contents of databases efficiently and effectively; (4) providing users with the ability to access and retrieve system independent data sets electronically; and (5) automatically alerting scientists to anomalies detected in data.

Treating childhood pneumonia in hard-to-reach areas: a model-based comparison of mobile clinics and community-based care.

PubMed

Pitt, Catherine; Roberts, Bayard; Checchi, Francesco

2012-01-10

Where hard-to-access populations (such as those living in insecure areas) lack access to basic health services, relief agencies, donors, and ministries of health face a dilemma in selecting the most effective intervention strategy. This paper uses a decision mathematical model to estimate the relative effectiveness of two alternative strategies, mobile clinics and fixed community-based health services, for antibiotic treatment of childhood pneumonia, the world's leading cause of child mortality. A "Markov cycle tree" cohort model was developed in Excel with Visual Basic to compare the number of deaths from pneumonia in children aged 1 to 59 months expected under three scenarios: 1) No curative services available, 2) Curative services provided by a highly-skilled but intermittent mobile clinic, and 3) Curative services provided by a low-skilled community health post. Parameter values were informed by literature and expert interviews. Probabilistic sensitivity analyses were conducted for several plausible scenarios. We estimated median pneumonia-specific under-5 mortality rates of 0.51 (95% credible interval: 0.49 to 0.541) deaths per 10,000 child-days without treatment, 0.45 (95% CI: 0.43 to 0.48) with weekly mobile clinics, and 0.31 (95% CI: 0.29 to 0.32) with CHWs in fixed health posts. Sensitivity analyses found the fixed strategy superior, except when mobile clinics visited communities daily, where rates of care-seeking were substantially higher at mobile clinics than fixed posts, or where several variables simultaneously differed substantially from our baseline assumptions. Current evidence does not support the hypothesis that mobile clinics are more effective than CHWs. A CHW strategy therefore warrants consideration in high-mortality, hard-to-access areas. Uncertainty remains, and parameter values may vary across contexts, but the model allows preliminary findings to be updated as new or context-specific evidence becomes available. Decision analytic modelling can guide needed field-based research efforts in hard-to-access areas and offer evidence-based insights for decision-makers.

50 CFR 648.59 - Sea Scallop Access Areas.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Sea Scallop Access Areas. 648.59 Section... Atlantic Sea Scallop Fishery § 648.59 Sea Scallop Access Areas. (a) Delmarva Sea Scallop Access Area. (1... in or from the area known as the Delmarva Sea Scallop Access Area, described in paragraph (a)(2) of...

50 CFR 648.59 - Sea Scallop Access Areas.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 12 2013-10-01 2013-10-01 false Sea Scallop Access Areas. 648.59 Section... Atlantic Sea Scallop Fishery § 648.59 Sea Scallop Access Areas. (a) [Reserved] (b) Closed Area I Access... whereby the vessel gains a Closed Area I Access Area trip and gives up a trip into another Sea Scallop...

Disparities in the access to primary healthcare in rural areas from the county of Iasi - Romania.

PubMed

Duma, Olga-Odetta; Roşu, Solange Tamara; Manole, M; Petrariu, F D; Constantin, Brânduşa

2014-01-01

To identify the factors that may conduct to various forms of social exclusion of the population from the primary healthcare and to analyze health disparities as population-specific differences in the access to primary healthcare in rural compared to urban residence areas from Iasi, the second biggest county, situated in the North--East region of Romania. This research is a type of inquiry-based opinion survey of the access to primary healthcare in rural compared to urban areas of the county of Iasi. Data were collected by face-to-face interviews. There were taken into account the socioeconomic status (education level in the adult population, employment status, family income, household size) and two temporal variables (the interval of time spent to arrive at the primary healthcare office as a marker for the geographical access and the waiting time for a consultation). The study group consisted of two samples, from rural and urban area, each of 150 patients, all ages, randomly selected, who were waiting at the family doctor's practice. The study has identified disparities related to a poor economic status assessed through the employed status ("not working" 15% in urban and of 20% in rural).The income calculated per member of family and divided in terciles has recorded significant differences for "high" (36.7% urban and 14.7% rural) and "low", respectively (14.6% urban and 56.6% rural). High household size with more than five members represented 22.6% of the total subjects in rural and 15.3% in urban areas. The assessment of the education level in the adult population (> 18 years) revealed that in the rural areas more than a half (56%) of the sample is placed in the category primary and secondary incomplete, whereas the value for secondary complete and postsecondary was 37.3%. The proportion of respondents in the urban areas who have post-secondary education is five times higher than those in rural areas (15.4% vs. 2.7%). The reduced geographical access assessed as the interval of time spent to arrive at the primary healthcare office revealed, on average, 25 minutes in urban versus 75 minutes in rural areas. The research outcomes highlight the fact that the population living in rural communities from the county of Iasi, are disadvantaged in accessing the primary health services, with negative consequences on the health status.

Structuring Broadcast Audio for Information Access

NASA Astrophysics Data System (ADS)

Gauvain, Jean-Luc; Lamel, Lori

2003-12-01

One rapidly expanding application area for state-of-the-art speech recognition technology is the automatic processing of broadcast audiovisual data for information access. Since much of the linguistic information is found in the audio channel, speech recognition is a key enabling technology which, when combined with information retrieval techniques, can be used for searching large audiovisual document collections. Audio indexing must take into account the specificities of audio data such as needing to deal with the continuous data stream and an imperfect word transcription. Other important considerations are dealing with language specificities and facilitating language portability. At Laboratoire d'Informatique pour la Mécanique et les Sciences de l'Ingénieur (LIMSI), broadcast news transcription systems have been developed for seven languages: English, French, German, Mandarin, Portuguese, Spanish, and Arabic. The transcription systems have been integrated into prototype demonstrators for several application areas such as audio data mining, structuring audiovisual archives, selective dissemination of information, and topic tracking for media monitoring. As examples, this paper addresses the spoken document retrieval and topic tracking tasks.

Internet testing for Chlamydia trachomatis in England, 2006 to 2010.

PubMed

Woodhall, Sarah C; Sile, Bersabeh; Talebi, Alireza; Nardone, Anthony; Baraitser, Paula

2012-12-19

In recent years there has been interest in websites as a means of increasing access to free chlamydia tests through the National Chlamydia Screening Programme (NCSP) in England. We aimed to describe and evaluate online access to chlamydia testing within the NCSP. We analysed NCSP chlamydia testing data (2006-2010) for 15-24 year olds from the 71/95 programme areas in England where site codes were available to identify tests ordered through the internet. The characteristics of people using online testing services in 2010 were compared with those testing in general practice (GP) or community sexual and reproductive health (SRH) services. We evaluated 58 websites offering free chlamydia tests through the NCSP, and 32 offering kits on a commercial basis for signposting to clinical service and health promotion advice offered. Between 2006 and 2010, 5% of all tests in the included programme areas were accessed through the internet. The number of internet tests increased from 18 (<1% of all tests) in 2006 to 59,750 in 2010 (6% of all NCSP tests). In 2010 the proportion of NCSP tests accessed online by programme area ranged from <1% to 38%. The proportion of tests with a positive result on the internet was higher than tests from general practice and comparable to those from community SRH services (internet 7.6%; GP 5.6%; Community SRH 8.2%). A higher proportion of people accessing online testing were male, aged 20-24 and reported >1 sexual partner in the past year. Provision of sexual health information and appropriate signposting for those in need of clinical services varied between websites. Service provision within the NCSP was fragmented with multiple providers serving specific geographical catchment areas. Internet testing reaches a population with a relatively high risk of chlamydia infection and appears acceptable to young men, a group that has been difficult to engage with chlamydia testing. In order to maximise the potential benefit of these services, websites should be consistent with national guidelines and adhere to minimum standards for signposting to clinical care and health promotion information. The current system with multiple providers servicing geographically specific catchment areas is contrary to the geographically unrestricted nature of the internet and potentially confusing for clients.

Recommendations from Transgender Healthcare Consumers in Rural Areas

PubMed Central

Knutson, Douglas; Martyr, Meredith A.; Mitchell, Travis A.; Arthur, Tori; Koch, Julie M.

2018-01-01

Abstract Purpose: Scholars indicate that rates of mental and physical health issues (e.g., substance use, anxiety, depression) may be much higher among transgender individuals relative to the general population. This disparity may be even greater for transgender individuals in rural areas. Clinical researchers suggest using affirmative therapeutic approaches and interventions to address the health concerns of transgender individuals, specifically to connect individuals with the transgender community. However, little is known about the content of information that is shared in transgender communities in rural areas. Method: For this qualitative study, researchers asked transgender individuals in rural areas (n=10) what recommendations they would offer to other transgender individuals in rural areas regarding healthcare access. Results: Results were organized into four domains: Access care, Quality control, Difficulties, and Mentorship. Within these domains, we identified 11 sub-domains: Get physical healthcare, Get mental healthcare, Provider search, Provider vetting, Treatment verification, It will be difficult, Know who you are, Believe in yourself, Move, Connect to community, and Other. Conclusions: We discuss implications of our findings for healthcare provision in rural areas, and we provide recommendations for future research.

50 CFR 648.59 - Sea Scallop Access Areas.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 10 2011-10-01 2011-10-01 false Sea Scallop Access Areas. 648.59 Section... Atlantic Sea Scallop Fishery § 648.59 Sea Scallop Access Areas. (a) Delmarva Sea Scallop Access Area. (1... Sea Scallop Access Area, described in paragraph (a)(2) of this section, only if the vessel is...

50 CFR 648.59 - Sea Scallop Access Areas.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 12 2012-10-01 2012-10-01 false Sea Scallop Access Areas. 648.59 Section... Atlantic Sea Scallop Fishery § 648.59 Sea Scallop Access Areas. (a) Delmarva Sea Scallop Access Area. (1... Sea Scallop Access Area, described in paragraph (a)(2) of this section, only if the vessel is...

Patient Experienced Continuity of Care in the Psychiatric Healthcare System—A Study Including Immigrants, Refugees and Ethnic Danes

PubMed Central

Jensen, Natasja Koitzsch; Johansen, Katrine Schepelern; Kastrup, Marianne; Krasnik, Allan; Norredam, Marie

2014-01-01

Aim: The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. Method: The study is based on 19 narrative interviews conducted with 15 patients with diverse migration backgrounds (immigrants, descendents, refugees, and ethnic Danes). Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refugees. Data were analysed through the lens of a theoretical framework of continuity of care in psychiatry, developed in 2004 by Joyce et al., which encompasses four domains: accessibility, individualised care, relationship base and service delivery. Results: Investigating continuity of care, we found issues of specific concern to immigrants and refugees, but also commonalities across the groups. For accessibility, areas pertinent to immigrants and refugees include lack of knowledge concerning mental illness and obligations towards children. In terms of individualised care, trauma, additional vulnerability, and taboo concerning mental illness were of specific concern. In the domain of service delivery, social services included assistance with immigration papers for immigrants and refugees. In the relationship base domain, no differences were identified. Implications for priority area: The treatment courses of patients in the psychiatric field are complex and diverse and the patient perspective of continuity of care provides important insight into the delivery of care. The study highlights the importance of person-centred care irrespective of migration background though it may be beneficial to have an awareness of areas that may be of more specific concern to immigrants and refugees. Conclusions: The study sheds light on concerns specific to immigrants and refugees in a framework of continuity of care, but also commonalities across the patient groups. PMID:25233017

The role of NASA's Water Resources applications area in improving access to water quality-related information and water resources management

NASA Astrophysics Data System (ADS)

Lee, C. M.

2016-02-01

The NASA Applied Sciences Program plays a unique role in facilitating access to remote sensing-based water information derived from US federal assets towards the goal of improving science and evidence-based decision-making in water resources management. The Water Resources Application Area within NASA Applied Sciences works specifically to develop and improve water data products to support improved management of water resources, with partners who are faced with real-world constraints and conditions including cost and regulatory standards. This poster will highlight the efforts and collaborations enabled by this program that have resulted in integration of remote sensing-based information for water quality modeling and monitoring within an operational context.

The role of NASA's Water Resources applications area in improving access to water quality-related information and water resources management

NASA Astrophysics Data System (ADS)

Lee, C. M.

2016-12-01

The NASA Applied Sciences Program plays a unique role in facilitating access to remote sensing-based water information derived from US federal assets towards the goal of improving science and evidence-based decision-making in water resources management. The Water Resources Application Area within NASA Applied Sciences works specifically to develop and improve water data products to support improved management of water resources, with partners who are faced with real-world constraints and conditions including cost and regulatory standards. This poster will highlight the efforts and collaborations enabled by this program that have resulted in integration of remote sensing-based information for water quality modeling and monitoring within an operational context.

Resource Inventories [1990].

ERIC Educational Resources Information Center

Council for Exceptional Children, Reston, VA. Center for Special Education Technology.

This set of 10 resource inventories provides listings of information and service resources organized by state or by subtopic. Listings typically include name, address, phone, and a contact person. The first inventory lists the 39 Alliance for Technology Access Centers which are community-based resources providing specific areas of expertise for…

32 CFR 635.1 - General.

Code of Federal Regulations, 2013 CFR

2013-07-01

... life. Specific examples include the social security number (SSN), medical history, home address, and... storage systems providing equal or greater protection may be used in accordance with AR 25-55. (e) Only personnel on official business can have access to areas in which computers are used to store, process or...

32 CFR 635.1 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... life. Specific examples include the social security number (SSN), medical history, home address, and... storage systems providing equal or greater protection may be used in accordance with AR 25-55. (e) Only personnel on official business can have access to areas in which computers are used to store, process or...

32 CFR 635.1 - General.

Code of Federal Regulations, 2012 CFR

2012-07-01

... life. Specific examples include the social security number (SSN), medical history, home address, and... storage systems providing equal or greater protection may be used in accordance with AR 25-55. (e) Only personnel on official business can have access to areas in which computers are used to store, process or...

32 CFR 635.1 - General.

Code of Federal Regulations, 2014 CFR

2014-07-01

... life. Specific examples include the social security number (SSN), medical history, home address, and... storage systems providing equal or greater protection may be used in accordance with AR 25-55. (e) Only personnel on official business can have access to areas in which computers are used to store, process or...

Breaking open the set top box

NASA Astrophysics Data System (ADS)

Banks, David; Wiley, Anthony; Catania, Nicolas; Coles, Alastair N.; Smith, Duncan; Baynham, Simon; Deliot, Eric; Chidzey, Rod

1998-02-01

In this paper we describe the work being done at HP Labs Bristol in the area of home networks and gateways. This work is based on the idea of breaking open the set top box by physically separating the access network specific functions from the application specific functions. The access network specific functions reside in an access network gateway that can be shared by many end user devices. The first section of the paper present the philosophy behind this approach. The end user devices and the access network gateways must be interconnected by a high bandwidth network which can offer a bounded delay service for delay sensitive traffic. We are advocating the use of IEEE 1394 for this network, and the next section of the paper gives a brief introduction to this technology. We then describe a prototype digital video broadcasting satellite compliant gateway that we have built. This gateway could be used, for example, by a PC for receiving a data service or by a digital TV for receiving an MPEG-2 video service. A control architecture is the presented which uses a PC application to provide a web based user interface to the system. Finally, we provide details of our work on extending the reach of IEEE 1394 and its standardization status.

Veterans Affairs: Data Needed to Help Improve Decisions Concerning Veterans’ Access to Burial Options

DTIC Science & Technology

2014-09-01

Comparison of Veteran Population Estimates for Humboldt County Using Proportional Distribution at the County Level and Census Tract Data 20 Figure 7...also areas where this methodology would overstate the veteran population that would be served in a specific area. For example, in Humboldt County...Veterans Cemeteries Figure 6: Comparison of Veteran Population Estimates for Humboldt County Using Proportional Distribution at the County Level and

Cleanups in My Community

EPA Pesticide Factsheets

Cleanups in My Community (CIMC) is a public web application that enables integrated access through maps, lists and search filtering to site-specific information EPA has across all cleanup programs. CIMC taps into data publicly available from EPA's EnviroFacts (RCRA Corrective Action facilities, Brownfields properties and grant areas, Superfund NPL sites, other facility data) and web services (water monitoring stations, impaired waters, emergency responses, tribal boundaries, congressional districts, etc.) and connects to other applications (e.g., Superfund's CPAD) to provide easy seamless access to site-specific cleanup information with explanatory text and within the context of related data. Data can be filtered by cleanup program, geography, environmental indicators, controls, and cleanup stage. CIMC also provides some web services that integrate these data for others to use in their applications.

Spatial accessibility of primary health care in China: A case study in Sichuan Province.

PubMed

Wang, Xiuli; Yang, Huazhen; Duan, Zhanqi; Pan, Jay

2018-05-10

Access to primary health care is considered a fundamental right and an important facilitator of overall population health. Township health centers (THCs) and Community health centers (CHCs) serve as central hubs of China's primary health care system and have been emphasized during recent health care reforms. Accessibility of these hubs is poorly understood and a better understanding of the current situation is essential for proper decision making. This study assesses spatial access to health care provided by primary health care institutions (THCs/CHCs) in Sichuan Province as a microcosm in China. The Nearest-Neighbor method, Enhanced Two-Step Floating Catchment Area (E2SFCA) method, and Gini Coefficient are utilized to represent travel impedance, spatial accessibility, and disparity of primary health care resources (hospital beds, doctors, and health professionals). Accessibilities and Gini Coefficients are correlated with social development indexes (GDP, ethnicity, etc.) to identify influencing factors. Spatial access to primary health care is better in southeastern Sichuan compared to northwestern Sichuan in terms of shorter travel time, higher spatial accessibility, and lower inequity. Social development indexes all showed significant correlation with county averaged spatial accessibilities/Gini Coefficients, with population density ranking top. The disparity of access to primary health care is also apparent between ethnic minority and non-minority regions. To improve spatial access to primary health care and narrow the inequity, more township health centers staffed by qualified health professionals are recommended for northwestern Sichuan. Improved road networks will also help. Among areas with insufficient primary health care, the specific counties where demographics are dominated by older people and children due to widespread rural-urban migration of the workforce, and by ethnic minorities, should be especially emphasized in future planning. Copyright © 2018 Elsevier Ltd. All rights reserved.

Identifying food deserts and swamps based on relative healthy food access: a spatio-temporal Bayesian approach.

PubMed

Luan, Hui; Law, Jane; Quick, Matthew

2015-12-30

Obesity and other adverse health outcomes are influenced by individual- and neighbourhood-scale risk factors, including the food environment. At the small-area scale, past research has analysed spatial patterns of food environments for one time period, overlooking how food environments change over time. Further, past research has infrequently analysed relative healthy food access (RHFA), a measure that is more representative of food purchasing and consumption behaviours than absolute outlet density. This research applies a Bayesian hierarchical model to analyse the spatio-temporal patterns of RHFA in the Region of Waterloo, Canada, from 2011 to 2014 at the small-area level. RHFA is calculated as the proportion of healthy food outlets (healthy outlets/healthy + unhealthy outlets) within 4-km from each small-area. This model measures spatial autocorrelation of RHFA, temporal trend of RHFA for the study region, and spatio-temporal trends of RHFA for small-areas. For the study region, a significant decreasing trend in RHFA is observed (-0.024), suggesting that food swamps have become more prevalent during the study period. For small-areas, significant decreasing temporal trends in RHFA were observed for all small-areas. Specific small-areas located in south Waterloo, north Kitchener, and southeast Cambridge exhibited the steepest decreasing spatio-temporal trends and are classified as spatio-temporal food swamps. This research demonstrates a Bayesian spatio-temporal modelling approach to analyse RHFA at the small-area scale. Results suggest that food swamps are more prevalent than food deserts in the Region of Waterloo. Analysing spatio-temporal trends of RHFA improves understanding of local food environment, highlighting specific small-areas where policies should be targeted to increase RHFA and reduce risk factors of adverse health outcomes such as obesity.

Access control for electronic patient records.

PubMed

Glagola, M J

1998-01-01

The transition from hardcopy records to electronic records is in the forefront for healthcare today. For healthcare facilities, a major issue is determining who can access patients' medical information and how access to this information can be controlled. There are three components to access control: identification, authentication and authorization. Checking proof of identity is a means of authenticating someone--through a driver's license, passport or their fingerprints. Similar processes are needed in a computer environment, through the use of passwords, one-time passwords or smartcards, encryption and kerberos, and call-back procedures. New in the area of access control are biometric devices, which are hardware/software combinations that digitize a physical characteristic and compare the sample with previously stored samples. Fingerprints, voiceprints and facial features are examples. Their cost is currently prohibitive, but in time, they may become more common. Digital certificates and certification authorities are other means used to authenticate identify. When a system challenges a user's identity at log on, the user provides a certification that tells the system to go to the issuing certification authority and find proof the user's claim is valid. Low-level certifications offer little value for sensitive data, but high-level certification is now being introduced. It requires more specific, detailed information on the applicant. Authorization, the final component of access control, establishes what a specific user can and cannot access. To have effective access control, transaction logging and system monitoring are needed to ensure the various techniques are being used and performing properly.

76 FR 16595 - Magnuson-Stevens Fishery Conservation and Management Act Provisions; Fisheries of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-24

... United States; Atlantic Sea Scallop Fishery; Amendment 15 to the Atlantic Sea Scallop Fishery Management... Amendment 15 to the Atlantic Sea Scallop Fishery Management Plan (FMP) (Amendment 15), incorporating the... basis for scallop fishery specifications, including days-at-sea, access area trip allocations, and IFQs...

A Review of Acquaintance/Date Rape Research: Implications for the University Campus.

ERIC Educational Resources Information Center

Drapeau, Robert F.

1992-01-01

Reviews literature on incidence and ramifications of acquaintance rape and discusses specific gender-related factors. Identifies four areas that require proactive college response: access and intrusion, nonnegligent hiring and training, alcohol and drugs, and awareness education. Concludes that effective response to acquaintance rape requires…

Data Visualization and Geospatial Tools | Geospatial Data Science | NREL

Science.gov Websites

renewable resources are available in a specific areas. General Analysis Renewable Energy Atlas View the geographic distribution of wind, solar, geothermal, hydropower, and biomass resources in the United States . Solar and Wind Energy Resource Assessment (SWERA) Model Access international renewable energy resource

49 CFR 38.117 - Floors, steps and thresholds.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Floors, steps and thresholds. 38.117 Section 38...) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES Intercity Rail Cars and Systems § 38.117 Floors, steps and thresholds. (a) Floor surfaces on aisles, step treads and areas where wheelchair and mobility aid...

An Open Learner Model for Trainee Pilots

ERIC Educational Resources Information Center

Gakhal, Inderdip; Bull, Susan

2008-01-01

This paper investigates the potential for simple open learner models for highly motivated, independent learners, using the example of trainee pilots. In particular we consider whether such users access their learner model to help them identify their current knowledge level, areas of difficulty and specific misconceptions, to help them plan their…

Spatial-Temporal dynamics of surface water flooding and consequences for emergency services accessibility

NASA Astrophysics Data System (ADS)

Pattison, Ian; Green, Daniel; Yu, Dapeng; Bosher, Lee; Wilby, Rob; Yang, Lili; Ryley, Tim

2016-04-01

Urban areas are increasingly susceptible to surface water flooding, with more intense precipitation and intensification of land development. Flooding has both direct impacts i.e. locations inundated with water, and indirect impacts i.e. transport networks, utility e.g. electricity/water services etc. The direct areas flooded evolve in space through the event, and are predicted by standard inundation models. However, the wider indirect impacts and the spatial-temporal patterns are less constrained and it is these that are needed to manage the impacts in real-time. This paper focusses on the Category One responders of the Fire and Rescue and Ambulance Services in the City of Leicester, East Midlands, UK. Leicester is ranked 16th out of 4215 settlements at risk of surface water flooding in the UK based upon the population at risk (15,200 people) (DEFRA, 2009). The analysis undertaken involved overlaying the flood extent with the Integrated Transport Network (ITN) data within a GIS framework. Then a simple transport routing algorithm was used to predict the travel time from specific nodes representing ambulance or fire stations to different parts of the city. Flood magnitudes with 1:20, 1:100 and 1:1000 return periods have been investigated. Under a scenario of no flooding, 100% of the city is accessible by the six fire stations in the city. However, in the 1 in 20 year surface water flood event the peak inundation results in 66.5% being accessible in the 10 minute permitted time and 6% is totally inaccessible. This falls to 40% and 13% respectively for the 1 in 100 year event. Maps show the area of the city that are accessible by two or more stations within the permitted response time, which shows these areas are the most resilient to surface water flooding. However, it isn't just the peak water depths at every location which impacts accessibility within the city but the spatial-temporal patterns of the inundation. The areas within the 10 minute response time expand and contract through the event as the inundated area makes roads in different parts of the city inaccessible through the event. These maps also allow key access roads to be identified. Key stakeholders, within the City of Leicester, have highlighted the potential benefit of such dynamic accessibility maps for their multi-agency planning and response for surface water flooding.

Employment and residential characteristics in relation to automated external defibrillator locations

PubMed Central

Griffis, Heather M.; Band, Roger A; Ruther, Matthew; Harhay, Michael; Asch, David A.; Hershey, John C.; Hill, Shawndra; Nadkarni, Lindsay; Kilaru, Austin; Branas, Charles C.; Shofer, Frances; Nichol, Graham; Becker, Lance B.; Merchant, Raina M.

2015-01-01

Background Survival from out-of-hospital cardiac arrest (OHCA) is generally poor and varies by geography. Variability in automated external defibrillator (AED) locations may be a contributing factor. To inform optimal placement of AEDs, we investigated AED access in a major US city relative to demographic and employment characteristics. Methods and Results This was a retrospective analysis of a Philadelphia AED registry (2,559 total AEDs). The 2010 US Census and the Local Employment Dynamics (LED) database by ZIP code was used. AED access was calculated as the weighted areal percentage of each ZIP code covered by a 400 meter radius around each AED. Of 47 ZIP codes, only 9%(4) were high AED service areas. In 26%(12) of ZIP codes, less than 35% of the area was covered by AED service areas. Higher AED access ZIP codes were more likely to have a moderately populated residential area (p=0.032), higher median household income (p=0.006), and higher paying jobs (p=008). Conclusions The locations of AEDs vary across specific ZIP codes; select residential and employment characteristics explain some variation. Further work on evaluating OHCA locations, AED use and availability, and OHCA outcomes could inform AED placement policies. Optimizing the placement of AEDs through this work may help to increase survival. PMID:26856232

A CoAP-Based Network Access Authentication Service for Low-Power Wide Area Networks: LO-CoAP-EAP.

PubMed

Garcia-Carrillo, Dan; Marin-Lopez, Rafael; Kandasamy, Arunprabhu; Pelov, Alexander

2017-11-17

The Internet-of-Things (IoT) landscape is expanding with new radio technologies. In addition to the Low-Rate Wireless Personal Area Network (LR-WPAN), the recent set of technologies conforming the so-called Low-Power Wide Area Networks (LP-WAN) offers long-range communications, allowing one to send small pieces of information at a reduced energy cost, which promotes the creation of new IoT applications and services. However, LP-WAN technologies pose new challenges since they have strong limitations in the available bandwidth. In general, a first step prior to a smart object being able to gain access to the network is the process of network access authentication. It involves authentication, authorization and key management operations. This process is of vital importance for operators to control network resources. However, proposals for managing network access authentication in LP-WAN are tailored to the specifics of each technology, which could introduce interoperability problems in the future. In this sense, little effort has been put so far into providing a wireless-independent solution for network access authentication in the area of LP-WAN. To fill this gap, we propose a service named Low-Overhead CoAP-EAP (LO-CoAP-EAP), which is based on previous work designed for LR-WPAN. LO-CoAP-EAP integrates the use of Authentication, Authorization and Accounting (AAA) infrastructures and the Extensible Authentication Protocol (EAP) protocol. For this integration, we use the Constrained Application Protocol (CoAP) to design a network authentication service independent of the type of LP-WAN technology. LO-CoAP-EAP represents a trade-off between flexibility, wireless technology independence, scalability and performance in LP-WAN.

A CoAP-Based Network Access Authentication Service for Low-Power Wide Area Networks: LO-CoAP-EAP

PubMed Central

Garcia-Carrillo, Dan; Marin-Lopez, Rafael; Kandasamy, Arunprabhu; Pelov, Alexander

2017-01-01

The Internet-of-Things (IoT) landscape is expanding with new radio technologies. In addition to the Low-Rate Wireless Personal Area Network (LR-WPAN), the recent set of technologies conforming the so-called Low-Power Wide Area Networks (LP-WAN) offers long-range communications, allowing one to send small pieces of information at a reduced energy cost, which promotes the creation of new IoT applications and services. However, LP-WAN technologies pose new challenges since they have strong limitations in the available bandwidth. In general, a first step prior to a smart object being able to gain access to the network is the process of network access authentication. It involves authentication, authorization and key management operations. This process is of vital importance for operators to control network resources. However, proposals for managing network access authentication in LP-WAN are tailored to the specifics of each technology, which could introduce interoperability problems in the future. In this sense, little effort has been put so far into providing a wireless-independent solution for network access authentication in the area of LP-WAN. To fill this gap, we propose a service named Low-Overhead CoAP-EAP (LO-CoAP-EAP), which is based on previous work designed for LR-WPAN. LO-CoAP-EAP integrates the use of Authentication, Authorization and Accounting (AAA) infrastructures and the Extensible Authentication Protocol (EAP) protocol. For this integration, we use the Constrained Application Protocol (CoAP) to design a network authentication service independent of the type of LP-WAN technology. LO-CoAP-EAP represents a trade-off between flexibility, wireless technology independence, scalability and performance in LP-WAN. PMID:29149040

50 CFR 648.60 - Sea scallop access area program requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

50 CFR 648.60 - Sea scallop access area program requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

50 CFR 648.60 - Sea scallop area access program requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

50 CFR 648.60 - Sea scallop access area program requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

50 CFR 648.60 - Sea scallop area access program requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Architecture engineering of supercapacitor electrode materials

NASA Astrophysics Data System (ADS)

Chen, Kunfeng; Li, Gong; Xue, Dongfeng

2016-02-01

The biggest challenge for today’s supercapacitor systems readily possessing high power density is their low energy density. Their electrode materials with controllable structure, specific surface area, electronic conductivity, and oxidation state, have long been highlighted. Architecture engineering of functional electrode materials toward powerful supercapacitor systems is becoming a big fashion in the community. The construction of ion-accessible tunnel structures can microscopically increase the specific capacitance and materials utilization; stiff 3D structures with high specific surface area can macroscopically assure high specific capacitance. Many exciting findings in electrode materials mainly focus on the construction of ice-folded graphene paper, in situ functionalized graphene, in situ crystallizing colloidal ionic particles and polymorphic metal oxides. This feature paper highlights some recent architecture engineering strategies toward high-energy supercapacitor electrode systems, including electric double-layer capacitance (EDLC) and pseudocapacitance.

Relations between nature-based solutions of green-blue area accessibility and socio-economic-ethnic patterns in the urban Stockholm region

NASA Astrophysics Data System (ADS)

Goldenberg, Romain; Kalantari, Zahra; Destouni, Georgia

2017-04-01

More than half of the world's population lives in cities, a proportion expected to increase to two thirds by 2050 (United Nations (UN), 2015). In this study, we investigate the spatial relationships that may exist between income and/or nationality homogeneity/heterogeneity levels of urban populations and their accessibility to local green-blue areas as possible nature-based solutions for sustainable urban design. For this investigation, we consider as a concrete case study the urban region of Stockholm, Sweden, for which we compile and use available land-cover and vegetation density data (the latter in terms of Normalised Difference Vegetation Index, NDVI) in order to identify and assess the spatial distributions of various green-blue area types and aspects. We further combine this data with spatial distribution data for population density, income and nationality, as well as with road-network data for assessing population travel times to nearby green-blue areas within the region. The present study results converge with those of other recent studies in showing large socio-economic-ethnic segregation in the Stockholm region. Moreover, the present data combination and analysis also show large spatial differences in and important socio-economic-ethnic correlations with accessibility to local green areas and nearby water bodies. Specifically, population income and share of Swedish nationals are well correlated in this region, with increases in both of these variables implying greater possibility to choose where to live within the region. The living choices of richer and more homogeneous (primarily Swedish) population parts are then found to be areas with greater local vegetation density (local green areas as identified by high-resolution NDVI data) and greater area extent of nearby water bodies (blue areas). For comparison, no such correlation is found between increased income or Swedish nationality homogeneity and accessibility to nearby forest areas (overall green area extent) or built facilities for recreation and sports. The found living choice correlations point at the importance of green-blue area parts as possible nature-based solutions in urban design and planning, with potential to improve wellbeing and social sustainability for the whole urban population and not just its rich component.

50 CFR 648.59 - Sea Scallop Access Areas.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 12 2014-10-01 2014-10-01 false Sea Scallop Access Areas. 648.59 Section... Atlantic Sea Scallop Fishery § 648.59 Sea Scallop Access Areas. (a) [Reserved] (b) Closed Area I Access... not fish for, possess, or land scallops in or from the area known as the Closed Area II Sea Scallop...

Development and characterization of a new set of genomic microsatellite markers in rice bean (Vigna umbellata (Thunb.) Ohwi and Ohashi) and their utilization in genetic diversity analysis of collections from North East India.

PubMed

Iangrai, Banshanlang; Pattanayak, Arunava; Khongwir, D Evanoreen Ann; Pale, Gratify; Gatphoh, Emica Mary; Das, Alpana; Chrungoo, Nikhil Kumar

2017-01-01

Rice bean [Vigna umbellate (Thumb.) Ohwi and Ohashi] is an underutilized crop believed to be domesticated in the Myanmar-Thailand region of Asia. In India, rice bean is mainly cultivated in the North-Eastern Hills, which is a hotspot for biological diversity. A 5' anchored PCR was used to develop microsatellite markers in rice bean. Twenty-eight specific primer pairs were designed and employed to characterize sixty five ricebean accessions collected from North East India. A total of 179 alleles were amplified with an average of 6.393 alleles per locus. The gene diversity was high (mean 0.534) in the accessions collected from Darjeeling, Nagaland and Manipur, which are bordering areas with East Nepal and Myanmar, respectively. Exceptionally high outcrossing rate was observed in the entire population. Population structure analysis identified three distinct clusters in which accessions collected from areas bordering Myanmar and East Nepal grouped separately. Using a combination of STRUCTURE and Principal Coordinate Analysis, relative affinity of the intermediate accessions could be established. However, differences in allelic counts among populations were non-significant. The results showed that there is a high level of genetic diversity within the accessions, with high outcrossing rate.

Designing for Educational Technology to Enhance the Experience of Learners in Distance Education: How Open Educational Resources, Learning Design and MOOCs Are Influencing Learning

ERIC Educational Resources Information Center

Scanlon, Eileen; McAndrew, Patrick; O'Shea, Tim

2015-01-01

The area of learning has a justifiable claim to be a special case in how it can be enhanced or supported by technology. In areas such as commerce and web design the aim is usually to ensure efficiency and support specific actions such as purchasing or accessing information as quickly and easily as possible. Working with technology for the purpose…

Currently important animal disease management issues in sub-Saharan Africa.

PubMed

Thomson, G R

2009-03-01

The present international approach to management of transboundary animal diseases (TADs) is based on the assumption that most can be eradicated; consequently, that is the usual objective adopted by international organizations concerned with animal health. However, for sub-Saharan Africa and southern Africa more particularly, eradication of most TADs is impossible for the foreseeable future for a variety of technical, financial and logistical reasons. Compounding this, the present basis for access to international markets for products derived from animals requires that the area of origin (country or zone) is free from trade-influencing TADs. The ongoing development of transfrontier conservation areas (TFCAs), extending across huge areas of southern Africa, therefore presents a development conundrum because it makes creation of geographic areas free from TADs more difficult and brings development based on wildlife conservation on the one hand and that based on livestock production on the other into sharp conflict. Sub-Saharan Africa is consequently confronted by a complex problem that contributes significantly to retarded rural development which, in turn, impedes poverty alleviation. In southern Africa specifically, foot-and-mouth disease (FMD) presents the greatest problem in relation to access to international markets for animal products. However, it is argued that this problem could be overcome by a combination between (1) implementation of a commodity-based approach to trade in products derived from animals and (2) amendment of the international standards for FMD specifically (i.e. the FMD chapter in the Terrestrial Animal Health Code of the World Organisation for Animal Health [OIE]) so that occurrence of SAT serotype viruses in free-living African buffalo need not necessarily mean exclusion of areas where buffalo occur from international markets for animal products. This would overcome a presently intractable constraint to market access for southern African countries and enable conservation and livestock production to be more effectively integrated, to the benefit of both.

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

Doczi, Julian, Dorr, Tobias; Mason, Nathaniel; Scott, Andrew

In this new working paper, the authors focus specifically on what would be necessary to achieve High Level Panel-style goals and targets for water, energy and transport, if these were to be eventually adopted by world leaders. In all three cases, much of the advocacy - and the proposed High Level Panel goals - have emphasized the need to strive for universal and sustainable access to at least basic levels of services from these sectors. Many of the proposals for post-2015 goals and targets appear ambitious, but what would it take to achieve them? This paper assesses what is neededmore » to achieve goals for universal and sustainable access to infrastructure, specifically water, energy and transport. Using illustrative goals and targets, the paper reviews the development challenges in each sector, and what will be necessary to overcome the barriers to universal and sustainable access to water, energy and transport infrastructure services, in the areas of governance, finance, capacity development and environmental protection. The paper ends with general conclusions about infrastructure in the post-2015 development agenda.« less

Health Access Livelihood Framework Reveals Potential Barriers in the Control of Schistosomiasis in the Dongting Lake Area of Hunan Province, China

PubMed Central

McManus, Donald P.; Raso, Giovanna; Utzinger, Jürg; Xiao, Shui-Yuan; Yu, Dong-Bao; Zhao, Zheng-Yuan; Li, Yue-Sheng

2013-01-01

Background Access to health care is a major requirement in improving health and fostering socioeconomic development. In the People's Republic of China (P.R. China), considerable changes have occurred in the social, economic, and health systems with a shift from a centrally planned to a socialist market economy. This brought about great benefits and new challenges, particularly for vertical disease control programs, including schistosomiasis. We explored systemic barriers in access to equitable and effective control of schistosomiasis. Methodology Between August 2002 and February 2003, 66 interviews with staff from anti-schistosomiasis control stations and six focus group discussions with health personnel were conducted in the Dongting Lake area, Hunan Province. Additionally, 79 patients with advanced schistosomiasis japonica were interviewed. The health access livelihood framework was utilized to examine availability, accessibility, affordability, adequacy, and acceptability of schistosomiasis-related health care. Principal Findings We found sufficient availability of infrastructure and human resources at most control stations. Many patients with advanced schistosomiasis resided in non-endemic or moderately endemic areas, however, with poor accessibility to disease-specific knowledge and specialized health services. Moreover, none of the patients interviewed had any form of health insurance, resulting in high out-of-pocket expenditure or unaffordable care. Reports on the adequacy and acceptability of care were mixed. Conclusions/Significance There is a need to strengthen health awareness and schistosomiasis surveillance in post-transmission control settings, as well as to reduce diagnostic and treatment costs. Further studies are needed to gain a multi-layered, in-depth understanding of remaining barriers, so that the ultimate goal of schistosomiasis elimination in P.R. China can be reached. PMID:23936580

Potential barriers in healthcare access of the elderly population influenced by the economic crisis and the troika agreement: a qualitative case study in Lisbon, Portugal.

PubMed

Doetsch, Julia; Pilot, Eva; Santana, Paula; Krafft, Thomas

2017-10-25

The recent economic and financial crisis in Portugal urged the Portuguese Government in April 2011 to request financial assistance from the troika austerity bail out program to get aid for its government debt. The troika agreement included health reforms and austerity measures of the National Health Service (NHS) in Portugal to save non-essential health care costs. This research aimed to identify potential barriers among the elderly population (aged 65 and above) to healthcare access influenced by the economic crisis and the troika agreement focussing on the Memorandum of Understanding on Specific Economic Policy Conditionality (MoU) in Lisbon metropolitan area, Portugal. The qualitative study is including 13 semi-structured interviews of healthcare experts, municipality authority, health care providers, negotiator of the troika agreement, hospital managers, health economists and elderly. A content analysis was performed to evaluate the interviews applying Nvivo2011 software. The barriers identified were clustered towards the five areas of the 'Conceptual framework on health care access' by Levesque et al. (Int J Equity Health 12:18, 2013). Healthcare access for the elderly was found inadequate in four areas of the framework: availability; appropriateness; approachability; and affordability. The fifth area on acceptability was not identified since the study neither followed a gender nor ethnic specific purpose. The main identified barriers were: current financial situation and pension cuts; insufficient provision and increased user fees in primary care; inadequate design and availability of hospital care service; lack of long-term care facilities; increased out-of-pocket-payment on pharmaceuticals; limitations in exemption allowances; cuts in non-emergent health transportation; increased waiting time for elective surgery; and poor unadapted housing conditions for elderly. The health reforms and health budget cuts in the MoU implemented as part of the troika agreement have been associated with increasing health inequalities in access to healthcare services for the elderly population. The majority of responses disclosed an increasing deficiency across the entire National Health Service (NHS) to collaborate, integrate and communicate between the different healthcare sectors for providing adequate care to the elderly. An urgent necessity of restructuring the health care system to adapt towards the elderly population was implied.

Easy Handling of Sensors and Actuators over TCP/IP Networks by Open Source Hardware/Software

PubMed Central

Mejías, Andrés; Herrera, Reyes S.; Márquez, Marco A.; Calderón, Antonio José; González, Isaías; Andújar, José Manuel

2017-01-01

There are several specific solutions for accessing sensors and actuators present in any process or system through a TCP/IP network, either local or a wide area type like the Internet. The usage of sensors and actuators of different nature and diverse interfaces (SPI, I2C, analogue, etc.) makes access to them from a network in a homogeneous and secure way more complex. A framework, including both software and hardware resources, is necessary to simplify and unify networked access to these devices. In this paper, a set of open-source software tools, specifically designed to cover the different issues concerning the access to sensors and actuators, and two proposed low-cost hardware architectures to operate with the abovementioned software tools are presented. They allow integrated and easy access to local or remote sensors and actuators. The software tools, integrated in the free authoring tool Easy Java and Javascript Simulations (EJS) solve the interaction issues between the subsystem that integrates sensors and actuators into the network, called convergence subsystem in this paper, and the Human Machine Interface (HMI)—this one designed using the intuitive graphical system of EJS—located on the user’s computer. The proposed hardware architectures and software tools are described and experimental implementations with the proposed tools are presented. PMID:28067801

Easy Handling of Sensors and Actuators over TCP/IP Networks by Open Source Hardware/Software.

PubMed

Mejías, Andrés; Herrera, Reyes S; Márquez, Marco A; Calderón, Antonio José; González, Isaías; Andújar, José Manuel

2017-01-05

There are several specific solutions for accessing sensors and actuators present in any process or system through a TCP/IP network, either local or a wide area type like the Internet. The usage of sensors and actuators of different nature and diverse interfaces (SPI, I2C, analogue, etc.) makes access to them from a network in a homogeneous and secure way more complex. A framework, including both software and hardware resources, is necessary to simplify and unify networked access to these devices. In this paper, a set of open-source software tools, specifically designed to cover the different issues concerning the access to sensors and actuators, and two proposed low-cost hardware architectures to operate with the abovementioned software tools are presented. They allow integrated and easy access to local or remote sensors and actuators. The software tools, integrated in the free authoring tool Easy Java and Javascript Simulations (EJS) solve the interaction issues between the subsystem that integrates sensors and actuators into the network, called convergence subsystem in this paper, and the Human Machine Interface (HMI)-this one designed using the intuitive graphical system of EJS-located on the user's computer. The proposed hardware architectures and software tools are described and experimental implementations with the proposed tools are presented.

Virtual Laboratory for QoS Study in Next-Generation Networks with Metro Ethernet Access

ERIC Educational Resources Information Center

Gomez-Sacristan, Angel; Sempere-Paya, Victor M.; Rodriguez-Hernandez, Miguel A.

2016-01-01

Teaching in university engineering departments is currently facing a number of challenges, especially for those involved in the most innovative and dynamic areas of information and communication technology. Learning model developments that place greater weight on laboratory activities require investment in specific equipment that is often very…

Using Augmented Reality Tools to Enhance Children's Library Services

ERIC Educational Resources Information Center

Meredith, Tamara R.

2015-01-01

Augmented reality (AR) has been used and documented for a variety of commercial and educational purposes, and the proliferation of mobile devices has increased the average person's access to AR systems and tools. However, little research has been done in the area of using AR to supplement traditional library services, specifically for patrons aged…

Elites, Bureaucrats, Ostriches, and Pussycats: Managing Research in Policy Settings.

ERIC Educational Resources Information Center

Marshall, Catherine

Female researchers conducting field research in educational politics encounter special problems of access, entry, reciprocity, and ethics. Accordingly, this study focuses first on field research methods in policy settings as a general topic, then on problems specific to women in this area. A researcher must be aware of informal coalitions or…

Impact of Social Factors on Labour Discrimination of Disabled Women

ERIC Educational Resources Information Center

Mondejar-Jimenez, Jose; Vargas-Vargas, Manuel; Meseguer-Santamaria, Maria-Leticia; Mondejar-Jimenez, Juan-Antonio

2009-01-01

Disabled women suffer from a double labour discrimination due to their gender and their disability. In rural areas, in addition, they also suffer from a lack of specific services, the isolation of the disabled associations, problems with public transport, the dispersion of population centres, and a limited access to information that could improve…

Steps Toward Understanding Rapid Culture Change in Native Rural Alaska.

ERIC Educational Resources Information Center

Davis, Nancy Yaw

To increase understanding of culture change in rural Alaska as it specifically pertains to selected policy-related issues outlined by the Federal-State Land Use Planning Commission staff, four general areas are addressed: traditional subsistence use and effects of changing access and availability of those activities, apparent long-range effects of…

30 CFR 816.11 - Signs and markers.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Identification signs shall be displayed at each point of access to the permit area from public roads. (2) Signs... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Signs and markers. 816.11 Section 816.11... § 816.11 Signs and markers. (a) Specifications. Signs and markers required under this part shall— (1) Be...

30 CFR 816.11 - Signs and markers.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Identification signs shall be displayed at each point of access to the permit area from public roads. (2) Signs... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Signs and markers. 816.11 Section 816.11... § 816.11 Signs and markers. (a) Specifications. Signs and markers required under this part shall— (1) Be...

30 CFR 816.11 - Signs and markers.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Identification signs shall be displayed at each point of access to the permit area from public roads. (2) Signs... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Signs and markers. 816.11 Section 816.11... § 816.11 Signs and markers. (a) Specifications. Signs and markers required under this part shall— (1) Be...

30 CFR 816.11 - Signs and markers.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Identification signs shall be displayed at each point of access to the permit area from public roads. (2) Signs... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Signs and markers. 816.11 Section 816.11... § 816.11 Signs and markers. (a) Specifications. Signs and markers required under this part shall— (1) Be...

30 CFR 816.11 - Signs and markers.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Identification signs shall be displayed at each point of access to the permit area from public roads. (2) Signs... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Signs and markers. 816.11 Section 816.11... § 816.11 Signs and markers. (a) Specifications. Signs and markers required under this part shall— (1) Be...

Crystalline mesoporous tungsten oxide nanoplate monoliths synthesized by directed soft template method for highly sensitive NO{sub 2} gas sensor applications

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

Hoa, Nguyen Duc, E-mail: ndhoa@itims.edu.vn; Duy, Nguyen Van; Hieu, Nguyen Van, E-mail: hieu@itims.edu.vn

2013-02-15

Graphical abstract: Display Omitted Highlights: ► Mesoporous WO{sub 3} nanoplate monoliths were obtained by direct templating synthesis. ► Enable effective accession of the analytic molecules for the sensor applications. ► The WO{sub 3} sensor exhibited a high performance to NO{sub 2} gas at low temperature. -- Abstract: Controllable synthesis of nanostructured metal oxide semiconductors with nanocrystalline size, porous structure, and large specific surface area is one of the key issues for effective gas sensor applications. In this study, crystalline mesoporous tungsten oxide nanoplate-like monoliths with high specific surface areas were obtained through instant direct-templating synthesis for highly sensitive nitrogen dioxidemore » (NO{sub 2}) sensor applications. The copolymer soft template was converted into a solid carbon framework by heat treatment in an inert gas prior to calcinations in air to sustain the mesoporous structure of tungsten oxide. The multidirectional mesoporous structures of tungsten oxide with small crystalline size, large specific surface area, and superior physical characteristics enabled the rapid and effective accession of analytic gas molecules. As a result, the sensor response was enhanced and the response and recovery times were reduced, in which the mesoporous tungsten oxide based gas sensor exhibited a superior response of 21,155% to 5 ppm NO{sub 2}. In addition, the developed sensor exhibited selective detection of low NO{sub 2} concentration in ammonia and ethanol at a low temperature of approximately 150 °C.« less

Beyond the VWFA: The orthography-semantics interface in spelling and reading

PubMed Central

Purcell, Jeremy J.; Shea, Jennifer; Rapp, Brenda

2014-01-01

Lexical orthographic information provides the basis for recovering the meanings of words in reading and for generating correct word spellings in writing. Research has provided evidence that an area of the left ventral temporal cortex, a sub-region of what is often referred to as the Visual Word Form Area (VWFA), plays a significant role specifically in lexical orthographic processing. The current investigation goes beyond this previous work by examining the neurotopography of the interface of lexical orthography with semantics. We apply a novel lesion mapping approach with three individuals with acquired dysgraphia and dyslexia who suffered lesions to left ventral temporal cortex. To map cognitive processes to their neural substrates, this lesion mapping approach applies similar logical constraints as used in cognitive neuropsychological research. Using this approach, this investigation: (1) Identifies a region anterior to the VWFA that is important in the interface of orthographic information with semantics for reading and spelling; (2) Determines that, within this Orthography-Semantics Interface Region (OSIR), access to orthography from semantics (spelling) is topographically distinct from access to semantics from orthography (reading); (3) Provides evidence that, within this region, there is modality-specific access to and from lexical semantics for both spoken and written modalities, in both word production and comprehension. Overall, this study contributes to our understanding of the neural architecture at the lexical orthography-semantic-phonological interface within left ventral temporal cortex. PMID:24833190

Long-Term Trends in Black and White Mortality in the Rural United States: Evidence of a Race-Specific Rural Mortality Penalty.

PubMed

James, Wesley; Cossman, Jeralynn S

2017-01-01

The rural mortality penalty-growing disparities in rural-urban macro-level mortality rates-has persisted in the United States since the mid 1980s. Substantial intrarural differences exist: rural places of modest population size, close to urban areas, experience a greater mortality burden than the most rural locales. This research builds on recent findings by examining whether a race-specific rural mortality penalty exists; that is, are some rural areas more detrimental to black and/or white mortality than others? Using data from the Compressed Mortality File from 1968 to 2012, we calculate annual age-adjusted, race-specific mortality rates for all rural-urban regions designated by the Rural-Urban Continuum Codes. Indicators for population, socioeconomic status, and health infrastructure, as a proxy for access to care, are used as predictors of race-specific mortality in multivariable regression models. Three important results emerge from this analysis: (1) there is a substantial mortality disadvantage for both black and white rural Americans, (2) the most advantageous regions of mortality for blacks exhibit higher mortality than the most disadvantageous regions for whites, and (3) access to health care is a much stronger predictor of white mortality than black mortality. The rural mortality penalty is evident in race-specific mortality trends over time, with an added disadvantage in black mortality. The rate of mortality improvement for rural blacks and whites lags behind their same-race, urban counterparts, creating a diverging gap in race-specific mortality trends in rural America. © 2016 National Rural Health Association.

The ESGF Software Stack: a Configurable and Extensible Framework for Enabling Access to Geospatial Data

NASA Astrophysics Data System (ADS)

Cinquini, L.; Bell, G. M.; Williams, D.; Harney, J.

2012-12-01

The Earth System Grid Federation (ESGF) is a multi-agency, international collaboration that aims at developing state-of-the-art services for the management and access of Earth system data. ESGF is currently used to serve the totality of the model output used for the forthcoming IPCC 5th assessment report on climate change, as well as supporting observational and reanalysis datasets. Also, it is been adopted by several other projects that focus on global, regional and local climate modeling. The ESGF software stack is composed of several modular applications that cover related but disjoint areas of functionality: data publishing, data search and discovery, data access, user management, security, and federation. Overall, the ESGF infrastructure offers a configurable end-to-end solution to the problem of enabling web-based access to large amounts of geospatial data. This talk will present the architectural and configuration options that are available to a data provider leveraging ESGF to serve their data: which services to expose, how to scale to larger data collections, how to establish access control, how to customize the user interface, and others. Additionally, the framework provides extension points that allow each site to plug in custom functionality such as crawling of specific metadata repositories, exposing domain-specific analysis and visualization services, developing custom access clients that interact with the system APIs. These configuration and extension capabilities are based on simple but effective domain-specific object models, that underpin the software applications: the data model, the security model, and the federation model. The ESGF software stack is developed collaboratively by software engineers at many institutions around the world, and is made freely available to the community under an open source license to promote adoption, reuse, inspection and continuous improvement.

Outdoors America: recreational opportunities on public lands

USGS Publications Warehouse

,

1998-01-01

This Federal Recreation Lands map is a consolidated guide to public lands offering outdoor recreation opportunities. Some areas have more recreation potential than others, and types of recreation available may vary from place to place. Many areas include private land not open to the public. Care should be taken to respect the rights of private property owners. For information regarding specific activities, services, facilities, hours and seasons of operation, entrance and other user fees, and accessibility, contact the appropriate agency office.

49 CFR 1560.105 - Denial of transport or sterile area access; designation for enhanced screening.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Denial of transport or sterile area access... Matching § 1560.105 Denial of transport or sterile area access; designation for enhanced screening. (a...-traveling individuals, including denial of transport or sterile area access or designation for enhanced...

75 FR 22073 - Fisheries of the Northeastern United States; Atlantic Sea Scallop Fishery; Framework Adjustment 21

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-27

... Elephant Trunk Access Area (ETAA), and one trip in the Delmarva Access Area (Delmarva). A part-time scallop... area trips into the Delmarva and Elephant Trunk Access Areas, as specified in Sec. 648.59(a) and (e... Delmarva and Elephant Trunk Access Areas specified in Sec. 648.59(a) and (e) during the period June 15...

Comparing the Information and Support Needs of Different Population Groups in Preparation for 2015 Government Approval for HIV Self-testing in France

PubMed Central

Greacen, Tim; Kersaudy-Rahib, Delphine; Le Gall, Jean-Marie; Lydié, Nathalie; Ghosn, Jade; Champenois, Karen

2016-01-01

Context HIV self-tests are currently being introduced in France with the aim of promoting screening both for the general population and for high-risk populations. Objective The current study aimed to identify and compare the information and support needs of the different target population groups. Methods The Delphi process was used to synthesize expert opinions for each population group. Experts were chosen for their experience and expertise in the area of HIV and HIV screening for each population. Each group developed recommendations for a specific population: six high HIV prevalence populations (men who have sex with men; transgender people; substance users; migrants from sub-Saharan Africa; French West Indies; French Guiana) and two low prevalence populations (the general population; people under 25). Each group included expertise from four areas: research, screening and care, policy-making, and community groups. Results A final total of 263 recommendations were grouped into eight main themes: Communicating at both national and community levels about self-test arrival (24% of all recommendations); Providing information adapted to the different community groups’ needs (23%); Providing counselling on self-test use and access to care (15%); Making self-tests available to all in terms of accessibility and cost (13%); Preparing community healthcare and screening systems for the arrival of the self-test (11%); Approving only high quality self-tests (6%); Defending self-test users’ legal rights (5%); Evaluating self-test use (3%). Although a large number of recommendations were common to several groups of experts, the study highlighted a certain number of recommendations specific to each different population group, particularly with regard to information content and access both to information and to the self-tests themselves. Conclusion Results from the current study should make a significant contribution to policy decisions concerning catering for the specific access, information and support needs of different potential HIV self-test user groups in France. PMID:27031234

Comparing the Information and Support Needs of Different Population Groups in Preparation for 2015 Government Approval for HIV Self-testing in France.

PubMed

Greacen, Tim; Kersaudy-Rahib, Delphine; Le Gall, Jean-Marie; Lydié, Nathalie; Ghosn, Jade; Champenois, Karen

2016-01-01

HIV self-tests are currently being introduced in France with the aim of promoting screening both for the general population and for high-risk populations. The current study aimed to identify and compare the information and support needs of the different target population groups. The Delphi process was used to synthesize expert opinions for each population group. Experts were chosen for their experience and expertise in the area of HIV and HIV screening for each population. Each group developed recommendations for a specific population: six high HIV prevalence populations (men who have sex with men; transgender people; substance users; migrants from sub-Saharan Africa; French West Indies; French Guiana) and two low prevalence populations (the general population; people under 25). Each group included expertise from four areas: research, screening and care, policy-making, and community groups. A final total of 263 recommendations were grouped into eight main themes: Communicating at both national and community levels about self-test arrival (24% of all recommendations); Providing information adapted to the different community groups' needs (23%); Providing counselling on self-test use and access to care (15%); Making self-tests available to all in terms of accessibility and cost (13%); Preparing community healthcare and screening systems for the arrival of the self-test (11%); Approving only high quality self-tests (6%); Defending self-test users' legal rights (5%); Evaluating self-test use (3%). Although a large number of recommendations were common to several groups of experts, the study highlighted a certain number of recommendations specific to each different population group, particularly with regard to information content and access both to information and to the self-tests themselves. Results from the current study should make a significant contribution to policy decisions concerning catering for the specific access, information and support needs of different potential HIV self-test user groups in France.

Increasing the treatment of hypertension through primary intervention

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

Fair, M.D.

1994-12-31

South Carolina is one of the leading states in stroke mortality. Hypertension is one of the major risk factors that lead to strokes. Unfortunately, many people who are hypertensive do not treat their disease properly due to lack of medical education. The specific objectives of this project are to access geographic areas to determine the level of medical representation available; to identify areas of medical needs based on race, income and health status; and, to structure an intervention plan to target areas that are in the highest hypertension at-risk category. The methods used are to identify medical coverage by geographicmore » areas. Health in poor areas is identified and mapped. Implementation of intervention strategies is prioritized based on areas of need.« less

Does prenatal care increase access to child immunization? Gender bias among children in India.

PubMed

Choi, Jin Young; Lee, Sang-Hyop

2006-07-01

Prenatal care appears to serve as a trigger in increasing the chances for access to subsequent health care services. Although several previous studies have investigated this connection, none have focused specifically on how parents' behavior differs before and after learning the gender of their babies. Investigating parents' behavioral changes after the child's birth provides a quasi-natural experiment with which to test the gender discrimination hypothesis. This issue was examined here, using a rich family health survey data set from India. We find evidence for the triggering effect of prenatal care on immunization only among rural boys, but we find no compelling evidence for this effect among other sub-samples. This finding suggests two things, which are not mutually exclusive. One is that the information spillover from prenatal care has a much larger impact in rural areas, where alternative sources of information are scarce, compared with urban areas. The other is that the sex of a child is a critical factor in producing different levels of health care behavior in rural areas, where sons are favored and more valued than in urban areas.

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...

Synthesis and use of 2-[ 18F]fluoromalondialdehyde, an accessible synthon for bioconjugation

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

Hooker, Jacob M.

We proposed methods for the synthesis and purification of 2-[ 18F]fluoromalondialdehyde, which will be a readily accessible synthon for bioconjugation. Our achievements in these areas will specifically address a stated goal of the DOE providing a transformational technology for macromolecule radiolabeling. Accomplishment of our aims will serve both DOE mission-related research as well as nuclear medicine research supported by the NIH and industry. At the heart of our proposal is the aim to “improve synthetic methodology for rapidly and efficiently incorporating radionuclides into a wide range of organic compounds.”

Negotiating Narratives, Accessing Asylum: Evaluating Language Policy as Multi-Level Practice, Beliefs and Management

ERIC Educational Resources Information Center

Smith-Khan, Laura

2017-01-01

Theories of language policy increasingly emphasise focusing on the specific contexts in which language management occurs. In government settings, policy seeks to shape how individuals interact with officials. Australian asylum procedure is an area where policy aims at tight control. I examine how communication is managed in this setting, in which…

Daughters with Disabilities: Reframing Science, Math, and Technology for Girls with Disabilities.

ERIC Educational Resources Information Center

Hammrich, Penny L.; Price, Lynda; Nourse, Steven

This report describes a new approach to teaching science, math, and technology to students, especially girls, with disabilities, who frequently do not have access to appropriate instruction in these critical areas for future academic success. Many specific suggestions, along with a sample lesson that can be used immediately, are presented as part…

Leveraging Cognitive Technology Tools to Expand Opportunities for Critical Thinking in Elementary Mathematics

ERIC Educational Resources Information Center

Suh, Jennifer

2010-01-01

The following study describes design research in an elementary school near the metropolitan D.C. area with a diverse student population. The goal of the project was to design tasks that leveraged technology and enhance the access to critical thinking in specific mathematical concepts: data analysis and probability. It highlights the opportunities…

Direct access to physical therapy for the patient with musculoskeletal disorders, a literature review.

PubMed

Piano, Leonardo; Maselli, Filippo; Viceconti, Antonello; Gianola, Silvia; Ciuro, Aldo

2017-08-01

[Purpose] To present legislation comparing direct and referred access-or other measures-to physical therapy. The focus is on the management of the most burdensome musculoskeletal disorders in terms of regulations, costs, effectiveness, safety and cost-effectiveness. [Methods] Main biomedical databases and gray literature were searched ranging from a global scenario to the analysis of targeted geographical areas and specifically Italy and the Region Piedmont. [Results] legislation on Direct Access highlights inconsistencies among the countries belonging to World Confederation for Physical Therapy. Direct Access could be an effective, safe and efficient organization model for the management of patients with musculoskeletal diseases and seems to be more effective safer and cost effective. [Conclusion] Direct Access is a virtuous model which can help improve the global quality of physical therapy services. Further studies are required to confirm this approach and determine whether the findings of the present overview can be replicated in different countries and healthcare systems.

Role of Geography and Nurse Practitioner Scope-of-Practice in Efforts to Expand Primary Care System Capacity: Health Reform and the Primary Care Workforce.

PubMed

Graves, John A; Mishra, Pranita; Dittus, Robert S; Parikh, Ravi; Perloff, Jennifer; Buerhaus, Peter I

2016-01-01

Little is known about the geographic distribution of the overall primary care workforce that includes both physician and nonphysician clinicians--particularly in areas with restrictive nurse practitioner scope-of-practice laws and where there are relatively large numbers of uninsured. We investigated whether geographic accessibility to primary care clinicians (PCCs) differed across urban and rural areas and across states with more or less restrictive scope-of-practice laws. An observational study. 2013 Area Health Resource File (AHRF) and US Census Bureau county travel data. The measures included percentage of the population in low-accessibility, medium-accessibility, and high-accessibility areas; number of geographically accessible primary care physicians (PCMDs), nurse practitioners (PCNPs), and physician assistants (PCPAs) per 100,000 population; and number of uninsured per PCC. We found divergent patterns in the geographic accessibility of PCCs. PCMDs constituted the largest share of the workforce across all settings, but were relatively more concentrated within urban areas. Accessibility to nonphysicians was highest in rural areas: there were more accessible PCNPs per 100,000 population in rural areas of restricted scope-of-practice states (21.4) than in urban areas of full practice states (13.9). Despite having more accessible nonphysician clinicians, rural areas had the largest number of uninsured per PCC in 2012. While less restrictive scope-of-practice states had up to 40% more PCNPs in some areas, we found little evidence of differences in the share of the overall population in low-accessibility areas across scope-of-practice categorizations. Removing restrictive scope-of-practice laws may expand the overall capacity of the primary care workforce, but only modestly in the short run. Additional efforts are needed that recognize the locational tendencies of physicians and nonphysicains.

Specifications of Standards in Systems and Synthetic Biology.

PubMed

Schreiber, Falk; Bader, Gary D; Golebiewski, Martin; Hucka, Michael; Kormeier, Benjamin; Le Novère, Nicolas; Myers, Chris; Nickerson, David; Sommer, Björn; Waltemath, Dagmar; Weise, Stephan

2015-09-04

Standards shape our everyday life. From nuts and bolts to electronic devices and technological processes, standardised products and processes are all around us. Standards have technological and economic benefits, such as making information exchange, production, and services more efficient. However, novel, innovative areas often either lack proper standards, or documents about standards in these areas are not available from a centralised platform or formal body (such as the International Standardisation Organisation). Systems and synthetic biology is a relatively novel area, and it is only in the last decade that the standardisation of data, information, and models related to systems and synthetic biology has become a community-wide effort. Several open standards have been established and are under continuous development as a community initiative. COMBINE, the ‘COmputational Modeling in BIology’ NEtwork has been established as an umbrella initiative to coordinate and promote the development of the various community standards and formats for computational models. There are yearly two meeting, HARMONY (Hackathons on Resources for Modeling in Biology), Hackathon-type meetings with a focus on development of the support for standards, and COMBINE forums, workshop-style events with oral presentations, discussion, poster, and breakout sessions for further developing the standards. For more information see http://co.mbine.org/. So far the different standards were published and made accessible through the standards’ web- pages or preprint services. The aim of this special issue is to provide a single, easily accessible and citable platform for the publication of standards in systems and synthetic biology. This special issue is intended to serve as a central access point to standards and related initiatives in systems and synthetic biology, it will be published annually to provide an opportunity for standard development groups to communicate updated specifications.

78 FR 27088 - Fisheries of the Northeastern United States; Atlantic Sea Scallop Fishery and Northeast...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-09

...). Framework 24 also continues the closures of the Delmarva and Elephant Trunk scallop access areas, refines... Scallop Access Areas Framework 24 closes both the Elephant Trunk (ET) area and the Delmarva Access Area...

Accessibility to health care facilities in Montreal Island: an application of relative accessibility indicators from the perspective of senior and non-senior residents.

PubMed

Paez, Antonio; Mercado, Ruben G; Farber, Steven; Morency, Catherine; Roorda, Matthew

2010-10-25

Geographical access to health care facilities is known to influence health services usage. As societies age, accessibility to health care becomes an increasingly acute public health concern. It is known that seniors tend to have lower mobility levels, and it is possible that this may negatively affect their ability to reach facilities and services. Therefore, it becomes important to examine the mobility situation of seniors vis-a-vis the spatial distribution of health care facilities, to identify areas where accessibility is low and interventions may be required. Accessibility is implemented using a cumulative opportunities measure. Instead of assuming a fixed bandwidth (i.e. a distance threshold) for measuring accessibility, in this paper the bandwidth is defined using model-based estimates of average trip length. Average trip length is an all-purpose indicator of individual mobility and geographical reach. Adoption of a spatial modelling approach allows us to tailor these estimates of travel behaviour to specific locations and person profiles. Replacing a fixed bandwidth with these estimates permits us to calculate customized location- and person-based accessibility measures that allow inter-personal as well as geographical comparisons. The case study is Montreal Island. Geo-coded travel behaviour data, specifically average trip length, and relevant traveller's attributes are obtained from the Montreal Household Travel Survey. These data are complemented with information from the Census. Health care facilities, also geo-coded, are extracted from a comprehensive business point database. Health care facilities are selected based on Standard Industrial Classification codes 8011-21 (Medical Doctors and Dentists). Model-based estimates of average trip length show that travel behaviour varies widely across space. With the exception of seniors in the downtown area, older residents of Montreal Island tend to be significantly less mobile than people of other age cohorts. The combination of average trip length estimates with the spatial distribution of health care facilities indicates that despite being more mobile, suburban residents tend to have lower levels of accessibility compared to central city residents. The effect is more marked for seniors. Furthermore, the results indicate that accessibility calculated using a fixed bandwidth would produce patterns of exposure to health care facilities that would be difficult to achieve for suburban seniors given actual mobility patterns. The analysis shows large disparities in accessibility between seniors and non-seniors, between urban and suburban seniors, and between vehicle owning and non-owning seniors. This research was concerned with potential accessibility levels. Follow up research could consider the results reported here to select case studies of actual access and usage of health care facilities, and related health outcomes.

75 FR 554 - Pacific Halibut Fisheries; Limited Access for Guided Sport Charter Vessels in Alaska

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-05

...NMFS issues regulations creating a limited access system for charter vessels in the guided sport fishery for Pacific halibut in waters of International Pacific Halibut Commission Regulatory Areas 2C (Southeast Alaska) and 3A (Central Gulf of Alaska). This limited access system limits the number of charter vessels that may participate in the guided sport fishery for halibut in these areas. NMFS will issue a charter halibut permit to a licensed charter fishing business owner based on his or her past participation in the charter halibut fishery and to a Community Quota Entity representing specific rural communities. All charter halibut permit holders are subject to limits on the number of permits they may hold and on the number of charter vessel anglers who may catch and retain halibut on permitted charter vessels. This action is necessary to achieve the approved halibut fishery management goals of the North Pacific Fishery Management Council. The intended effect is to curtail growth of fishing capacity in the guided sport fishery for halibut.

Interplay between morphology and frequency in lexical access: The case of the base frequency effect

PubMed Central

Vannest, Jennifer; Newport, Elissa L.; Newman, Aaron J.; Bavelier, Daphne

2011-01-01

A major issue in lexical processing concerns storage and access of lexical items. Here we make use of the base frequency effect to examine this. Specifically, reaction time to morphologically complex words (words made up of base and suffix, e.g., agree+able) typically reflects frequency of the base element (i.e., total frequency of all words in which agree appears) rather than surface word frequency (i.e., frequency of agreeable itself). We term these complex words decomposable. However, a class of words termed whole-word do not show such sensitivity to base frequency (e.g., serenity). Using an event-related MRI design, we exploited the fact that processing low-frequency words increases BOLD activity relative to high frequency ones, and examined effects of base frequency on brain activity for decomposable and whole-word items. Morphologically complex words, half high and half low base frequency, were compared to matched high and low frequency simple monomorphemic words using a lexical decision task. Morphologically complex words increased activation in left inferior frontal and left superior temporal cortices versus simple words. The only area to mirror the behavioral distinction between decomposable and whole-word types was the thalamus. Surprisingly, most frequency-sensitive areas failed to show base frequency effects. This variety of responses to frequency and word type across brain areas supports an integrative view of multiple variables during lexical access, rather than a dichotomy between memory-based access and on-line computation. Lexical access appears best captured as interplay of several neural processes with different sensitivities to various linguistic factors including frequency and morphological complexity. PMID:21167136

Identifying the impact of social determinants of health on disease rates using correlation analysis of area-based summary information.

PubMed

Song, Ruiguang; Hall, H Irene; Harrison, Kathleen McDavid; Sharpe, Tanya Telfair; Lin, Lillian S; Dean, Hazel D

2011-01-01

We developed a statistical tool that brings together standard, accessible, and well-understood analytic approaches and uses area-based information and other publicly available data to identify social determinants of health (SDH) that significantly affect the morbidity of a specific disease. We specified AIDS as the disease of interest and used data from the American Community Survey and the National HIV Surveillance System. Morbidity and socioeconomic variables in the two data systems were linked through geographic areas that can be identified in both systems. Correlation and partial correlation coefficients were used to measure the impact of socioeconomic factors on AIDS diagnosis rates in certain geographic areas. We developed an easily explained approach that can be used by a data analyst with access to publicly available datasets and standard statistical software to identify the impact of SDH. We found that the AIDS diagnosis rate was highly correlated with the distribution of race/ethnicity, population density, and marital status in an area. The impact of poverty, education level, and unemployment depended on other SDH variables. Area-based measures of socioeconomic variables can be used to identify risk factors associated with a disease of interest. When correlation analysis is used to identify risk factors, potential confounding from other variables must be taken into account.

Topography of the casein micelle surface by surface plasmon resonance (SPR) using a selection of specific monoclonal antibodies.

PubMed

Dupont, Didier; Johansson, Annette; Marchin, Stephane; Rolet-Repecaud, Odile; Marchesseau, Sylvie; Leonil, Joelle

2011-08-10

Several theoretical models of the casein micelle structure have been proposed in the past, but the exact organization of the four individual caseins (α(s1), α(s2), β, and κ) within this supramolecular structure remains unknown. The present study aims at determining the topography of the casein micelle surface by following the interaction between 44 monoclonal antibodies specific for different epitopes of α(s1)-, α(s2)-, β-, and κ-casein and the casein micelle in real time and no labeling using a surface plasmon resonance (SPR)-based biosensor. Although the four individual caseins were found to be accessible for antibody binding, data confirmed that the C-terminal extremity of κ-casein was highly accessible and located at the periphery of the structure. When casein micelles were submitted to proteolysis, the C-terminal extremity of κ-casein was rapidly hydrolyzed. Disintegration of the micellar structure resulted in an increased access for antibodies to hydrophobic areas of α(s1)- and α(s2)-casein.

46 CFR 154.340 - Access to tanks and spaces in the cargo area.

Code of Federal Regulations, 2010 CFR

2010-10-01

... access from the weather deck to gas-safe spaces in the cargo area must be at least 2.4 m (7.9 ft.) above... 46 Shipping 5 2010-10-01 2010-10-01 false Access to tanks and spaces in the cargo area. 154.340... Equipment Ship Arrangements § 154.340 Access to tanks and spaces in the cargo area. (a) Each cargo tank must...

46 CFR 154.340 - Access to tanks and spaces in the cargo area.

Code of Federal Regulations, 2011 CFR

2011-10-01

... access from the weather deck to gas-safe spaces in the cargo area must be at least 2.4 m (7.9 ft.) above... 46 Shipping 5 2011-10-01 2011-10-01 false Access to tanks and spaces in the cargo area. 154.340... Equipment Ship Arrangements § 154.340 Access to tanks and spaces in the cargo area. (a) Each cargo tank must...

46 CFR 154.340 - Access to tanks and spaces in the cargo area.

Code of Federal Regulations, 2014 CFR

2014-10-01

... access from the weather deck to gas-safe spaces in the cargo area must be at least 2.4 m (7.9 ft.) above... 46 Shipping 5 2014-10-01 2014-10-01 false Access to tanks and spaces in the cargo area. 154.340... Equipment Ship Arrangements § 154.340 Access to tanks and spaces in the cargo area. (a) Each cargo tank must...

46 CFR 154.340 - Access to tanks and spaces in the cargo area.

Code of Federal Regulations, 2012 CFR

2012-10-01

... access from the weather deck to gas-safe spaces in the cargo area must be at least 2.4 m (7.9 ft.) above... 46 Shipping 5 2012-10-01 2012-10-01 false Access to tanks and spaces in the cargo area. 154.340... Equipment Ship Arrangements § 154.340 Access to tanks and spaces in the cargo area. (a) Each cargo tank must...

46 CFR 154.340 - Access to tanks and spaces in the cargo area.

Code of Federal Regulations, 2013 CFR

2013-10-01

... access from the weather deck to gas-safe spaces in the cargo area must be at least 2.4 m (7.9 ft.) above... 46 Shipping 5 2013-10-01 2013-10-01 false Access to tanks and spaces in the cargo area. 154.340... Equipment Ship Arrangements § 154.340 Access to tanks and spaces in the cargo area. (a) Each cargo tank must...

33 CFR 104.107 - Employee access area.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., excluding cruise ships, may designate areas within the vessel as employee access areas. (b) An employee... measures for access control, of a ferry or passenger vessel that is open only to employees and not to...

33 CFR 104.107 - Employee access area.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., excluding cruise ships, may designate areas within the vessel as employee access areas. (b) An employee... measures for access control, of a ferry or passenger vessel that is open only to employees and not to...

33 CFR 104.107 - Employee access area.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., excluding cruise ships, may designate areas within the vessel as employee access areas. (b) An employee... measures for access control, of a ferry or passenger vessel that is open only to employees and not to...

33 CFR 104.106 - Passenger access area.

Code of Federal Regulations, 2011 CFR

2011-07-01

... measures for access control, of a ferry, passenger vessel, or cruise ship that is open to passengers. It is..., or cruise ship may designate areas within the vessel as passenger access areas. (b) A passenger...

33 CFR 104.106 - Passenger access area.

Code of Federal Regulations, 2010 CFR

2010-07-01

... measures for access control, of a ferry, passenger vessel, or cruise ship that is open to passengers. It is..., or cruise ship may designate areas within the vessel as passenger access areas. (b) A passenger...

33 CFR 104.107 - Employee access area.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., excluding cruise ships, may designate areas within the vessel as employee access areas. (b) An employee... measures for access control, of a ferry or passenger vessel that is open only to employees and not to...

33 CFR 104.107 - Employee access area.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., excluding cruise ships, may designate areas within the vessel as employee access areas. (b) An employee... measures for access control, of a ferry or passenger vessel that is open only to employees and not to...

33 CFR 104.106 - Passenger access area.

Code of Federal Regulations, 2013 CFR

2013-07-01

... measures for access control, of a ferry, passenger vessel, or cruise ship that is open to passengers. It is..., or cruise ship may designate areas within the vessel as passenger access areas. (b) A passenger...

33 CFR 104.106 - Passenger access area.

Code of Federal Regulations, 2012 CFR

2012-07-01

... measures for access control, of a ferry, passenger vessel, or cruise ship that is open to passengers. It is..., or cruise ship may designate areas within the vessel as passenger access areas. (b) A passenger...

33 CFR 104.106 - Passenger access area.

Code of Federal Regulations, 2014 CFR

2014-07-01

... measures for access control, of a ferry, passenger vessel, or cruise ship that is open to passengers. It is..., or cruise ship may designate areas within the vessel as passenger access areas. (b) A passenger...

Text to Speech: A 4-H Model of Accessibility and Inclusion

ERIC Educational Resources Information Center

Green, Jeremy W.

2012-01-01

4-H project manuals play an integral part in a youth's ability to achieve mastery in a specific project area. For youth who struggle with reading, written 4-H materials prove inadequate in addressing the needs of the learner. This article proposes a new delivery method of 4-H educational material designed to create a more inclusive and…

Economic comparisons of haul road construction versus forwarding versus longer skid distances

Treesearch

Michael D. Erickson; Curt C. Hassler; Chris B. LeDoux

1992-01-01

There currently exists no set of basic guidelines for Appalachian loggers to use in the decision making process for selecting the best way to harvest a tract of timber. Specifically, guidelines are needed for deciding between the alternatives of constructing truck haul roads to access an area or other alternatives such as skidding or forwarding timber longer distances...

Exploration of NSF-ATE Projects Approaches in the Integration of Technology and Engineering Education at the K-12 Levels

ERIC Educational Resources Information Center

Strobel, Johannes; Mendoza Díaz, Noemi V.

2012-01-01

Access to post-secondary education, specifically in the technical, two-year institution area, is a topic of growing interest in the country. Funding agencies, such as NSF, via the Advanced Technological Education Program (ATE), are supporting initiatives and research aimed at increasing the number of technicians and engineers and improving…

Information Sources on Scientific Research Related to the Preservation of Books, Paper, and Adhesives. Directory.

ERIC Educational Resources Information Center

Commission on Preservation and Access, Washington, DC.

Produced as part of an effort by the Commission on Preservation and Access to assist with the formation of a preservation research agenda, this report contains: (1) a directory of laboratories and organizations working in the four specific areas of concern in preservation--books, paper, adhesives, and mold; (2) directories of indexes, abstracts,…

Technological Pedagogical Content Knowledge and Teaching Poetry: Preparing Preservice Teachers to Integrate Content with VoiceThread Technology

ERIC Educational Resources Information Center

Carlson, David Lee; Archambault, Leanna

2013-01-01

Although there is a vast research base on the literacy practices of adolescents and the issues surrounding the integration of technology despite current widespread access to tools and the Internet (Cuban, 2003), very little has been completed on the attempts of teacher educators to integrate technology within a specific content area to prepare…

Assessing Barriers to Neurosurgical Care in Sub-Saharan Africa: The Role of Resources and Infrastructure.

PubMed

Sader, Elie; Yee, Philip; Hodaie, Mojgan

2017-02-01

Quantitative estimates of surgical capacity and infrastructure and perceived care limitations in low-resource countries are essential baseline measures that can provide strategies for improving access to surgical care. Information about these barriers in Africa is scarce, particularly with respect to neurosurgery. We conducted a survey to better understand the unmet surgical need and resources available for the care of neurosurgery patients in Sub-Saharan Africa. Using SurveyMonkey, we administered a neurosurgery-specific survey to neurosurgery attending surgeons and residents in Sub-Saharan African countries. Key outcome measures included workforce, access to imaging modalities and instruments, volume and breakdown of neurosurgical cases, and perceived limitations of care. We obtained a 41% survey response (129/314 sent). In addition to the expected large gap in workforce between low- and high-income countries, we found a dramatic paucity of neurosurgical resources in Central Africa, whereas specific pockets in West and South Africa have better neurosurgical care. Access to neuroimaging was not a major limitation in Sub-Saharan African countries. The most commonly perceived limitations of care included infrastructure, anesthesia/nursing availability, wait times, and strength of training. This large survey defines important self-perceived limitations to care within neurosurgery and highlights the importance of infrastructure and allied professions in this role. A clear understanding of areas of focus will enable a more efficient and sustainable response to the limitations in surgical care in low-resource areas. Copyright © 2016 Elsevier Inc. All rights reserved.

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

PubMed

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

2017-07-19

Studies have shown that inadequate access to healthcare is associated with lower levels of health and well-being in older adults. Studies have also shown significant urban-rural differences in access to healthcare in developing countries such as China. However, there is limited evidence of whether the association between access to healthcare and health outcomes differs by urban-rural residence at older ages in China. Four waves of data (2005, 2008/2009, 2011/2012, and 2014) from the largest national longitudinal survey of adults aged 65 and older in mainland China (n = 26,604) were used for analysis. The association between inadequate access to healthcare (y/n) and multiple health outcomes were examined-including instrumental activities of daily living (IADL) disability, ADL disability, cognitive impairment, and all-cause mortality. A series of multivariate models were used to obtain robust estimates and to account for various covariates associated with access to healthcare and/or health outcomes. All models were stratified by urban-rural residence. Inadequate access to healthcare was significantly higher among older adults in rural areas than in urban areas (9.1% vs. 5.4%; p < 0.01). Results from multivariate models showed that inadequate access to healthcare was associated with significantly higher odds of IADL disability in older adults living in urban areas (odds ratio [OR] = 1.58-1.79) and rural areas (OR = 1.95-2.30) relative to their counterparts with adequate access to healthcare. In terms of ADL disability, we found significant increases in the odds of disability among rural older adults (OR = 1.89-3.05) but not among urban older adults. Inadequate access to healthcare was also associated with substantially higher odds of cognitive impairment in older adults from rural areas (OR = 2.37-3.19) compared with those in rural areas with adequate access to healthcare; however, no significant differences in cognitive impairment were found among older adults in urban areas. Finally, we found that inadequate access to healthcare increased overall mortality risks in older adults by 33-37% in urban areas and 28-29% in rural areas. However, the increased risk of mortality in urban areas was not significant after taking into account health behaviors and baseline health status. Inadequate access to healthcare was significantly associated with higher rates of disability, cognitive impairment, and all-cause mortality among older adults in China. The associations between access to healthcare and health outcomes were generally stronger among older adults in rural areas than in urban areas. Our findings underscore the importance of providing adequate access to healthcare for older adults-particularly for those living in rural areas in developing countries such as China.

A regional assessment of medicaid access to outpatient orthopaedic care: the influence of population density and proximity to academic medical centers on patient access.

PubMed

Patterson, Brendan M; Draeger, Reid W; Olsson, Erik C; Spang, Jeffrey T; Lin, Feng-Chang; Kamath, Ganesh V

2014-09-17

Access to care is limited for patients with Medicaid with many conditions, but data investigating this relationship in the orthopaedic literature are limited. The purpose of this study was to investigate the relationship between health insurance status and access to care for a diverse group of adult orthopaedic patients, specifically if access to orthopaedic care is influenced by population density or distance from academic teaching hospitals. Two hundred and three orthopaedic practices within the state of North Carolina were randomly selected and were contacted on two different occasions separated by three weeks. An appointment was requested for a fictitious adult orthopaedic patient with a potential surgical problem. Injury scenarios included patients with acute rotator cuff tears, zone-II flexor tendon lacerations, and acute lumbar disc herniations. Insurance status was reported as Medicaid at the time of the first request and private insurance at the time of the second request. County population density and the distance from each practice to the nearest academic hospital were recorded. Of the 203 practices, 119 (59%) offered the patient with Medicaid an appointment within two weeks, and 160 (79%) offered the patient with private insurance an appointment within this time period (p < 0.001). Practices in rural counties were more likely to offer patients with Medicaid an appointment as compared with practices in urban counties (odds ratio, 2.25 [95% confidence interval, 1.16 to 4.34]; p = 0.016). Practices more than sixty miles from academic hospitals were more likely to accept patients with Medicaid than practices closer to academic hospitals (odds ratio, 3.35 [95% confidence interval, 1.44 to 7.83]; p = 0.005). Access to orthopaedic care was significantly decreased for patients with Medicaid. Practices in less populous areas were more likely to offer an appointment to patients with Medicaid than practices in more populous areas. Practices that were farther from academic hospitals were more likely to offer an appointment to patients with Medicaid than practices closer to academic hospitals. This study illustrates the barriers to timely outpatient orthopaedic care that patients with Medicaid face. The findings from our study imply that patients with Medicaid in more populous areas and in areas closer to academic medical centers are less likely to obtain an outpatient orthopaedic appointment than patients with Medicaid in less populous areas and in areas more distant from academic medical centers. A shift in policy to enhance access to orthopaedic care for patients with Medicaid, especially those in urban areas and areas close to academic medical centers, will become increasingly important as more patients become eligible for Medicaid through the Patient Protection and Affordable Care Act of 2010. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

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

Valassi, A.; Clemencic, M.; Dykstra, D.

The Persistency Framework consists of three software packages (CORAL, COOL and POOL) addressing the data access requirements of the LHC experiments in different areas. It is the result of the collaboration between the CERN IT Department and the three experiments (ATLAS, CMS and LHCb) that use this software to access their data. POOL is a hybrid technology store for C++ objects, metadata catalogs and collections. CORAL is a relational database abstraction layer with an SQL-free API. COOL provides specific software tools and components for the handling of conditions data. This paper reports on the status and outlook of the projectmore » and reviews in detail the usage of each package in the three experiments.« less

Making our offices universally accessible: guidelines for physicians

PubMed Central

Jones, K E; Tamari, I E

1997-01-01

OBJECTIVE: To develop recommendations for office-based physicians who wish to make their offices accessible to all patients. OPTIONS: Include taking steps to make offices more accessible, or not; offices may be accessible to varying degrees. OUTCOMES: Outcomes of accessibility involve patient-care, economic, ethical and legal issues. Stakeholders in these outcomes include patients, physicians, government and society. EVIDENCE: Data were obtained from a series of searches of MEDLINE, CINAHL and Healthstar (previously Health) databases for articles on disability and family medicine, primary (health) care and family practice, and on access and offices, and health services accessibility, and from a telephone survey of 50 stakeholders. VALUES: A high value was placed on services to persons with disabilities and on stakeholder input. Universal accessibility was valued as an overall goal; improved accessibility was also highly valued. BENEFITS, HARMS AND COSTS: Benefits to patients include improved access to care as guaranteed by the Canada Health Act and in keeping with provincial Human Rights Codes. Benefits to physicians include contact with a broader patient population and freedom from fear of litigation. Costs of improved accessibility vary depending on individual circumstances and on whether an office is being built or renovated; some improvement costs are minimal. RECOMMENDATIONS: All physicians should take measures to improve practice accessibility. Improved access should be considered in each of the following areas: transportation and entrance to the facility, entrance to the office, waiting rooms, rest rooms, examination rooms, general building features and other features. VALIDATION: No similar guidelines exist. To assess the content validity of these guidelines, the authors had a draft document reviewed by 18 stakeholders. All specific recommendations met the minimum criterion of adherence to current legislation, including national and provincial building codes. The specific recommendations are endorsed by the Canadian Paraplegic Association (national and Ontario offices), the DisAbled Women's Network (Ontario) and the Centre for Independent Living (Toronto). SPONSORS: Development of these guidelines was supported in part by the Department of Family and Community Medicine, Toronto Hospital, Toronto, Ont. PMID:9068570

Rotorcraft air transportation

NASA Technical Reports Server (NTRS)

Gilbert, G. A.

1983-01-01

Intermodal relationships and the particular ways in which they affect public transportation applications of rotorcraft are addressed. Some aspects of integrated services and general comparisons with other transportation modes are reviewed. Two potential application scenarios are discussed: down-to-downtown rotorcraft service and urban public transport rotorcraft service. It is concluded that to integrate well with ground access modes community rotorcraft service should be limited stop service with published schedules, and operate on a few specific routes between a few specific destinations. For downtown-to-downtown service, time savings favorable to rotorcraft are benefits that reflect its more direct access, relatively higher line-haul travel speeds, and less circuitous travel. For the scenario of public transport within urban areas, first, improving cruise speeds has a limited potential due to allowing for a ""station spacing'' effect. Secondly, public acceptance of higher acceleration/deceleration rates may be just as effective as a technological innovation as achieving higher cruise speeds.

The effect of a Lean quality improvement implementation program on surgical pathology specimen accessioning and gross preparation error frequency.

PubMed

Smith, Maxwell L; Wilkerson, Trent; Grzybicki, Dana M; Raab, Stephen S

2012-09-01

Few reports have documented the effectiveness of Lean quality improvement in changing anatomic pathology patient safety. We used Lean methods of education; hoshin kanri goal setting and culture change; kaizen events; observation of work activities, hand-offs, and pathways; A3-problem solving, metric development, and measurement; and frontline work redesign in the accessioning and gross examination areas of an anatomic pathology laboratory. We compared the pre- and post-Lean implementation proportion of near-miss events and changes made in specific work processes. In the implementation phase, we documented 29 individual A3-root cause analyses. The pre- and postimplementation proportions of process- and operator-dependent near-miss events were 5.5 and 1.8 (P < .002) and 0.6 and 0.6, respectively. We conclude that through culture change and implementation of specific work process changes, Lean implementation may improve pathology patient safety.

10 CFR 20.1601 - Control of access to high radiation areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Control of access to high radiation areas. 20.1601 Section 20.1601 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Control of Exposure From External Sources in Restricted Areas § 20.1601 Control of access to high radiation areas. (a...

33 CFR 127.1325 - Access to marine transfer area for LHG.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Access to marine transfer area... to marine transfer area for LHG. Each operator of a waterfront facility handling LHG shall ensure that— (a) Access to the marine transfer area for LHG from shoreside and waterside is limited to— (1...

33 CFR 127.1325 - Access to marine transfer area for LHG.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Access to marine transfer area... to marine transfer area for LHG. Each operator of a waterfront facility handling LHG shall ensure that— (a) Access to the marine transfer area for LHG from shoreside and waterside is limited to— (1...

33 CFR 127.1325 - Access to marine transfer area for LHG.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Access to marine transfer area... to marine transfer area for LHG. Each operator of a waterfront facility handling LHG shall ensure that— (a) Access to the marine transfer area for LHG from shoreside and waterside is limited to— (1...

10 CFR 20.1601 - Control of access to high radiation areas.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Control of access to high radiation areas. 20.1601 Section 20.1601 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Control of Exposure From External Sources in Restricted Areas § 20.1601 Control of access to high radiation areas. (a...

10 CFR 20.1601 - Control of access to high radiation areas.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Control of access to high radiation areas. 20.1601 Section 20.1601 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Control of Exposure From External Sources in Restricted Areas § 20.1601 Control of access to high radiation areas. (a...

10 CFR 20.1601 - Control of access to high radiation areas.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Control of access to high radiation areas. 20.1601 Section 20.1601 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Control of Exposure From External Sources in Restricted Areas § 20.1601 Control of access to high radiation areas. (a...

10 CFR 20.1601 - Control of access to high radiation areas.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Control of access to high radiation areas. 20.1601 Section 20.1601 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Control of Exposure From External Sources in Restricted Areas § 20.1601 Control of access to high radiation areas. (a...

14 CFR 1203a.103 - Access to security areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Access to security areas. 1203a.103 Section 1203a.103 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION NASA SECURITY AREAS § 1203a.103 Access to security areas. (a) Only those NASA employees, NASA contractor employees, and...

14 CFR 1203a.103 - Access to security areas.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Access to security areas. 1203a.103 Section 1203a.103 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION NASA SECURITY AREAS § 1203a.103 Access to security areas. (a) Only those NASA employees, NASA contractor employees, and...

Estimation of reactive surface area using a combined method of laboratory analyses and digital image processing

NASA Astrophysics Data System (ADS)

Ma, Jin; Kong, Xiang-Zhao; Saar, Martin O.

2017-04-01

Fluid-rock interactions play an important role in the engineering processes such as chemical stimulation of enhanced geothermal systems and carbon capture, utilization, and storage. However, these interactions highly depend on the accessible reactive surface area of the minerals that are generally poorly constrained for natural geologic samples. In particular, quantifying surface area of each reacting mineral within whole rock samples is challenging due to the heterogeneous distribution of minerals and pore space. In this study, detailed laboratory analyses were performed on sandstone samples from deep geothermal sites in Lithuania. We measure specific surface area of whole rock samples using a gas adsorption method (so-called B.E.T.) with N2 at a temperature of 77.3K. We also quantify their porosity and pore size distribution by a Helium gas pycnometer and a Hg porosimetry, respectively. Rock compositions are determined by a combination of X-ray fluorescence (XRF) and quantitative scanning electron microscopy (SEM) - Energy-dispersive X-ray spectroscopy (EDS), which are later geometrically mapped on images of two-dimensional SEM- Backscattered electrons (BSE) with a resolution of 1.2 μm and three-dimensional micro-CT with a resolution of 10.3 μm to produce a digital mineral map for further constraining the accessibility of reactive minerals. Moreover, we attempt to link the whole rock porosity, pore size distribution, and B.E.T. specific surface area with the digital mineral maps. We anticipate these necessary analyses to provide in-depth understanding of fluid sample chemistry from later hydrothermal reactive flow-through experiments on whole rock samples at elevated pressure and temperature.

Primary care access for mental illness in Australia: Patterns of access to general practice from 2006 to 2016.

PubMed

Farrer, Louise M; Walker, Jennie; Harrison, Christopher; Banfield, Michelle

2018-01-01

General practice has an important role within the Australian healthcare system to provide access to care and effective management of chronic health conditions. However, people with serious mental illness experience challenges associated with service access. The current paper seeks to examine drivers of access to general practice for people with common and serious mental disorders, compared with people who access care for type II diabetes, a common physical health problem managed in general practice. The Bettering the Evaluation and Care of Health (BEACH) programme provides the most comprehensive and objective measurement of general practitioner activity in Australia. Using BEACH data, this study compared general practice encounters for depression, anxiety, bipolar disorder, schizophrenia, and type II diabetes during a 10-year period between 2006 and 2016. Analysis revealed more frequent encounters for depression compared to anxiety, and a higher representation of women in encounters for bipolar disorder compared to men. The relationship between number of encounters and patient age was strongly associated with the life course and mortality characteristics associated with each disorder. The findings highlight specific challenges associated with access to primary care for people with serious mental illness, and suggest areas of focus to improve the ability of these patients to access and navigate the health system.

Specializing network analysis to detect anomalous insider actions

PubMed Central

Chen, You; Nyemba, Steve; Zhang, Wen; Malin, Bradley

2012-01-01

Collaborative information systems (CIS) enable users to coordinate efficiently over shared tasks in complex distributed environments. For flexibility, they provide users with broad access privileges, which, as a side-effect, leave such systems vulnerable to various attacks. Some of the more damaging malicious activities stem from internal misuse, where users are authorized to access system resources. A promising class of insider threat detection models for CIS focuses on mining access patterns from audit logs, however, current models are limited in that they assume organizations have significant resources to generate label cases for training classifiers or assume the user has committed a large number of actions that deviate from “normal” behavior. In lieu of the previous assumptions, we introduce an approach that detects when specific actions of an insider deviate from expectation in the context of collaborative behavior. Specifically, in this paper, we introduce a specialized network anomaly detection model, or SNAD, to detect such events. This approach assesses the extent to which a user influences the similarity of the group of users that access a particular record in the CIS. From a theoretical perspective, we show that the proposed model is appropriate for detecting insider actions in dynamic collaborative systems. From an empirical perspective, we perform an extensive evaluation of SNAD with the access logs of two distinct environments: the patient record access logs a large electronic health record system (6,015 users, 130,457 patients and 1,327,500 accesses) and the editing logs of Wikipedia (2,394,385 revisors, 55,200 articles and 6,482,780 revisions). We compare our model with several competing methods and demonstrate SNAD is significantly more effective: on average it achieves 20–30% greater area under an ROC curve. PMID:23399988

High surface area electrodes by template-free self-assembled hierarchical porous gold architecture.

PubMed

Morag, Ahiud; Golub, Tatiana; Becker, James; Jelinek, Raz

2016-06-15

The electrode active surface area is a crucial determinant in many electrochemical applications and devices. Porous metal substrates have been employed in electrode design, however construction of such materials generally involves multistep processes, generating in many instances electrodes exhibiting incomplete access to internal pore surfaces. Here we describe fabrication of electrodes comprising hierarchical, nano-to-microscale porous gold matrix, synthesized through spontaneous crystallization of gold thiocyanate in water. Cyclic voltammetry analysis revealed that the specific surface area of the conductive nanoporous Au microwires was very high and depended only upon the amount of gold used, not electrode areas or geometries. Application of the electrode in a pseudo-capacitor device is presented. Copyright © 2016 Elsevier Inc. All rights reserved.

10 CFR 20.1602 - Control of access to very high radiation areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Control of access to very high radiation areas. 20.1602 Section 20.1602 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Control of Exposure From External Sources in Restricted Areas § 20.1602 Control of access to very high radiation areas...

50 CFR 648.53 - Acceptable biological catch (ABC), annual catch limits (ACL), annual catch targets (ACT), DAS...

Code of Federal Regulations, 2011 CFR

2011-10-01

... be implemented as soon as possible after September 30 each year. (v) The Elephant Trunk Access Area shall change to an open area starting in fishing year 2011. For reference, the Elephant Trunk Access... chart depicting the area previously known as the Elephant Trunk Access Area are available from the...

50 CFR 648.53 - Acceptable biological catch (ABC), annual catch limits (ACL), annual catch targets (ACT), DAS...

Code of Federal Regulations, 2012 CFR

2012-10-01

... be implemented as soon as possible after September 30 each year. (v) The Elephant Trunk Access Area shall change to an open area starting in fishing year 2011. For reference, the Elephant Trunk Access... chart depicting the area previously known as the Elephant Trunk Access Area are available from the...

10 CFR 20.1602 - Control of access to very high radiation areas.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Control of access to very high radiation areas. 20.1602 Section 20.1602 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Control of Exposure From External Sources in Restricted Areas § 20.1602 Control of access to very high radiation areas...

10 CFR 20.1602 - Control of access to very high radiation areas.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Control of access to very high radiation areas. 20.1602 Section 20.1602 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Control of Exposure From External Sources in Restricted Areas § 20.1602 Control of access to very high radiation areas...

10 CFR 20.1602 - Control of access to very high radiation areas.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Control of access to very high radiation areas. 20.1602 Section 20.1602 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Control of Exposure From External Sources in Restricted Areas § 20.1602 Control of access to very high radiation areas...

10 CFR 20.1602 - Control of access to very high radiation areas.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Control of access to very high radiation areas. 20.1602 Section 20.1602 Energy NUCLEAR REGULATORY COMMISSION STANDARDS FOR PROTECTION AGAINST RADIATION Control of Exposure From External Sources in Restricted Areas § 20.1602 Control of access to very high radiation areas...

Access to Gender-Sensitive Higher Education in Eastern and Central Europe: Reflections on the CEPES Project "Good Practice in Promoting Gender Equality in Higher Education"

ERIC Educational Resources Information Center

Grunberg, Laura

2005-01-01

Summarizing the incomplete results of the United Nations Educational and Scientific Organization (UNESCO) program "Good Practice in Promoting Gender Equality in Higher Education," the author asks that any assessment of the progress made in the area of gender-sensitive education take regional specificities into account. The regional…

Job retention and breast cancer: employee perspectives and implications for rehabilitation planning.

PubMed

Rumrill, P D; Nutter, D L; Hennessey, M; Ware, M E

1998-01-01

The article presents four case studies of employed women who have had breast cancer. Specifically, the authors examine respondents' career maintenance concerns in the areas of (a) worksite accessibility, (b) performance of essential job functions, (c) job mastery, and (d) job satisfaction. Post-employment strategies are presented to assist rehabilitation professionals in meeting the on-the-job needs of women with breast cancer.

Classifying neighbourhoods by level of access to stores selling fresh fruit and vegetables and groceries: identifying problematic areas in the city of Gatineau, Quebec.

PubMed

Gould, Adrian C; Apparicio, Philippe; Cloutier, Marie-Soleil

2012-11-06

Physical access to stores selling groceries, fresh fruit and vegetables (FV) is essential for urban dwellers. In Canadian cities where low-density development practices are common, social and material deprivation may be compounded by poor geographic access to healthy food. This case study examines access to food stores selling fresh FV in Gatineau, Quebec, to identify areas where poor access is coincident with high deprivation. Food retailers were identified using two secondary sources and each store was visited to establish the total surface area devoted to the sale of fresh FV. Four population-weighted accessibility measures were then calculated for each dissemination area (DA) using road network distances. A deprivation index was created using variables from the 2006 Statistics Canada census, also at the scale of the DA. Finally, six classes of accessibility to a healthy diet were constructed using a k-means classification procedure. These were mapped and superimposed over high deprivation areas. Overall, deprivation is positively correlated with better accessibility. However, more than 18,000 residents (7.5% of the population) live in high deprivation areas characterized by large distances to the nearest retail food store (means of 1.4 km or greater) and virtually no access to fresh FV within walking distance (radius of 1 km). In this research, we identified areas where poor geographic access may introduce an additional constraint for residents already dealing with the challenges of limited financial and social resources. Our results may help guide local food security policies and initiatives.

Accuracy of visual inspection performed by community health workers in cervical cancer screening.

PubMed

Driscoll, Susan D; Tappen, Ruth M; Newman, David; Voege-Harvey, Kathi

2018-05-22

Cervical cancer remains the leading cause of cancer and mortality in low-resource areas with healthcare personnel shortages. Visual inspection is a low-resource alternative method of cervical cancer screening in areas with limited access to healthcare. To assess accuracy of visual inspection performed by community health workers (CHWs) and licensed providers, and the effect of provider training on visual inspection accuracy. Five databases and four websites were queried for studies published in English up to December 31, 2015. Derivations of "cervical cancer screening" and "visual inspection" were search terms. Visual inspection screening studies with provider definitions, colposcopy reference standards, and accuracy data were included. A priori variables were extracted by two independent reviewers. Bivariate linear mixed-effects models were used to compare visual inspection accuracy. Provider type was a significant predictor of visual inspection sensitivity (P=0.048); sensitivity was 15 percentage points higher among CHWs than physicians (P=0.014). Components of provider training were significant predictors of sensitivity and specificity. Community-based visual inspection programs using adequately trained CHWs could reduce barriers and expand access to screening, thereby decreasing cervical cancer incidence and mortality for women at highest risk and those living in remote areas with limited access to healthcare personnel. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Direct access to physical therapy for the patient with musculoskeletal disorders, a literature review

PubMed Central

Piano, Leonardo; Maselli, Filippo; Viceconti, Antonello; Gianola, Silvia; Ciuro, Aldo

2017-01-01

[Purpose] To present legislation comparing direct and referred access—or other measures—to physical therapy. The focus is on the management of the most burdensome musculoskeletal disorders in terms of regulations, costs, effectiveness, safety and cost-effectiveness. [Methods] Main biomedical databases and gray literature were searched ranging from a global scenario to the analysis of targeted geographical areas and specifically Italy and the Region Piedmont. [Results] legislation on Direct Access highlights inconsistencies among the countries belonging to World Confederation for Physical Therapy. Direct Access could be an effective, safe and efficient organization model for the management of patients with musculoskeletal diseases and seems to be more effective safer and cost effective. [Conclusion] Direct Access is a virtuous model which can help improve the global quality of physical therapy services. Further studies are required to confirm this approach and determine whether the findings of the present overview can be replicated in different countries and healthcare systems. PMID:28878484

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 resources and the reimbursement policies of the New Cooperative Medical Scheme have led to an edge effect regarding spatial accessibility of health services in Donghai County, whereby people living on the edge of the county have less access to health services. Comprehensive measures should be considered to alleviate the unequal spatial accessibility of health services in areas that are more remote and isolated. PMID:23688278

UAS Integration into the NAS Project

NASA Technical Reports Server (NTRS)

Bauer, Jeff

2010-01-01

The goal of the UAS Integration in the NAS Project is to contribute capabilities that reduce technical barriers related to the safety and operational challenges associated with enabling routine UAS access to the NAS This goal will be accomplished through a two-phased approach of system-level integration of key concepts, technologies and/or procedures, and demonstrations of integrated capabilities in an operationally relevant environment. Technical objectives include: PHASE 1: a) Validating the key technical areas identified by this project. System-level analyses, a State of the Art Analysis (SOAA), and a ConOps will identify the challenges and barriers preventing routine UAS access to the NAS. b) Developing a national roadmap and gap analysis identifying specific deliverables in the area of operations, procedures, and technologies that will impact future policy decisions. PHASE 2: a) Provide regulators with a methodology for developing airworthiness requirements for UAS and data to support development of certifications standards and regulatory guidance. b) Provide systems-level integrated testing of concepts and/or capabilities that address barriers to routine access to the NAS. Through simulation and flight testing, address issues including separation assurance, communications requirements, and Pilot Aircraft Interfaces (PAIs) in operationally relevant environments

An efficient General Transit Feed Specification (GTFS) enabled algorithm for dynamic transit accessibility analysis.

PubMed

Fayyaz S, S Kiavash; Liu, Xiaoyue Cathy; Zhang, Guohui

2017-01-01

The social functions of urbanized areas are highly dependent on and supported by the convenient access to public transportation systems, particularly for the less privileged populations who have restrained auto ownership. To accurately evaluate the public transit accessibility, it is critical to capture the spatiotemporal variation of transit services. This can be achieved by measuring the shortest paths or minimum travel time between origin-destination (OD) pairs at each time-of-day (e.g. every minute). In recent years, General Transit Feed Specification (GTFS) data has been gaining popularity for between-station travel time estimation due to its interoperability in spatiotemporal analytics. Many software packages, such as ArcGIS, have developed toolbox to enable the travel time estimation with GTFS. They perform reasonably well in calculating travel time between OD pairs for a specific time-of-day (e.g. 8:00 AM), yet can become computational inefficient and unpractical with the increase of data dimensions (e.g. all times-of-day and large network). In this paper, we introduce a new algorithm that is computationally elegant and mathematically efficient to address this issue. An open-source toolbox written in C++ is developed to implement the algorithm. We implemented the algorithm on City of St. George's transit network to showcase the accessibility analysis enabled by the toolbox. The experimental evidence shows significant reduction on computational time. The proposed algorithm and toolbox presented is easily transferable to other transit networks to allow transit agencies and researchers perform high resolution transit performance analysis.

An efficient General Transit Feed Specification (GTFS) enabled algorithm for dynamic transit accessibility analysis

PubMed Central

Fayyaz S., S. Kiavash; Zhang, Guohui

2017-01-01

The social functions of urbanized areas are highly dependent on and supported by the convenient access to public transportation systems, particularly for the less privileged populations who have restrained auto ownership. To accurately evaluate the public transit accessibility, it is critical to capture the spatiotemporal variation of transit services. This can be achieved by measuring the shortest paths or minimum travel time between origin-destination (OD) pairs at each time-of-day (e.g. every minute). In recent years, General Transit Feed Specification (GTFS) data has been gaining popularity for between-station travel time estimation due to its interoperability in spatiotemporal analytics. Many software packages, such as ArcGIS, have developed toolbox to enable the travel time estimation with GTFS. They perform reasonably well in calculating travel time between OD pairs for a specific time-of-day (e.g. 8:00 AM), yet can become computational inefficient and unpractical with the increase of data dimensions (e.g. all times-of-day and large network). In this paper, we introduce a new algorithm that is computationally elegant and mathematically efficient to address this issue. An open-source toolbox written in C++ is developed to implement the algorithm. We implemented the algorithm on City of St. George’s transit network to showcase the accessibility analysis enabled by the toolbox. The experimental evidence shows significant reduction on computational time. The proposed algorithm and toolbox presented is easily transferable to other transit networks to allow transit agencies and researchers perform high resolution transit performance analysis. PMID:28981544

Access to recreational physical activities by car and bus: an assessment of socio-spatial inequalities in mainland Scotland.

PubMed

Ferguson, Neil S; Lamb, Karen E; Wang, Yang; Ogilvie, David; Ellaway, Anne

2013-01-01

Obesity and other chronic conditions linked with low levels of physical activity (PA) are associated with deprivation. One reason for this could be that it is more difficult for low-income groups to access recreational PA facilities such as swimming pools and sports centres than high-income groups. In this paper, we explore the distribution of access to PA facilities by car and bus across mainland Scotland by income deprivation at datazone level. GIS car and bus networks were created to determine the number of PA facilities accessible within travel times of 10, 20 and 30 minutes. Multilevel negative binomial regression models were then used to investigate the distribution of the number of accessible facilities, adjusting for datazone population size and local authority. Access to PA facilities by car was significantly (p<0.01) higher for the most affluent quintile of area-based income deprivation than for most other quintiles in small towns and all other quintiles in rural areas. Accessibility by bus was significantly lower for the most affluent quintile than for other quintiles in urban areas and small towns, but not in rural areas. Overall, we found that the most disadvantaged groups were those without access to a car and living in the most affluent areas or in rural areas.

Food and Nutrition Insecurity in Selected Rural Communities of KwaZulu-Natal, South Africa—Linking Human Nutrition and Agriculture

PubMed Central

Govender, Laurencia; Pillay, Kirthee; Siwela, Muthulisi; Modi, Albert; Mabhaudhi, Tafadzwanashe

2016-01-01

Lack of access to nutritious and balanced diets remains a major impediment to the health and well-being of people living in rural areas. The study utilizes a qualitative systematic approach to conduct an environmental scan and review of scientific literature of studies conducted in South Africa, specifically KwaZulu-Natal (KZN). Availability and access to nutritious, diverse and balanced diets were identified as key constraints for achieving food and nutrition security as well as for human health and well-being. This has led to both under- and over-nutrition, with the former, in particular stunting, affecting children under 5 years. A high incidence of over-nutrition, both overweight and obesity, was observed among black African females. In South Africa, poor people rely mostly on social grants and cannot afford a balanced diet. Under these circumstances, agriculture could be used to increase availability and access to diverse and nutritious foods for the attainment of a balanced diet. The wider use of traditional vegetable crops and pulses could improve availability and access to healthy and locally available alternatives. The promotion of household and community food gardens, and the use of nutrient dense crops with low levels of water use, i.e., high nutritional water productivity, offers prospects for addressing malnutrition in poor rural areas. PMID:28036008

Food and Nutrition Insecurity in Selected Rural Communities of KwaZulu-Natal, South Africa-Linking Human Nutrition and Agriculture.

PubMed

Govender, Laurencia; Pillay, Kirthee; Siwela, Muthulisi; Modi, Albert; Mabhaudhi, Tafadzwanashe

2016-12-27

Lack of access to nutritious and balanced diets remains a major impediment to the health and well-being of people living in rural areas. The study utilizes a qualitative systematic approach to conduct an environmental scan and review of scientific literature of studies conducted in South Africa, specifically KwaZulu-Natal (KZN). Availability and access to nutritious, diverse and balanced diets were identified as key constraints for achieving food and nutrition security as well as for human health and well-being. This has led to both under- and over-nutrition, with the former, in particular stunting, affecting children under 5 years. A high incidence of over-nutrition, both overweight and obesity, was observed among black African females. In South Africa, poor people rely mostly on social grants and cannot afford a balanced diet. Under these circumstances, agriculture could be used to increase availability and access to diverse and nutritious foods for the attainment of a balanced diet. The wider use of traditional vegetable crops and pulses could improve availability and access to healthy and locally available alternatives. The promotion of household and community food gardens, and the use of nutrient dense crops with low levels of water use, i.e., high nutritional water productivity, offers prospects for addressing malnutrition in poor rural areas.

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...

Lessons learned in dealing with self luminous exit signs.

PubMed

Linsley, Mark E

2005-02-01

Self-luminous signs are generally licensed consumer products used to identifying exits, handicap accessibility areas, parking lots, no smoking areas, life boat locations, and emergency stair locations. While purchasers of these signs are exempt from the requirement of applying for a specific license, they are not exempt from all other requirements concerning radioactive material. And they might not be exempt from the liability that can result from lost or damaged signs and improper disposal. A review of the potential for contamination from these signs is presented along with suggestions for handling a contaminating event involving a damaged sign.

Predicting impact of multi-paths on phase change in map-based vehicular ad hoc networks

NASA Astrophysics Data System (ADS)

Rahmes, Mark; Lemieux, George; Sonnenberg, Jerome; Chester, David B.

2014-05-01

Dynamic Spectrum Access, which through its ability to adapt the operating frequency of a radio, is widely believed to be a solution to the limited spectrum problem. Mobile Ad Hoc Networks (MANETs) can extend high capacity mobile communications over large areas where fixed and tethered-mobile systems are not available. In one use case with high potential impact cognitive radio employs spectrum sensing to facilitate identification of allocated frequencies not currently accessed by their primary users. Primary users own the rights to radiate at a specific frequency and geographic location, secondary users opportunistically attempt to radiate at a specific frequency when the primary user is not using it. We quantify optimal signal detection in map based cognitive radio networks with multiple rapidly varying phase changes and multiple orthogonal signals. Doppler shift occurs due to reflection, scattering, and rapid vehicle movement. Path propagation as well as vehicle movement produces either constructive or destructive interference with the incident wave. Our signal detection algorithms can assist the Doppler spread compensation algorithm by deciding how many phase changes in signals are present in a selected band of interest. Additionally we can populate a spatial radio environment map (REM) database with known information that can be leveraged in an ad hoc network to facilitate Dynamic Spectrum Access. We show how topography can help predict the impact of multi-paths on phase change, as well as about the prediction from dense traffic areas. Utilization of high resolution geospatial data layers in RF propagation analysis is directly applicable.

Cystic Echinococcosis in Spain: Current Situation and Relevance for Other Endemic Areas in Europe

PubMed Central

Rojo-Vazquez, Francisco A.; Pardo-Lledias, Javier; Francos-Von Hunefeld, Marcelo; Cordero-Sanchez, Miguel; Alamo-Sanz, Rufino; Hernandez-Gonzalez, Ana; Brunetti, Enrico; Siles-Lucas, Mar

2011-01-01

Cystic echinococcosis (CE) remains an important health problem in many regions of the world, both where no control measures have been implemented, and where control programs have been incompletely successful with ensuing re-emergence of the disease. In Spain, official data on CE show an increase in the proportion of intermediate hosts with CE during the last few years, and autochthonous pediatric patients have been reported, a sign of active local transmission of disease. A similar picture emerges from data reported to the European Food Safety Authority by other European countries. Nevertheless, several crucial aspects related to CE that would help better understand and control the disease have not been tackled appropriately, in particular the emergence of infection in specific geographical areas. In this respect, while some data are missing, other data are conflicting because they come from different databases. We review the current situation of CE in Spain compared with areas in which similar problems in the CE field exist, and offer recommendations on how to overcome those limitations. Specifically, we believe that the introduction of national registries for CE with online data entry, following the example set by the European Registry for Alveolar Echinococcosis, would help streamline data collection on CE by eliminating the need for evaluating and integrating data from multiple regions, by avoiding duplication of data from patients who access several different health facilities over time, and by providing much needed clinical and epidemiological data that are currently accessible only to clinicians. PMID:21283615

Mental Illness and Firearms: Legal Context and Clinical Approaches.

PubMed

Pinals, Debra A; Anacker, Lisa

2016-12-01

Gun violence and mental illness is a major area of media attention, especially because highly publicized mass shootings seem to have become more commonly reported in the press. Gun access also is undergoing a highly politicized debate in the United States. It is important for mental health practitioners to understand the background and context of laws related to firearms access, and to understand data related to risk of suicide and violence toward others caused by gun violence among persons with mental illness. In addition, clinically driven risk assessments with specific inquiry related to firearms can be important for identifying individuals for whom firearm-focused clinical risk mitigation may be warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

Working towards an inclusive curriculum.

PubMed

Wren, Y; Parkhouse, J

1998-01-01

The move towards an inclusive model of education presents teachers with the difficulty of differentiating the curriculum for children with speech, language and communication impairments. This paper focuses on the 'WiSaLT Curriculum Appendix'-a tool which can be used by teachers and speech and language therapists to help such children access the mainstream curriculum and to promote improvement in their language and communication skills. As well as highlighting potential areas of difficulty within each attainment target for key stage one, the appendix guides users to specific strategies and activities. Thus the speech and language therapist and teacher can identify which attainment targets might prove problematic for any one child and also have access to ideas which can help.

75 FR 29588 - Notice of Availability of the Models for Plant-Specific Adoption of Technical Specifications Task...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-26

... Documents Access and Management System (ADAMS) under Accession Number ML090510686. The proposed changes... Documents Access and Management System (ADAMS): Publicly available documents created or received at the NRC... expedited approval of plant-specific adoption of TSTF- 501, Revision 1. Documents: You can access publicly...

Individual- and area-level disparities in access to the road network, subway system and a public bicycle share program on the Island of Montreal, Canada.

PubMed

Fuller, Daniel; Gauvin, Lise; Kestens, Yan

2013-02-01

Few studies have examined potential disparities in access to transportation infrastructures, an important determinant of population health. To examine individual- and area-level disparities in access to the road network, public transportation system, and a public bicycle share program in Montreal, Canada. Examining associations between sociodemographic variables and access to the road network, public transportation system, and a public bicycle share program, 6,495 adult respondents (mean age, 48.7 years; 59.0 % female) nested in 33 areas were included in a multilevel analysis. Individuals with lower incomes lived significantly closer to public transportation and the bicycle share program. At the area level, the interaction between low-education and low-income neighborhoods showed that these areas were significantly closer to public transportation and the bicycle share program controlling for individual and urbanicity variables. More deprived areas of the Island of Montreal have better access to transportation infrastructure than less-deprived areas.

Using Geographical Information Systems to Identify Populations in Need of Improved Accessibility to Antivenom Treatment for Snakebite Envenoming in Costa Rica

PubMed Central

Hansson, Erik; Sasa, Mahmood; Mattisson, Kristoffer; Robles, Arodys; Gutiérrez, José María

2013-01-01

Introduction Snakebite accidents are an important health problem in rural areas of tropical countries worldwide, including Costa Rica, where most bites are caused by the pit-viper Bothrops asper. The treatment of these potentially fatal accidents is based on the timely administration of specific antivenom. In many regions of the world, insufficient health care systems and lack of antivenom in remote and poor areas where snakebites are common, means that efficient treatment is unavailable for many snakebite victims, leading to unnecessary mortality and morbidity. In this study, geographical information systems (GIS) were used to identify populations in Costa Rica with a need of improved access to antivenom treatment: those living in areas with a high risk of snakebites and long time to reach antivenom treatment. Method/Principal Findings Populations living in areas with high risk of snakebites were identified using two approaches: one based on the district-level reported incidence, and another based on mapping environmental factors favoring B. asper presence. Time to reach treatment using ambulance was estimated using cost surface analysis, thereby enabling adjustment of transportation speed by road availability and quality, topography and land use. By mapping populations in high risk of snakebites and the estimated time to treatment, populations with need of improved treatment access were identified. Conclusion/Significance This study demonstrates the usefulness of GIS for improving treatment of snakebites. By mapping reported incidence, risk factors, location of existing treatment resources, and the time estimated to reach these for at-risk populations, rational allocation of treatment resources is facilitated. PMID:23383352

Using geographical information systems to identify populations in need of improved accessibility to antivenom treatment for snakebite envenoming in Costa Rica.

PubMed

Hansson, Erik; Sasa, Mahmood; Mattisson, Kristoffer; Robles, Arodys; Gutiérrez, José María

2013-01-01

Snakebite accidents are an important health problem in rural areas of tropical countries worldwide, including Costa Rica, where most bites are caused by the pit-viper Bothrops asper. The treatment of these potentially fatal accidents is based on the timely administration of specific antivenom. In many regions of the world, insufficient health care systems and lack of antivenom in remote and poor areas where snakebites are common, means that efficient treatment is unavailable for many snakebite victims, leading to unnecessary mortality and morbidity. In this study, geographical information systems (GIS) were used to identify populations in Costa Rica with a need of improved access to antivenom treatment: those living in areas with a high risk of snakebites and long time to reach antivenom treatment. Populations living in areas with high risk of snakebites were identified using two approaches: one based on the district-level reported incidence, and another based on mapping environmental factors favoring B. asper presence. Time to reach treatment using ambulance was estimated using cost surface analysis, thereby enabling adjustment of transportation speed by road availability and quality, topography and land use. By mapping populations in high risk of snakebites and the estimated time to treatment, populations with need of improved treatment access were identified. This study demonstrates the usefulness of GIS for improving treatment of snakebites. By mapping reported incidence, risk factors, location of existing treatment resources, and the time estimated to reach these for at-risk populations, rational allocation of treatment resources is facilitated.

Soil erosion model predictions using parent material/soil texture-based parameters compared to using site-specific parameters

Treesearch

R. B. Foltz; W. J. Elliot; N. S. Wagenbrenner

2011-01-01

Forested areas disturbed by access roads produce large amounts of sediment. One method to predict erosion and, hence, manage forest roads is the use of physically based soil erosion models. A perceived advantage of a physically based model is that it can be parameterized at one location and applied at another location with similar soil texture or geological parent...

Compendium of Arms Control Verification Proposals.

DTIC Science & Technology

1982-03-01

proposals. This appears to be the case for virtually all kinds of prospective arms control topics from general and complete disarmament to control of specific... virtually anywhere. Unrestricted access would be particularly necessary in the case of states which previously had nuclear weapons. Practically speaking...been transferred out of the area, it would be harder to check on remaining stocks without some intrusive inspection and it would be virtually impossible

Operational support considerations in Space Shuttle prelaunch processing

NASA Technical Reports Server (NTRS)

Schuiling, Roelof L.

1991-01-01

This paper presents an overview of operational support for Space Shuttle payload processing at the John F. Kennedy Space Center. The paper begins with a discussion of the Shuttle payload processing operation itself. It discusses the major organizational roles and describes the two major classes of payload operations: Spacelab mission payload and vertically-installed payload operations. The paper continues by describing the Launch Site Support Team and the Payload Processing Test Team. Specific areas of operational support are then identified including security and access, training, transport and handling, documentation and scheduling. Specific references for further investigatgion are included.

32 CFR 552.168 - Fort Lewis Area Access Office.

Code of Federal Regulations, 2011 CFR

2011-07-01

... issued to each person authorized access. The permit is not transferable. Entry to the Fort Lewis range... valid for one year. When a permit expires, the holder must re-register to renew privileges, and a new... been coordinated and approved, Area Access will determine when called for entry whether the area...

32 CFR 552.168 - Fort Lewis Area Access Office.

Code of Federal Regulations, 2012 CFR

2012-07-01

... issued to each person authorized access. The permit is not transferable. Entry to the Fort Lewis range... valid for one year. When a permit expires, the holder must re-register to renew privileges, and a new... been coordinated and approved, Area Access will determine when called for entry whether the area...

32 CFR 552.168 - Fort Lewis Area Access Office.

Code of Federal Regulations, 2010 CFR

2010-07-01

... issued to each person authorized access. The permit is not transferable. Entry to the Fort Lewis range... valid for one year. When a permit expires, the holder must re-register to renew privileges, and a new... been coordinated and approved, Area Access will determine when called for entry whether the area...

32 CFR 552.168 - Fort Lewis Area Access Office.

Code of Federal Regulations, 2013 CFR

2013-07-01

... issued to each person authorized access. The permit is not transferable. Entry to the Fort Lewis range... valid for one year. When a permit expires, the holder must re-register to renew privileges, and a new... been coordinated and approved, Area Access will determine when called for entry whether the area...

Politics and patriarchy: barriers to health screening for socially disadvantaged women.

PubMed

Peters, Kathleen

2012-10-01

Health screening and early detection of cancer results in significantly better health outcomes and lower mortality. However barriers to such screening are multiple and complex. This paper specifically addresses barriers to women's health screening for socially disadvantaged women in an economically and service disadvantaged area. In this qualitative study, women's healthcare workers and consumers of women's health screening were interviewed and data related to issues for women who had special needs were analysed. Findings indicate there is a lack of access to appropriate services for socially disadvantaged women which affects their screening uptake rates. This study also highlights the difficulties socially disadvantaged women encountered when they were able to access these services which also influenced their decisions regarding subsequent health screening. Implications for nurses and other healthcare professionals are manifold and include advocating for greater access to services and more sensitive care in the delivery of health screening services for socially disadvantaged women.

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

PubMed

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

2012-11-01

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

Smallholder farmers' attitudes toward the provision of drinking water for dairy cows in Kagera, Tanzania.

PubMed

Forbes, Barbara; Kepe, Thembela

2015-02-01

Agriculture's large share of Tanzanian GDP and the large percentage of rural poor engaged in the sector make it a focus for many development projects that see it as an area of attention for reducing rural poverty. This paper uses a case of the Kamachumu community, where a dairy cow loan project was implemented using the heifer-in-trust (HIT) model. This study finds that productivity is limited by how the cows are being managed, particularly with many animals not having ad lib access to drinking water. The paper explores reasons why farmers do or do not provide their cows with unlimited access to drinking water. The study concludes that there are many barriers farmers face, including water accessibility, education and training, infrastructure, simple negligence, and security. These results suggest an increase in extension services and national and local livestock policies that consider the specific realities of small-scale dairy farmers.

Vaccine and microbicide tax credit legislation introduced in Congress.

PubMed

1999-04-02

The Lifesaving Vaccine Technology Act of 1999, a House bill to stimulate HIV vaccine research and development, has been introduced by Representative Nancy Pelosi (D - Calif.), Representative Charles Rangel (D - N.Y.), and seven other cosponsors. Pelosi presents a summary of the Act, which may offer tax credits to companies for vaccine research costs in the areas of malaria, tuberculosis, HIV, or other infectious diseases. These companies would also be obligated to establish a way of maximizing access to the vaccine. The Act reflects the idea that the President and specific Federal agencies should work together to increase vaccine access. The need for this Act is shown in the 1998 survey results from Pharmaceutical Research and Manufacturers of America, which indicate that none of the 43 vaccines in development were for HIV. Information is provided for accessing the full-text of the Act.

How youth-friendly are pharmacies in New Zealand? Surveying aspects of accessibility and the pharmacy environment using a youth participatory approach.

PubMed

Horsfield, Emma; Kelly, Fiona; Clark, Terryann; Sheridan, Janie

2014-01-01

The international youth population has significant unmet health needs, and there have been many calls to increase youth health care access. Community pharmacies may be able to help address these needs, but very little research has investigated this area and it is not known whether the current community pharmacy setting is acceptable or appropriate for youth. 1) To obtain information on physical factors which could affect young people's use of community pharmacies in New Zealand, including accessibility, opening times and the physical youth-friendliness of the pharmacy environment. 2) To involve and utilize young people in the research process, in order to understand their needs and interpretation of survey data. This study applied a cross sectional survey design, informed by a sequential youth participatory approach. A questionnaire was developed in consultation with a youth advisory group (YAG). Questionnaires distributed to pharmacists at 500 randomly selected pharmacies nationwide between May and September 2011 collected information on whether the pharmacy met selected youth-friendly criteria. These included physical aspects of youth-friendliness, such as opening times and the pharmacy environment. The YAG also provided a youth perspective in the interpretation of the results. Three mail shots achieved a response rate of 50.5%. Most respondents reported the pharmacy to be accessible by public transport and many had extended opening hours. Although most pharmacies met some youth-friendly criteria with regards to the pharmacy environment (e.g. having a private consultation area), more specific criteria (such as displaying youth health information) were usually not met. Interpretive feedback from the YAG highlighted areas for improvement. Pharmacies show potential as youth-friendly health care access points and most already meet some youth-friendly criteria. Areas identified for improvement will require a greater youth focus from the profession, and should be undertaken in consultation with young people. We recommend the use of youth participation approaches in future pharmacy practice research into youth health services. Copyright © 2014 Elsevier Inc. All rights reserved.

EU accession: A policy window opportunity for nursing?

PubMed

De Raeve, Paul; Rafferty, Anne-Marie; Bariball, Louise; Young, Ruth; Boiko, Olga

2017-03-01

European enlargement has been studied in a wide range of policy areas within and beyond health. Yet the impact of EU enlargement upon one of the largest health professions, nursing, has been largely neglected. This paper aims to explore nurse leadership using a comparative case study method in two former Communist countries, Romania and Croatia. Specifically, it considers the extent to which engagement in the EU accession policy-making process provided a policy window for the leaders to formulate and implement a professional agenda while negotiating EU accession. Findings of qualitative interviews and documentary analysis indicate that the mechanisms used to facilitate the accession process were not successful in achieving compliance with the education standards in the Community Acquis, as highlighted in the criteria on the mutual recognition of professional qualifications set out in Directive 2005/36/EC. EU accession capacity building and accession funds were not deployed efficiently to upgrade Romanian and Croatian nursing education towards meeting EU standards. Conflicting views on accession held by the various nursing stakeholders (nursing regulator, nursing union, governmental chief nurse and the professional association) inhibited the setting of a common policy agenda to achieve compliance with EU standards. The study findings suggest a need to critically review EU accession mechanisms and better align leadership at all governance levels. Copyright © 2017 Elsevier B.V. All rights reserved.

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.

Diagnostic Accuracy of Computer Tomography Angiography and Magnetic Resonance Angiography in the Stenosis Detection of Autologuous Hemodialysis Access: A Meta-Analysis

PubMed Central

Liu, Shiyuan

2013-01-01

Purpose To compare the diagnostic performances of computer tomography angiography (CTA) and magnetic resonance angiography (MRA) for detection and assessment of stenosis in patients with autologuous hemodialysis access. Materials and Methods Search of PubMed, MEDLINE, EMBASE and Cochrane Library database from January 1984 to May 2013 for studies comparing CTA or MRA with DSA or surgery for autologuous hemodialysis access. Eligible studies were in English language, aimed to detect more than 50% stenosis or occlusion of autologuous vascular access in hemodialysis patients with CTA and MRA technology and provided sufficient data about diagnosis performance. Methodological quality was assessed by the Quality Assessment of Diagnostic Studies (QUADAS) instrument. Sensitivities (SEN), specificities (SPE), positive likelihood ratio (PLR), negative likelihood values (NLR), diagnostic odds ratio (DOR) and areas under the receiver operator characteristic curve (AUC) were pooled statistically. Potential threshold effect, heterogeneity and publication bias was evaluated. The clinical utility of CTA and MRA in detection of stenosis was also investigated. Result Sixteen eligible studies were included, with a total of 500 patients. Both CTA and MRA were accurate modality (sensitivity, 96.2% and 95.4%, respectively; specificity, 97.1 and 96.1%, respectively; DOR [diagnostic odds ratio], 393.69 and 211.47, respectively) for hemodialysis vascular access. No significant difference was detected between the diagnostic performance of CTA (AUC, 0.988) and MRA (AUC, 0.982). Meta-regression analyses and subgroup analyses revealed no statistical difference. The Deek’s funnel plots suggested a publication bias. Conclusion Diagnostic performance of CTA and MRA for detecting stenosis of hemodialysis vascular access had no statistical difference. Both techniques may function as an alternative or an important complement to conventional digital subtraction angiography (DSA) and may be able to help guide medical management. PMID:24194928

Face Patch Resting State Networks Link Face Processing to Social Cognition

PubMed Central

Schwiedrzik, Caspar M.; Zarco, Wilbert; Everling, Stefan; Freiwald, Winrich A.

2015-01-01

Faces transmit a wealth of social information. How this information is exchanged between face-processing centers and brain areas supporting social cognition remains largely unclear. Here we identify these routes using resting state functional magnetic resonance imaging in macaque monkeys. We find that face areas functionally connect to specific regions within frontal, temporal, and parietal cortices, as well as subcortical structures supporting emotive, mnemonic, and cognitive functions. This establishes the existence of an extended face-recognition system in the macaque. Furthermore, the face patch resting state networks and the default mode network in monkeys show a pattern of overlap akin to that between the social brain and the default mode network in humans: this overlap specifically includes the posterior superior temporal sulcus, medial parietal, and dorsomedial prefrontal cortex, areas supporting high-level social cognition in humans. Together, these results reveal the embedding of face areas into larger brain networks and suggest that the resting state networks of the face patch system offer a new, easily accessible venue into the functional organization of the social brain and into the evolution of possibly uniquely human social skills. PMID:26348613

Study on resources and environmental data integration towards data warehouse construction covering trans-boundary area of China, Russia and Mongolia

NASA Astrophysics Data System (ADS)

Wang, J.; Song, J.; Gao, M.; Zhu, L.

2014-02-01

The trans-boundary area between Northern China, Mongolia and eastern Siberia of Russia is a continuous geographical area located in north eastern Asia. Many common issues in this region need to be addressed based on a uniform resources and environmental data warehouse. Based on the practice of joint scientific expedition, the paper presented a data integration solution including 3 steps, i.e., data collection standards and specifications making, data reorganization and process, data warehouse design and development. A series of data collection standards and specifications were drawn up firstly covering more than 10 domains. According to the uniform standard, 20 resources and environmental survey databases in regional scale, and 11 in-situ observation databases were reorganized and integrated. North East Asia Resources and Environmental Data Warehouse was designed, which included 4 layers, i.e., resources layer, core business logic layer, internet interoperation layer, and web portal layer. The data warehouse prototype was developed and deployed initially. All the integrated data in this area can be accessed online.

Sociospatial distribution of access to facilities for moderate and vigorous intensity physical activity in Scotland by different modes of transport

PubMed Central

2012-01-01

Background People living in neighbourhoods of lower socioeconomic status have been shown to have higher rates of obesity and a lower likelihood of meeting physical activity recommendations than their more affluent counterparts. This study examines the sociospatial distribution of access to facilities for moderate or vigorous intensity physical activity in Scotland and whether such access differs by the mode of transport available and by Urban Rural Classification. Methods A database of all fixed physical activity facilities was obtained from the national agency for sport in Scotland. Facilities were categorised into light, moderate and vigorous intensity activity groupings before being mapped. Transport networks were created to assess the number of each type of facility accessible from the population weighted centroid of each small area in Scotland on foot, by bicycle, by car and by bus. Multilevel modelling was used to investigate the distribution of the number of accessible facilities by small area deprivation within urban, small town and rural areas separately, adjusting for population size and local authority. Results Prior to adjustment for Urban Rural Classification and local authority, the median number of accessible facilities for moderate or vigorous intensity activity increased with increasing deprivation from the most affluent or second most affluent quintile to the most deprived for all modes of transport. However, after adjustment, the modelling results suggest that those in more affluent areas have significantly higher access to moderate and vigorous intensity facilities by car than those living in more deprived areas. Conclusions The sociospatial distributions of access to facilities for both moderate intensity and vigorous intensity physical activity were similar. However, the results suggest that those living in the most affluent neighbourhoods have poorer access to facilities of either type that can be reached on foot, by bicycle or by bus than those living in less affluent areas. This poorer access from the most affluent areas appears to be reversed for those with access to a car. PMID:22568969

Access to Recreational Physical Activities by Car and Bus: An Assessment of Socio-Spatial Inequalities in Mainland Scotland

PubMed Central

Ferguson, Neil S.; Lamb, Karen E.; Wang, Yang; Ogilvie, David; Ellaway, Anne

2013-01-01

Obesity and other chronic conditions linked with low levels of physical activity (PA) are associated with deprivation. One reason for this could be that it is more difficult for low-income groups to access recreational PA facilities such as swimming pools and sports centres than high-income groups. In this paper, we explore the distribution of access to PA facilities by car and bus across mainland Scotland by income deprivation at datazone level. GIS car and bus networks were created to determine the number of PA facilities accessible within travel times of 10, 20 and 30 minutes. Multilevel negative binomial regression models were then used to investigate the distribution of the number of accessible facilities, adjusting for datazone population size and local authority. Access to PA facilities by car was significantly (p<0.01) higher for the most affluent quintile of area-based income deprivation than for most other quintiles in small towns and all other quintiles in rural areas. Accessibility by bus was significantly lower for the most affluent quintile than for other quintiles in urban areas and small towns, but not in rural areas. Overall, we found that the most disadvantaged groups were those without access to a car and living in the most affluent areas or in rural areas. PMID:23409012

A systematic analysis of the needs of people with HIV in Australia: stakeholder views of the key elements for a healthy life.

PubMed

Dodson, Sarity; Batterham, Roy; McDonald, Karalyn; Elliott, Julian H; Osborne, Richard H

2016-07-04

Background: The HealthMap project is developing an intervention to reduce cardiovascular risk in people living with HIV. As part of the formative stages of the intervention design, we sought to understand the needs of people with HIV (PWHIV). Methods: Two concept-mapping workshops with PWHIV (n=10), and one with HIV care providers (n=6) were conducted. The workshop findings were consolidated into a questionnaire administered to PWHIV (n=300) and HIV care providers (n=107). Participants were asked to rate the importance of each of 81 presented needs and the degree to which it was currently being met. Results: Workshops provided insights into what PWHIV perceive they need, to live with and manage their condition, and its impact on their life; these included: (1) clinical science research and development; (2) information and support; (3) personal situation; (4) healthcare quality; (5) access to services; (6) access to services specific to ageing; and (7) social justice. Questionnaire results revealed that PWHIV considered information and support, and research and development most important. For providers, healthcare quality, clients' personal situation, and social justice were most important. In terms of unmet needs, PWHIV and providers both highlighted issues in the areas of social justice, and access to aged care services. Conclusions: PWHIV and HIV providers continue to report unmet needs in the areas of social justice and emerging concerns about access to aged care services. Services must continue to address these issues of access and equity.

AREA RESTRICTIONS, RISK, HARM, AND HEALTH CARE ACCESS AMONG PEOPLE WHO USE DRUGS IN VANCOUVER, CANADA: A SPATIALLY ORIENTED QUALITATIVE STUDY

PubMed Central

McNeil, Ryan; Cooper, Hannah; Small, Will; Kerr, Thomas

2015-01-01

Area restrictions prohibiting people from entering drug scenes or areas where they were arrested are a common socio-legal mechanism employed to regulate the spatial practices of people who use drugs (PWUD). To explore how socio-spatial patterns stemming from area restrictions shape risk, harm, and health care access, qualitative interviews and mapping exercises were conducted with 24 PWUD with area restrictions in Vancouver, Canada. Area restrictions disrupted access to health and social resources (e.g., HIV care) concentrated in drug scenes, while territorial stigma prevented PWUD from accessing supports in other neighbourhoods. Rather than preventing involvement in drug-related activities, area restrictions displaced these activities to other locations and increased vulnerability to diverse risks and harms (e.g., unsafe drug use practices, violence). Given the harms stemming from area restrictions there is an urgent need to reconsider this socio-legal strategy. PMID:26241893

Access to primary care for socioeconomically disadvantaged older people in rural areas: a realist review.

PubMed

Ford, John A; Wong, Geoff; Jones, Andy P; Steel, Nick

2016-05-17

The aim of this review is to identify and understand the contexts that effect access to high-quality primary care for socioeconomically disadvantaged older people in rural areas. A realist review. MEDLINE and EMBASE electronic databases and grey literature (from inception to December 2014). Broad inclusion criteria were used to allow articles which were not specific, but might be relevant to the population of interest to be considered. Studies meeting the inclusion criteria were assessed for rigour and relevance and coded for concepts relating to context, mechanism or outcome. An overarching patient pathway was generated and used as the basis to explore contexts, causal mechanisms and outcomes. 162 articles were included. Most were from the USA or the UK, cross-sectional in design and presented subgroup data by age, rurality or deprivation. From these studies, a patient pathway was generated which included 7 steps (problem identified, decision to seek help, actively seek help, obtain appointment, get to appointment, primary care interaction and outcome). Important contexts were stoicism, education status, expectations of ageing, financial resources, understanding the healthcare system, access to suitable transport, capacity within practice, the booking system and experience of healthcare. Prominent causal mechanisms were health literacy, perceived convenience, patient empowerment and responsiveness of the practice. Socioeconomically disadvantaged older people in rural areas face personal, community and healthcare barriers that limit their access to primary care. Initiatives should be targeted at local contextual factors to help individuals recognise problems, feel welcome, navigate the healthcare system, book appointments easily, access appropriate transport and have sufficient time with professional staff to improve their experience of healthcare; all of which will require dedicated primary care resources. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

An enhanced two-step floating catchment area (E2SFCA) method for measuring spatial accessibility to primary care physicians.

PubMed

Luo, Wei; Qi, Yi

2009-12-01

This paper presents an enhancement of the two-step floating catchment area (2SFCA) method for measuring spatial accessibility, addressing the problem of uniform access within the catchment by applying weights to different travel time zones to account for distance decay. The enhancement is proved to be another special case of the gravity model. When applying this enhanced 2SFCA (E2SFCA) to measure the spatial access to primary care physicians in a study area in northern Illinois, we find that it reveals spatial accessibility pattern that is more consistent with intuition and delineates more spatially explicit health professional shortage areas. It is easy to implement in GIS and straightforward to interpret.

Use of geographic information systems technology to track critical health code violations in retail facilities available to populations of different socioeconomic status and demographics.

PubMed

Darcey, Valerie L; Quinlan, Jennifer J

2011-09-01

Research shows that community socioeconomic status (SES) predicts, based on food service types available, whether a population has access to healthy food. It is not known, however, if a relationship exists between SES and risk for foodborne illness (FBI) at the community level. Geographic information systems (GIS) give researchers the ability to pinpoint health indicators to specific geographic locations and detect resulting environmental gradients. It has been used extensively to characterize the food environment, with respect to access to healthy foods. This research investigated the utility of GIS in determining whether community SES and/or demographics relate to access to safe food, as measured by food service critical health code violations (CHV) as a proxy for risk for FBI. Health inspection records documenting CHV for 10,859 food service facilities collected between 2005 and 2008 in Philadelphia, PA, were accessed. Using an overlay analysis through GIS, CHV were plotted over census tracts of the corresponding area. Census tracts (n = 368) were categorized into quintiles, based on poverty level. Overall, food service facilities in higher poverty areas had a greater number of facilities (with at least one CHV) and had more frequent inspections than facilities in lower poverty areas. The facilities in lower poverty areas, however, had a higher average number of CHV per inspection. Analysis of CHV rates in census tracts with high concentrations of minority populations found Hispanic facilities had more CHV than other demographics, and Hispanic and African American facilities had fewer days between inspections. This research demonstrates the potential for utilization of GIS mapping for tracking risks for FBI. Conversely, it sheds light on the subjective nature of health inspections, and indicates that underlying factors might be affecting inspection frequency and identification of CHV, such that CHV might not be a true proxy for risk for FBI.

The effects of health sector market factors and vulnerable group membership on access to alcohol, drug, and mental health care.

PubMed

Stockdale, Susan E; Tang, Lingqi; Zhang, Lily; Belin, Thomas R; Wells, Kenneth B

2007-06-01

This study adapts Andersen's Behavioral Model to determine if health sector market conditions affect vulnerable subgroups' use of alcohol, drug, and mental health services (ADM) differently than the general population, focusing specifically on community-level predisposing and enabling characteristics. Wave 2 data (2000-2001) from the Health Care for Communities study, supplemented with cases from wave 1 (1997-1998), were merged with area characteristics taken from Census, Area Resource File (ARF), and other data sources. The study used four-level hierarchical logistic regression to examine access to ADM care from any provider and specialty ADM access. Interactions between community-level predisposing and enabling vulnerability characteristics with individual race/ethnicity, age, income category, and insurance type were explored. Nonwhites, the poor, uninsured, and elderly had lower likelihoods of service use, but interactions between race/ethnicity, income, age and insurance status with community-level vulnerability factors were not statistically significant for any service use. For ADM specialty care, those with Medicare, Medicaid, private fully managed, and private partially managed insurance, the likelihood of utilization was higher in areas with higher HMO penetration. However, for those with other insurance or no insurance plan, the likelihood of utilization was lower in areas with higher HMO penetration. Community-level enabling factors explain part of the effect of disadvantaged status but, with the exception of the effect of HMO penetration on the relationship between insurance and specialty care use, do not modify any of the residual individual-level effects of disadvantage. Interventions targeting both structural and individual levels may be necessary to address the problem of health disparities. More research with longitudinal data is necessary to sort out the causal direction of social context and ADM access outcomes, and whether policy interventions to change health sector market conditions can shift ADM treatment utilization.

Research access to privately owned wetland basins in the prairie pothole region of the United States

USGS Publications Warehouse

Fellows, David P.; Buhl, Thomas K.

1995-01-01

We describe efforts to obtain access for research to 81 wetland basins on 69 farms in four zones of the Prairie Pothole Region of North Dakota, South Dakota, and Minnesota. Access was obtained to 54% of the farms in areas where land was intensively cropped and 87% of farms in areas of low cropping intensity. On average, 1.35 operators had to be contacted and 1.70 interviews were required to obtain a decision on access to a farm. On 77% of the farms, cooperators placed at least one restriction on access, most commonly requiring walking access only or notification before nighttime work. Cost of obtaining access averaged $265/farm in wages and travel expenses. No cooperators were willing to sign written access agreements. Operators rescinded access to four farms and drained three wetland basins during the first year; six of the seven sites lost were in the intensively cropped portion of a low-wetland-density zone. The difficulty of obtaining and retaining research access to privately owned wetland basins in intensively cropped areas may be related to landowner attitudes towards wetlands. Researchers may have to rely on remote sensing or consider payment for access to secure representative research sites in such areas. Unwillingness of cooperators to sign access agreements may jeopardize research by the newly formed National Biological Service and other resource management agencies.

The positive pharmacy care law: an area-level analysis of the relationship between community pharmacy distribution, urbanity and social deprivation in England

PubMed Central

Todd, Adam; Copeland, Alison; Husband, Andy; Kasim, Adetayo; Bambra, Clare

2014-01-01

Objectives To: (1) determine the percentage of the population in England that have access to a community pharmacy within 20 min walk; (2) explore any relationship between the walking distance and urbanity; (3) explore any relationship between the walking distance and social deprivation; and (4) explore any interactions between urbanity, social deprivation and community pharmacy access. Design This area level analysis spatial study used postcodes for all community pharmacies in England. Each postcode was assigned to a population lookup table and lower super output area (LSOA). The LSOA was then matched to urbanity (urban, town and fringe or village, hamlet and isolated dwellings) and deprivation decile (using the Index of Multiple Deprivation score). Primary outcome measure Access to a community pharmacy within 20 min walk. Results Overall, 89.2% of the population is estimated to have access to a community pharmacy within 20 min walk. For urban areas, that is 98.3% of the population, for town and fringe, 79.9% of the population, while for rural areas, 18.9% of the population. For areas of lowest deprivation (deprivation decile 1) 90.2% of the population have access to a community pharmacy within 20 min walk, compared to 99.8% in areas of highest deprivation (deprivation decile 10), a percentage difference of 9.6% (8.2, 10.9). Conclusions Our study shows that the majority of the population can access a community pharmacy within 20 min walk and crucially, access is greater in areas of highest deprivation—a positive pharmacy care law. More research is needed to explore the perceptions and experiences of people—from various levels of deprivation—around the accessibility of community pharmacy services. PMID:25116456

Walkyourplace - Evaluating Neighbourhood Accessibility at Street Level

NASA Astrophysics Data System (ADS)

Steiniger, S.; Poorazizi, M. E.; Hunter, A. J. S.

2013-05-01

The popularity of a neighbourhood is often explained by its perceived "higher" quality of life. Good access to shops, restaurants, parks, etc., is seen as an indicator that reflects improved quality of life. We present a web-based tool for assessment of accessibility to such services. The system evaluates in real time an area that is accessible using pedestrian, transit, and cycling infrastructure. The accessible area is evaluated using "quality of life" indicators, such as the number of grocery stores, shopping and recreation facilities, and local crime within that area. This tool sets itself apart from pre-computed and neighbourhood-level walkability indices, because it makes use of detailed street-level data, rather than block-level generalizations. It uses real network travel time, and, when transit data are provided, permits the creation and evaluation of accessibility areas for a combination of travel modes such as walking with transit use.

Mixed methods analysis of eighteen worksite policies, programs, and environments for physical activity.

PubMed

Hipp, J Aaron; Dodson, Elizabeth A; Lee, Jung Ae; Marx, Christine M; Yang, Lin; Tabak, Rachel G; Hoehner, Christine; Marquet, Oriol; Brownson, Ross C

2017-06-14

This study examined whether specific worksite supports for physical activity (PA) were associated with total and domain-specific PA. A cross-sectional, telephone-based study was conducted in four Missouri, USA, metropolitan areas in 2012 and 2013. Outcome variables included total PA and sub-domains (leisure, work, travel) measured using the International Physical Activity Questionnaire. Logistic regression determined odds of meeting PA recommendations, given access to and use of 18 unique PA worksite supports. A subsample of 119 participants also wore hip accelerometry for seven consecutive days and maintained a wear-time diary. Access to worksite supports were associated with odds of meeting objective moderate and vigorous (MV) PA above 150 min per week. Among 2013 survey participants, meeting PA recommendations while performing work-related tasks was significantly associated with several supports (e.g., walking maps, stair prompts), as was meeting recommendations during travel (e.g., flextime for PA, incentives for public transportation, walking/bicycling to work). Access to 11 worksite supports increased odds of meeting PA recommendations through leisure-time PA; five supports were associated with total PA. There were significant differences between access to and use of supports. Using objective MVPA, access to worksite challenges and bike storage were significantly associated with five and three times greater odds of meeting 150 min of MVPA per week, respectively. Worksite wellness plans are increasing across the US and employers are eager for evidence-based supports for increasing PA. This study provides insights into the utility of multiple worksite supports for PA to increase odds that employees meet PA recommendations.

Vulnerability and access to care for South Asian Sikh and Muslim patients with life limiting illness in Scotland: prospective longitudinal qualitative study

PubMed Central

Worth, Allison; Irshad, Tasneem; Bhopal, Raj; Brown, Duncan; Lawton, Julia; Grant, Elizabeth; Murray, Scott; Kendall, Marilyn; Adam, James; Gardee, Rafik

2009-01-01

Objectives To examine the care experiences of South Asian Sikh and Muslim patients in Scotland with life limiting illness and their families and to understand the reasons for any difficulties with access to services and how these might be overcome. Design Prospective, longitudinal, qualitative design using in-depth interviews. Setting Central Scotland. Participants 25 purposively selected South Asian Sikh and Muslim patients, 18 family carers, and 20 key health professionals. Results 92 interviews took place. Most services struggled to deliver responsive, culturally appropriate care. Barriers to accessing effective end of life care included resource constrained services; institutional and, occasionally, personal racial and religious discrimination; limited awareness and understanding among South Asian people of the role of hospices; and difficulty discussing death. The most vulnerable patients, including recent migrants and those with poor English language skills, with no family advocate, and dying of non-malignant diseases were at particularly high risk of inadequate care. Conclusions Despite a robust Scottish diversity policy, services for South Asian Sikh and Muslim patients with life limiting illness were wanting in many key areas. Active case management of the most vulnerable patients and carers, and “real time” support, from where professionals can obtain advice specific to an individual patient and family, are the approaches most likely to instigate noticeable improvements in access to high quality end of life care. Improving access to palliative care for all, particularly those with non-malignant illnesses, as well as focusing on the specific needs of ethnic minority groups, is required. PMID:19190015

Predicted eelgrass response to sea level rise and its availability to foraging Black Brant in Pacific coast estuaries.

PubMed

Shaughnessy, Frank J; Gilkerson, Whelan; Black, Jeffrey M; Ward, David H; Petrie, Mark

2012-09-01

Managers need to predict how animals will respond to habitat redistributions caused by climate change. Our objective was to model the effects of sea level rise on total eelgrass (Zostera marina) habitat area and on the amount of that area that is accessible to Brant geese (Branta bernicla), specialist grazers of eelgrass. Digital elevation models were developed for seven estuaries from Alaska, Washington, California (USA), and Mexico. Scenarios of future total eelgrass area were derived from combinations of estuarine specific sediment and tectonic rates (i.e., bottom change rate) with three rates of eustatic sea level rise (ESLR). Percentages of total eelgrass areas that were accessible to foraging Brant were determined for December when the birds overwinter at more southerly sites and in April as they move north to sites where they build body stores on their way to nesting areas in Alaska. The modeling showed that accessible eelgrass area could be lower than total area due to how daytime low-tide height, eelgrass shoot length, and the upper elevation of eelgrass determined Brant-reaching depth. Projections of future eelgrass area indicated that present-day ESLR (2.8 mm/yr) and bottom change rates should sustain the current pattern of estuarine use by Brant except in Morro Bay, where use should decrease because eelgrass is being ejected from this estuary by a positive bottom change rate. Higher ESLR rates (6.3 and 12.7 mm/yr) should result in less Brant use of estuaries at the northern and southern ends of the flyway, particularly during the winter, but more use of mid-latitude estuaries. The capacity of mid-latitude estuaries to function as Brant feeding refugia, or for these estuaries and Izembek Lagoon to provide drift rather than attached leaves, is eventually limited by the decrease in total eelgrass area, which is a result of a light extinction affect on the eelgrass, or the habitat being pushed out of the estuary by positive tectonic rates. Management responses are limited to the increase or decrease of sediment supply and the relocation of levees to allow for upslope migration of eelgrass habitat.

Predicted eelgrass response to sea level rise and its availability to foraging Black Brant in Pacific coast estuaries

USGS Publications Warehouse

Shaughnessy, Frank J.; Gilkerson, Whelan; Black, Jeffrey M.; Ward, David H.; Petrie, Mark

2012-01-01

Managers need to predict how animals will respond to habitat redistributions caused by climate change. Our objective was to model the effects of sea level rise on total eelgrass (Zostera marina) habitat area and on the amount of that area that is accessible to Brant geese (Branta bernicla), specialist grazers of eelgrass. Digital elevation models were developed for seven estuaries from Alaska, Washington, California (USA), and Mexico. Scenarios of future total eelgrass area were derived from combinations of estuarine specific sediment and tectonic rates (i.e., bottom change rate) with three rates of eustatic sea level rise (ESLR). Percentages of total eelgrass areas that were accessible to foraging Brant were determined for December when the birds overwinter at more southerly sites and in April as they move north to sites where they build body stores on their way to nesting areas in Alaska. The modeling showed that accessible eelgrass area could be lower than total area due to how daytime low-tide height, eelgrass shoot length, and the upper elevation of eelgrass determined Brant-reaching depth. Projections of future eelgrass area indicated that present-day ESLR (2.8 mm/yr) and bottom change rates should sustain the current pattern of estuarine use by Brant except in Morro Bay, where use should decrease because eelgrass is being ejected from this estuary by a positive bottom change rate. Higher ESLR rates (6.3 and 12.7 mm/yr) should result in less Brant use of estuaries at the northern and southern ends of the flyway, particularly during the winter, but more use of mid-latitude estuaries. The capacity of mid-latitude estuaries to function as Brant feeding refugia, or for these estuaries and Izembek Lagoon to provide drift rather than attached leaves, is eventually limited by the decrease in total eelgrass area, which is a result of a light extinction affect on the eelgrass, or the habitat being pushed out of the estuary by positive tectonic rates. Management responses are limited to the increase or decrease of sediment supply and the relocation of levees to allow for upslope migration of eelgrass habitat.

ExPASy: SIB bioinformatics resource portal.

PubMed

Artimo, Panu; Jonnalagedda, Manohar; Arnold, Konstantin; Baratin, Delphine; Csardi, Gabor; de Castro, Edouard; Duvaud, Séverine; Flegel, Volker; Fortier, Arnaud; Gasteiger, Elisabeth; Grosdidier, Aurélien; Hernandez, Céline; Ioannidis, Vassilios; Kuznetsov, Dmitry; Liechti, Robin; Moretti, Sébastien; Mostaguir, Khaled; Redaschi, Nicole; Rossier, Grégoire; Xenarios, Ioannis; Stockinger, Heinz

2012-07-01

ExPASy (http://www.expasy.org) has worldwide reputation as one of the main bioinformatics resources for proteomics. It has now evolved, becoming an extensible and integrative portal accessing many scientific resources, databases and software tools in different areas of life sciences. Scientists can henceforth access seamlessly a wide range of resources in many different domains, such as proteomics, genomics, phylogeny/evolution, systems biology, population genetics, transcriptomics, etc. The individual resources (databases, web-based and downloadable software tools) are hosted in a 'decentralized' way by different groups of the SIB Swiss Institute of Bioinformatics and partner institutions. Specifically, a single web portal provides a common entry point to a wide range of resources developed and operated by different SIB groups and external institutions. The portal features a search function across 'selected' resources. Additionally, the availability and usage of resources are monitored. The portal is aimed for both expert users and people who are not familiar with a specific domain in life sciences. The new web interface provides, in particular, visual guidance for newcomers to ExPASy.

Current Developments in Machine Learning Techniques in Biological Data Mining.

PubMed

Dumancas, Gerard G; Adrianto, Indra; Bello, Ghalib; Dozmorov, Mikhail

2017-01-01

This supplement is intended to focus on the use of machine learning techniques to generate meaningful information on biological data. This supplement under Bioinformatics and Biology Insights aims to provide scientists and researchers working in this rapid and evolving field with online, open-access articles authored by leading international experts in this field. Advances in the field of biology have generated massive opportunities to allow the implementation of modern computational and statistical techniques. Machine learning methods in particular, a subfield of computer science, have evolved as an indispensable tool applied to a wide spectrum of bioinformatics applications. Thus, it is broadly used to investigate the underlying mechanisms leading to a specific disease, as well as the biomarker discovery process. With a growth in this specific area of science comes the need to access up-to-date, high-quality scholarly articles that will leverage the knowledge of scientists and researchers in the various applications of machine learning techniques in mining biological data.

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.

Factors facilitating acceptable mammography services for women with disabilities

PubMed Central

Jarman, Molly P.; Bowling, J. Michael; Dickens, Pamela; Luken, Karen; Yankaskas, Bonnie C.

2012-01-01

Introduction and Background Prior research has described general barriers to breast cancer screening for women with disabilities (WWD). We explored specific accommodations described as necessary by WWD who have accessed screening services, and the presence of such accommodations in community based screening programs. Methods We surveyed WWD in the Carolina Mammography Registry to determine what accommodations were needed when accessing breast screening services, and whether or not these needs were met. The sample of 1,348 WWD was identified through a survey of limitations, with a response rate of 45.5% (4,498/9,885). Of the 1,348 WWD eligible for the second survey, 739 responded for a response rate of 54.8%. Results The most frequently needed accommodations were an accessible changing area with a bench (60.0%), oral description of the procedure by the technologist (60.5%), and handicapped/accessible parking (27.6%). Handicapped parking was the need most likely to go unmet (3.1%). Conclusions Most needs are being met by radiology facilities and staff, and the few needs going unmet are related to the physical/built environment. Overall, for WWD who are in screening, the mammography system appears to be more accessible than generally perceived. PMID:22818248

Exploring 3D optimal channel networks by multiple organizing principles

NASA Astrophysics Data System (ADS)

Mason, Emanuele; Bizzi, Simone; Cominola, Andrea; Castelletti, Andrea; Paik, Kyungrock

2017-04-01

Catchment topography and flow networks are shaped by the interactions of water and sediment across various spatial and temporal scales. The complexity of these processes hinders the development of models able to assess the validity of general principles governing such phenomena. The theory of Optimal Channel Networks (OCNs) proved that it is possible to generate drainage networks statistically comparable to those observed in nature by minimizing the energy spent by the water flowing through them. So far, the OCN theory has been developed for planar 2D domains, assuming equal energy expenditure per unit area of channel and, correspondingly, a constant slope-discharge relationship. In this work, we apply the OCN theory to 3D problems by introducing a multi-principle minimization starting from an artificial digital elevation model of pyramidal shape. The OCN theory assumption of constant slope-area relationship is relaxed and embedded into a second-order principle. The modelled 3D channel networks achieve lower total energy expenditure corresponding to 2D sub-optimal OCNs bound to specific slope-area relationships. This is the first time we are able to explore accessible 3D OCNs starting from a general DEM. By contrasting the modelled 3D OCNs and natural river networks, we found statistical similarities of two indexes, namely the area exponent index and the profile concavity index. Among the wide range of alternative and sub-optimal river networks, a minimum degree of 3D network organization is found to guarantee the indexes values within the natural range. These networks simultaneously possess topological and topographic properties of real river networks. We found a pivotal functional link between slope-area relationship and accessible sub-optimal 2D river network paths, which suggests that geological and climate conditions producing slope-area relationships in natural basins co-determine the degree of optimality of accessible network paths.

Accessing Biomedical Literature in the Current Information Landscape

PubMed Central

Khare, Ritu; Leaman, Robert; Lu, Zhiyong

2015-01-01

i. Summary Biomedical and life sciences literature is unique because of its exponentially increasing volume and interdisciplinary nature. Biomedical literature access is essential for several types of users including biomedical researchers, clinicians, database curators, and bibliometricians. In the past few decades, several online search tools and literature archives, generic as well as biomedicine-specific, have been developed. We present this chapter in the light of three consecutive steps of literature access: searching for citations, retrieving full-text, and viewing the article. The first section presents the current state of practice of biomedical literature access, including an analysis of the search tools most frequently used by the users, including PubMed, Google Scholar, Web of Science, Scopus, and Embase, and a study on biomedical literature archives such as PubMed Central. The next section describes current research and the state-of-the-art systems motivated by the challenges a user faces during query formulation and interpretation of search results. The research solutions are classified into five key areas related to text and data mining, text similarity search, semantic search, query support, relevance ranking, and clustering results. Finally, the last section describes some predicted future trends for improving biomedical literature access, such as searching and reading articles on portable devices, and adoption of the open access policy. PMID:24788259

Los Coches Creek, San Diego County, California Detailed Project Report for Flood Control and Environmental Assessment. Main Report and Environmental Appendix.

DTIC Science & Technology

1984-08-01

as California buckwheat (Eriogonum fasciculatum), elderberry ( Sambucus p.), bror.r bacoharis (Baccharis sarathroides), and coast live oak (Quercus...emergent wetland and riparian habitat, essentially all of the wetland and riparian habitat in the project area (Table EA-1). Access requirements for...reach a level of significance. The construction specifications would require the construction contractor to avoid polluting the creek with fuels, oils

Towards medicinal mechanochemistry: evolution of milling from pharmaceutical solid form screening to the synthesis of active pharmaceutical ingredients (APIs).

PubMed

Tan, Davin; Loots, Leigh; Friščić, Tomislav

2016-06-14

This overview highlights the emergent area of mechanochemical reactions for making active pharmaceutical ingredients (APIs), and covers the latest advances in the recently established area of mechanochemical screening and synthesis of pharmaceutical solid forms, specifically polymorphs, cocrystals, salts and salt cocrystals. We also provide an overview of the most recent developments in pharmaceutical uses of mechanochemistry, including real-time reaction monitoring, techniques for polymorph control and approaches for continuous manufacture using twin screw extrusion, and more. Most importantly, we show how the overlap of previously unrelated areas of mechanochemical screening for API solid forms, organic synthesis by milling, and mechanochemical screening for molecular recognition, enables the emergence of a new research discipline in which different aspects of pharmaceutical and medicinal chemistry are addressed through mechanochemistry rather than through conventional solution-based routes. The emergence of such medicinal mechanochemistry is likely to have a strong impact on future pharmaceutical and medicinal chemistry, as it offers not only access to materials and reactivity that are sometimes difficult or even impossible to access from solution, but can also provide a general answer to the demands of the pharmaceutical industry for cleaner, safer and efficient synthetic solutions.

LCG Persistency Framework (CORAL, COOL, POOL): Status and Outlook

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

Valassi, A.; /CERN; Clemencic, M.

2012-04-19

The Persistency Framework consists of three software packages (CORAL, COOL and POOL) addressing the data access requirements of the LHC experiments in different areas. It is the result of the collaboration between the CERN IT Department and the three experiments (ATLAS, CMS and LHCb) that use this software to access their data. POOL is a hybrid technology store for C++ objects, metadata catalogs and collections. CORAL is a relational database abstraction layer with an SQL-free API. COOL provides specific software tools and components for the handling of conditions data. This paper reports on the status and outlook of the projectmore » and reviews in detail the usage of each package in the three experiments.« less

Final priority; National Institute on Disability and Rehabilitation Research--Rehabilitation Engineering Research Centers. Final priority.

PubMed

2014-07-09

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for a Rehabilitation Engineering Research Center (RERC) on Improving the Accessibility, Usability, and Performance of Technology for Individuals who are Deaf or Hard of Hearing. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus research attention on an area of national need. We intend the priority to contribute to improving the accessibility, usability, and performance of technology for individuals who are deaf or hard of hearing.

Enabling Access to Medical and Health Education in Rwanda Using Mobile Technology: Needs Assessment for the Development of Mobile Medical Educator Apps

PubMed Central

Tomaszewski, Brian; Dusabejambo, Vincent; Ndayiragije, Vincent; Gonsalves, Snedden; Sawant, Aishwarya; Mumararungu, Angeline; Gasana, George; Amendezo, Etienne; Haake, Anne; Mutesa, Leon

2016-01-01

Background Lack of access to health and medical education resources for doctors in the developing world is a serious global health problem. In Rwanda, with a population of 11 million, there is only one medical school, hence a shortage in well-trained medical staff. The growth of interactive health technologies has played a role in the improvement of health care in developed countries and has offered alternative ways to offer continuous medical education while improving patient's care. However, low and middle-income countries (LMIC) like Rwanda have struggled to implement medical education technologies adapted to local settings in medical practice and continuing education. Developing a user-centered mobile computing approach for medical and health education programs has potential to bring continuous medical education to doctors in rural and urban areas of Rwanda and influence patient care outcomes. Objective The aim of this study is to determine user requirements, currently available resources, and perspectives for potential medical education technologies in Rwanda. Methods Information baseline and needs assessments data collection were conducted in all 44 district hospitals (DHs) throughout Rwanda. The research team collected qualitative data through interviews with 16 general practitioners working across Rwanda and 97 self-administered online questionnaires for rural areas. Data were collected and analyzed to address two key questions: (1) what are the currently available tools for the use of mobile-based technology for medical education in Rwanda, and (2) what are user's requirements for the creation of a mobile medical education technology in Rwanda? Results General practitioners from different hospitals highlighted that none of the available technologies avail local resources such as the Ministry of Health (MOH) clinical treatment guidelines. Considering the number of patients that doctors see in Rwanda, an average of 32 patients per day, there is need for a locally adapted mobile education app that utilizes specific Rwandan medical education resources. Based on our results, we propose a mobile medical education app that could provide many benefits such as rapid decision making with lower error rates, increasing the quality of data management and accessibility, and improving practice efficiency and knowledge. In areas where Internet access is limited, the proposed mobile medical education app would need to run on a mobile device without Internet access. Conclusions A user-centered design approach was adopted, starting with a needs assessment with representative end users, which provided recommendations for the development of a mobile medical education app specific to Rwanda. Specific app features were identified through the needs assessment and it was evident that there will be future benefits to ongoing incorporation of user-centered design methods to better inform the software development and improve its usability. Results of the user-centered design reported here can inform other medical education technology developments in LMIC to ensure that technologies developed are usable by all stakeholders. PMID:27731861

Enabling Access to Medical and Health Education in Rwanda Using Mobile Technology: Needs Assessment for the Development of Mobile Medical Educator Apps.

PubMed

Rusatira, Jean Christophe; Tomaszewski, Brian; Dusabejambo, Vincent; Ndayiragije, Vincent; Gonsalves, Snedden; Sawant, Aishwarya; Mumararungu, Angeline; Gasana, George; Amendezo, Etienne; Haake, Anne; Mutesa, Leon

2016-06-01

Lack of access to health and medical education resources for doctors in the developing world is a serious global health problem. In Rwanda, with a population of 11 million, there is only one medical school, hence a shortage in well-trained medical staff. The growth of interactive health technologies has played a role in the improvement of health care in developed countries and has offered alternative ways to offer continuous medical education while improving patient's care. However, low and middle-income countries (LMIC) like Rwanda have struggled to implement medical education technologies adapted to local settings in medical practice and continuing education. Developing a user-centered mobile computing approach for medical and health education programs has potential to bring continuous medical education to doctors in rural and urban areas of Rwanda and influence patient care outcomes. The aim of this study is to determine user requirements, currently available resources, and perspectives for potential medical education technologies in Rwanda. Information baseline and needs assessments data collection were conducted in all 44 district hospitals (DHs) throughout Rwanda. The research team collected qualitative data through interviews with 16 general practitioners working across Rwanda and 97 self-administered online questionnaires for rural areas. Data were collected and analyzed to address two key questions: (1) what are the currently available tools for the use of mobile-based technology for medical education in Rwanda, and (2) what are user's requirements for the creation of a mobile medical education technology in Rwanda? General practitioners from different hospitals highlighted that none of the available technologies avail local resources such as the Ministry of Health (MOH) clinical treatment guidelines. Considering the number of patients that doctors see in Rwanda, an average of 32 patients per day, there is need for a locally adapted mobile education app that utilizes specific Rwandan medical education resources. Based on our results, we propose a mobile medical education app that could provide many benefits such as rapid decision making with lower error rates, increasing the quality of data management and accessibility, and improving practice efficiency and knowledge. In areas where Internet access is limited, the proposed mobile medical education app would need to run on a mobile device without Internet access. A user-centered design approach was adopted, starting with a needs assessment with representative end users, which provided recommendations for the development of a mobile medical education app specific to Rwanda. Specific app features were identified through the needs assessment and it was evident that there will be future benefits to ongoing incorporation of user-centered design methods to better inform the software development and improve its usability. Results of the user-centered design reported here can inform other medical education technology developments in LMIC to ensure that technologies developed are usable by all stakeholders.

Water sanitation, access, use and self-reported diarrheal disease in rural Honduras.

PubMed

Halder, Gabriela E; Bearman, Gonzalo; Sanogo, Kakotan; Stevens, Michael P

2013-01-01

Only 79% of individuals living in rural Honduras use improved water sources. Inadequate drinking water quality is related to diarrheal illness, which in Honduras contributes to 18.6 episodes of diarrhea per child year in children under five years of age. The purpose of this study was to examine and compare access to drinking water and sanitation, as well as self-reported diarrheal disease incidence among three proximal communities in the Department of Yoro area of Honduras. An 11-item language-specific, interviewer-administered, anonymous questionnaire was administered to 263 randomly selected adults attending a June 2011 medical brigade held in the communities of Coyoles, La Hicaca, and Lomitas. Chi-square with Fisher exact tests were utilized to compare water access, sanitation, and self-reported diarrheal incidence among these communities. Coyoles and La Hicaca used private faucets as their primary water sources. Coyoles had the greatest use of bottled water. Lomitas used rivers as their primary water source, and did not use bottled water. Mostly, females were responsible for acquiring water. Usage of multiple water sanitation methods was most common in Coyoles, while no sanitation method was most common in Lomitas. In Lomitas and La Hicaca, water filters were mostly provided via donation by non-governmental organizations. Lomitas had the highest reported incidence of diarrhea among self and other household members. Critical differences in water access, sanitation, and self-reported diarrheal incidence among three geographically distinct, yet proximal, communities highlights the need for targeted interventions even in geographically proximal rural areas.

An investigation of ADA compliance of aquatic facilities in the North Texas area.

PubMed

Pike, Hilary; Walker, Joseph; Collins, John; Hodges, Jan

2008-01-01

The study expands research on accessibility, comparing compliance scores of aquatic facilities in North Texas built before the 1991 Title III Americans with Disabilities Act Accessibility Guidelines (ADAAG) with facilities built after the 1991 ADAAG and the proposed 2002 supplement. A quasi-experimental design directed the selection of 52 facilities where measurements were taken to determine compliance with ADAAG and the supplement. A focus group provided insight into interpreting which features functioned as barriers or constraints to participation. Metropolitan statistical area in North Texas. A total of 52 aquatic facilities and 12 focus group participants (University of North Texas institutional review board 07-283). ADA aquatic facility compliance instrument. Frequency, ratios. No facilities were 100% ADA compliant overall, although some facilities were 100% compliant with specific structural domains. Women's restrooms rated lowest (average = 55%), and men's restrooms received the second lowest rating (average = 64%). Focus group results indicated that improperly designed restrooms and pool entries are primary barriers to participation. The findings support a need for stronger enforcement of policies that improve accessibility of facilities. Architectural reviews and construction practices need to be improved. The structural barriers and constraints identified can be limiting factors in efforts aimed at increasing physical activity among individuals with disabilities and individuals with physical limitations.

Improving technical information use: what can be learnt from a manager's perspective?

PubMed

Jacobson, C; Lisle, A; Carter, R W; Hockings, M T

2013-07-01

Conservation practice reportedly suffers from low use of technical information. Understanding of factors that affect the influence of technical information on management decision-making is limited. We sought to identify leverage points for improved technical information dissemination in the New South Wales Parks and Wildlife Service, Australia, given the significant recent investments in monitoring and evaluation that had been made. We did so by exploring the inter-relationships between factors affecting the influence of different information types on management decisions. Results indicate that managers have a high inclination toward adaptive behavior, given they operate in an information poor environment. The most influential types of information were those that enabled interaction between information provider and recipient (e.g., staff experience and expertise). An analysis of the concordance in individuals' responses for different information types showed that neither accessibility nor organizational expectation of use was aligned with influence on decision-making. Alignment of responses also varied by work area. Raising expectations of information use or increasing access to particular types of information is therefore unlikely to result in an increase in influence on management decision-making. Rather than focussing on matching accessibility and expected use of particular information types, our results indicate that technical information uptake is best supported through existing peer networks tailored to specific work areas.

Territorial user rights for fisheries as ancillary instruments for marine coastal conservation in Chile.

PubMed

Gelcich, Stefan; Fernández, Miriam; Godoy, Natalio; Canepa, Antonio; Prado, Luis; Castilla, Juan Carlos

2012-12-01

Territorial user rights for fisheries have been advocated as a way to achieve sustainable resource management. However, few researchers have empirically assessed their potential as ancillary marine conservation instruments by comparing them to no-take marine protected areas. In kelp (Lessonia trabeculata) forests of central Chile, we compared species richness, density, and biomass of macroinvertebrates and reef fishes among territorial-user-right areas with low-level and high-level enforcement, no-take marine protected areas, and open-access areas in 42 100-m subtidal transects. We also assessed structural complexity of the kelp forest and substratum composition. Multivariate randomized permutation tests indicated macroinvertebrate and reef fish communities associated with the different access regimes differed significantly. Substratum composition and structural complexity of kelp forest did not differ among access regimes. Univariate analyses showed species richness, biomass, and density of macroinvertebrates and reef fishes were greater in highly enforced territorial-user-right areas and no-take marine protected areas than in open-access areas. Densities of macroinvertebrates and reef fishes of economic importance were not significantly different between highly enforced territorial-user-right and no-take marine protected areas. Densities of economically important macroinvertebrates in areas with low-level enforcement were significantly lower than those in areas with high-level enforcement and no-take marine protected areas but were significantly higher than in areas with open access. Territorial-user-right areas could be important ancillary conservation instruments if they are well enforced. ©2012 Society for Conservation Biology.

Android Based Area Web Monitoring

NASA Astrophysics Data System (ADS)

Kanigoro, Bayu; Galih Salman, Afan; Moniaga, Jurike V.; Chandra, Eric; Rezky Chandra, Zein

2014-03-01

The research objective is to develop an application that can be used in the monitoring of an area by using a webcam. It aims to create a sense of security on the user's application because it can monitor an area using mobile phone anywhere. The results obtained in this study is to create an area with a webcam monitoring application that can be accessed anywhere as long as the monitoring results have internet access and can also be accessed through Android Based Mobile Phone.

41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2010 CFR

2010-07-01

... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2012 CFR

2012-01-01

... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2013 CFR

2013-07-01

... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2011 CFR

2011-01-01

... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

41 CFR 102-76.80 - What is required if the costs of alterations to provide an accessible path of travel to an...

Code of Federal Regulations, 2014 CFR

2014-01-01

... to provide an accessible path of travel to an altered area containing a primary function are... accessible path of travel to an altered area containing a primary function are disproportionate to the costs... exceeding 20 percent of the costs of the alterations to the primary function area. Priority should be given...

Understanding in an instant: neurophysiological evidence for mechanistic language circuits in the brain.

PubMed

Pulvermüller, Friedemann; Shtyrov, Yury; Hauk, Olaf

2009-08-01

How long does it take the human mind to grasp the idea when hearing or reading a sentence? Neurophysiological methods looking directly at the time course of brain activity indexes of comprehension are critical for finding the answer to this question. As the dominant cognitive approaches, models of serial/cascaded and parallel processing, make conflicting predictions on the time course of psycholinguistic information access, they can be tested using neurophysiological brain activation recorded in MEG and EEG experiments. Seriality and cascading of lexical, semantic and syntactic processes receives support from late (latency approximately 1/2s) sequential neurophysiological responses, especially N400 and P600. However, parallelism is substantiated by early near-simultaneous brain indexes of a range of psycholinguistic processes, up to the level of semantic access and context integration, emerging already 100-250ms after critical stimulus information is present. Crucially, however, there are reliable latency differences of 20-50ms between early cortical area activations reflecting lexical, semantic and syntactic processes, which are left unexplained by current serial and parallel brain models of language. We here offer a mechanistic model grounded in cortical nerve cell circuits that builds upon neuroanatomical and neurophysiological knowledge and explains both near-simultaneous activations and fine-grained delays. A key concept is that of discrete distributed cortical circuits with specific inter-area topographies. The full activation, or ignition, of specifically distributed binding circuits explains the near-simultaneity of early neurophysiological indexes of lexical, syntactic and semantic processing. Activity spreading within circuits determined by between-area conduction delays accounts for comprehension-related regional activation differences in the millisecond range.

Spatial access to residential care resources in Beijing, China

PubMed Central

2012-01-01

Background As the population is ageing rapidly in Beijing, the residential care sector is in a fast expansion process with the support of the municipal government. Understanding spatial accessibility to residential care resources by older people supports the need for rational allocation of care resources in future planning. Methods Based on population data and data on residential care resources, this study uses two Geographic Information System (GIS) based methods – shortest path analysis and a two-step floating catchment area (2SFCA) method to analyse spatial accessibility to residential care resources. Results Spatial accessibility varies as the methods and considered factors change. When only time distance is considered, residential care resources are more accessible in the central city than in suburban and exurban areas. If care resources are considered in addition to time distance, spatial accessibility is relatively poor in the central city compared to the northeast to southeast side of the suburban and exurban areas. The resources in the northwest to southwest side of the city are the least accessible, even though several hotspots of residential care resources are located in these areas. Conclusions For policy making, it may require combining various methods for a comprehensive analysis. The methods used in this study provide tools for identifying underserved areas in order to improve equity in access to and efficiency in allocation of residential care resources in future planning. PMID:22877360

Genetic diversity and population structure analysis in Perilla frutescens from Northern areas of China based on simple sequence repeats.

PubMed

Ma, S J; Sa, K J; Hong, T K; Lee, J K

2017-09-21

In this study, 21 simple sequence repeat (SSR) markers were used to evaluate the genetic diversity and population structure among 77 Perilla accessions from high-latitude and middle-latitude areas of China. Ninety-five alleles were identified with an average of 4.52 alleles per locus. The average polymorphic information content (PIC) and genetic diversity values were 0.346 and 0.372, respectively. The level of genetic diversity and PIC value for cultivated accessions of Perilla frutescens var. frutescens from middle-latitude areas were higher than accessions from high-latitude areas. Based on the dendrogram of unweighted pair group method with arithmetic mean (UPGMA), all accessions were classified into four major groups with a genetic similarity of 46%. All accessions of the cultivated var. frutescens were discriminated from the cultivated P. frutescens var. crispa. Furthermore, most accessions of the cultivated var. frutescens collected in high-latitude and middle-latitude areas were distinguished depending on their geographical location. However, the geographical locations of several accessions of the cultivated var. frutescens have no relation with their positions in the UPGMA dendrogram and population structure. This result implies that the diffusion of accessions of the cultivated Perilla crop in the northern areas of China might be through multiple routes. On the population structure analysis, 77 Perilla accessions were divided into Group I, Group II, and an admixed group based on a membership probability threshold of 0.8. Finally, the findings in this study can provide useful theoretical knowledge for further study on the population structure and genetic diversity of Perilla and benefit for Perilla crop breeding and germplasm conservation.

Implementation of two new resource management information systems in Australia

NASA Astrophysics Data System (ADS)

Kessell, Stephen R.; Good, Roger B.; Hopkins, Angas J. M.

1984-05-01

This paper describes the development and implementation of PREPLAN, A Pristine Environment Planning Language and Simulator, for two conservation areas in Australia, Kosciusko National Park (New South Wales) and Tutanning Nature Reserve (Western Australia). PREPLAN was derived from the North American gradient modeling systems and the Forest Planning Language and Simulator (FORPLAN), but includes unique characteristics not previously available. PREPLAN includes an integrated resource management data base, modules for predicting site-specific vegetation, fuels, animals, fire behavior, and fire effects, and an English language instruction set. PREPLAN was developed specifically to provide available information and understanding of ecosystems to managers in a readily accessible and usable form, and to provide the motivation to conduct additional required research projects. An evaluation of the system's advantages and limitations is presented, and the way the utilization of such systems is improving natural area decision making throughout Australia is discussed.

Porous carbon derived from aniline-modified fungus for symmetrical supercapacitor electrodes

DOE PAGES

Wang, Keliang; Xu, Ming; Wang, Xiaomin; ...

2017-01-23

N incorporated carbon materials are proven to be efficient EDLCs electrode materials. In this work, aniline modified fungus served as a raw material, and N-doped porous activated carbon is prepared via an efficient KOH activation method. A porous network with a high specific surface area of 2339 m 2g -1 is displayed by the prepared carbon material, resulting in a high accessible surface area and low ion diffusion resistance which is desirable for EDLC electrode materials. In assembled EDLCs, the N–AC based electrode exhibits a specific capacitance of 218 F g -1 at a current density of 0.1 A gmore » -1. Besides, excellent stability is displayed after 5000 continuous cycles at different current densities ranging from 0.1 to 10 A g -1. Thus, the present work reveals a promising candidate for electrode materials of EDLCs.« less

Insights into Broker - User interactions from the BCube Project

NASA Astrophysics Data System (ADS)

Santoro, M.; Nativi, S.; Pearlman, J.; Khalsa, S. J. S.; Fulweiler, R. W.

2015-12-01

Introducing a broad brokering capability for science interoperability and cross-disciplinary research has many challenges and perspectives. Developing a business model that is sustainable is one aspect. Engaging and supporting the science research community is a second. In working with this community, significant added value must be provided. Various facets of the broker capability from discovery and access to data transformations and mapping are elements that were examined and applied to science use cases. In this presentation, we look at these facets and their benefits and challenges for specific use cases in the areas of ocean, coastal and arctic research . Specific recommendations for future implementations will be discussed.

Quality of malaria information provided on Internet travel operator websites.

PubMed

Bazaz, Rohit; Green, Edward; Green, Steve T

2010-09-01

Over the past 20 years, there has been a steady growth in the number of reported cases of malaria in the UK. With increasing Internet flight sales over recent years, online travel operator websites may be the only place many travellers could conceivably receive pre-travel malaria prevention advice. 29 Travel operator websites which allow for online flight purchases to malarious areas from the UK, identified using a Google(®) web search and the website of the International Air Transport Association, were assessed for the existence, accuracy and accessibility of malaria prevention advice available through internal and external website links. Eight (28%) websites provided malaria prevention information on their own pages. Five (17%) websites contained country specific malaria information relevant to the requested destination, including variation of malaria risk within that country and accurate destination specific chemoprophylaxis advice. No malaria information was available, either on internal or external links, on 8 (28%) websites. On average, it took 2.4 additional mouse clicks to access malaria information during the online flight booking process. Six of the 29 websites (21%) allowed for access to information with only 1 click. Malaria prevention information on online travel operator websites is most often absent or inadequate. Even on websites where such information is of good quality, it can be difficult to access. The travel industry should introduce and enforce guidelines for the malaria information provided by online travel operators. Copyright © 2010 Elsevier Ltd. All rights reserved.

Evolution of grid-wide access to database resident information in ATLAS using Frontier

NASA Astrophysics Data System (ADS)

Barberis, D.; Bujor, F.; de Stefano, J.; Dewhurst, A. L.; Dykstra, D.; Front, D.; Gallas, E.; Gamboa, C. F.; Luehring, F.; Walker, R.

2012-12-01

The ATLAS experiment deployed Frontier technology worldwide during the initial year of LHC collision data taking to enable user analysis jobs running on the Worldwide LHC Computing Grid to access database resident data. Since that time, the deployment model has evolved to optimize resources, improve performance, and streamline maintenance of Frontier and related infrastructure. In this presentation we focus on the specific changes in the deployment and improvements undertaken, such as the optimization of cache and launchpad location, the use of RPMs for more uniform deployment of underlying Frontier related components, improvements in monitoring, optimization of fail-over, and an increasing use of a centrally managed database containing site specific information (for configuration of services and monitoring). In addition, analysis of Frontier logs has allowed us a deeper understanding of problematic queries and understanding of use cases. Use of the system has grown beyond user analysis and subsystem specific tasks such as calibration and alignment, extending into production processing areas, such as initial reconstruction and trigger reprocessing. With a more robust and tuned system, we are better equipped to satisfy the still growing number of diverse clients and the demands of increasingly sophisticated processing and analysis.

The Role of Community Health Centers in Reducing Racial Disparities in Spatial Access to Primary Care.

PubMed

Seymour, Jane W; Polsky, Daniel E; Brown, Elizabeth J; Barbu, Corentin M; Grande, David

2017-07-01

Racial minorities are more likely to live in primary care shortage areas. We sought to understand community health centers' (CHCs) role in reducing disparities. We surveyed all primary care practices in an urban area, identified low access areas, and examined how CHCs influence spatial accessibility. Census tracts with higher rates of public insurance (≥40% vs <10%, odds ratio [OR] = 31.06, P < .001; 30-39% vs 10%, OR = 7.84, P = 0.001) were more likely to be near a CHC and those with moderate rates of uninsurance (10%-19% vs <10%, OR = 0.42, P = .045) were less likely. Racial composition was not associated with proximity. Tracts close to a CHC were less likely (OR = 0.11, P < .0001) to be in a low access area. This association did not differ based on racial composition. Although CHCs were more likely to be in areas with a greater fraction of racial minorities, location was more strongly influenced by public insurance rates. CHCs reduced the likelihood of being in low access areas but the effect did not vary by tract racial composition.

The National Institute on Disability, Independent Living, and Rehabilitation Research Burn Model System: Twenty Years of Contributions to Clinical Service and Research.

PubMed

Goverman, Jeremy; Mathews, Katie; Holavanahalli, Radha K; Vardanian, Andrew; Herndon, David N; Meyer, Walter J; Kowalske, Karen; Fauerbach, Jim; Gibran, Nicole S; Carrougher, Gretchen J; Amtmann, Dagmar; Schneider, Jeffrey C; Ryan, Colleen M

The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) established the Burn Model System (BMS) in 1993 to improve the lives of burn survivors. The BMS program includes 1) a multicenter longitudinal database describing the functional and psychosocial recovery of burn survivors; 2) site-specific burn-related research; and 3) a knowledge dissemination component directed toward patients and providers. Output from each BMS component was analyzed. Database structure, content, and access procedures are described. Publications using the database were identified and categorized to illustrate the content area of the work. Unused areas of the database were identified for future study. Publications related to site-specific projects were cataloged. The most frequently cited articles are summarized to illustrate the scope of these projects. The effectiveness of dissemination activities was measured by quantifying website hits and information downloads. There were 25 NIDILRR-supported publications that utilized the database. These articles covered topics related to psychological outcomes, functional outcomes, community reintegration, and burn demographics. There were 172 site-specific publications; highly cited articles demonstrate a wide scope of study. For information dissemination, visits to the BMS website quadrupled between 2013 and 2014, with 124,063 downloads of educational material in 2014. The NIDILRR BMS program has played a major role in defining the course of burn recovery, and making that information accessible to the general public. The accumulating information in the database serves as a rich resource to the burn community for future study. The BMS is a model for collaborative research that is multidisciplinary and outcome focused.

Architecture and Functionality of the Advanced Life Support On-Line Project Information System (OPIS)

NASA Technical Reports Server (NTRS)

Hogan, John A.; Levri, Julie A.; Morrow, Rich; Cavazzoni, Jim; Rodriquez, Luis F.; Riano, Rebecca; Whitaker, Dawn R.

2004-01-01

An ongoing effort is underway at NASA Amcs Research Center (ARC) tu develop an On-line Project Information System (OPIS) for the Advanced Life Support (ALS) Program. The objective of this three-year project is to develop, test, revise and deploy OPIS to enhance the quality of decision-making metrics and attainment of Program goals through improved knowledge sharing. OPIS will centrally locate detailed project information solicited from investigators on an annual basis and make it readily accessible by the ALS Community via a web-accessible interface. The data will be stored in an object-oriented relational database (created in MySQL(Trademark) located on a secure server at NASA ARC. OPE will simultaneously serve several functions, including being an R&TD status information hub that can potentially serve as the primary annual reporting mechanism. Using OPIS, ALS managers and element leads will be able to carry out informed research and technology development investment decisions, and allow analysts to perform accurate systems evaluations. Additionally, the range and specificity of information solicited will serve to educate technology developers of programmatic needs. OPIS will collect comprehensive information from all ALS projects as well as highly detailed information specific to technology development in each ALS area (Waste, Water, Air, Biomass, Food, Thermal, and Control). Because the scope of needed information can vary dramatically between areas, element-specific technology information is being compiled with the aid of multiple specialized working groups. This paper presents the current development status in terms of the architecture and functionality of OPIS. Possible implementation approaches for OPIS are also discussed.

Building a School District's Wide Area Network.

ERIC Educational Resources Information Center

Mastel, Vern L.

1996-01-01

Describes the development of a wide area network (WAN) in the Bismarck Public School District (North Dakota). Topics include design goals, network infrastructure, implementing library access, sharing resources across platforms, electronic mail, dial-in access, Internet access, adhering to software licenses, shareware and freeware, and monitoring…

Digital Watermarks Enabling E-Commerce Strategies: Conditional and User Specific Access to Services and Resources

NASA Astrophysics Data System (ADS)

Dittmann, Jana; Steinebach, Martin; Wohlmacher, Petra; Ackermann, Ralf

2002-12-01

Digital watermarking is well known as enabling technology to prove ownership on copyrighted material, detect originators of illegally made copies, monitor the usage of the copyrighted multimedia data and analyze the spread spectrum of the data over networks and servers. Research has shown that data hiding techniques can be applied successfully to other application areas like manipulations recognition. In this paper, we show our innovative approach for integrating watermark and cryptography based methods within a framework of new application scenarios spanning a wide range from dedicated and user specific services, "Try&Buy" mechanisms to general means for long-term customer relationships. The tremendous recent efforts to develop and deploy ubiquitous mobile communication possibilities are changing the demands but also possibilities for establishing new business and commerce relationships. Especially we motivate annotation watermarks and aspects of M-Commerce to show important scenarios for access control. Based on a description of the challenges of the application domain and our latest work we discuss, which methods can be used for establishing services in a fast convenient and secure way for conditional access services based on digital watermarking combined with cryptographic techniques. We introduce an example scenario for digital audio and an overview of steps in order to establish these concepts practically.

The impact of standalone call centres and GP cooperatives on access to after hours GP care: a before and after study adjusted for secular trend.

PubMed

Dunt, David; Day, Susan E; Kelaher, Margaret; Montalto, Michael

2006-08-01

The After Hours Primary Medical Trials were initiated by the Australian government to redress difficulties in after hours (AH) GP care in areas of high need. The study's objective is to study the impact of two standalone call centres and one GP cooperative offering comprehensive services, in improving consumer access to services for residents of a defined geographic area. A pre-post design was used to evaluate their impact after adjusting for secular trend at a national level. Access was considered in terms of availability, accessibility, affordability, acceptability and responsiveness of care. Unmet need and ease of obtaining AH telephone professional medical advice were also considered. Pre-trial and post-trial telephone surveys of two separate random samples of approximately 350 households using AH services in each trial area as well as in a national sample outside the trial areas. Consumer acceptability and affordability increased in residents in the area served by the GP cooperative. Access, however measured, did not improve in either of the standalone call centre areas. Reduction in unmet need approached but did not achieve statistical significance in most but not all trial areas. Improvements in access in the GP cooperative conformed to expectations based on current and pre-existing AH care arrangements put in place. Absence of improvements in access in the standalone call centres did not conform to expectations but may be partly explained by the reductions in consumer acceptability, following introduction of telephone triage systems reported elsewhere.

Supermarket access, transport mode and BMI: the potential for urban design and planning policy across socio-economic areas.

PubMed

Murphy, Maureen; Koohsari, Mohammad Javad; Badland, Hannah; Giles-Corti, Billie

2017-12-01

To investigate dietary intake, BMI and supermarket access at varying geographic scales and transport modes across areas of socio-economic disadvantage, and to evaluate the implementation of an urban planning policy that provides guidance on spatial access to supermarkets. Cross-sectional study used generalised estimating equations to investigate associations between supermarket density and proximity, vegetable and fruit intake and BMI at five geographic scales representing distances people travel to purchase food by varying transport modes. A stratified analysis by area-level disadvantage was conducted to detect optimal distances to supermarkets across socio-economic areas. Spatial distribution of supermarket and transport access was analysed using a geographic information system. Melbourne, Australia. Adults (n 3128) from twelve local government areas (LGA) across Melbourne. Supermarket access was protective of BMI for participants in high disadvantaged areas within 800 m (P=0·040) and 1000 m (P=0·032) road network buffers around the household but not for participants in less disadvantaged areas. In urban growth area LGA, only 26 % of dwellings were within 1 km of a supermarket, far less than 80-90 % of dwellings suggested in the local urban planning policy. Low public transport access compounded disadvantage. Rapid urbanisation is a global health challenge linked to increases in dietary risk factors and BMI. Our findings highlight the importance of identifying the most appropriate geographic scale to inform urban planning policy for optimal health outcomes across socio-economic strata. Urban planning policy implementation in disadvantaged areas within cities has potential for reducing health inequities.

Using the Fusion Proximal Area Method and Gravity Method to Identify Areas with Physician Shortages

PubMed Central

Xiong, Xuechen; Jin, Chao; Chen, Haile; Luo, Li

2016-01-01

Objectives This paper presents a geographic information system (GIS)-based proximal area method and gravity method for identifying areas with physician shortages. The innovation of this paper is that it uses the appropriate methods to discover each type of health resource and then integrates all these methods to assess spatial access to health resources using population distribution data. In this way, spatial access to health resources for an entire city can be visualized in one neat package, which can help health policy makers quickly comprehend realistic distributions of health resources at a macro level. Methods First, classify health resources according to the trade areas of the patients they serve. Second, apply an appropriate method to each different type of health resource to measure spatial access to those resources. Third, integrate all types of access using population distribution data. Results In case study of Shanghai with the fusion method, areas with physician shortages are located primarily in suburban districts, especially in district junction areas. The result suggests that the government of Shanghai should pay more attention to these areas by investing in new or relocating existing health resources. Conclusion The fusion method is demonstrated to be more accurate and practicable than using a single method to assess spatial access to health resources. PMID:27695105

Preparation for an Airport Master Plan for Joint Use Operation at Scott AFB, Illinois.

DTIC Science & Technology

1987-08-01

Airfield and approach lighting b) Air traffic control tower c) Meteorological facilities d) Airport access and service roads e) Utilities f) Public...use, and to comply with all requirements for control of air, water and noise pollution as well as solid waste disposal. Specific conditions would be...Identification of Persons e Identification of Ground Vehicles S• Fencing 0 Gates I * Security Lighting i * Locks and Key Control 9 Critical Areas (Other Than

Local network assessment

NASA Astrophysics Data System (ADS)

Glen, D. V.

1985-04-01

Local networks, related standards activities of the Institute of Electrical and Electronics Engineers the American National Standards Institute and other elements are presented. These elements include: (1) technology choices such as topology, transmission media, and access protocols; (2) descriptions of standards for the 802 local area networks (LAN's); high speed local networks (HSLN's) and military specification local networks; and (3) intra- and internetworking using bridges and gateways with protocols Interconnection (OSI) reference model. The convergence of LAN/PBX technology is also described.

Conjugated Organosilicon Materials for Organic Electronics and Photonics

NASA Astrophysics Data System (ADS)

Ponomarenko, Sergei A.; Kirchmeyer, Stephan

In this chapter different types of conjugated organosilicon materials possessing luminescent and/or semiconducting properties will be described. Such macromolecules have various topologies and molecular structures: linear, branched and hyperbranched oligomers, polymers, and dendrimers. Specific synthetic approaches to access these structures will be discussed. Special attention is devoted to the role of silicon in these structures and its influence on their optical and electrical properties, leading to their potential application in the emerging areas of organic and hybrid electronics.

The positive pharmacy care law: an area-level analysis of the relationship between community pharmacy distribution, urbanity and social deprivation in England.

PubMed

Todd, Adam; Copeland, Alison; Husband, Andy; Kasim, Adetayo; Bambra, Clare

2014-08-12

To: (1) determine the percentage of the population in England that have access to a community pharmacy within 20 min walk; (2) explore any relationship between the walking distance and urbanity; (3) explore any relationship between the walking distance and social deprivation; and (4) explore any interactions between urbanity, social deprivation and community pharmacy access. This area level analysis spatial study used postcodes for all community pharmacies in England. Each postcode was assigned to a population lookup table and lower super output area (LSOA). The LSOA was then matched to urbanity (urban, town and fringe or village, hamlet and isolated dwellings) and deprivation decile (using the Index of Multiple Deprivation score). Access to a community pharmacy within 20 min walk. Overall, 89.2% of the population is estimated to have access to a community pharmacy within 20 min walk. For urban areas, that is 98.3% of the population, for town and fringe, 79.9% of the population, while for rural areas, 18.9% of the population. For areas of lowest deprivation (deprivation decile 1) 90.2% of the population have access to a community pharmacy within 20 min walk, compared to 99.8% in areas of highest deprivation (deprivation decile 10), a percentage difference of 9.6% (8.2, 10.9). Our study shows that the majority of the population can access a community pharmacy within 20 min walk and crucially, access is greater in areas of highest deprivation--a positive pharmacy care law. More research is needed to explore the perceptions and experiences of people--from various levels of deprivation--around the accessibility of community pharmacy services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Type and Proximity of Green Spaces Are Important for Preventing Cardiovascular Morbidity and Diabetes—A Cross-Sectional Study for Quebec, Canada

PubMed Central

Ngom, Roland; Gosselin, Pierre; Blais, Claudia; Rochette, Louis

2016-01-01

This study aimed at determining the role of proximity to specific types of green spaces (GSes) as well as their spatial location in the relationship with the most morbid cardiovascular diseases (CVD) and diabetes. We measured the accessibility to various types of GS and used a cross-sectional approach at census Dissemination Area (DA) levels in the Montreal and Quebec City metropolitan zones for the period 2006–2011. Poisson and negative binomial regression models were fitted to quantify the relationship between distances to specific types of GS and CVD morbidity as well as some risk factors (diabetes and hypertension) while controlling for several social and environmental confounders. GSes that have sports facilities showed a significant relationship to cerebrovascular diseases: the most distant population had an 11% higher prevalence rate ratio (PRR) compared to the nearest, as well as higher diabetes risk (PRR 9%) than the nearest. However, the overall model performance and the understanding of the role of GSes with sport facilities may be substantially achieved with lifestyle factors. Significantly higher prevalence of diabetes and cerebrovascular diseases as well as lower access to GSes equipped with sports facilities were found in suburban areas. GSes can advantageously be used to prevent some CVDs and their risk factors, but there may be a need to reconsider their types and location. PMID:27089356

75 FR 26294 - Notice of Availability of the Models for Plant-Specific Adoption of Technical Specifications Task...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

... an errata sheet are available in the Agencywide Documents Access and Management System (ADAMS) under... Agencywide Documents Access and Management System (ADAMS): Publicly available documents created or received... facilitate expedited approval of plant-specific adoption of TSTF-493, Revision 4. Documents: You can access...

Neighbourhood food environment and area deprivation: spatial accessibility to grocery stores selling fresh fruit and vegetables in urban and rural settings.

PubMed

Smith, Dianna M; Cummins, Steven; Taylor, Mathew; Dawson, John; Marshall, David; Sparks, Leigh; Anderson, Annie S

2010-02-01

The 'deprivation amplification' hypothesis suggests that residents of deprived neighbourhoods have universally poorer access to high-quality food environments, which in turn contributes to the development of spatial inequalities in diet and diet-related chronic disease. This paper presents results from a study that quantified access to grocery stores selling fresh fruit and vegetables in four environmental settings in Scotland, UK. Spatial accessibility, as measured by network travel times, to 457 grocery stores located in 205 neighbourhoods in four environmental settings (island, rural, small town and urban) in Scotland was calculated using Geographical Information Systems. The distribution of accessibility by neighbourhood deprivation in each of these four settings was investigated. Overall, the most deprived neighbourhoods had the best access to grocery stores and grocery stores selling fresh produce. Stratified analysis by environmental setting suggests that the least deprived compared with the most deprived urban neighbourhoods have greater accessibility to grocery stores than their counterparts in island, rural and small town locations. Access to fresh produce is better in more deprived compared with less deprived urban and small town neighbourhoods, but poorest in the most affluent island communities with mixed results for rural settings. The results presented here suggest that the assumption of a universal 'deprivation amplification' hypothesis in studies of the neighbourhood food environment may be misguided. Associations between neighbourhood deprivation and grocery store accessibility vary by environmental setting. Theories and policies aimed at understanding and rectifying spatial inequalities in the distribution of neighbourhood exposures for poor diet need to be context specific.

Neighborhood Environmental Health and Premature Death From Cardiovascular Disease.

PubMed

Gaglioti, Anne H; Xu, Junjun; Rollins, Latrice; Baltrus, Peter; O'Connell, Laura Kathryn; Cooper, Dexter L; Hopkins, Jammie; Botchwey, Nisha D; Akintobi, Tabia Henry

2018-02-01

Cardiovascular disease (CVD) is the leading cause of death in the United States and disproportionately affects racial/ethnic minority groups. Healthy neighborhood conditions are associated with increased uptake of health behaviors that reduce CVD risk, but minority neighborhoods often have poor food access and poor walkability. This study tested the community-driven hypothesis that poor access to food at the neighborhood level and poor neighborhood walkability are associated with racial disparities in premature deaths from CVD. We examined the relationship between neighborhood-level food access and walkability on premature CVD mortality rates at the census tract level for the city of Atlanta using multivariable logistic regression models. We produced maps to illustrate premature CVD mortality, food access, and walkability by census tract for the city. We found significant racial differences in premature CVD mortality rates and geographic disparities in food access and walkability among census tracts in Atlanta. Improved food access and walkability were associated with reduced overall premature CVD mortality in unadjusted models, but this association did not persist in models adjusted for census tract population composition and poverty. Census tracts with high concentrations of minority populations had higher levels of poor food access, poor walkability, and premature CVD mortality. This study highlights disparities in premature CVD mortality and neighborhood food access and walkability at the census tract level in the city of Atlanta. Improving food access may have differential effects for subpopulations living in the same area. These results can be used to calibrate neighborhood-level interventions, and they highlight the need to examine race-specific health outcomes.

Neighborhood Environmental Health and Premature Death From Cardiovascular Disease

PubMed Central

Xu, Junjun; Rollins, Latrice; Baltrus, Peter; O’Connell, Laura Kathryn; Cooper, Dexter L.; Hopkins, Jammie; Botchwey, Nisha D.; Akintobi, Tabia Henry

2018-01-01

Introduction Cardiovascular disease (CVD) is the leading cause of death in the United States and disproportionately affects racial/ethnic minority groups. Healthy neighborhood conditions are associated with increased uptake of health behaviors that reduce CVD risk, but minority neighborhoods often have poor food access and poor walkability. This study tested the community-driven hypothesis that poor access to food at the neighborhood level and poor neighborhood walkability are associated with racial disparities in premature deaths from CVD. Methods We examined the relationship between neighborhood-level food access and walkability on premature CVD mortality rates at the census tract level for the city of Atlanta using multivariable logistic regression models. We produced maps to illustrate premature CVD mortality, food access, and walkability by census tract for the city. Results We found significant racial differences in premature CVD mortality rates and geographic disparities in food access and walkability among census tracts in Atlanta. Improved food access and walkability were associated with reduced overall premature CVD mortality in unadjusted models, but this association did not persist in models adjusted for census tract population composition and poverty. Census tracts with high concentrations of minority populations had higher levels of poor food access, poor walkability, and premature CVD mortality. Conclusion This study highlights disparities in premature CVD mortality and neighborhood food access and walkability at the census tract level in the city of Atlanta. Improving food access may have differential effects for subpopulations living in the same area. These results can be used to calibrate neighborhood-level interventions, and they highlight the need to examine race-specific health outcomes. PMID:29389312

Data management and analysis for the Earth System Grid

NASA Astrophysics Data System (ADS)

Williams, D. N.; Ananthakrishnan, R.; Bernholdt, D. E.; Bharathi, S.; Brown, D.; Chen, M.; Chervenak, A. L.; Cinquini, L.; Drach, R.; Foster, I. T.; Fox, P.; Hankin, S.; Henson, V. E.; Jones, P.; Middleton, D. E.; Schwidder, J.; Schweitzer, R.; Schuler, R.; Shoshani, A.; Siebenlist, F.; Sim, A.; Strand, W. G.; Wilhelmi, N.; Su, M.

2008-07-01

The international climate community is expected to generate hundreds of petabytes of simulation data within the next five to seven years. This data must be accessed and analyzed by thousands of analysts worldwide in order to provide accurate and timely estimates of the likely impact of climate change on physical, biological, and human systems. Climate change is thus not only a scientific challenge of the first order but also a major technological challenge. In order to address this technological challenge, the Earth System Grid Center for Enabling Technologies (ESG-CET) has been established within the U.S. Department of Energy's Scientific Discovery through Advanced Computing (SciDAC)-2 program, with support from the offices of Advanced Scientific Computing Research and Biological and Environmental Research. ESG-CET's mission is to provide climate researchers worldwide with access to the data, information, models, analysis tools, and computational capabilities required to make sense of enormous climate simulation datasets. Its specific goals are to (1) make data more useful to climate researchers by developing Grid technology that enhances data usability; (2) meet specific distributed database, data access, and data movement needs of national and international climate projects; (3) provide a universal and secure web-based data access portal for broad multi-model data collections; and (4) provide a wide-range of Grid-enabled climate data analysis tools and diagnostic methods to international climate centers and U.S. government agencies. Building on the successes of the previous Earth System Grid (ESG) project, which has enabled thousands of researchers to access tens of terabytes of data from a small number of ESG sites, ESG-CET is working to integrate a far larger number of distributed data providers, high-bandwidth wide-area networks, and remote computers in a highly collaborative problem-solving environment.

The Geographic Distribution of Physicians Revisited

PubMed Central

Rosenthal, Meredith B; Zaslavsky, Alan; Newhouse, Joseph P

2005-01-01

Context While there is debate over whether the U.S. is training too many physicians, many seem to agree that physicians are geographically maldistributed, with too few in rural areas. Objective Official definitions of shortage areas assume the market for physician services is based on county boundaries. We wished to ascertain how the picture of a possible shortage changes using alternative measures of geographic access. We measure geographic access by the number of full-time equivalent physicians serving a community divided by the expected number of patients (possibly both from within the community and outside) receiving care from those physicians. Moreover, we wished to determine how the geographic distribution of physicians had changed since previous studies, in light of the large increase in physician numbers. Design Cross-sectional data analyses of alternative measures of geographic access to physicians in 23 states with low physician–population ratios. Results Between 1979 and 1999, the number of physicians doubled in the sample states. Although most specialties experienced greater diffusion everywhere, smaller specialties had not yet diffused to the smallest towns. Multiple measures of geographic access, including physician-to-population ratios, average distance traveled to the nearest physician, and projected average caseload per physician, confirm that residents of metropolitan areas have better geographic access to physicians. Physician-to-population ratios exhibit the largest degree of geographic disparity, but ratios in rural counties adjacent to metropolitan areas are smaller than in those not adjacent to metropolitan areas. Distance-traveled and caseload models that allow patients to cross county lines show less disparity and indicate that residents of isolated rural counties have less access than those living in counties adjacent to metropolitan areas. Conclusion Geographic access to physicians has continued to improve over the past two decades, although some smaller specialties have not diffused to the most rural areas. While substantial variation in the supply of physicians across communities remains, current measures of geographic access to physicians overstate the extent of maldistribution and yield an incorrect ranking of areas according to geographic accessibility of physicians. PMID:16336557

Pressures on safety net access: the level of managed care penetration and uninsurance rate in a community.

PubMed

Cunningham, P J

1999-04-01

To examine the effects of managed care penetration and the uninsurance rate in an area on access to care of low-income uninsured persons and to compare differences in access between low-income insured and uninsured persons across these different market areas. Primarily the Community Tracking Study household survey. Other market-level data were obtained from the Community Tracking Study physician survey, American Hospital Association annual survey of hospitals, Area Resource File, HCFA Administrative Data, Bureau of Primary Care data on Community Health Centers. Individuals are grouped based on the level of managed care penetration and uninsurance rate in the site where they reside. Measures of managed care include overall managed care penetration in the site, and the level of Medicaid managed care penetration in the state. Uninsurance rate is defined as the percentage of people uninsured in the site. Measures of access include the percentage with a usual source of care, percentage with any ambulatory care use, and percentage of persons who reported unmet medical care needs. Estimates are adjusted to control for other confounding factors, including both individual and market-level characteristics. A survey, primarily telephoned, of households concentrated in 60 sites, defined as metropolitan statistical areas and nonmetropolitan areas. Access to care for low-income uninsured persons is lower in states with high Medicaid managed care penetration, compared to uninsured persons in states with low Medicaid managed care penetration. Access to care for low-income uninsured persons is also lower in areas with high uninsurance rates. The "access gap" (differences in access between insured and uninsured persons) is also larger in areas with high Medicaid managed care penetration and areas with high uninsurance rates. Efforts to achieve cost savings under managed care may result in financial pressures that limit cross-subsidization of care to the medically indigent, particularly for those providers who are heavily dependent on Medicaid revenue. High demand for care (as reflected in high uninsurance rates) may further strain limited resources for indigent care, further limiting access to care for uninsured persons.

Small wastewater treatment plants in mountain areas: combination of septic tank and biological filter.

PubMed

Maunoir, S; Philip, H; Rambaud, A

2007-01-01

Research work has been carried out for more than 20 years by Eparco and the University of Montpellier (France) on the application of biological wastewater treatment processes for small communities. This research has led to a new process which is particularly suitable for remote populations, taking into account several specificities such as as the seasonal fluctuations in the population, the accessibility of the site, the absence of a power supply on site, the reduced area of land available and the low maintenance. Thus, the process, which combines a septic tank operating under anaerobic conditions and a biological aerobic filter, is a solution for wastewater treatment in mountain areas. This paper presents the process and three full-scale applications in the region of the Alps.

Measuring food access in Melbourne: access to healthy and fast foods by car, bus and foot in an urban municipality in Melbourne.

PubMed

Burns, C M; Inglis, A D

2007-12-01

Access to healthy food can be an important determinant of a healthy diet. This paper describes the assessment of access to healthy and unhealthy foods using a GIS accessibility programme in a large outer municipality of Melbourne. Access to a major supermarket was used as a proxy for access to a healthy diet and fast food outlet as proxy for access to unhealthy food. Our results indicated that most (>80%) residents lived within an 8-10 min car journey of a major supermarket i.e. have good access to a healthy diet. However, more advantaged areas had closer access to supermarkets, conversely less advantaged areas had closer access to fast food outlets. These findings have application for urban planners, public health practitioners and policy makers.

From Medical to Recreational Marijuana Sales: Marijuana Outlets and Crime in an Era of Changing Marijuana Legislation.

PubMed

Freisthler, Bridget; Gaidus, Andrew; Tam, Christina; Ponicki, William R; Gruenewald, Paul J

2017-06-01

A movement from medical to recreational marijuana use allows for a larger base of potential users who have easier access to marijuana, because they do not have to visit a physician before using marijuana. This study examines whether changes in the density of marijuana outlets were related to violent, property, and marijuana-specific crimes in Denver, CO during a time in which marijuana outlets began selling marijuana for recreational, and not just medical, use. We collected data on locations of crimes, marijuana outlets and covariates for 481 Census block groups over 34 months (N = 16,354 space-time units). A Bayesian Poisson space-time model assessed statistical relationships between independent measures and crime counts within "local" Census block groups. We examined spatial "lag" effects to assess whether crimes in Census block groups adjacent to locations of outlets were also affected. Independent of the effects of covariates, densities of marijuana outlets were unrelated to property and violent crimes in local areas. However, the density of marijuana outlets in spatially adjacent areas was positively related to property crime in spatially adjacent areas over time. Further, the density of marijuana outlets in local and spatially adjacent blocks groups was related to higher rates of marijuana-specific crime. This study suggests that the effects of the availability of marijuana outlets on crime do not necessarily occur within the specific areas within which these outlets are located, but may occur in adjacent areas. Thus studies assessing the effects of these outlets in local areas alone may risk underestimating their true effects.

Barriers and facilitators to intraosseous access in adult resuscitations when peripheral intravenous access is not achievable.

PubMed

James Cheung, Warren; Rosenberg, Hans; Vaillancourt, Christian

2014-03-01

Studies suggest that intraosseous (IO) access is underutilized in adult resuscitations, despite recommendations from advanced trauma and cardiac life support guidelines. The objective was to determine factors associated with IO access use by physicians during adult resuscitations when intravenous (IV) access is not immediately achievable. This study was an online survey among physicians purposefully recruited from various clinical care areas at three teaching hospitals. Questions were generated from the qualitative results of 20 iterative interviews, verified for internal validity, and piloted. The interview guide was based on the constructs of the Theory of Planned Behavior (TPB), which elicits salient attitudes, social influences, and control beliefs that potentially influence intention to use IO access. Recruitment took place in September 2012 until reaching more than 100% of the required sample size (n = 200). Internal consistency was measured using Cronbach's alpha, and the effect of TPB constructs and specific beliefs were assessed with regression analyses. For the 205 respondents, the mean age was 35 years (range = 20 to 66 years), and 53.3% were male. Participants' departmental affiliations were 50.3% emergency medicine (EM), 16.9% internal medicine, 14.9% anesthesia, 10.8% general surgery, and 7.2% critical care. Residents comprised 60.7% of the sample, and 39.3% were attending physicians. Median intention to use IO access when IV is not immediately achievable was 4.67 (interquartile range [IQR] = 4 to 5) out of 5 (5 highest) and predicted by the following TPB constructs: attitudes (AdjCoefficients = 0.504; 95% confidence interval [CI] = 0.334 to 0.673), social influences (AdjCoefficients = 0.285; 95% CI = 0.172 to 0.398), and control beliefs (AdjCoefficients 0.217; 95% CI = 0.113 to 0.320). Physicians were more likely to use IO access if they believed that it provided rapid vascular access for delivering large volumes of fluids, could prevent delays in care, and was associated with a low complication rate. Conversely, the perception that nurses are not familiar or supportive of IO access and a lack of physician confidence regarding the appropriate indications for IO access were barriers to use. These data are an important step in the knowledge-to-action process, as they identify specific factors associated with physician use of IO access. Interventions addressing these actionable facilitators and barriers are likely to have a positive effect on increasing the appropriate physician use of this potentially life-saving technique in adult patients requiring emergent vascular access. © 2014 by the Society for Academic Emergency Medicine.

Disparities in Geographic Accessibility of National Cancer Institute Cancer Centers in the United States.

PubMed

Xu, Yanqing; Fu, Cong; Onega, Tracy; Shi, Xun; Wang, Fahui

2017-11-11

The National Cancer Institute (NCI) Cancer Centers form the backbone of the cancer care system in the United States since their inception in the early 1970s. Most studies on their geographic accessibility used primitive measures, and did not examine the disparities across urbanicity or demographic groups. This research uses an advanced accessibility method, termed "2-step floating catchment area (2SFCA)" and implemented in Geographic Information Systems (GIS), to capture the degree of geographic access to NCI Cancer Centers by accounting for competition intensity for the services and travel time between residents and the facilities. The results indicate that urban advantage is pronounced as the average accessibility is highest in large central metro areas, declines to large fringe metro, medium metro, small metro, micropolitan and noncore rural areas. Population under the poverty line are disproportionally concentrated in lower accessibility areas. However, on average Non-Hispanic White have the lowest geographic accessibility, followed by Hispanic, Non-Hispanic Black and Asian, and the differences are statistically significant. The "reversed racial disadvantage" in NCI Cancer Center accessibility seems counterintuitive but is consistent with an influential prior study; and it is in contrast to the common observation of co-location of concentration of minority groups and people under the poverty line.

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

Trentadue, R.; Clemencic, M.; Dykstra, D.

The LCG Persistency Framework consists of three software packages (CORAL, COOL and POOL) that address the data access requirements of the LHC experiments in several different areas. The project is the result of the collaboration between the CERN IT Department and the three experiments (ATLAS, CMS and LHCb) that are using some or all of the Persistency Framework components to access their data. POOL is a hybrid technology store for C++ objects, using a mixture of streaming and relational technologies to implement both object persistency and object metadata catalogs and collections. CORAL is an abstraction layer with an SQL-free APImore » for accessing data stored using relational database technologies. COOL provides specific software components and tools for the handling of the time variation and versioning of the experiment conditions data. This presentation reports on the status and outlook in each of the three sub-projects at the time of the CHEP2012 conference, reviewing the usage of each package in the three LHC experiments.« less

Standardized Access and Processing of Multi-Source Earth Observation Time-Series Data within a Regional Data Middleware

NASA Astrophysics Data System (ADS)

Eberle, J.; Schmullius, C.

2017-12-01

Increasing archives of global satellite data present a new challenge to handle multi-source satellite data in a user-friendly way. Any user is confronted with different data formats and data access services. In addition the handling of time-series data is complex as an automated processing and execution of data processing steps is needed to supply the user with the desired product for a specific area of interest. In order to simplify the access to data archives of various satellite missions and to facilitate the subsequent processing, a regional data and processing middleware has been developed. The aim of this system is to provide standardized and web-based interfaces to multi-source time-series data for individual regions on Earth. For further use and analysis uniform data formats and data access services are provided. Interfaces to data archives of the sensor MODIS (NASA) as well as the satellites Landsat (USGS) and Sentinel (ESA) have been integrated in the middleware. Various scientific algorithms, such as the calculation of trends and breakpoints of time-series data, can be carried out on the preprocessed data on the basis of uniform data management. Jupyter Notebooks are linked to the data and further processing can be conducted directly on the server using Python and the statistical language R. In addition to accessing EO data, the middleware is also used as an intermediary between the user and external databases (e.g., Flickr, YouTube). Standardized web services as specified by OGC are provided for all tools of the middleware. Currently, the use of cloud services is being researched to bring algorithms to the data. As a thematic example, an operational monitoring of vegetation phenology is being implemented on the basis of various optical satellite data and validation data from the German Weather Service. Other examples demonstrate the monitoring of wetlands focusing on automated discovery and access of Landsat and Sentinel data for local areas.

Internet Usage by Low-Literacy Adults Seeking Health Information: An Observational Analysis

PubMed Central

Birru, Mehret S; Monaco, Valerie M; Charles, Lonelyss; Drew, Hadiya; Njie, Valerie; Bierria, Timothy; Detlefsen, Ellen

2004-01-01

Background Adults with low literacy may encounter informational obstacles on the Internet when searching for health information, in part because most health Web sites require at least a high-school reading proficiency for optimal access. Objective The purpose of this study was to 1) determine how low-literacy adults independently access and evaluate health information on the Internet, 2) identify challenges and areas of proficiency in the Internet-searching skills of low-literacy adults. Methods Subjects (n=8) were enrolled in a reading assistance program at Bidwell Training Center in Pittsburgh, PA, and read at a 3rd to 8th grade level. Subjects conducted self-directed Internet searches for designated health topics while utilizing a think-aloud protocol. Subjects' keystrokes and comments were recorded using Camtasia Studio screen-capture software. The search terms used to find health information, the amount of time spent on each Web site, the number of Web sites accessed, the reading level of Web sites accessed, and the responses of subjects to questionnaires were assessed. Results Subjects collectively answered 8 out of 24 questions correctly. Seven out of 8 subjects selected "sponsored sites"-paid Web advertisements-over search engine-generated links when answering health questions. On average, subjects accessed health Web sites written at or above a 10th grade reading level. Standard methodologies used for measuring health literacy and for promoting subjects to verbalize responses to Web-site form and content had limited utility in this population. Conclusion This study demonstrates that Web health information requires a reading level that prohibits optimal access by some low-literacy adults. These results highlight the low-literacy adult population as a potential audience for Web health information, and indicate some areas of difficulty that these individuals face when using the Internet and health Web sites to find information on specific health topics. PMID:15471751

Distinct cortical areas for names of numbers and body parts independent of language and input modality.

PubMed

Le Clec'H, G; Dehaene, S; Cohen, L; Mehler, J; Dupoux, E; Poline, J B; Lehéricy, S; van de Moortele, P F; Le Bihan, D

2000-10-01

Some models of word comprehension postulate that the processing of words presented in different modalities and languages ultimately converges toward common cerebral systems associated with semantic-level processing and that the localization of these systems may vary with the category of semantic knowledge being accessed. We used functional magnetic resonance imaging to investigate this hypothesis with two categories of words, numerals, and body parts, for which the existence of distinct category-specific areas is debated in neuropsychology. Across two experiments, one with a blocked design and the other with an event-related design, a reproducible set of left-hemispheric parietal and prefrontal areas showed greater activation during the manipulation of topographical knowledge about body parts and a right-hemispheric parietal network during the manipulation of numerical quantities. These results complement the existing neuropsychological and brain-imaging literature by suggesting that within the extensive network of bilateral parietal regions active during both number and body-part processing, a subset shows category-specific responses independent of the language and modality of presentation. Copyright 2000 Academic Press.

National Knowledge Commission

NASA Astrophysics Data System (ADS)

Pitroda, Sam

2007-04-01

India's National Knowledge Commission (NKC) established by the prime minister is focused on building institutions and infrastructure in Education, Science and Technology, Innovation etc. to meet the challenges of the knowledge economy in the 21st century and increase India's competitive advantage in the global market. India today stands poised to reap the benefits of a rapidly growing economy and a major demographic advantage, with 550 million young people below the age of 25 years, the largest in the world. The NKC is focused on five critical areas of knowledge related to access, concepts, creation, applications and services. This includes a variety of subject areas such as language, translations, libraries, networks, portals, affirmative action, distance learning, intellectual property, Entrepreneurship, application in Agriculture, health, small and medium scale industries, e-governance etc. One of the keys to this effort is to build a national broadband gigabit of networks of 500 nodes to connect universities, Libraries, Laboratories, Hospitals, Agriculture institutions etc. to share resources and collaborate on multidisciplinary activities. This presentation will introduce the NKC, discuss methodology, subject areas, specific recommendation and outline a plan to build knowledge networks and specifics on network architecture, applications, and utilities.

Prediction of phenotypes of missense mutations in human proteins from biological assemblies.

PubMed

Wei, Qiong; Xu, Qifang; Dunbrack, Roland L

2013-02-01

Single nucleotide polymorphisms (SNPs) are the most frequent variation in the human genome. Nonsynonymous SNPs that lead to missense mutations can be neutral or deleterious, and several computational methods have been presented that predict the phenotype of human missense mutations. These methods use sequence-based and structure-based features in various combinations, relying on different statistical distributions of these features for deleterious and neutral mutations. One structure-based feature that has not been studied significantly is the accessible surface area within biologically relevant oligomeric assemblies. These assemblies are different from the crystallographic asymmetric unit for more than half of X-ray crystal structures. We find that mutations in the core of proteins or in the interfaces in biological assemblies are significantly more likely to be disease-associated than those on the surface of the biological assemblies. For structures with more than one protein in the biological assembly (whether the same sequence or different), we find the accessible surface area from biological assemblies provides a statistically significant improvement in prediction over the accessible surface area of monomers from protein crystal structures (P = 6e-5). When adding this information to sequence-based features such as the difference between wildtype and mutant position-specific profile scores, the improvement from biological assemblies is statistically significant but much smaller (P = 0.018). Combining this information with sequence-based features in a support vector machine leads to 82% accuracy on a balanced dataset of 50% disease-associated mutations from SwissVar and 50% neutral mutations from human/primate sequence differences in orthologous proteins. Copyright © 2012 Wiley Periodicals, Inc.

Aviation Security: Background and Policy Options for Screening and Securing Air Cargo

DTIC Science & Technology

2008-02-25

today, employees with unescorted access privileges to security identification display areas ( SIDAs ) may access secured areas and aircraft without...where all-cargo aircraft are loaded and unloaded, as security identification display areas ( SIDAs ). This effectively elevates the required security

20. INTERIOR VIEW TO THE EAST OF THE ACCESS RAMP ...

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

20. INTERIOR VIEW TO THE EAST OF THE ACCESS RAMP TO THE HOT DISASSEMBLY AREA FROM THE COLD ASSEMBLY AREA. - Nevada Test Site, Reactor Maintenance Assembly & Dissassembly Facility, Area 25, Jackass Flats, Junction of Roads F & G, Mercury, Nye County, NV

Reduced food access due to a lack of money, inability to lift and lack of access to a car for food shopping: a multilevel study in Melbourne, Victoria.

PubMed

Burns, Cate; Bentley, Rebecca; Thornton, Lukar; Kavanagh, Anne

2011-06-01

To describe associations between demographic and individual and area-level socio-economic variables and restricted household food access due to lack of money, inability to lift groceries and lack of access to a car to do food shopping. Multilevel study of three measures of restricted food access, i.e. running out of money to buy food, inability to lift groceries and lack of access to a car for food shopping. Multilevel logistic regression was conducted to examine the risk of each of these outcomes according to demographic and socio-economic variables. Random selection of households from fifty small areas in Melbourne, Australia, in 2003. The main food shoppers in each household (n 2564). A lack of money was significantly more likely among the young and in households with single adults. Difficulty lifting was more likely among the elderly and those born overseas. The youngest and highest age groups both reported reduced car access, as did those born overseas and single-adult households. All three factors were most likely among those with a lower individual or household socio-economic position. Increased levels of area disadvantage were independently associated with difficulty lifting and reduced car access. In Melbourne, households with lower individual socio-economic position and area disadvantage have restricted access to food because of a lack of money and/or having physical limitations due difficulty lifting or lack of access to a car for food shopping. Further research is required to explore the relationship between physical restrictions and food access.

Sustainable Food Security in the Mountains of Pakistan: Towards a Policy Framework.

PubMed

Rasul, Golam; Hussain, Abid

2015-01-01

The nature and causes of food and livelihood security in mountain areas are quite different to those in the plains. Rapid socioeconomic and environmental changes added to the topographical constraints have exacerbated the problem of food insecurity in the Hindu Kush-Himalayan (HKH) region. In Pakistan, food insecurity is significantly higher in the mountain areas than in the plains as a result of a range of biophysical and socioeconomic factors. The potential of mountain niche products such as fruit, nuts, and livestock has remained underutilized. Moreover, the opportunities offered by globalization, market integration, remittances, and non-farm income have not been fully tapped. This paper analyzes the opportunities and challenges of food security in Pakistan's mountain areas, and outlines a framework for addressing the specific issues in terms of four different types of area differentiated by agro-ecological potential and access to markets, information, and institutional services.

Faculty experiences with providing online courses. Thorns among the roses.

PubMed

Cravener, P A

1999-01-01

This article presents a review of the literature summarizing faculty reports of their experiences with computer-mediated distance education compared with their traditional face-to-face teaching experiences. Both challenges and benefits of distance learning programs contrasted with classroom-based teaching are revealed. Specific difficulties and advantages identified by online faculty were categorized into four broad areas of impact on the teaching/learning experience: (a) faculty workload, (b) access to education, (c) adapting to technology, and (d) instructional quality. Challenges appear to be related predominantly to faculty workloads, new technologies, and online course management. Benefits identified by online educators indicate that computer-mediated distance education has high potential for expanding student access to educational resources, for providing individualized instruction, and for promoting active learning among geographically separated members of learning groups.

Access and Costs: Recommendations for Title IV. Hearing on Examining Proposals Authorizing Funds for Title IV Student Aid Programs and Issues Relating to Access to Costs of Postsecondary Education of the Higher Education Act, Including S. 1036, To Revise Section 435 of the Higher Education Act To Allow for the Young Americans Bank and Similar Small, Nonprofit Organizations to Provide Additional Funds for Educational Programming, of the Committee on Labor and Human Resources. United States Senate, One Hundred Fifth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

This 10th and final hearing in a series related to the reauthorization of the Higher Education Act, focused on three specific areas: (1) the challenges posed by demographic changes in the college student population--nearly half of all students attend community colleges where the average age of students is 29; (2) the challenges and opportunities…

HotRegion: a database of predicted hot spot clusters.

PubMed

Cukuroglu, Engin; Gursoy, Attila; Keskin, Ozlem

2012-01-01

Hot spots are energetically important residues at protein interfaces and they are not randomly distributed across the interface but rather clustered. These clustered hot spots form hot regions. Hot regions are important for the stability of protein complexes, as well as providing specificity to binding sites. We propose a database called HotRegion, which provides the hot region information of the interfaces by using predicted hot spot residues, and structural properties of these interface residues such as pair potentials of interface residues, accessible surface area (ASA) and relative ASA values of interface residues of both monomer and complex forms of proteins. Also, the 3D visualization of the interface and interactions among hot spot residues are provided. HotRegion is accessible at http://prism.ccbb.ku.edu.tr/hotregion.

Simulation study on heat conduction of a nanoscale phase-change random access memory cell.

PubMed

Kim, Junho; Song, Ki-Bong

2006-11-01

We have investigated heat transfer characteristics of a nano-scale phase-change random access memory (PRAM) cell using finite element method (FEM) simulation. Our PRAM cell is based on ternary chalcogenide alloy, Ge2Sb2Te5 (GST), which is used as a recording layer. For contact area of 100 x 100 nm2, simulations of crystallization and amorphization processes were carried out. Physical quantities such as electric conductivity, thermal conductivity, and specific heat were treated as temperature-dependent parameters. Through many simulations, it is concluded that one can reduce set current by decreasing both electric conductivities of amorphous GST and crystalline GST, and in addition to these conditions by decreasing electric conductivity of molten GST one can also reduce reset current significantly.

AccessMRS: integrating OpenMRS with smart forms on Android.

PubMed

Fazen, Louis E; Chemwolo, Benjamin T; Songok, Julia J; Ruhl, Laura J; Kipkoech, Carolyne; Green, James M; Ikemeri, Justus E; Christoffersen-Deb, Astrid

2013-01-01

We present a new open-source Android application, AccessMRS, for interfacing with an electronic medical record system (OpenMRS) and loading 'Smart Forms' on a mobile device. AccessMRS functions as a patient-centered interface for viewing OpenMRS data; managing patient information in reminders, task lists, and previous encounters; and launching patient-specific 'Smart Forms' for electronic data collection and dissemination of health information. We present AccessMRS in the context of related software applications we developed to serve Community Health Workers, including AccessInfo, AccessAdmin, AccessMaps, and AccessForms. The specific features and design of AccessMRS are detailed in relationship to the requirements that drove development: the workflows of the Kenyan Ministry of Health Community Health Volunteers (CHVs) supported by the AMPATH Primary Health Care Program. Specifically, AccessMRS was designed to improve the quality of community-based Maternal and Child Health services delivered by CHVs in Kosirai Division. AccessMRS is currently in use by more than 80 CHVs in Kenya and undergoing formal assessment of acceptability, effectiveness, and cost.

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

Referral for secondary restorative dental care in rural and urban areas of Scotland: findings from the Highlands Et Islands Teledentistry Project.

PubMed

Nuttall, N M; Steed, M S; Donachie, M A

2002-02-23

To compare the reported level of use of secondary care services for restorative dental care in rural and urban areas of Scotland. Postal questionnaire survey Postal questionnaire sent to all dentists in the Highland region, the island regions in Scotland and Dumfries Et Galloway (n = 150) and an equal number were sampled from the remainder of Scotland stratified by health board area. Non-respondents were sent 2 reminders after which 62% of the sample had responded. Most dentists (85%) who practised in what they considered were urban areas of Scotland said they felt that they had good access to a secondary referral service. Whereas most of those who practised in what they considered were rural areas either said they had no access to such a service (26%) or that access was difficult (53%), only 3% of those in urban areas said they had no access to a secondary restorative consultative service compared with 14% of dentists practising in rural areas of mainland Scotland and 54% of those practising on Scottish islands. The survey suggests the people of the Scottish islands and some of the remoter parts of the Scottish mainland would be among those who might benefit from improvement in access to a restorative dentistry consultant service.

Decline in Radiation Hardened Microcircuit Infrastructure

NASA Technical Reports Server (NTRS)

LaBel, Kenneth A.

2015-01-01

Two areas of radiation hardened microcircuit infrastructure will be discussed: 1) The availability and performance of radiation hardened microcircuits, and, and 2) The access to radiation test facilities primarily for proton single event effects (SEE) testing. Other areas not discussed, but are a concern include: The challenge for maintaining radiation effects tool access for assurance purposes, and, the access to radiation test facilities primarily for heavy ion single event effects (SEE) testing. Status and implications will be discussed for each area.

Regional Disparities in Online Map User Access Volume and Determining Factors

NASA Astrophysics Data System (ADS)

Li, R.; Yang, N.; Li, R.; Huang, W.; Wu, H.

2017-09-01

The regional disparities of online map user access volume (use `user access volume' in this paper to indicate briefly) is a topic of growing interest with the increment of popularity in public users, which helps to target the construction of geographic information services for different areas. At first place we statistically analysed the online map user access logs and quantified these regional access disparities on different scales. The results show that the volume of user access is decreasing from east to the west in China as a whole, while East China produces the most access volume; these cities are also the crucial economic and transport centres. Then Principal Component Regression (PCR) is applied to explore the regional disparities of user access volume. A determining model for Online Map access volume is proposed afterwards, which indicates that area scale is the primary determining factor for regional disparities, followed by public transport development level and public service development level. Other factors like user quality index and financial index have very limited influence on the user access volume. According to the study of regional disparities in user access volume, map providers can reasonably dispatch and allocate the data resources and service resources in each area and improve the operational efficiency of the Online Map server cluster.

Does deregulation in community pharmacy impact accessibility of medicines, quality of pharmacy services and costs? Evidence from nine European countries.

PubMed

Vogler, Sabine; Habimana, Katharina; Arts, Danielle

2014-09-01

To analyse the impact of deregulation in community pharmacy on accessibility of medicines, quality of pharmacy services and costs. We analysed and compared community pharmacy systems in five rather deregulated countries (England, Ireland, the Netherlands, Norway, Sweden) and four rather regulated countries (Austria, Denmark, Finland, Spain). Data were collected by literature review, a questionnaire survey and interviews. Following a deregulation, several new pharmacies and dispensaries of Over-the-Counter (OTC) medicines tended to be established, predominantly in urban areas. Unless prevented by regulation, specific stakeholders, e.g. wholesalers, were seen to gain market dominance which limited envisaged competition. There were indications for an increased workload for pharmacists in some deregulated countries. Economic pressure to increase the pharmacy turnover through the sale of OTC medicines and non-pharmaceuticals was observed in deregulated and regulated countries. Prices of OTC medicines were not found to decrease after a deregulation in pharmacy. Access to pharmacies usually increases after a deregulation but this is likely to favour urban populations with already good accessibility. Policy-makers are recommended to take action to ensure equitable accessibility and sustainable competition in a more deregulated environment. No association between pharmaceutical expenditure and the extent of regulation/deregulation appears to exist. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Heterogeneity of Powdery Mildew Resistance Revealed in Accessions of the ICARDA Wild Barley Collection

PubMed Central

Dreiseitl, Antonin

2017-01-01

The primary genepool of barley comprises two subspecies – wild barley (Hordeum vulgare subsp. spontaneum) and cultivated barley H. vulgare. subsp. vulgare. The former originated 5.5 million years ago in southwest Asia and is the immediate ancestor of cultivated barley, which arose around 10,000 years ago. In this study, the specific resistance of a set of 146 wild barley accessions, maintained by the International Center for Agriculture Research in the Dry Areas (ICARDA), to 32 isolates of barley powdery mildew caused by Blumeria graminis f. sp. hordei was evaluated. The set comprised 146 heterogeneous accessions of a previously tested collection. Seed was obtained by single seed descent and each accession was usually represented by five single plant progenies. In total, 687 plant progenies were tested. There were 211 phenotypes of resistance among the accessions, 87 of which were found in single plants, while 202 plants contained the eight most common phenotypes. The most frequent phenotype was found in 56 plants that were susceptible to all pathogen isolates, whereas the second most frequent phenotype, which occurred in 46 plants, was resistant to all isolates. The broad resistance diversity that was revealed is of practical importance and is an aid to determining the extent and role of resistance in natural ecosystems. PMID:28261253

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

NASA Technical Reports Server (NTRS)

1978-01-01

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

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

ERIC Educational Resources Information Center

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

2014-01-01

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

Biosecurity measures in 48 isolation facilities managing highly infectious diseases.

PubMed

Puro, Vincenzo; Fusco, Francesco M; Schilling, Stefan; Thomson, Gail; De Iaco, Giuseppina; Brouqui, Philippe; Maltezou, Helena C; Bannister, Barbara; Gottschalk, René; Brodt, Hans-Rheinhard; Ippolito, Giuseppe

2012-06-01

Biosecurity measures are traditionally applied to laboratories, but they may also be usefully applied in highly specialized clinical settings, such as the isolation facilities for the management of patients with highly infectious diseases (eg, viral hemorrhagic fevers, SARS, smallpox, potentially severe pandemic flu, and MDR- and XDR-tuberculosis). In 2009 the European Network for Highly Infectious Diseases conducted a survey in 48 isolation facilities in 16 European countries to determine biosecurity measures for access control to the facility. Security personnel are present in 39 facilities (81%). In 35 facilities (73%), entrance to the isolation area is restricted; control methods include electronic keys, a PIN system, closed-circuit TV, and guards at the doors. In 25 facilities (52%), identification and registration of all staff entering and exiting the isolation area are required. Access control is used in most surveyed centers, but specific lacks exist in some facilities. Further data are needed to assess other biosecurity aspects, such as the security measures during the transportation of potentially contaminated materials and measures to address the risk of an "insider attack."

Discourses of illegality and exclusion: when water access matters.

PubMed

Mudege, Netsayi Noris; Zulu, Eliya M

2011-01-01

This paper examines the politics and the underlying discourses of water provisioning and how residents of Korogocho and Viwandani slum settlements in Nairobi city cope with challenges relating to water access. We use qualitative data from 36 focus group discussions conducted in the two slums to unravel discourses regarding water provisioning in the rapidly growing slum settlements in African cities. Results show that the problems concerning water provisioning within Nairobi slums are less about water scarcity and more about unequal distribution and the marginalisation of slum areas in development plans. Poor water management, lack of equity-based policies and programmes, and other slum-specific features such as land-tenure systems and insecurity exacerbate water-supply problems within slum areas. It is hard to see how water supply in these communities can improve without the direct and active involvement of the government in infrastructural development and oversight of the water-supply actors. Innovative public-private partnerships in water provision and the harnessing of existing community efforts to improve the water supply would go a long way towards improving the water supply to the rapidly growing urban poor population in Africa.

Knowledge Management - A Necessity For The Training Of Future Specialists Of The Sustainable Entreprises

NASA Astrophysics Data System (ADS)

Rotaru, Ionela Magdalena

2015-09-01

The world we are living in is shaped by what is a reality for years already: globalisation of economy. The lack of borders makes the impact that technology has on society to be a major one. The virtual world so accessible today is not just about new markets, access to cheaper work force, work online but also fierce competition. The common denominator of most efforts in the area of industry is performance. Limits continuously moving willingness to pay for products that delineate the performance delivered be the same range. Here too we can see the role of the education. For example, Landes shows that both knowledge and know-how are the ones that determine how well off societies are. The education of engineers is therefore critical to every nation to ensure the prosperity of its citizens. This paper here intends to approach the educational process of the engineering specific area of knowledge from the management perspective. The training process becomes sustainable in accordance with the requirements of the future: trained specialists for sustainable enterprises.

The spatial data and knowledge gateways at the International Water Management Institute (IWMI)

NASA Astrophysics Data System (ADS)

Thenkabail, P. S.; Biradar, C. M.; Noojipady, P.; Islam, A.; Velpuri, M.; Vithanage, J.; Kulawardhana, W.; Li, Yuan Jie; Dheeravath, V.; Gunasinghe, S.; Alankara, R.

2006-10-01

In this paper we discuss spatial data and knowledge base (SDKB) gateway portals developed by the International Water Management Institute (IWMI). Our vision is to generate and/or facilitate easy and free access to state-of-art SDKB of excellence globally. Our mission is to make SDKB accessible online, globally, for free. The IWMI data storehouse pathway (IWMIDSP; http://www.iwmidsp.org) is a pathfinder global public good (GPG) portal on remote sensing and GIS (RS/GIS) data and products with specific emphasis on river basin data, but also storing valuable data on Nations, Regions, and the World. A number of other specialty GPG portals have also been released. These include Global map of irrigated area (http://www.iwmigiam.org), Drought monitoring system for southwest Asia (http://dms.iwmi.org), Tsunami satellite sensor data catalogue (http://tsdc.iwmi.org), and Knowledge base system (KBS) for Sri Lanka (http://www.iwmikbs.org). The IWMIDSP has been the backbone of several other projects such as global irrigated area mapping, drought monitoring system, wetlands, and knowledge base systems. A discussion on these pathfinder web portals follow.

Biosecurity Measures in 48 Isolation Facilities Managing Highly Infectious Diseases

PubMed Central

Puro, Vincenzo; Schilling, Stefan; Thomson, Gail; De Iaco, Giuseppina; Brouqui, Philippe; Maltezou, Helena C.; Bannister, Barbara; Gottschalk, René; Brodt, Hans-Rheinhard; Ippolito, Giuseppe

2012-01-01

Biosecurity measures are traditionally applied to laboratories, but they may also be usefully applied in highly specialized clinical settings, such as the isolation facilities for the management of patients with highly infectious diseases (eg, viral hemorrhagic fevers, SARS, smallpox, potentially severe pandemic flu, and MDR- and XDR-tuberculosis). In 2009 the European Network for Highly Infectious Diseases conducted a survey in 48 isolation facilities in 16 European countries to determine biosecurity measures for access control to the facility. Security personnel are present in 39 facilities (81%). In 35 facilities (73%), entrance to the isolation area is restricted; control methods include electronic keys, a PIN system, closed-circuit TV, and guards at the doors. In 25 facilities (52%), identification and registration of all staff entering and exiting the isolation area are required. Access control is used in most surveyed centers, but specific lacks exist in some facilities. Further data are needed to assess other biosecurity aspects, such as the security measures during the transportation of potentially contaminated materials and measures to address the risk of an “insider attack.” PMID:22571373

The Need for More Research on Language Barriers in Health Care: A Proposed Research Agenda

PubMed Central

Jacobs, Elizabeth; Chen, Alice HM; Karliner, Leah S; Agger-Gupta, Niels; Mutha, Sunita

2006-01-01

Many U.S. residents who speak little English may face language barriers when seeking health care. This article describes what is currently known about language barriers in health care and outlines a research agenda based on mismatches between the current state of knowledge of language barriers and what health care stakeholders need to know. Three broad areas needing more research are discussed: the ways in which language barriers affect health and health care, the efficacy of linguistic access service interventions, and the costs of language barriers and efforts to overcome them. In each of these areas, we outline specific research questions and recommendations. PMID:16529570

Local health department activities to ensure access to care.

PubMed

Luo, Huabin; Sotnikov, Sergey; Shah, Gulzar

2013-12-01

Local health departments (LHDs) can play an important role in linking people to personal health services and ensuring the provision of health care when it is otherwise unavailable. However, the extent to which LHDs are involved in ensuring access to health care in its jurisdictions is not well known. To provide nationally representative estimates of LHD involvement in specific activities to ensure access to healthcare services and to assess their association with macro-environment/community and LHD capacity and process characteristics. Data used were from the 2010 National Profile of Local Health Departments Study, Area Resource Files, and the Association of State and Territorial Health Officials' 2010 Profile of State Public Health Agencies Survey. Data were analyzed in 2012. Approximately 66.0% of LHDs conducted activities to ensure access to medical care, 45.9% to dental care, and 32.0% to behavioral health care. About 28% of LHDs had not conducted activities to ensure access to health care in their jurisdictions in 2010. LHDs with higher per capita expenditures and larger jurisdiction population sizes were more likely to provide access to care services (p <0.05). There is substantial variation in LHD engagement in activities to ensure access to care. Differences in LHD capacity and the needs of the communities in which they are located may account for this variation. Further research is needed to determine whether this variation is associated with adverse population health outcomes. © 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.

Variation in geographic access to specialist inpatient hospices in England and Wales.

PubMed

Gatrell, Anthony C; Wood, D Justin

2012-07-01

We seek to map and describe variation in geographic access to the set of 189 specialist adult inpatient hospices in England and Wales. Using almost 35,000 small Census areas (Local Super Output Areas: LSOAs) as our units of analysis, the locations of hospices, and estimated drive times from LSOAs to hospices we construct an accessibility 'score' for each LSOA, for England and Wales as a whole. Data on cancer mortality are used as a proxy for the 'demand' for hospice care and we then identify that subset of small areas in which accessibility (service supply) is relatively poor yet the potential 'demand' for hospice services is above average. That subset is then filtered according to the deprivation score for each LSOA, in order to identify those LSOAs which are also above average in terms of deprivation. While urban areas are relatively well served, large parts of England and Wales have poor access to hospices, and there is a risk that the needs of those living in relatively deprived areas may be unmet. Copyright © 2012 Elsevier Ltd. All rights reserved.

Impact of service provision platforms on maternal and newborn health in conflict areas and their acceptability in Pakistan: a systematic review.

PubMed

Lassi, Zohra S; Aftab, Wafa; Ariff, Shabina; Kumar, Rohail; Hussain, Imtiaz; Musavi, Nabiha B; Memon, Zahid; Soofi, Sajid B; Bhutta, Zulfiqar A

2015-01-01

Various models and strategies have been implemented over the years in different parts of the world to improve maternal and newborn health (MNH) in conflict affected areas. These strategies are based on specific needs and acceptability of local communities. This paper has undertaken a systematic review of global and local (Pakistan) information from conflict areas on platforms of health service provision in the last 10 years and information on acceptability from local stakeholders on effective models of service delivery; and drafted key recommendations for improving coverage of health services in conflict affected areas. The literature search revealed ten studies that described MNH service delivery platforms. The results from the systematic review showed that with utilisation of community outreach services, the greatest impacts were observed in skilled birth attendance and antenatal consultation rates. Facility level services, on the other hand, showed that labour room services for an internally displaced population (IDP) improved antenatal care coverage, contraceptive prevalence rate and maternal mortality. Consultative meetings and discussions conducted in Quetta and Peshawar (capitals of conflict affected provinces) with relevant stakeholders revealed that no systematic models of MNH service delivery, especially tailored for conflict areas, are available. During conflict, even previously available services and infrastructure suffered due to various barriers specific to times of conflict and unrest. A number of barriers that hinder MNH services were discussed. Suggestions for improving MNH services in conflict areas were also laid down by participants. The review identified some important steps that can be undertaken to mitigate the effects of conflict on MNH services, which include: improve provision and access to infrastructure and equipment; development and training of healthcare providers; and advocacy at different levels for free access to healthcare services and for the introduction of the programme model in existing healthcare system. The obligation is enormous, however, for a sustainable programme, it is important to work closely with both the IDP and host community, and collaborating with the government and non-government organisations.

Evolution of area access safety training required for gaining access to Space Shuttle launch and landing facilities

NASA Technical Reports Server (NTRS)

Willams, M. C.

1985-01-01

Assuring personnel and equipment are fully protected during the Space Shuttle launch and landing operations has been a primary concern of NASA and its associated contractors since the inception of the program. A key factor in support of this policy has been the area access safety training requirements for badging of employees assigned to work on Space Shuttle Launch and Facilities. This requirement was targeted for possible cost savings and the transition of physical on-site walkdowns to the use of television tapes has realized program cost savings while continuing to fully satisfy the area access safety training requirements.

Environmental Impact Analysis Process. Environmental Assessment for Replacement Medical Clinic 61st Medical Squadron, Los Angeles Air Force Base

DTIC Science & Technology

1999-12-01

mass transit (buses, commuter trains and light rail ) serves Los Angeles County. Immediate public transit access to Los Angeles AFB is by bus only. 3.8...mostly paved. As a result, surface drainage enters the storm sewer system. Stormwater run-off from Area B of Los Angeles AFB, and specifically from...leaves the installation in the form of stormwater run-off. Little infiltration of rainfall is expected. 3.4 BIOLOGICAL RESOURCES As a result of the

Engineering and Technology in Wheelchair Sport.

PubMed

Cooper, Rory A; Tuakli-Wosornu, Yetsa A; Henderson, Geoffrey V; Quinby, Eleanor; Dicianno, Brad E; Tsang, Kalai; Ding, Dan; Cooper, Rosemarie; Crytzer, Theresa M; Koontz, Alicia M; Rice, Ian; Bleakney, Adam W

2018-05-01

Technologies capable of projecting injury and performance metrics to athletes and coaches are being developed. Wheelchair athletes must be cognizant of their upper limb health; therefore, systems must be designed to promote efficient transfer of energy to the handrims and evaluated for simultaneous effects on the upper limbs. This article is brief review of resources that help wheelchair users increase physiologic response to exercise, develop ideas for adaptive workout routines, locate accessible facilities and outdoor areas, and develop wheelchair sports-specific skills. Published by Elsevier Inc.

33 CFR 125.15 - Access to waterfront facilities, and port and harbor areas, including vessels and harbor craft...

Code of Federal Regulations, 2010 CFR

2010-07-01

..., and port and harbor areas, including vessels and harbor craft therein. 125.15 Section 125.15....15 Access to waterfront facilities, and port and harbor areas, including vessels and harbor craft....09 to those waterfront facilities, and port and harbor areas, including vessels and harbor craft...

Pipe dream? Envisioning a grassroots Python ecosystem of open, common software tools and data access in support of river and coastal biogeochemical research (Invited)

NASA Astrophysics Data System (ADS)

Mayorga, E.

2013-12-01

Practical, problem oriented software developed by scientists and graduate students in domains lacking a strong software development tradition is often balkanized into the scripting environments provided by dominant, typically proprietary tools. In environmental fields, these tools include ArcGIS, Matlab, SAS, Excel and others, and are often constrained to specific operating systems. While this situation is the outcome of rational choices, it limits the dissemination of useful tools and their integration into loosely coupled frameworks that can meet wider needs and be developed organically by groups addressing their own needs. Open-source dynamic languages offer the advantages of an accessible programming syntax, a wealth of pre-existing libraries, multi-platform access, linkage to community libraries developed in lower level languages such as C or FORTRAN, and access to web service infrastructure. Python in particular has seen a large and increasing uptake in scientific communities, as evidenced by the continued growth of the annual SciPy conference. Ecosystems with distinctive physical structures and organization, and mechanistic processes that are well characterized, are both factors that have often led to the grass-roots development of useful code meeting the needs of a range of communities. In aquatic applications, examples include river and watershed analysis tools (River Tools, Taudem, etc), and geochemical modules such as CO2SYS, PHREEQ and LOADEST. I will review the state of affairs and explore the potential offered by a Python tool ecosystem in supporting aquatic biogeochemistry and water quality research. This potential is multi-faceted and broadly involves accessibility to lone grad students, access to a wide community of programmers and problem solvers via online resources such as StackExchange, and opportunities to leverage broader cyberinfrastructure efforts and tools, including those from widely different domains. Collaborative development of such tools can provide the additional advantage of enhancing cohesion and communication across specific research areas, and reducing research obstacles in a range of disciplines.

Development of a human-specific B. thetaiotaomicron IMS ...

EPA Pesticide Factsheets

Immunomagnetic separation/adenosine triphosphate (IMS/ATP) assays utilize paramagnetic beads and target-specific antibodies to isolate target organisms. Following isolation, adenosine tri-phosphate (ATP) is extracted from the target population and quantified. An inversely-coupled (Inv-IMS/ATP)assay for detection of Bacteroides thetaiotaomicron was developed and applied for rapid detection of human-associated fecal contamination in surface waters in Baja California. Specificity of the assay was tested against challenge solutions of varying concentrations of dog, gull, horse and chicken feces, and a field validation survey of coastal and WWTP effluent water quality in Rosarito and Enseneda, Baja California was conducted. Inv IMS/ATP measurements made shown to be specific and sensitive to human fecal contamination. At test concentrations of less than 1000 MPN ENT/100 mL, sensitivity and specificity of the assay both exceeded 80%. Moreover, the Inv-IMS/ATP assay yielded measurements of viable B. thetaiotaomicron that were comparable to the HF183 human marker in complex surface waters impacted with both wastewater and runoff, and the Inv-IMS/ATP assay was able to effectively differentiate between surface waters impacted with adequately and inadequately treated wastewater. The Inv-IMS/ATP assays shows promise for rapid evaluation of recreational water quality in areas where access to more expensive methods is limited and in areas where water quality in unpredicta

A Venue-Based Survey of Malaria, Anemia and Mobility Patterns among Migrant Farm Workers in Amhara Region, Ethiopia

PubMed Central

Schicker, Rebekah Stewart; Hiruy, Neway; Melak, Berhanu; Gelaye, Woyneshet; Bezabih, Belay; Stephenson, Rob; Patterson, Amy E.; Tadesse, Zerihun; Emerson, Paul M.; Richards, Frank O.; Noland, Gregory S.

2015-01-01

Background Mobile populations present unique challenges to malaria control and elimination efforts. Each year, a large number of individuals travel to northwest Amhara Region, Ethiopia to seek seasonal employment on large-scale farms. Agricultural areas typically report the heaviest malaria burden within Amhara thereby placing migrants at high risk of infection. Yet little is known about these seasonal migrants and their malaria-related risk factors. Methods and Findings In July 2013, a venue-based survey of 605 migrant laborers 18 years or older was conducted in two districts of North Gondar zone, Amhara. The study population was predominantly male (97.7%) and young (mean age 22.8 years). Plasmodium prevalence by rapid diagnostic test (RDT) was 12.0%; One quarter (28.3%) of individuals were anemic (hemoglobin <13 g/dl). Nearly all participants (95.6%) originated from within Amhara Region, with half (51.6%) coming from within North Gondar zone. Around half (51.2%) slept in temporary shelters, while 20.5% regularly slept outside. Only 11.9% of participants had access to a long lasting insecticidal net (LLIN). Reported net use the previous night was 8.8% overall but 74.6% among those with LLIN access. Nearly one-third (30.1%) reported having fever within the past two weeks, of whom 31.3% sought care. Cost and distance were the main reported barriers to seeking care. LLIN access (odds ratio [OR] = 0.30, P = 0.04) and malaria knowledge (OR = 0.50, P = 0.02) were significantly associated with reduced Plasmodium infection among migrants, with a similar but non-significant trend observed for reported net use the previous night (OR = 0.16, P = 0.14). Conclusions High prevalence of malaria and anemia were observed among a young population that originated from relatively proximate areas. Low access to care and low IRS and LLIN coverage likely place migrant workers at significant risk of malaria in this area and their return home may facilitate parasite transport to other areas. Strategies specifically tailored to migrant farm workers are needed to support malaria control and elimination activities in Ethiopia. PMID:26619114

Accessibility of low-income family flats in North Jakarta city

NASA Astrophysics Data System (ADS)

Feminin, T. A.; Wiranegara, H. W.; Supriatna, Y.

2018-01-01

The majority of relocated, low-income families in North Jakarta city who residing the flats, complained at decreasing their accessibility to the workplaces and to the social facilities. The aim of this research was to identify the changing of their accessibility before and after relocated, viewed from three dimensions: distance, travel time, and travel cost to the workplaces, educational facilities, and shopping areas. The research design was questionnaire survey containing the degree of accessibility before and after resided the flats. Five flats were chosen as cases. Their inhabitants were chosen as respondents which used simple random sampling. The result showed that their flats accessibility to the workplaces in all three dimensions was lower than when they resided in the slum area. Also, in distance and travel time accessibility to shopping areas was lower. Only accessibility to educational facilities measured in those three dimensions was higher after they moved. Supply for affordable public transport from their flats to reach their workplaces is needed to raise their accessibility. Also, they need subsidizeto rent of their flats so the burden to their income lesser.Using the ground space of their flats for retail activities was to make more accessible for their shopping activities.

33. Second floor, detail of plumbing access area Veterans ...

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

33. Second floor, detail of plumbing access area - Veterans Administration Center, Officers Duplex Quarters, 5302 East Kellogg (Legal Address); 5500 East Kellogg (Common Address), Wichita, Sedgwick County, KS

77 FR 61014 - Federal Property Suitable as Facilities to Assist the Homeless

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-05

...; asbestos & lead present; restricted area; contact AF for info. on accessibility/removal reqs. 38 Buildings.../renovations needed; asbestos & lead present; restricted area; contact AF for info. on accessibility/removal...; military housing; minor repairs/renovations needed; asbestos & lead present; restricted area; contact AF...

How to Conduct a Barrier Survey.

ERIC Educational Resources Information Center

Georgia Univ., Athens.

Provided is a sample survey form for identifying architectural barriers in any building or area that needs to be accessible for the handicapped. The checklist covers the following areas: offstreet parking, on street parking, passenger loading zone, approach to selected entrance, entrance doors, elevators-escalators, essential areas, access from…

50 CFR Table 3 (north) to Part 660... - Non-Trawl Rockfish Conservation Areas and Trip Limits for Open Access Gears North of 40°10′ N. Lat.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 11 2011-10-01 2011-10-01 false Non-Trawl Rockfish Conservation Areas and Trip Limits for Open Access Gears North of 40°10â² N. Lat. 3 Table 3 (North) to Part 660, Subpart F...) to Part 660, Subpart F—Non-Trawl Rockfish Conservation Areas and Trip Limits for Open Access Gears...

50 CFR Table 3 (south) to Part 660... - Non-Trawl Rockfish Conservation Areas and Trip Limits for Open Access Gears South of 40°10′ N. Lat.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 11 2011-10-01 2011-10-01 false Non-Trawl Rockfish Conservation Areas and Trip Limits for Open Access Gears South of 40°10â² N. Lat. 3 Table 3 (South) to Part 660, Subpart F...) to Part 660, Subpart F—Non-Trawl Rockfish Conservation Areas and Trip Limits for Open Access Gears...

Is the closest facility the one actually used? An assessment of travel time estimation based on mammography facilities.

PubMed

Alford-Teaster, Jennifer; Lange, Jane M; Hubbard, Rebecca A; Lee, Christoph I; Haas, Jennifer S; Shi, Xun; Carlos, Heather A; Henderson, Louise; Hill, Deirdre; Tosteson, Anna N A; Onega, Tracy

2016-02-18

Characterizing geographic access depends on a broad range of methods available to researchers and the healthcare context to which the method is applied. Globally, travel time is one frequently used measure of geographic access with known limitations associated with data availability. Specifically, due to lack of available utilization data, many travel time studies assume that patients use the closest facility. To examine this assumption, an example using mammography screening data, which is considered a geographically abundant health care service in the United States, is explored. This work makes an important methodological contribution to measuring access--which is a critical component of health care planning and equity almost everywhere. We analyzed one mammogram from each of 646,553 women participating in the US based Breast Cancer Surveillance Consortium for years 2005-2012. We geocoded each record to street level address data in order to calculate travel time to the closest and to the actually used mammography facility. Travel time between the closest and the actual facility used was explored by woman-level and facility characteristics. Only 35% of women in the study population used their closest facility, but nearly three-quarters of women not using their closest facility used a facility within 5 min of the closest facility. Individuals that by-passed the closest facility tended to live in an urban core, within higher income neighborhoods, or in areas where the average travel times to work was longer. Those living in small towns or isolated rural areas had longer closer and actual median drive times. Since the majority of US women accessed a facility within a few minutes of their closest facility this suggests that distance to the closest facility may serve as an adequate proxy for utilization studies of geographically abundant services like mammography in areas where the transportation networks are well established.

Supercapacitors based on modified graphene electrodes with poly(ionic liquid)

NASA Astrophysics Data System (ADS)

Trigueiro, João Paulo C.; Lavall, Rodrigo L.; Silva, Glaura G.

2014-06-01

The improved accessibility of the electrolyte to the surface of carbon nanomaterials is a challenge to be overcome in supercapacitors based on ionic liquid electrolytes. In this study, we report the preparation of supercapacitors based on reduced graphene oxide (RGO) electrodes and ionic liquid as the electrolyte (specifically, 1-methyl-1-propylpyrrolidinium bis(trifluoromethylsulfonyl)imide or [MPPy][TFSI]). Two types of electrodes were compared: the RGO-based electrode and a poly(ionic liquid)-modified RGO electrode (PIL:RGO). The supercapacitor produced with the PIL:RGO electrode and [MPPy][TFSI] showed an electrochemical stability of 3 V and provided a capacitance of 71.5 F g-1 at room temperature; this capacitance is 130% higher with respect to the RGO-based supercapacitor. The decrease of the specific capacitance after 2000 cycles is only 10% for the PIL:RGO-based device. The results revealed the potential of the PIL:RGO material as an electrode for supercapacitors. This composite electrode increases the compatibility with the ionic liquid electrolyte compared to an RGO electrode, promoting an increase in the effective surface area of the electrode accessible to the electrolyte ions.

The secure authorization model for healthcare information system.

PubMed

Hsu, Wen-Shin; Pan, Jiann-I

2013-10-01

Exploring healthcare system for assisting medical services or transmitting patients' personal health information in web application has been widely investigated. Information and communication technologies have been applied to the medical services and healthcare area for a number of years to resolve problems in medical management. In the healthcare system, not all users are allowed to access all the information. Several authorization models for restricting users to access specific information at specific permissions have been proposed. However, as the number of users and the amount of information grows, the difficulties for administrating user authorization will increase. The critical problem limits the widespread usage of the healthcare system. This paper proposes an approach for role-based and extends it to deal with the information for authorizations in the healthcare system. We propose the role-based authorization model which supports authorizations for different kinds of objects, and a new authorization domain. Based on this model, we discuss the issues and requirements of security in the healthcare systems. The security issues for services shared between different healthcare industries will also be discussed.

Can performance-based financing help reaching the poor with maternal and child health services? The experience of rural Rwanda.

PubMed

Lannes, Laurence; Meessen, Bruno; Soucat, Agnes; Basinga, Paulin

2016-07-01

More than 20 countries in Africa are scaling up performance-based financing (PBF), but its impact on equity in access to health services remains to be documented. This paper draws on evidence from Rwanda to examine the capacity of PBF to ensure equal access to key health interventions especially in rural areas where most of the poor live. Specifically, it focuses on maternal and child health services, distinguishing two wealth groups, and uses data from a rigorous impact evaluation. Difference-in-difference technique is used, and different model specifications are tested: control for unobserved heterogeneity and common random error using linear probability model, seemingly unrelated regression equations, and clustering and fixed effects. Results suggest that in Rwanda, PBF improved efficiency rather than equity for most health services. We find that PBF achieved efficiency gains by improving access to health services for those easier to reach, generally the relatively more affluent. It turns out to be less effective in reaching the poorest. Our results illustrate the advantages of rigorous randomized impact evaluation data as results published earlier using a nationally representative survey (Demographic and Health Survey) were not able to capture the pro-rich nature of the PBF scheme in Rwanda. Our paper advocates for building mechanisms targeting the vulnerable groups in PBF strategies. It also highlights the need to understand the impact of PBF together with the specific development of health insurance coverage and the organization of the health system. Copyright © 2015 John Wiley & Sons, Ltd.

Evaluation of high-perimeter electrode designs for deep brain stimulation

NASA Astrophysics Data System (ADS)

Howell, Bryan; Grill, Warren M.

2014-08-01

Objective. Deep brain stimulation (DBS) is an effective treatment for movement disorders and a promising therapy for treating epilepsy and psychiatric disorders. Despite its clinical success, complications including infections and mis-programing following surgical replacement of the battery-powered implantable pulse generator adversely impact the safety profile of this therapy. We sought to decrease power consumption and extend battery life by modifying the electrode geometry to increase stimulation efficiency. The specific goal of this study was to determine whether electrode contact perimeter or area had a greater effect on increasing stimulation efficiency. Approach. Finite-element method (FEM) models of eight prototype electrode designs were used to calculate the electrode access resistance, and the FEM models were coupled with cable models of passing axons to quantify stimulation efficiency. We also measured in vitro the electrical properties of the prototype electrode designs and measured in vivo the stimulation efficiency following acute implantation in anesthetized cats. Main results. Area had a greater effect than perimeter on altering the electrode access resistance; electrode (access or dynamic) resistance alone did not predict stimulation efficiency because efficiency was dependent on the shape of the potential distribution in the tissue; and, quantitative assessment of stimulation efficiency required consideration of the effects of the electrode-tissue interface impedance. Significance. These results advance understanding of the features of electrode geometry that are important for designing the next generation of efficient DBS electrodes.

Providing accurate near real-time fire alerts for Protected Areas through NASA FIRMS: Opportunities and Challenges

NASA Astrophysics Data System (ADS)

Ilavajhala, S.; Davies, D.; Schmaltz, J. E.; Wong, M.; Murphy, K. J.

2013-12-01

The NASA Fire Information for Resource Management System (FIRMS) is at the forefront of providing global near real-time (NRT) MODIS thermal anomalies / hotspot location data to end-users . FIRMS serves the data via an interactive Web GIS named Web Fire Mapper, downloads of NRT active fire, archive data downloads for MODIS hotspots dating back to 1999 and a hotspot email alert system The FIRMS Email Alerts system has been successfully alerting users of fires in their area of interest in near real-time and/or via daily and weekly email summaries, with an option to receive MODIS hotspot data as a text file (CSV) attachment. Currently, there are more than 7000 email alert subscriptions from more than 100 countries. Specifically, the email alerts system is designed to generate and send an email alert for any region or area on the globe, with a special focus on providing alerts for protected areas worldwide. For many protected areas, email alerts are particularly useful for early fire detection, monitoring on going fires, as well as allocating resources to protect wildlife and natural resources of particular value. For protected areas, FIRMS uses the World Database on Protected Areas (WDPA) supplied by United Nations Environment Program - World Conservation Monitoring Centre (UNEP-WCMC). Maintaining the most up-to-date, accurate boundary geometry for the protected areas for the email alerts is a challenge as the WDPA is continuously updated due to changing boundaries, merging or delisting of certain protected areas. Because of this dynamic nature of the protected areas database, the FIRMS protected areas database is frequently out-of-date with the most current version of WDPA database. To maintain the most up-to-date boundary information for protected areas and to be in compliance with the WDPA terms and conditions, FIRMS needs to constantly update its database of protected areas. Currently, FIRMS strives to keep its database up to date by downloading the most recent WDPA database at regular intervals, processing it, and ingesting it into the FIRMS spatial database. However, due to the large size of database, the process to download, process and ingest the database is quite time consuming. The FIRMS team is currently working on developing a method to update the protected areas database via web at regular intervals or on-demand. Using such a solution, FIRMS will be able access the most up-to-date extents of any protected area and the corresponding spatial geometries in real time. As such, FIRMS can utilize such a service to access the protected areas and their associated geometries to keep users' protected area boundaries in sync with those of the most recent WDPA database, and thus serve a more accurate email alert to the users. Furthermore, any client accessing the WDPA protected areas database could potentially use the solution of real-time access to the protected areas database. This talk primarily focuses on the challenges for FIRMS in sending accurate email alerts for protected areas, along with the solution the FIRMS team is developing. This talk also introduces the FIRMS fire information system and its components, with a special emphasis on the FIRMS email alerts system.

Tool kit development to refine and visualize essential climate data and information for marine protected areas

NASA Astrophysics Data System (ADS)

Cecil, L.; Stachniewicz, J.; Shein, K. A.; Ansari, S.; Jarvis, C.

2013-05-01

Marine ecosystem responses to climate variability and change such as changing water temperature, water chemistry (e.g., pH, salinity), water level, or storminess may result in adverse impacts including mass mortality, loss of habitat, increased disease susceptibility, and trophic cascade feedbacks. Unfortunately, while marine ecosystem resource managers are aware of these threats, they often lack sufficient expertise with identifying, accessing and using the many large and complex climate data products that would inform ecosystem-scale climate impact assessments. NOAA's National Climatic Data Center (NCDC) has been working with the Gulf of the Farallones National Marine Sanctuary Ocean Climate Center to enhance and expand the functionality of NCDC's Weather and Climate Toolkit (WCT) to begin to address this limitation. The WCT is a freely available, Java-based user interface (http://www.ncdc.noaa.gov/oa/wct/) designed to access, analyze, and display a variety of NCDC's georeferenced climate data products (e.g., satellite data, radar, reanalysis datasets, in-situ observations). However, the WCT requires the user to have already identified a data set of interest and gained access to it. This can limit its utility by users who are not knowledgeable about which data sets are relevant to their needs and where those data sets can be found. The Integrated Marine Protected Area Climate Tools (IMPACT) prototype modification to the WCT addresses those requirements through an iterative process between climate scientists and resource managers. The WCT-IMPACT prototype couples a user query approach with a quasi-expert system that determines, retrieves, and loads the appropriate data products for visualization and analysis by the user. Relevant data products are identified based on the environmental variables in which ecosystem managers have indicated an importance to their ecosystems. To improve response time, the user, through the WCT-IMPACT interface, crops (or subsets) the larger gridded data products, such as NOAA's satellite Climate Data Records to the geographic boundaries of each included marine protected area (MPA). These clipped data sets are processed to produce MPA-specific analytics (e.g., files for averages, extremes, peaks over threshold, etc). Once a specific MPA has been selected, the associated data may be visualized, analyzed, and exported to other formats (e.g., netCDF, KML) from within the tool. The WCT-IMPACT tool kit will provide marine ecosystem managers with the capacity to answer such questions as what was the climate like during periods of optimal ecological health, or have climate conditions changed equally across an ecosystem's domain? The WCT-IMPACT extension is being developed specifically to address the needs of marine ecosystem managers to have access to relevant climate data and information for developing ecosystem-scale climate assessments, while retaining the ability for a WCT user to identify and access the full suite of georeferenced climate data provided by NCDC. In this tool kit development scheme, the need to coordinate with the resource managers is paramount and end user participation in an iterative process with the climate scientists is essential.

Impact of the Digital Divide on Computer Use and Internet Access on the Poor in Nigeria

ERIC Educational Resources Information Center

Tayo, Omolara; Thompson, Randall; Thompson, Elizabeth

2016-01-01

We recruited 20 community members in Ido Local Government Area, Oyo state and Yewa Local Government Area, Ogun state in Nigeria to explore experiences and perceptions of Internet access and computer use. Face-to-face interviews were conducted using open-ended questions to collect qualitative data regarding accessibility of information and…

[Health on the borders: access to and demands on the Brazilian National Health System by foreigners and non-resident Brazilians in cities along the border with MERCOSUR countries from the perspective of municipal health secretaries].

PubMed

Giovanella, Ligia; Guimarães, Luisa; Nogueira, Vera Maria Ribeiro; Lobato, Lenaura de Vasconcelos Costa; Damacena, Giseli Nogueira

2007-01-01

In the context of forming common markets, border areas require special attention, since they anticipate the effects of integration processes. Along borders, different political, monetary, security, and social systems coexist; the intensification of flows resulting from integration raises challenges for the health systems, requiring specific policies focused on guaranteeing the right to health. This article presents the results of a study on the conditions for access to (and demands for) health services in the MERCOSUR border cities. A survey was performed with municipal health secretaries in the 69 Brazilian cities in the States of Rio Grande do Sul, Santa Catarina, Paraná, and Mato Grosso do Sul that border on the other MERCOSUR countries. The study attempted to identify the services demanded by the border population, mechanisms used for access, flows between services and systems, response strategies, and local agreements. Initiatives for cooperation between Brazilian and foreign local administrators were identified in nearly half of the municipalities and can orient the formulation of guidelines for border situations, allowing improvement in comprehensive access to health care.

Strategies for Optimal MAC Parameters Tuning in IEEE 802.15.6 Wearable Wireless Sensor Networks.

PubMed

Alam, Muhammad Mahtab; Ben Hamida, Elyes

2015-09-01

Wireless body area networks (WBAN) has penetrated immensely in revolutionizing the classical heath-care system. Recently, number of WBAN applications has emerged which introduce potential limits to existing solutions. In particular, IEEE 802.15.6 standard has provided great flexibility, provisions and capabilities to deal emerging applications. In this paper, we investigate the application-specific throughput analysis by fine-tuning the physical (PHY) and medium access control (MAC) parameters of the IEEE 802.15.6 standard. Based on PHY characterizations in narrow band, at the MAC layer, carrier sense multiple access collision avoidance (CSMA/CA) and scheduled access protocols are extensively analyzed. It is concluded that, IEEE 802.15.6 standard can satisfy most of the WBANs applications throughput requirements by maximum achieving 680 Kbps. However, those emerging applications which require high quality audio or video transmissions, standard is not able to meet their constraints. Moreover, delay, energy efficiency and successful packet reception are considered as key performance metrics for comparing the MAC protocols. CSMA/CA protocol provides the best results to meet the delay constraints of medical and non-medical WBAN applications. Whereas, the scheduled access approach, performs very well both in energy efficiency and packet reception ratio.

Travel by public transit to mammography facilities in 6 US urban areas.

PubMed

Graham, S; Lewis, B; Flanagan, B; Watson, M; Peipins, L

2015-12-01

We examined lack of private vehicle access and 30 minutes or longer public transportation travel time to mammography facilities for women 40 years of age or older in the urban areas of Boston, Philadelphia, San Antonio, San Diego, Denver, and Seattle to identify transit marginalized populations - women for whom these travel characteristics may jointly present a barrier to clinic access. This ecological study used sex and race/ethnicity data from the 2010 US Census and household vehicle availability data from the American Community Survey 2008-2012, all at Census tract level. Using the public transportation option on Google Trip Planner we obtained the travel time from the centroid of each census tract to all local mammography facilities to determine the nearest mammography facility in each urban area. Median travel times by public transportation to the nearest facility for women with no household access to a private vehicle were obtained by ranking travel time by population group across all U.S. census tracts in each urban area and across the entire study area. The overall median travel times for each urban area for women without household access to a private vehicle ranged from a low of 15 minutes in Boston and Philadelphia to 27 minutes in San Diego. The numbers and percentages of transit marginalized women were then calculated for all urban areas by population group. While black women were less likely to have private vehicle access, and both Hispanic and black women were more likely to be transit marginalized, this outcome varied by urban area. White women constituted the largest number of transit marginalized. Our results indicate that mammography facilities are favorably located for the large majority of women, although there are still substantial numbers for whom travel may likely present a barrier to mammography facility access.

Architecture and Functionality of the Advanced Life Support On-Line Project Information System

NASA Technical Reports Server (NTRS)

Hogan, John A.; Levri, Julie A.; Morrow, Rich; Cavazzoni, Jim; Rodriguez, Luis F.; Riano, Rebecca; Whitaker, Dawn R.

2004-01-01

An ongoing effort is underway at NASA Ames Research Center (ARC) to develop an On-line Project Information System (OPIS) for the Advanced Life Support (ALS) Program. The objective of this three-year project is to develop, test, revise and deploy OPIS to enhance the quality of decision-making metrics and attainment of Program goals through improved knowledge sharing. OPIS will centrally locate detailed project information solicited from investigators on an annual basis and make it readily accessible by the ALS Community via a Web-accessible interface. The data will be stored in an object-oriented relational database (created in MySQL) located on a secure server at NASA ARC. OPE will simultaneously serve several functions, including being an research and technology development (R&TD) status information hub that can potentially serve as the primary annual reporting mechanism for ALS-funded projects. Using OPIS, ALS managers and element leads will be able to carry out informed R&TD investment decisions, and allow analysts to perform accurate systems evaluations. Additionally, the range and specificity of information solicited will serve to educate technology developers of programmatic needs. OPIS will collect comprehensive information from all ALS projects as well as highly detailed information specific to technology development in each ALS area (Waste, Water, Air, Biomass, Food, Thermal, Controls and Systems Analysis). Because the scope of needed information can vary dramatically between areas, element-specific technology information is being compiled with the aid of multiple specialized working groups. This paper presents the current development status in terms of the architecture and functionality of OPIS. Possible implementation approaches for OPIS are also discussed.

41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

Code of Federal Regulations, 2013 CFR

2013-07-01

... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

Code of Federal Regulations, 2010 CFR

2010-07-01

... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

Code of Federal Regulations, 2014 CFR

2014-01-01

... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

Code of Federal Regulations, 2012 CFR

2012-01-01

... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

41 CFR 102-76.70 - When are the costs of alterations to provide an accessible path of travel to an altered area...

Code of Federal Regulations, 2011 CFR

2011-01-01

... alterations to provide an accessible path of travel to an altered area containing a primary function... to an altered area containing a primary function disproportionate to the costs of the overall... area containing a primary function are disproportionate to the costs of the overall alterations when...

Increasing Access and Usability of Remote Sensing Data: The NASA Protected Area Archive

NASA Technical Reports Server (NTRS)

Geller, Gary N.

2004-01-01

Although remote sensing data are now widely available, much of it at low or no-cost, many managers of protected conservation areas do not have the expertise or tools to view or analyze it. Thus access to it by the protected area management community is effectively blocked. The Protected Area Archive will increase access to remote sensing data by creating collections of satellite images of protected areas and packaging them with simple-to-use visualization and analytical tools. The user can easily locate the area and image of interest on a map, then display, roam, and zoom the image. A set of simple tools will be provided so the user can explore the data and employ it to assist in management and monitoring of their area. The 'Phase 1 ' version requires only a Windows-based computer and basic computer skills, and may be of particular help to protected area managers in developing countries.

Mars Tumbleweed: FY2003 Conceptual Design Assessment

NASA Technical Reports Server (NTRS)

Antol, Jeffrey; Calhoun, Philip C.; Flick, John J.; Hajos, Gregory a.; Keys, Jennifer P.; Stillwagen, Frederic H.; Krizan, Shawn A.; Strickland, Christopher V.; Owens, Rachel; Wisniewski, Michael

2005-01-01

NASA LaRC is studying concepts for a new type of Mars exploration vehicle that would be propelled by the wind. Known as the Mars Tumbleweed, it would derive mobility through use of the Martian surface winds. Tumbleweeds could conceivably travel greater distances, cover larger areas of the surface, and provide access to areas inaccessible by conventional vehicles. They would be lightweight and relatively inexpensive, allowing a multiple vehicle network to be deployed on a single mission. Tumbleweeds would be equipped with sensors for conducting science and serve as scouts searching broad areas to identify specific locations for follow-on investigation by other explorers. An extensive assessment of LaRC Tumbleweed concepts was conducted in FY03, including refinement of science mission scenarios, definition of supporting subsystems (structures, power, communications), testing in wind tunnels, and development of a dynamic simulation capability.

The Nuclear Energy Knowledge and Validation Center Summary of Activities Conducted in FY16

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

Gougar, Hans David

The Nuclear Energy Knowledge and Validation Center (NEKVaC) is a new initiative by the Department of Energy (DOE) and Idaho National Laboratory (INL) to coordinate and focus the resources and expertise that exist with the DOE toward solving issues in modern nuclear code validation and knowledge management. In time, code owners, users, and developers will view the NEKVaC as a partner and essential resource for acquiring the best practices and latest techniques for validating codes, providing guidance in planning and executing experiments, facilitating access to and maximizing the usefulness of existing data, and preserving knowledge for continual use by nuclearmore » professionals and organizations for their own validation needs. The scope of the NEKVaC covers many interrelated activities that will need to be cultivated carefully in the near term and managed properly once the NEKVaC is fully functional. Three areas comprise the principal mission: (1) identify and prioritize projects that extend the field of validation science and its application to modern codes, (2) develop and disseminate best practices and guidelines for high-fidelity multiphysics/multiscale analysis code development and associated experiment design, and (3) define protocols for data acquisition and knowledge preservation and provide a portal for access to databases currently scattered among numerous organizations. These mission areas, while each having a unique focus, are interdependent and complementary. Likewise, all activities supported by the NEKVaC, both near term and long term, must possess elements supporting all three areas. This cross cutting nature is essential to ensuring that activities and supporting personnel do not become “stove piped” (i.e., focused a specific function that the activity itself becomes the objective rather than achieving the larger vision). This report begins with a description of the mission areas; specifically, the role played by each major committee and the types of activities for which they are responsible. It then lists and describes the proposed near term tasks upon which future efforts can build.« less

Infrastructure of pharmacies of the primary health care in the Brazilian Unified Health System: Analysis of PNAUM - Services data.

PubMed

Leite, Silvana Nair; Manzini, Fernanda; Álvares, Juliana; Guerra, Augusto Afonso; Costa, Ediná Alves; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mário; Farias, Mareni Rocha

2017-11-13

To characterize the infrastructure of the primary health care pharmacies of the Brazilian Unified Health System, aiming at humanizing the offered services. This is a cross-sectional study, of quantitative approach, from data obtained in the Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015). Information on 1,175 pharmacies/dispensing units were gathered from direct observation and assessment of dispensing units installations conducted by trained researchers who used a standardized form. The analyzed variables refer to the physical structure of pharmacies or medicine dispensing units of the health units under research. The pharmacy area was greater than 14 m2 in 40.3% of the sampled units, highlighting those from Midwest (56.9%) and Southeast (56.2%) regions and those of Northeast, with only 23.3%. About 80.2% units had waiting rooms with chairs for patients, 31.8% of them had dispensing areas inferior to 5m2, while in 46.2% these areas were superior to 10m2. Bars were found in service counters in 23.8% of health units, thus separating the patient from the professional; 44.1% had internet access. In most units, the area of medicine storage had no refrigerator or freezer for their exclusive storage and 13.7% had a specific room for pharmaceutical consultation. Aiming at achieving care humanization and improving working conditions for professionals, the structuring of the environment of pharmacy services is necessary. This would contribute to the better qualification of pharmacy services, comprising more than medicine delivery. Data on the Northeast region indicated less favorable conditions to the development of adequate dispensing services. Based on the panorama pointed out, we suggest the expansion of stimulus concerning the physical structure of pharmaceutical services, considering regional specificities.

Changing perceptions of protected area benefits and problems around Kibale National Park, Uganda.

PubMed

MacKenzie, Catrina A; Salerno, Jonathan; Hartter, Joel; Chapman, Colin A; Reyna, Rafael; Tumusiime, David Mwesigye; Drake, Michael

2017-09-15

Local residents' changing perceptions of benefits and problems from living next to a protected area in western Uganda are assessed by comparing household survey data from 2006, 2009, and 2012. Findings are contextualized and supported by long-term data sources for tourism, protected area-based employment, tourism revenue sharing, resource access agreements, and problem animal abundance. We found decreasing perceived benefit and increasing perceived problems associated with the protected area over time, with both trends dominated by increased human-wildlife conflict due to recovering elephant numbers. Proportions of households claiming benefit from specific conservation strategies were increasing, but not enough to offset crop raiding. Ecosystem services mitigated perceptions of problems. As human and animal populations rise, wildlife authorities in Sub-Saharan Africa will be challenged to balance perceptions and adapt policies to ensure the continued existence of protected areas. Understanding the dynamic nature of local people's perceptions provides a tool to adapt protected area management plans, prioritize conservation resources, and engage local communities to support protected areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

Correlates of children’s time-specific physical activity: A review of the literature

PubMed Central

2012-01-01

Assessment of correlates of physical activity occurring at different times of the day, locations and contexts, is imperative to understanding children’s physical activity behaviour. The purpose of this review was to identify the correlates of children’s physical activity (aged 8–14 years) occurring during the school break time and after-school periods. A review was conducted of the peer-reviewed literature, published between 1990 and January 2011. A total of 22 studies (12 school break time studies, 10 after-school studies) were included in the review. Across the 22 studies, 17 studies were cross-sectional and five studies were interventions. In the school break time studies, 39 potential correlates were identified, of which gender and age were consistently associated with school break time physical activity in two or more studies, and family affluence, access to a gym, access to four or more physical activity programs and the condition of a playing field were all associated with school break time physical activity in only one study. Access to loose and fixed equipment, playground markings, size of and access to play space and the length of school break time were all positively associated with changes in school break time physical activity in intervention studies. Thirty-six potential correlates of after-school physical activity were identified. Gender (with boys more active), younger age, lower body mass index (for females), lower TV viewing/playing video games, and greater access to facilities were associated with higher levels of after-school physical activity in two or more studies. Parent supervision was negatively associated with females’ after-school physical activity in one study. This review has revealed a relatively small number of studies investigating the school break time and after-school periods in the specified age range and only a few correlates have demonstrated a consistent association with physical activity. This highlights the infancy of this area and a need for further investigation into time-specific physical activity behaviour so that interventions designed for these specific periods can target the important correlates. PMID:22546218

Decreased Cancer Mortality-to-Incidence Ratios with Increased Accessibility of Federally Qualified Health Centers

PubMed Central

Adams, Swann Arp; Choi, Seul Ki; Khang, Leepao; Campbell, Dayna A.; Friedman, Daniela B.; Eberth, Jan M.; Glasgow, Russell E.; Tucker-Seeley, Reginald; Xirasagar, Sudha; Yip, Mei Po; Young, Vicki M.; Hébert, James R.

2015-01-01

Federally qualified health centers (FQHCs) offer primary and preventive healthcare, including cancer screening, for the nation’s most vulnerable population. The purpose of this study was to explore the relationship between access to FQHCs and cancer mortality-to-incidence ratios (MIRs). One-way analysis of variance was conducted to compare the mean MIRs for breast, cervical, prostate, and colorectal cancers for each U.S. county for 2006–2010 by access to FQHCs (direct access, in-county FQHC; indirect access, adjacent-county FQHC; no access, no FQHC either in the county or in adjacent counties). ArcMap 10.1 software was used to map cancer MIRs and FQHC access levels. The mean MIRs for breast, cervical, and prostate cancer differed significantly across FQHC access levels (p < 0.05). In urban and healthcare professional shortage areas, mean MIRs decreased as FQHC access increased. A trend of lower breast and prostate cancer MIRs in direct access to FQHCs was found for all racial groups, but this trend was significant for whites only. States with a large proportion of rural and medically underserved areas had high mean MIRs, with correspondingly more direct FQHC access. Expanding FQHCs to more underserved areas and concentrations of disparity populations may have an important role in reducing cancer morbidity and mortality, as well as racial-ethnic disparities, in the United States. PMID:25634545

Advanced software development workstation project ACCESS user's guide

NASA Technical Reports Server (NTRS)

1990-01-01

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

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 particular, the results show that the low access neighbourhoods tend to be clustered in the neighbourhoods at the urban periphery and immediately surrounding the downtown area.

Retail food environments, shopping experiences, First Nations and the provincial Norths.

PubMed

Burnett, Kristin; Skinner, Kelly; Hay, Travis; LeBlanc, Joseph; Chambers, Lori

2017-10-01

This paper looks at the market food environments of First Nations communities located in the provincial Norths by examining the potential retail competition faced by the North West Company (NWC) and by reporting on the grocery shopping experiences of people living in northern Canada. We employed two methodological approaches to assess northern retail food environments. First, we mapped food retailers in the North to examine the breadth of retail competition in the provincial Norths, focussing specifically on those communities without year-round road access. Second, we surveyed people living in communities in northern Canada about their retail and shopping experiences. Fifty-four percent of communities in the provincial Norths and Far North without year-round road access did not have a grocery store that competed with the NWC. The provinces with the highest percentage of northern communities without retail competition were Ontario (87%), Saskatchewan (83%) and Manitoba (72%). Respondents to the survey (n = 92) expressed concern about their shopping experiences in three main areas: the cost of food, food quality and freshness, and availability of specific foods. There is limited retail competition in the provincial Norths. In Manitoba, Saskatchewan and Ontario, the NWC has no store competition in at least 70% of northern communities. Consumers living in northern Canada find it difficult to afford nutritious foods and would like access to a wider selection of perishable foods in good condition.

Measuring potential access to food stores and food-service places in rural areas in the U.S.

PubMed

Sharkey, Joseph R

2009-04-01

Geographic access to healthy food resources remains a major focus of research that examines the contribution of the built environment to healthful eating. Methods used to define and measure spatial accessibility can significantly affect the results. Considering the implications for marketing, policy, and programs, adequate measurement of the food environment is important. Little of the published work on food access has focused on rural areas, where the burden of nutrition-related disease is greater. This article seeks to expand our understanding of the challenges to measurement of potential spatial access to food resources in rural areas in the U.S. Key challenges to the accurate measurement of the food environment in rural areas include: (1) defining the rural food environment while recognizing that market factors may be changing; (2) describing characteristics that may differentiate similar types of food stores and food-service places; and (3) determining location coordinates for food stores and food-service places. In order to enhance measurements in rural areas, "ground-truthed" methodology, which includes on-site observation and collection of GPS data, should become the standard for rural areas. Measurement must also recognize the emergence of new and changing store formats. Efforts should be made to determine accessibility, in terms of both proximity to a single location and variety of multiple locations within a specified buffer, from origins other than the home, and consider multipurpose trips and trip chaining. The measurement of food access will be critical for community-based approaches to meet dietary needs. Researchers must be willing to take the steps necessary for rigorous measurement of a dynamic food environment.

Web Accessibility Knowledge and Skills for Non-Web Library Staff

ERIC Educational Resources Information Center

McHale, Nina

2012-01-01

Why do librarians and library staff other than Web librarians and developers need to know about accessibility? Web services staff do not--or should not--operate in isolation from the rest of the library staff. It is important to consider what areas of online accessibility are applicable to other areas of library work and to colleagues' regular job…

Utah ski patrol: assessing training types and resources.

PubMed

Sagalyn, Emily B; McDevitt, Marion C; Ernst, Ryan

2014-12-01

Skiers and snowboarders incur a variety of injuries and medical emergencies each year at ski resorts. The ski patrol is primarily responsible for initial triage, assessment and stabilization of these problems. The purpose of this study was to subjectively evaluate the type of training, resources, and equipment available to local ski patrols within Utah. Ski patrol directors at ski resorts in Utah were asked to complete a voluntary computerized survey. Of the 14 ski areas in Utah, ski patrol directors representing 8 resorts responded. The majority of patrols in Utah use Outdoor Emergency Care (OEC) as their primary education and certification source. Most programs also include site-specific training in addition to basic certification. All responding resorts had basic first responder equipment, including splinting devices, basic airway management, and hemorrhage control. Six of 8 responding resorts had affiliated clinics, and all had access to aeromedical transport. All of the responding ski patrol directors believed the current training level was adequate. Utah area ski patrollers frequently see trauma-related injuries and have the resources to assess and provide initial immobilization techniques. Many resorts have affiliated clinics with advanced providers, and all have access to aeromedical support to rapidly transfer patients to trauma centers. Medical directors may be of use for training as well as developing extended scope of practice protocols for advanced airway use or medication administration. Patrols may benefit from additional resort-specific training that addresses other frequently seen injuries or illnesses. Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Towards good dementia care: Awareness and uptake of an online Dementia Pathways tool for rural and regional primary health practitioners.

PubMed

Ollerenshaw, Alison; Wong Shee, Anna; Yates, Mark

2018-04-01

To explore the awareness and usage of an online dementia pathways tool (including decision tree and region-specific dementia services) for primary health practitioners (GPs and nurses) in regional Victoria. Quantitative pilot study using surveys and Google Analytics. A large regional area (48 000 square kilometres, population 220 000) in Victoria. Two hundred and sixty-three GPs and 160 practice nurses were invited to participate, with 42 respondents (GPs, n = 21; practice nurses, n = 21). Primary care practitioners' awareness and usage of the dementia pathways tool. Survey respondents that had used the tool (n = 14) reported accessing information about diagnosis, management and referral. Practitioners reported improvements in knowledge, skills and confidence about core dementia topics. There were 9683 page views between August 2013 and February 2015 (monthly average: 509 page views). The average time spent on page was 2.03 min, with many visitors (68%) spending more than 4 min at the site. This research demonstrates that the tool has been well received by practitioners and has been consistently used since its launch. Health practitioners' valued the content and the availability of local resources. Primary health practitioners reported that the dementia pathways tool provided access to region-specific referral and management resources for all stages of dementia. Such tools have broad transferability in other health areas with further research needed to determine their contribution to learning in the practice setting and over time. © 2017 National Rural Health Alliance Inc.

4. VIEW OF AREA EXCAVATED FOR ACCESS TO MERCURY RETORT. ...

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

4. VIEW OF AREA EXCAVATED FOR ACCESS TO MERCURY RETORT. VIEW SOUTH FROM RETORT. (OCTOBER, 1995) - McCormick Group Mine, Mercury Retort, East slope of Buckskin Mountain, Paradise Valley, Humboldt County, NV

The geographic accessibility of pharmacies in Nova Scotia

PubMed Central

Heard, Deborah; Fisher, Judith; Douillard, Jay; Muzika, Greg; Sketris, Ingrid S.

2013-01-01

Introduction: Geographic proximity is an important component of access to primary care and the pharmaceutical services of community pharmacies. Variations in access to primary care have been found between rural and urban areas in Canadian and international jurisdictions. We studied access to community pharmacies in the province of Nova Scotia. Methods: We used information on the locations of 297 community pharmacies operating in Nova Scotia in June 2011. Population estimates at the census block level and network analysis were used to study the number of Nova Scotia residents living within 800 m (walking) and 2 km and 5 km (driving) distances of a pharmacy. We then simulated the impact of pharmacy closures on geographic access in urban and rural areas. Results: We found that 40.3% of Nova Scotia residents lived within walking distance of a pharmacy; 62.6% and 78.8% lived within 2 km and 5 km, respectively. Differences between urban and rural areas were pronounced: 99.2% of urban residents lived within 5 km of a pharmacy compared with 53.3% of rural residents. Simulated pharmacy closures had a greater impact on geographic access to community pharmacies in rural areas than urban areas. Conclusion: The majority of Nova Scotia residents lived within walking or short driving distance of at least 1 community pharmacy. While overall geographic access appears to be lower than in the province of Ontario, the difference appears to be largely driven by the higher proportion of rural dwellers in Nova Scotia. Further studies should examine how geographic proximity to pharmacies influences patients’ access to traditional and specialized pharmacy services, as well as health outcomes and adherence to therapy. Can Pharm J 2013;146:39-46. PMID:23795168

The geographic accessibility of pharmacies in Nova Scotia.

PubMed

Law, Michael R; Heard, Deborah; Fisher, Judith; Douillard, Jay; Muzika, Greg; Sketris, Ingrid S

2013-01-01

Geographic proximity is an important component of access to primary care and the pharmaceutical services of community pharmacies. Variations in access to primary care have been found between rural and urban areas in Canadian and international jurisdictions. We studied access to community pharmacies in the province of Nova Scotia. We used information on the locations of 297 community pharmacies operating in Nova Scotia in June 2011. Population estimates at the census block level and network analysis were used to study the number of Nova Scotia residents living within 800 m (walking) and 2 km and 5 km (driving) distances of a pharmacy. We then simulated the impact of pharmacy closures on geographic access in urban and rural areas. We found that 40.3% of Nova Scotia residents lived within walking distance of a pharmacy; 62.6% and 78.8% lived within 2 km and 5 km, respectively. Differences between urban and rural areas were pronounced: 99.2% of urban residents lived within 5 km of a pharmacy compared with 53.3% of rural residents. Simulated pharmacy closures had a greater impact on geographic access to community pharmacies in rural areas than urban areas. The majority of Nova Scotia residents lived within walking or short driving distance of at least 1 community pharmacy. While overall geographic access appears to be lower than in the province of Ontario, the difference appears to be largely driven by the higher proportion of rural dwellers in Nova Scotia. Further studies should examine how geographic proximity to pharmacies influences patients' access to traditional and specialized pharmacy services, as well as health outcomes and adherence to therapy. Can Pharm J 2013;146:39-46.

Not all reading disabilities are dyslexia: distinct neurobiology of specific comprehension deficits.

PubMed

Cutting, Laurie E; Clements-Stephens, Amy; Pugh, Kenneth R; Burns, Scott; Cao, Aize; Pekar, James J; Davis, Nicole; Rimrodt, Sheryl L

2013-01-01

Although an extensive literature exists on the neurobiological correlates of dyslexia (DYS), to date, no studies have examined the neurobiological profile of those who exhibit poor reading comprehension despite intact word-level abilities (specific reading comprehension deficits [S-RCD]). Here we investigated the word-level abilities of S-RCD as compared to typically developing readers (TD) and those with DYS by examining the blood oxygenation-level dependent response to words varying on frequency. Understanding whether S-RCD process words in the same manner as TD, or show alternate pathways to achieve normal word-reading abilities, may provide insights into the origin of this disorder. Results showed that as compared to TD, DYS showed abnormal covariance during word processing with right-hemisphere homologs of the left-hemisphere reading network in conjunction with left occipitotemporal underactivation. In contrast, S-RCD showed an intact neurobiological response to word stimuli in occipitotemporal regions (associated with fast and efficient word processing); however, inferior frontal gyrus (IFG) abnormalities were observed. Specifically, TD showed a higher-percent signal change within right IFG for low-versus-high frequency words as compared to both S-RCD and DYS. Using psychophysiological interaction analyses, a coupling-by-reading group interaction was found in right IFG for DYS, as indicated by a widespread greater covariance between right IFG and right occipitotemporal cortex/visual word-form areas, as well as bilateral medial frontal gyrus, as compared to TD. For S-RCD, the context-dependent functional interaction anomaly was most prominently seen in left IFG, which covaried to a greater extent with hippocampal, parahippocampal, and prefrontal areas than for TD for low- as compared to high-frequency words. Given the greater lexical access demands of low frequency as compared to high-frequency words, these results may suggest specific weaknesses in accessing lexical-semantic representations during word recognition. These novel findings provide foundational insights into the nature of S-RCD, and set the stage for future investigations of this common, but understudied, reading disorder.

Metropolitan natural area protection to maximize public access and species representation

Treesearch

Jane A. Ruliffson; Robert G. Haight; Paul H. Gobster; Frances R. Homans

2003-01-01

In response to widespread urban development, local governments in metropolitan areas in the United States acquire and protect privately-owned open space. We addressed the planner's problem of allocating a fixed budget for open space protection among eligible natural areas with the twin objectives of maximizing public access and species representation. Both...

Final priorities; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priorities.

PubMed

2013-06-11

The Assistant Secretary for Special Education and Rehabilitative Services announces priorities under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce priorities for a Rehabilitation Engineering Research Center (RERC) on Rehabilitation Strategies, Techniques, and Interventions (Priority 1), Information and Communication Technologies Access (Priority 2), Individual Mobility and Manipulation (Priority 3), and Physical Access and Transportation (Priority 4). The Assistant Secretary may use one or more of these priorities for competitions in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend these priorities to improve community living and participation, health and function, and employment outcomes of individuals with disabilities.

[Cross-sectional study of the variability of work-related stress among post-graduate medical residents at the main University Polyclinic of Sicily].

PubMed

Costantino, Claudio; Albeggiani, Valentina; Bonfante, Maria Stefania; Monte, Caterina; Lo Cascio, Nunzio; Mazzucco, Walter

2015-02-10

Among health care workers (HCWs), work-related stress is one of the main topics in risk assessment and prevention at the workplace. Post-graduate medical residents (MRs) are a group of HCWs comparable to medical doctors in terms of occupational exposure and occurrence of work-related stress syndromes. Risk assessment of work-related stress among MRs attending the major University Hospital of Sicily. A cross-sectional survey via an anonymous and self-administered questionnaire. 45% of clinical MRs and 37% of surgical MRs had access to compensatory rest days against 92% of MRs of the services area (p<0.001). A work attendance recording system for MRs was available in 80% of the postgraduate medical schools of the services area, in 60% of the clinical postgraduate schools and in 50% of the surgical postgraduate schools (p<0.001). MRs of the postgraduate surgical schools reported having access to work breaks (41%) with less frequency compared to clinical (60%) and services MRs (74%) (p<0.001). Both clinical (47%) and surgical MRs (47%) were more exposed to work-related stress than MRs of the services area (27%) (p<0.001). The survey demonstrated excess exposure to work-related stress for all the considered variables in MRs of the surgical area, compared with MRs of clinical and services areas. It is strongly recommended to provide specific training programmes aimed at managing the MRs' risk of exposure to work-related stress, focusing both on the workers and the work environment.

Orthopedic workforce planning in Germany – an analysis of orthopedic accessibility

PubMed Central

Müller, Peter; Maier, Werner; Groneberg, David A.

2017-01-01

In Germany, orthopedic workforce planning relies on population-to-provider-ratios represented by the ‘official degree of care provision’. However, with geographic information systems (GIS), more sophisticated measurements are available. By utilizing GIS-based technologies we analyzed the current state of demand and supply of the orthopedic workforce in Germany (orthopedic accessibility) with the integrated Floating Catchment Area method. The analysis of n = 153,352,220 distances revealed significant geographical variations on national scale: 5,617,595 people (6.9% of total population) lived in an area with significant low orthopedic accessibility (average z-score = -4.0), whereas 31,748,161 people (39.0% of total population) lived in an area with significant high orthopedic accessibility (average z-score = 8.0). Accessibility was positively correlated with the degree of urbanization (r = 0.49; p<0.001) and the official degree of care provision (r = 0.33; p<0.001) and negatively correlated with regional social deprivation (r = -0.47; p<0.001). Despite advantages of simpler measures regarding implementation and acceptance in health policy, more sophisticated measures of accessibility have the potential to reduce costs as well as improve health care. With this study, significant geographical variations were revealed that show the need to reduce oversupply in less deprived urban areas in order to enable adequate care in more deprived rural areas. PMID:28178335

An evaluation of edge effects in nutritional accessibility and availability measures: a simulation study

PubMed Central

2010-01-01

Background This paper addresses the statistical use of accessibility and availability indices and the effect of study boundaries on these measures. The measures are evaluated via an extensive simulation based on cluster models for local outlet density. We define outlet to mean either food retail store (convenience store, supermarket, gas station) or restaurant (limited service or full service restaurants). We designed a simulation whereby a cluster outlet model is assumed in a large study window and an internal subset of that window is constructed. We performed simulations on various criteria including one scenario representing an urban area with 2000 outlets as well as a non-urban area simulated with only 300 outlets. A comparison is made between estimates obtained with the full study area and estimates using only the subset area. This allows the study of the effect of edge censoring on accessibility measures. Results The results suggest that considerable bias is found at the edges of study regions in particular for accessibility measures. Edge effects are smaller for availability measures (when not smoothed) and also for short range accessibility Conclusions It is recommended that any study utilizing these measures should correct for edge effects. The use of edge correction via guard areas is recommended and the avoidance of large range distance-based accessibility measures is also proposed. PMID:20663199

Mild alkaline presoaking and organosolv pretreatment of corn stover and their impacts on corn stover composition, structure, and digestibility.

PubMed

Qing, Qing; Zhou, Linlin; Guo, Qi; Gao, Xiaohang; Zhang, Yan; He, Yucai; Zhang, Yue

2017-06-01

An efficient strategy was developed in current work for biochemical conversion of carbohydrates of corn stover into monosaccharides. Corn stover was first presoaked in mild alkaline solution (1% Na 2 S) under 40°C for 4h, after which about 35.3% of the lignin was successfully removed while the specific surface area was notably enlarged. Then the presoaked solids were subjected to organosolv pretreatment that employed 20% methanol with an addition of 0.2% HCl as catalyst at 160°C for 20min, and the maximum total sugar yield of the pretreated corn stover achieved was 98.6%. The intact structure of corn stover was disrupted by this two-step process, which resulted in a porous but crystalline structure of the regenerated solids that were mainly composed of cellulose. The enlarged specific surface area and increased accessibility made the regenerated solids highly digestible by a moderate enzyme loading. Copyright © 2017 Elsevier Ltd. All rights reserved.

Layer-specific chromatin accessibility landscapes reveal regulatory networks in adult mouse visual cortex

PubMed Central

Gray, Lucas T; Yao, Zizhen; Nguyen, Thuc Nghi; Kim, Tae Kyung; Zeng, Hongkui; Tasic, Bosiljka

2017-01-01

Mammalian cortex is a laminar structure, with each layer composed of a characteristic set of cell types with different morphological, electrophysiological, and connectional properties. Here, we define chromatin accessibility landscapes of major, layer-specific excitatory classes of neurons, and compare them to each other and to inhibitory cortical neurons using the Assay for Transposase-Accessible Chromatin with high-throughput sequencing (ATAC-seq). We identify a large number of layer-specific accessible sites, and significant association with genes that are expressed in specific cortical layers. Integration of these data with layer-specific transcriptomic profiles and transcription factor binding motifs enabled us to construct a regulatory network revealing potential key layer-specific regulators, including Cux1/2, Foxp2, Nfia, Pou3f2, and Rorb. This dataset is a valuable resource for identifying candidate layer-specific cis-regulatory elements in adult mouse cortex. DOI: http://dx.doi.org/10.7554/eLife.21883.001 PMID:28112643

Protection of West Indian manatees (Trichechus manatus) in Florida. Final report

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

Reynolds, J.E.; Gluckman, C.J.

1988-05-01

Research and management actions necessary for the recovery of endangered West Indian manatees (Trichechus manatus) have received considerable attention over the past decade from many individuals, institutions, and agencies. A new Manatee Recovery Plan is being developed by the United States Fish and Wildlife Service and promises to provide research goals and timetables to enhance further recovery of manatees in Florida. Recommendations are made in the following areas; implementing local, site-specific management plans that specifically address manatee protection and habitat conservation; increasing research funding to allow better assessment of manatee critical habitat, life history parameters, mortality, and movement patterns; acquiringmore » or restricting access to critical manatee habitat to create a system of reserves; expanding enforcement capability to protect manatees and their habitat; and coordinating education and awareness programs that target specific user groups.« less

Intersection of Living in a Rural Versus Urban Area and Race/Ethnicity in Explaining Access to Health Care in the United States.

PubMed

Caldwell, Julia T; Ford, Chandra L; Wallace, Steven P; Wang, May C; Takahashi, Lois M

2016-08-01

To examine whether living in a rural versus urban area differentially exposes populations to social conditions associated with disparities in access to health care. We linked Medical Expenditure Panel Survey (2005-2010) data to geographic data from the American Community Survey (2005-2009) and Area Health Resource File (2010). We categorized census tracts as rural and urban by using the Rural-Urban Commuting Area Codes. Respondent sample sizes ranged from 49 839 to 105 306. Outcomes were access to a usual source of health care, cholesterol screening, cervical screening, dental visit within recommended intervals, and health care needs met. African Americans in rural areas had lower odds of cholesterol screening (odds ratio[OR] = 0.37; 95% confidence interval[CI] = 0.25, 0.57) and cervical screening (OR = 0.48; 95% CI = 0.29, 0.80) than African Americans in urban areas. Whites had fewer screenings and dental visits in rural versus urban areas. There were mixed results for which racial/ethnic group had better access. Rural status confers additional disadvantage for most of the health care use measures, independently of poverty and health care supply.

Determinants of farmers' choice for veterinary service providers in Nepal Mountains.

PubMed

Lamichhane, Dirga Kumar; Shrestha, Sabina

2012-08-01

This study was aimed to analyze factors that affect farmers' choice for major actors of veterinary service providers in village areas of Kaski district of Nepal, with the objective of identifying choice-specific attributes which could be addressed for improving the penetration of professional veterinary services in village areas. The information was obtained from 125 farmers using a structured questionnaire. A proportional hazard model was used for data analysis because of its ability to accommodate the attributes of both the chooser and the choice simultaneously. The results showed that village animal health workers (VAHWs) were the most preferred service providers followed by veterinarians and mid-level technicians. The farmers' age and education level had a significant but inverse relationship with the probability of choosing any of the three service providers. From our study, we found that the main choice-specific attributes with a significant impact on the choice probability was the distance to the preferred service provider. Since there was a high preference for VAHW, this suggests the possibility of poorly trained service providers dominating veterinary service market in village areas of Kaski district. Hence, the efforts put forward in the legalization of VAHW system in Nepal should first address the constraints that obstruct the accessibility of professional veterinary service providers in village areas.

Planting the SEED: Towards a Spatial Economic Ecological Database for a shared understanding of the Dutch Wadden area

NASA Astrophysics Data System (ADS)

Daams, Michiel N.; Sijtsma, Frans J.

2013-09-01

In this paper we address the characteristics of a publicly accessible Spatial Economic Ecological Database (SEED) and its ability to support a shared understanding among planners and experts of the economy and ecology of the Dutch Wadden area. Theoretical building blocks for a Wadden SEED are discussed. Our SEED contains a comprehensive set of stakeholder validated spatially explicit data on key economic and ecological indicators. These data extend over various spatial scales. Spatial issues relevant to the specification of a Wadden-SEED and its data needs are explored in this paper and illustrated using empirical data for the Dutch Wadden area. The purpose of the SEED is to integrate basic economic and ecologic information in order to support the resolution of specific (policy) questions and to facilitate connections between project level and strategic level in the spatial planning process. Although modest in its ambitions, we will argue that a Wadden SEED can serve as a valuable element in the much debated science-policy interface. A Wadden SEED is valuable since it is a consensus-based common knowledge base on the economy and ecology of an area rife with ecological-economic conflict, including conflict in which scientific information is often challenged and disputed.

Advancing rights for women: the role of litigation.

PubMed

Cabal, Luisa

2006-12-01

Litigation is becoming an increasingly attractive advocacy tool for human rights movements around the world. It has served as an effective strategy not only for reforming or enforcing laws that deny or protect basic human rights, but also for raising awareness of and mobilizing support for human rights issues. In this article, which is based on a presentation at a symposium session at the conference, Luisa Cabal focuses on a specific area within the realm of women's health and rights--the rights of HIV-positive women and girls, and in particular, violations they experience vis-à-vis access to health care--and discusses the potential for litigation to help raise awareness and advance efforts to protect and promote human rights in this area.

Metacognition: computation, biology and function

PubMed Central

Fleming, Stephen M.; Dolan, Raymond J.; Frith, Christopher D.

2012-01-01

Many complex systems maintain a self-referential check and balance. In animals, such reflective monitoring and control processes have been grouped under the rubric of metacognition. In this introductory article to a Theme Issue on metacognition, we review recent and rapidly progressing developments from neuroscience, cognitive psychology, computer science and philosophy of mind. While each of these areas is represented in detail by individual contributions to the volume, we take this opportunity to draw links between disciplines, and highlight areas where further integration is needed. Specifically, we cover the definition, measurement, neurobiology and possible functions of metacognition, and assess the relationship between metacognition and consciousness. We propose a framework in which level of representation, order of behaviour and access consciousness are orthogonal dimensions of the conceptual landscape. PMID:22492746

Beyond Access: An Analysis of the Influence of the E-Rate Program in Bridging the Digital Divide in American Schools

ERIC Educational Resources Information Center

Park, Euna; Sinha, Hansa; Chong, Jing

2007-01-01

E-Rate is a U.S. federal funding program for providing discounts for telecommunications, Internet access and internal networking costs for schools and libraries to ensure access equity across poor and rich, rural, urban and suburban areas, and highly served and underserved areas. This paper examines the impact of the E-Rate program on social…

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…

Effects of visitor pressure on understory vegetation in Warsaw forested parks (Poland).

PubMed

Sikorski, Piotr; Szumacher, Iwona; Sikorska, Daria; Kozak, Marcin; Wierzba, Marek

2013-07-01

Visitor's access to understorey vegetation in park forest stands results in the impoverishment of plant species composition and a reduction in habitat quality. The phenomenon of biotic homogenisation is typical in urban landscapes, but it can proceed differently depending on the scale, a detail that has not been observed in previous studies. This research was carried out in seven Warsaw parks (both public and restricted access). Thirty-four forested areas were randomly selected, some subjected to strong visitors' pressure and some within restricted access areas, free of such impacts. The latter category included woodlands growing in old forest and secondary habitats. Public access to the study areas contributed to the disappearance of some forest species and their replacement by cosmopolitan non-forest species, leading to loss of floristic biodiversity in areas of high ecological importance at the city scale. Some human-induced factors, including soil compaction and changes in soil pH, moisture and capillary volume, were found to cause habitat changes that favoured native non-forest plants. Despite changes in species composition, the taxonomic similarity of understorey vegetation in both categories--public access and restricted access--was comparable. In a distance gradient of measurements taken around selected individual trees, there was found to be significant variation (in light, soil pH and compaction) affecting the quality and quantity of understorey vegetation (including rare species). In conclusion, the protection of rare forest species could be achieved by limiting access to forested areas, particularly in old forest fragments, and we highly recommend its consideration in the proposal of future park restoration plans.

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. Conclusion By incorporating the demand (population) and the supply (capacities of heath care centers), AccessMod provides a unifying tool to efficiently assess the geographic coverage of a network of health care facilities. This tool should be of particular interest to developing countries that have a relatively good geographic information on population distribution, terrain, and health facility locations. PMID:19087277

Development of simulated groundwater-contributing areas to selected streams, ponds, coastal water bodies, and production wells in the Plymouth-Carver region and Cape Cod, Massachusetts

USGS Publications Warehouse

Carlson, Carl S.; Masterson, John P.; Walter, Donald A.; Barbaro, Jeffrey R.

2017-12-21

IntroductionThe U.S. Geological Survey (USGS), in support of the Massachusetts Estuaries Project (MEP), delineated groundwater-contributing areas to various hydrologic receptors including ponds, streams, and coastal water bodies throughout southeastern Massachusetts, including portions of the Plymouth-Carver aquifer system and all of Cape Cod. These contributing areas were delineated over a 6-year period from 2003 through 2008 by using previously published regional USGS groundwater-flow models for the Plymouth-Carver region (Masterson and others, 2009), the Sagamore (western) and Monomoy (eastern) flow lenses of Cape Cod (Walter and Whealan, 2005), and lower Cape Cod (Masterson, 2004). The original USGS groundwater-contributing areas were subsequently revised in some locations by the MEP to remove modeling artifacts or to make the contributing areas more consistent with site-specific hydrologic conditions without further USGS review. This report describes the process used to create the USGS groundwater-contributing areas and provides these model results in their original format in a single, publicly accessible publication.

Human rights responsibilities of pharmaceutical companies in relation to access to medicines.

PubMed

Lee, Joo-Young; Hunt, Paul

2012-01-01

Although access to medicines is a vital feature of the right to the highest attainable standard of health ("right to health"), almost two billion people lack access to essential medicines, leading to immense avoidable suffering. While the human rights responsibility to provide access to medicines lies mainly with States, pharmaceutical companies also have human rights responsibilities in relation to access to medicines. This article provides an introduction to these responsibilities. It briefly outlines the new UN Guiding Principles on Business and Human Rights and places the human rights responsibilities of pharmaceutical companies in this context. The authors draw from the work of the first UN Special Rapporteur on the right to the highest attainable standard of health, in particular the Human Rights Guidelines for Pharmaceutical Companies in Relation to Access to Medicines that he presented to the UN General Assembly in 2008, and his UN report on GlaxoSmithKline (GSK). While the Guiding Principles on Business and Human Rights are general human rights standards applicable to all business entities, the Human Rights Guidelines for Pharmaceutical Companies consider the specific human rights responsibilities of one sector (pharmaceutical companies) in relation to one area of activity (access to medicines). The article signals the human rights responsibilities of all pharmaceutical companies, with particular attention to patent-holding pharmaceutical companies. Adopting a right-to-health "lens," the article discusses GSK and accountability. The authors argue that human rights should shape pharmaceutical companies' policies, and provide standards in relation to which pharmaceutical companies could, and should, be held accountable. They conclude that it is now crucial to devise independent, accessible, transparent, and effective mechanisms to monitor pharmaceutical companies and hold them publicly accountable for their human rights responsibilities. © 2012 American Society of Law, Medicine & Ethics, Inc.

The impact of changing the land surface scheme in ACCESS(v1.0/1.1) on the surface climatology

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

Kowalczyk, Eva A.; Stevens, Lauren E.; Law, Rachel M.

The Community Atmosphere Biosphere Land Exchange (CABLE) model has been coupled to the UK Met Office Unified Model (UM) within the existing framework of the Australian Community Climate and Earth System Simulator (ACCESS), replacing the Met Office Surface Exchange Scheme (MOSES). Here we investigate how features of the CABLE model impact on present-day surface climate using ACCESS atmosphere-only simulations. The main differences attributed to CABLE include a warmer winter and a cooler summer in the Northern Hemisphere (NH), earlier NH spring runoff from snowmelt, and smaller seasonal and diurnal temperature ranges. The cooler NH summer temperatures in canopy-covered regions aremore » more consistent with observations and are attributed to two factors. Firstly, CABLE accounts for aerodynamic and radiative interactions between the canopy and the ground below; this placement of the canopy above the ground eliminates the need for a separate bare ground tile in canopy-covered areas. Secondly, CABLE simulates larger evapotranspiration fluxes and a slightly larger daytime cloud cover fraction. Warmer NH winter temperatures result from the parameterization of cold climate processes in CABLE in snow-covered areas. In particular, prognostic snow density increases through the winter and lowers the diurnally resolved snow albedo; variable snow thermal conductivity prevents early winter heat loss but allows more heat to enter the ground as the snow season progresses; liquid precipitation freezing within the snowpack delays the building of the snowpack in autumn and accelerates snow melting in spring. Altogether we find that the ACCESS simulation of surface air temperature benefits from the specific representation of the turbulent transport within and just above the canopy in the roughness sublayer as well as the more complex snow scheme in CABLE relative to MOSES.« less

The impact of changing the land surface scheme in ACCESS(v1.0/1.1) on the surface climatology

DOE PAGES

Kowalczyk, Eva A.; Stevens, Lauren E.; Law, Rachel M.; ...

2016-08-23

The Community Atmosphere Biosphere Land Exchange (CABLE) model has been coupled to the UK Met Office Unified Model (UM) within the existing framework of the Australian Community Climate and Earth System Simulator (ACCESS), replacing the Met Office Surface Exchange Scheme (MOSES). Here we investigate how features of the CABLE model impact on present-day surface climate using ACCESS atmosphere-only simulations. The main differences attributed to CABLE include a warmer winter and a cooler summer in the Northern Hemisphere (NH), earlier NH spring runoff from snowmelt, and smaller seasonal and diurnal temperature ranges. The cooler NH summer temperatures in canopy-covered regions aremore » more consistent with observations and are attributed to two factors. Firstly, CABLE accounts for aerodynamic and radiative interactions between the canopy and the ground below; this placement of the canopy above the ground eliminates the need for a separate bare ground tile in canopy-covered areas. Secondly, CABLE simulates larger evapotranspiration fluxes and a slightly larger daytime cloud cover fraction. Warmer NH winter temperatures result from the parameterization of cold climate processes in CABLE in snow-covered areas. In particular, prognostic snow density increases through the winter and lowers the diurnally resolved snow albedo; variable snow thermal conductivity prevents early winter heat loss but allows more heat to enter the ground as the snow season progresses; liquid precipitation freezing within the snowpack delays the building of the snowpack in autumn and accelerates snow melting in spring. Altogether we find that the ACCESS simulation of surface air temperature benefits from the specific representation of the turbulent transport within and just above the canopy in the roughness sublayer as well as the more complex snow scheme in CABLE relative to MOSES.« less

Engagement: an indicator of difference in the perceptions of antenatal care for pregnant women from diverse socioeconomic backgrounds

PubMed Central

Docherty, Angie; Bugge, Carol; Watterson, Andrew

2011-01-01

Abstract Background  Socioeconomically deprived women are at greater risk of adverse pregnancy outcomes. Research tends to focus on access of services. Yet access may not equate with the equity of services for women from different socioeconomic backgrounds. Objectives  To determine whether pregnant women’s perceptions of antenatal provision differed in relation to their socioeconomic deprivation ranking (determined by the Scottish Index of Multiple Deprivation 2006). Design  A longitudinal, qualitative study with comparative antenatal case studies between January 2007 and April 2009. Setting/Participants  Cases were primigravida women from ‘least deprived’ (n = 9) and ‘most deprived’ (n = 12) geographical areas within one local authority in Scotland. Analysis  Data were analysed using case study replication analysis. Results  There was little difference in access to antenatal services between the ‘least’ and ‘most’ deprived groups. Perception of care differed in relation to the level of ‘engagement’ (defined using constructs of: language and personalization of care; power and relationships; and health literacy). Engagement was evidenced in most of the ‘least deprived’ cases and almost none of the ‘most deprived’ cases. Specifically, socioeconomically deprived women described less evidence of personal connection to their own care, effective communication and the opportunity for shared decision making. Conclusion  In women from socioeconomically deprived areas, access may be a less useful indicator than engagement when assessing antenatal service quality. As engagement levels may be one method by which to predict and improve health outcomes, a more equitable antenatal service may need to be developed through the early identification of those women at risk of non‐engagement. PMID:21615639

Seabird bycatch mitigation trials in artisanal demersal longliners of the Western Mediterranean.

PubMed

Cortés, Verónica; González-Solís, Jacob

2018-01-01

High numbers of seabirds are killed annually worldwide in longline fisheries. In the Mediterranean, this mortality is seriously affecting the viability of seabird populations, in particular of the three endemic shearwaters. Even so, there is currently no specific seabird mitigation requirements for the longline fleet operating in this area. From 2013 to 2014, we assessed the efficiency and practical applicability of four mitigation measures on artisanal demersal longliners targeting European hake (Merluccius merluccius) in the western Mediterranean: night setting, tori line, weighted lines and artificial baits. We performed fifty-two pairs of experimental (with the tested mitigation measure) and control settings (without any measure), and compared their effects on seabird interactions and fish catches. In addition, we estimated the longline sink rates and the seabird access area to baited hooks in different longline configurations. Night setting reduced bycatch risk without affecting target and non-commercial fish catches. The tori line may have reduced the bycatch risk by displacing bait attacks beyond the end of the line, but at this distance shearwaters could still access to the baits and the streamers did not deter birds under calm wind conditions. Weighted lines increased sink rate, but it resulted in only a minor reduction of the seabird access window to baited hooks and led to some operational problems during the setting. Artificial baits substantially reduced commercial catches. Moreover, the seabird access to the baited hooks was influenced by the longline configuration, the setting speed and the relative position to the floats and weights. So far, night setting stands out as the best mitigation measure for reducing bycatch levels without compromising target catches in demersal longliners. Ideally, these results should be confirmed in longliners targeting species other than European hake.

Quantification of Organic Porosity and Water Accessibility in Marcellus Shale Using Neutron Scattering

DOE PAGES

Gu, Xin; Mildner, David F. R.; Cole, David R.; ...

2016-04-28

Pores within organic matter (OM) are a significant contributor to the total pore system in gas shales. These pores contribute most of the storage capacity in gas shales. Here we present a novel approach to characterize the OM pore structure (including the porosity, specific surface area, pore size distribution, and water accessibility) in Marcellus shale. By using ultrasmall and small-angle neutron scattering, and by exploiting the contrast matching of the shale matrix with suitable mixtures of deuterated and protonated water, both total and water-accessible porosity were measured on centimeter-sized samples from two boreholes from the nanometer to micrometer scale withmore » good statistical coverage. Samples were also measured after combustion at 450 °C. Analysis of scattering data from these procedures allowed quantification of OM porosity and water accessibility. OM hosts 24–47% of the total porosity for both organic-rich and -poor samples. This porosity occupies as much as 29% of the OM volume. In contrast to the current paradigm in the literature that OM porosity is organophilic and therefore not likely to contain water, our results demonstrate that OM pores with widths >20 nm exhibit the characteristics of water accessibility. In conclusion, our approach reveals the complex structure and wetting behavior of the OM porosity at scales that are hard to interrogate using other techniques.« less

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

PubMed

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

2014-04-01

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

Importance-Performance Matrix Analysis (IPMA) Of Transport Disadvantage Variables on Social Exclusion in a Rural Context

NASA Astrophysics Data System (ADS)

Larasati, Ophilia; Puspita Dirgahayani, Eng., Dr.

2018-05-01

Transport services are essential to support daily life. A lack of transport supply leads to the existence of transport disadvantaged (TDA) groups who are vulnerable to social exclusion, which happens when a particular group or individual is having difficulties to access certain activities that are considered normal in society. To tackle this phenomenon, the understanding of the influence of TDA variables on social exclusion is needed. The aim of this study is to analyze the influences of TDA variables on social exclusion in a rural context, with Cibeureum Village (Bandung Barat Regency) and Bunikasih Village (Subang Regency) as the study case. Both case studies provide different characteristics of accessibility. Partial Least Squares (PLS) Structural Equation Modeling (SEM) is chosen as the method to analyze the influences of TDA variables on social exclusion. The PLS-SEM model is developed according to the social exclusion variable and four TDA variables, i.e., accessibility, individual characteristics, private vehicle existence, and travel behavior. IPMA is done after the PLS-SEM model is evaluated. The study reveals that among four of the TDA variables, accessibility has the most influence on social exclusion, hence interventions related to improving accessibility are needed to tackle social exclusion. More specifically, the provision of alternative modes is needed in both study areas, while in Bunikasih Village the cost of travel is also an important variable to consider.

Quantification of Organic Porosity and Water Accessibility in Marcellus Shale Using Neutron Scattering

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

Gu, Xin; Mildner, David F. R.; Cole, David R.

Pores within organic matter (OM) are a significant contributor to the total pore system in gas shales. These pores contribute most of the storage capacity in gas shales. Here we present a novel approach to characterize the OM pore structure (including the porosity, specific surface area, pore size distribution, and water accessibility) in Marcellus shale. By using ultrasmall and small-angle neutron scattering, and by exploiting the contrast matching of the shale matrix with suitable mixtures of deuterated and protonated water, both total and water-accessible porosity were measured on centimeter-sized samples from two boreholes from the nanometer to micrometer scale withmore » good statistical coverage. Samples were also measured after combustion at 450 °C. Analysis of scattering data from these procedures allowed quantification of OM porosity and water accessibility. OM hosts 24–47% of the total porosity for both organic-rich and -poor samples. This porosity occupies as much as 29% of the OM volume. In contrast to the current paradigm in the literature that OM porosity is organophilic and therefore not likely to contain water, our results demonstrate that OM pores with widths >20 nm exhibit the characteristics of water accessibility. In conclusion, our approach reveals the complex structure and wetting behavior of the OM porosity at scales that are hard to interrogate using other techniques.« less

Protein Solvent-Accessibility Prediction by a Stacked Deep Bidirectional Recurrent Neural Network.

PubMed

Zhang, Buzhong; Li, Linqing; Lü, Qiang

2018-05-25

Residue solvent accessibility is closely related to the spatial arrangement and packing of residues. Predicting the solvent accessibility of a protein is an important step to understand its structure and function. In this work, we present a deep learning method to predict residue solvent accessibility, which is based on a stacked deep bidirectional recurrent neural network applied to sequence profiles. To capture more long-range sequence information, a merging operator was proposed when bidirectional information from hidden nodes was merged for outputs. Three types of merging operators were used in our improved model, with a long short-term memory network performing as a hidden computing node. The trained database was constructed from 7361 proteins extracted from the PISCES server using a cut-off of 25% sequence identity. Sequence-derived features including position-specific scoring matrix, physical properties, physicochemical characteristics, conservation score and protein coding were used to represent a residue. Using this method, predictive values of continuous relative solvent-accessible area were obtained, and then, these values were transformed into binary states with predefined thresholds. Our experimental results showed that our deep learning method improved prediction quality relative to current methods, with mean absolute error and Pearson's correlation coefficient values of 8.8% and 74.8%, respectively, on the CB502 dataset and 8.2% and 78%, respectively, on the Manesh215 dataset.

[Multidisciplinary health houses and regional development: a necessarily shared dyanamics.].

PubMed

Autès, Michel; Dufay, Marie-Guite

2009-03-29

Many regional authorities (Conseils Régionaux) have taken up the issue of health houses by underlining their competence in dealing with regional development issues. This initiative is part of a broader process designed to ensure the continuity of healthcare at the different levels of provision as well as equal, universal access according to the specific needs of patients, from prevention to the most specialized forms of medical treatment. Health houses are one of the chief access points in this process, and are situated at the cross-roads of health and healthcare. The territorial health project must provide the fondations of the new health house model. According to the Health Committee of the Association of French Regions (Commission Santé de l'Association des Régions de France), there are three prerequisites: 1. a multidisciplinary offer of access to front-line healthcare services; 2. public healthcare activities: prevention, promotion of health...; 3. a network mode of organization with the local and regional hospital system to ensure optimum healthcare provision for patients. Yet a number of obstacles need to be overcome, particularly the risk of concentrating healthcare provision within a single center, thus depriving the surrounding area, but also the ill-adapted current framework of remuneration for independent medical practitioners. The purpose of regional authorities (i.e. Conseils Régionaux) is not to ensure the expansion of health houses, but rather to enable innovation by accompanying the different actors involved within the sector. Heeding the specific requirements of the local area and its needs, as well as the will of elected representatives and healthcare professionals, their aim is to develop a policy of exemplarity with all the actors involved in the sector and to uphold their legitimacy as agents of regional development. The ?Hospital, patients, health and territories' law (loi "Hôpital, patients, santé et territoires") may yet throw the entire process into question.

76 FR 19510 - Notice of Availability (NOA) of the Models For Plant-Specific Adoption of Technical...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-07

...-Specific Adoption of Technical Specifications Task Force (TSTF) Traveler TSTF- 422, Revision 2, ``Change In... model safety evaluation (SE) for plant-specific adoption of TSTF Traveler TSTF-422, Revision 2, ``Change..., Revision 2, is available in the Agencywide Documents Access and Management System (ADAMS) under Accession...

7 CFR 301.55-4 - Conditions governing the interstate movement of regulated articles from quarantined areas.

Code of Federal Regulations, 2013 CFR

2013-01-01

... woven cloth) adequate to prevent access by South American cactus moths while moving through the... woven cloth) adequate to prevent access by South American cactus moths while within the quarantined area...

7 CFR 301.55-4 - Conditions governing the interstate movement of regulated articles from quarantined areas.

Code of Federal Regulations, 2012 CFR

2012-01-01

... woven cloth) adequate to prevent access by South American cactus moths while moving through the... woven cloth) adequate to prevent access by South American cactus moths while within the quarantined area...

7 CFR 301.55-4 - Conditions governing the interstate movement of regulated articles from quarantined areas.

Code of Federal Regulations, 2011 CFR

2011-01-01

... woven cloth) adequate to prevent access by South American cactus moths while moving through the... woven cloth) adequate to prevent access by South American cactus moths while within the quarantined area...

7 CFR 301.55-4 - Conditions governing the interstate movement of regulated articles from quarantined areas.

Code of Federal Regulations, 2014 CFR

2014-01-01

... woven cloth) adequate to prevent access by South American cactus moths while moving through the... woven cloth) adequate to prevent access by South American cactus moths while within the quarantined area...

14. Inner double blast door entrance to perimeter acquisition radar ...

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

14. Inner double blast door entrance to perimeter acquisition radar building security area - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

Map data-driven assessment of urban areas accessibility

NASA Astrophysics Data System (ADS)

Parygin, D. S.; Aleshkevich, A. A.; Golubev, A. V.; Smykovskaya, T. K.; Finogeev, A. G.

2018-05-01

The study analyzes the existing approaches to assessment of the city territory transport accessibility. The method for the city territory sections connectedness assessment through the personal and public transport was developed. The assessment of transport accessibility is proposed based on an analysis of open cartographic data. The technology of calculation and visualization of urban areas interconnectedness with the use of a street network graph and public transport routes, data obtained from Internet map services have been developed. An example of territory accessibility assessments visualization on an online map is given.

Measures of Social Deprivation That Predict Health Care Access and Need within a Rational Area of Primary Care Service Delivery

PubMed Central

Butler, Danielle C; Petterson, Stephen; Phillips, Robert L; Bazemore, Andrew W

2013-01-01

Objective To develop a measure of social deprivation that is associated with health care access and health outcomes at a novel geographic level, primary care service area. Data Sources/Study Setting Secondary analysis of data from the Dartmouth Atlas, AMA Masterfile, National Provider Identifier data, Small Area Health Insurance Estimates, American Community Survey, Area Resource File, and Behavioural Risk Factor Surveillance System. Data were aggregated to primary care service areas (PCSAs). Study Design Social deprivation variables were selected from literature review and international examples. Factor analysis was used. Correlation and multivariate analyses were conducted between index, health outcomes, and measures of health care access. The derived index was compared with poverty as a predictor of health outcomes. Data Collection/Extraction Methods Variables not available at the PCSA level were estimated at block level, then aggregated to PCSA level. Principal Findings Our social deprivation index is positively associated with poor access and poor health outcomes. This pattern holds in multivariate analyses controlling for other measures of access. A multidimensional measure of deprivation is more strongly associated with health outcomes than a measure of poverty alone. Conclusions This geographic index has utility for identifying areas in need of assistance and is timely for revision of 35-year-old provider shortage and geographic underservice designation criteria used to allocate federal resources. PMID:22816561

Publishing in Discipline-Specific Open Access Journals: Opportunities and Outreach for Librarians

ERIC Educational Resources Information Center

Tomaszewski, Robert; Poulin, Sonia; MacDonald, Karen I.

2013-01-01

Open access (OA) journals promote the opportunity for peer-reviewed journal articles to be freely accessible. In recent years, the number of OA journals has exploded in all disciplines. Previous studies have identified print-based pedagogical discipline-specific journals outside the field of Library and Information Science (LIS) for librarians to…

Fast food purchasing and access to fast food restaurants: a multilevel analysis of VicLANES.

PubMed

Thornton, Lukar E; Bentley, Rebecca J; Kavanagh, Anne M

2009-05-27

While previous research on fast food access and purchasing has not found evidence of an association, these studies have had methodological problems including aggregation error, lack of specificity between the exposures and outcomes, and lack of adjustment for potential confounding. In this paper we attempt to address these methodological problems using data from the Victorian Lifestyle and Neighbourhood Environments Study (VicLANES) - a cross-sectional multilevel study conducted within metropolitan Melbourne, Australia in 2003. The VicLANES data used in this analysis included 2547 participants from 49 census collector districts in metropolitan Melbourne, Australia. The outcome of interest was the total frequency of fast food purchased for consumption at home within the previous month (never, monthly and weekly) from five major fast food chains (Red Rooster, McDonalds, Kentucky Fried Chicken, Hungry Jacks and Pizza Hut). Three measures of fast food access were created: density and variety, defined as the number of fast food restaurants and the number of different fast food chains within 3 kilometres of road network distance respectively, and proximity defined as the road network distance to the closest fast food restaurant.Multilevel multinomial models were used to estimate the associations between fast food restaurant access and purchasing with never purchased as the reference category. Models were adjusted for confounders including determinants of demand (attitudes and tastes that influence food purchasing decisions) as well as individual and area socio-economic characteristics. Purchasing fast food on a monthly basis was related to the variety of fast food restaurants (odds ratio 1.13; 95% confidence interval 1.02 - 1.25) after adjusting for individual and area characteristics. Density and proximity were not found to be significant predictors of fast food purchasing after adjustment for individual socio-economic predictors. Although we found an independent association between fast food purchasing and access to a wider variety of fast food restaurant, density and proximity were not significant predictors. The methods used in our study are an advance on previous analyses.

Accessibility to primary health care in Belgium: an evaluation of policies awarding financial assistance in shortage areas.

PubMed

Dewulf, Bart; Neutens, Tijs; De Weerdt, Yves; Van de Weghe, Nico

2013-08-22

In many countries, financial assistance is awarded to physicians who settle in an area that is designated as a shortage area to prevent unequal accessibility to primary health care. Today, however, policy makers use fairly simple methods to define health care accessibility, with physician-to-population ratios (PPRs) within predefined administrative boundaries being overwhelmingly favoured. Our purpose is to verify whether these simple methods are accurate enough for adequately designating medical shortage areas and explore how these perform relative to more advanced GIS-based methods. Using a geographical information system (GIS), we conduct a nation-wide study of accessibility to primary care physicians in Belgium using four different methods: PPR, distance to closest physician, cumulative opportunity, and floating catchment area (FCA) methods. The official method used by policy makers in Belgium (calculating PPR per physician zone) offers only a crude representation of health care accessibility, especially because large contiguous areas (physician zones) are considered. We found substantial differences in the number and spatial distribution of medical shortage areas when applying different methods. The assessment of spatial health care accessibility and concomitant policy initiatives are affected by and dependent on the methodology used. The major disadvantage of PPR methods is its aggregated approach, masking subtle local variations. Some simple GIS methods overcome this issue, but have limitations in terms of conceptualisation of physician interaction and distance decay. Conceptually, the enhanced 2-step floating catchment area (E2SFCA) method, an advanced FCA method, was found to be most appropriate for supporting areal health care policies, since this method is able to calculate accessibility at a small scale (e.g., census tracts), takes interaction between physicians into account, and considers distance decay. While at present in health care research methodological differences and modifiable areal unit problems have remained largely overlooked, this manuscript shows that these aspects have a significant influence on the insights obtained. Hence, it is important for policy makers to ascertain to what extent their policy evaluations hold under different scales of analysis and when different methods are used.

Accessibility to primary health care in Belgium: an evaluation of policies awarding financial assistance in shortage areas

PubMed Central

2013-01-01

Background In many countries, financial assistance is awarded to physicians who settle in an area that is designated as a shortage area to prevent unequal accessibility to primary health care. Today, however, policy makers use fairly simple methods to define health care accessibility, with physician-to-population ratios (PPRs) within predefined administrative boundaries being overwhelmingly favoured. Our purpose is to verify whether these simple methods are accurate enough for adequately designating medical shortage areas and explore how these perform relative to more advanced GIS-based methods. Methods Using a geographical information system (GIS), we conduct a nation-wide study of accessibility to primary care physicians in Belgium using four different methods: PPR, distance to closest physician, cumulative opportunity, and floating catchment area (FCA) methods. Results The official method used by policy makers in Belgium (calculating PPR per physician zone) offers only a crude representation of health care accessibility, especially because large contiguous areas (physician zones) are considered. We found substantial differences in the number and spatial distribution of medical shortage areas when applying different methods. Conclusions The assessment of spatial health care accessibility and concomitant policy initiatives are affected by and dependent on the methodology used. The major disadvantage of PPR methods is its aggregated approach, masking subtle local variations. Some simple GIS methods overcome this issue, but have limitations in terms of conceptualisation of physician interaction and distance decay. Conceptually, the enhanced 2-step floating catchment area (E2SFCA) method, an advanced FCA method, was found to be most appropriate for supporting areal health care policies, since this method is able to calculate accessibility at a small scale (e.g. census tracts), takes interaction between physicians into account, and considers distance decay. While at present in health care research methodological differences and modifiable areal unit problems have remained largely overlooked, this manuscript shows that these aspects have a significant influence on the insights obtained. Hence, it is important for policy makers to ascertain to what extent their policy evaluations hold under different scales of analysis and when different methods are used. PMID:23964751

Enhancing Ear and Hearing Health Access for Children With Technology and Connectivity.

PubMed

Swanepoel, De Wet

2017-10-12

Technology and connectivity advances are demonstrating increasing potential to improve access of service delivery to persons with hearing loss. This article demonstrates use cases from community-based hearing screening and automated diagnosis of ear disease. This brief report reviews recent evidence for school- and home-based hearing testing in underserved communities using smartphone technologies paired with calibrated headphones. Another area of potential impact facilitated by technology and connectivity is the use of feature extraction algorithms to facilitate automated diagnosis of most common ear conditions from video-otoscopic images. Smartphone hearing screening using calibrated headphones demonstrated equivalent sensitivity and specificity for school-based hearing screening. Automating test sequences with a forced-choice response paradigm allowed persons with minimal training to offer screening in underserved communities. The automated image analysis and diagnosis system for ear disease demonstrated an overall accuracy of 80.6%, which is up to par and exceeds accuracy rates previously reported for general practitioners and pediatricians. The emergence of these tools that capitalize on technology and connectivity advances enables affordable and accessible models of service delivery for community-based ear and hearing care.

Intellectual Disability and Assistive Technology: Opening the GATE Wider.

PubMed

Boot, Fleur Heleen; Dinsmore, John; Khasnabis, Chapal; MacLachlan, Malcolm

2017-01-01

The World Health Organization has launched a program to promote Global Cooperation on Assistive Technology (GATE). The objective of the GATE program is to improve access to high quality, affordable assistive technology for people with varying disabilities, diseases, and age-related conditions. As a first step, GATE has developed the assistive products list, a list of priority assistive products based on addressing the greatest need at population level. A specific group of people who can benefit from user appropriate assistive technology are people with intellectual disabilities. However, the use of assistive products by people with intellectual disabilities is a neglected area of research and practice, and offers considerable opportunities for the advancement of population health and the realization of basic human rights. It is unknown how many people with intellectual disabilities globally have access to appropriate assistive products and which factors influence their access. We call for a much greater focus on people with intellectual disabilities within the GATE program. We present a framework for understanding the complex interaction between intellectual disability, health and wellbeing, and assistive technology.

Portfolio Analysis Tool

NASA Technical Reports Server (NTRS)

Barth, Tim; Zapata, Edgar; Benjamin, Perakath; Graul, Mike; Jones, Doug

2005-01-01

Portfolio Analysis Tool (PAT) is a Web-based, client/server computer program that helps managers of multiple projects funded by different customers to make decisions regarding investments in those projects. PAT facilitates analysis on a macroscopic level, without distraction by parochial concerns or tactical details of individual projects, so that managers decisions can reflect the broad strategy of their organization. PAT is accessible via almost any Web-browser software. Experts in specific projects can contribute to a broad database that managers can use in analyzing the costs and benefits of all projects, but do not have access for modifying criteria for analyzing projects: access for modifying criteria is limited to managers according to levels of administrative privilege. PAT affords flexibility for modifying criteria for particular "focus areas" so as to enable standardization of criteria among similar projects, thereby making it possible to improve assessments without need to rewrite computer code or to rehire experts, and thereby further reducing the cost of maintaining and upgrading computer code. Information in the PAT database and results of PAT analyses can be incorporated into a variety of ready-made or customizable tabular or graphical displays.

Tuberculosis in the immigrant population in Italy: state-of-the-art review.

PubMed

Scotto, Gaetano; Fazio, Vincenzina; Lo Muzio, Lorenzo

2017-09-01

Although the incidence of tuberculosis (TB) has been decreasing in the European Union/European Economic Area (EU/EEA) in recent decades, specific subgroups of the population, such as immigrants, remain at high risk of the disease. Immigration from areas of high incidence is thought to have fuelled the resurgence of TB in areas of low incidence. Indeed, while immigrants have a high risk of acquiring TB prior to migration, after migration they are exposed to additional risk factors for acquiring or reactivating TB infection, such as poverty, stressful living conditions, social inequalities, overcrowded housing, malnutrition, substance abuse and limited access to health care. In Italy as well, TB has increasingly become a disease for specific population subgroups such as immigrants and in urban settings often driven by reactivation of imported latent TB infection (LTBI). In this paper we present an analysis of the national scientific literature from recent years in order to estimate the burden of TB in foreign-born populations, to establish the burden of TB in migrants by gender, age group and country of origin as well as other relevant subgroups, and evaluate the clinical manifestations of latent or active tuberculosis and treatment response.

The impact of patient advocacy: the University of California-San Francisco experience.

PubMed

Carroll, Peter R

2004-11-01

Although the principal goals of health care advocacy are to raise awareness of specific issues and make them national priorities, it is important that physicians should recognize that advocacy is a multidimensional phenomenon. In 1997 a group of scientists, administrators, clinicians and patients met to discuss individual goals, needs and areas of mutual interest in the areas of prostate cancer care and research. A formal advocacy group was established and advocates were integrated into the administration and planning process in specific areas of the clinical and research program. In an effort to quantitate and communicate the impact of this group we assessed outcomes in the last 5 years in 4 areas matched to group interests and priorities, namely research, clinical trials, patient services and philanthropy. Improvements in all assessed metrics were noted (18% to 1,796%), most substantially in the areas of research grants (286%) and philanthropy (1,796%). The highlight of the collaborative effort was the awarding of the University of California-San Francisco Prostate Cancer SPORE, which included a highly rated, formal advocacy core. Advocates initiated at least 25 new initiatives to improve patient services in the areas of access to care, patient education, psychosocial support, outreach, etc. Since the initiation of a prostate cancer advocacy effort at our institution, substantial and quantitative improvements in several key metrics have been identified. Although an exact cause and effect cannot be stated with certainty, it seems likely. The successful collaboration was based on a multidimensional patient advocacy effort.

A back-pack shocker for collecting lamprey ammocoetes

USGS Publications Warehouse

Braem, Robert A.; Ebel, Wesley J.

1961-01-01

IN 1958, THE BUREAU OF COMMERCIAL FISHERIES began to use specific larvicides for sea lamprey control in streams tributary to the Great Lakes. The successful application of larvicides required treatment of all areas of the streams infested by sea lamprey ammocoetes. Intensive surveys were needed to determine distribution of the larvae. The use of electrical methods to determinelarval distribution has been described (Stauffer and Hansen 1958). A light portable shocker was needed for these surveys because of the difficulty of access to some of the watersheds tributary to Lake Superior.

Primary and Secondary Education in Afghanistan: Comprehensive Assessments Needed to Determine the Progress and Effectiveness of Over $759 Million in DOD, State, and USAID Programs

DTIC Science & Technology

2016-04-26

through 12 for boys and girls in public, private, and community-based schools. To accomplish our objectives, we compiled all primary and secondary... girls and boys in remote rural and semi-urban areas, where access to MOE facilities is impractical due to distance or because the students are too...supporting grades 1–12 for boys and girls in public, private, and community-based schools. We focused specifically on activities that directly support

Are You Connected to the Best Apps?

PubMed

Gaudette, Robert F

2015-11-01

While the vast majority of pharmacists use computers to access medical information, many prefer a mobile device to find information quickly. This review discusses pharmacists' use of mobile device applications (apps) and highlights an assortment of apps that are particularly helpful. Epocrates, which provides drug information and clinical content, was the first popular smartphone app developed in this area and was used to introduce the concept. Today, apps that provide a wide range of drug information can be supplemented with apps that fine-tune specific information about drug monitoring, disease states, and cost.

Marine C2 in Support of HA/DR: Observations and Critical Assessments Following Super-Typhoon Haiyan

DTIC Science & Technology

2014-06-01

farm (Figure 1), established Internet access over commercial satellite service 6 (Figure 2), and configured a wireless local area network ( WLAN ...included support for a larger diameter wireless local area network ( WLAN ), providing greater freedom of movement for users accessing the GATR...emerging commercial capabilities, both communications systems and handheld/user-access devices involves the establishment of a synergistic application

Establishing an NP-staffed minor emergency area.

PubMed

Buchanan, L; Powers, R D

1997-04-01

Patients with problems of high acuity need fully trained emergency physicians and nurses. Some patients with nonurgent problems can be cared for within the emergency department (ED) in a lower-cost setting designed and staffed specifically for this purpose. Staffing a fast track or minor emergency area (MEA) with nurse practitioners (NPs) is one way to satisfy the ED's care needs. One site analysis of the effectiveness of NPs indicates that patients are satisfied with their care, that nurses' interpersonal skills are better than those of physicians, that technical skills are equivalent, that patient outcomes are equivalent or superior and that NPs improve access to care. A nurse practitioner-staffed minor emergency area provides high quality care for approximately 21% of this site's adult emergency department population. Patients are triaged based on set criteria, allowing for short treatment times. The physical layout, triage criteria, and the NPs' scope of practice in the level 1 trauma center's ED are detailed.

Word Spotting for Indic Documents to Facilitate Retrieval

NASA Astrophysics Data System (ADS)

Bhardwaj, Anurag; Setlur, Srirangaraj; Govindaraju, Venu

With advances in the field of digitization of printed documents and several mass digitization projects underway, information retrieval and document search have emerged as key research areas. However, most of the current work in these areas is limited to English and a few oriental languages. The lack of efficient solutions for Indic scripts has hampered information extraction from a large body of documents of cultural and historical importance. This chapter presents two relevant topics in this area. First, we describe the use of a script-specific keyword spotting for Devanagari documents that makes use of domain knowledge of the script. Second, we address the needs of a digital library to provide access to a collection of documents from multiple scripts. This requires intelligent solutions which scale across different scripts. We present a script-independent keyword spotting approach for this purpose. Experimental results illustrate the efficacy of our methods.

Differences in food environment perceptions and spatial attributes of food shopping between residents of low and high food access areas.

PubMed

Sohi, Inderbir; Bell, Bethany A; Liu, Jihong; Battersby, Sarah E; Liese, Angela D

2014-01-01

To explore potential differences in food shopping behaviors and healthy food availability perceptions between residents living in areas with low and high food access. A cross-sectional telephone survey to assess food shopping behaviors and perceptions. Data from an 8-county food environment field census used to define the Centers for Disease Control and Prevention (CDC) healthier food retail tract and US Department of Agriculture Economic Research Service food desert measure. A total of 968 residents in 8 South Carolina counties. Residents' food shopping behaviors and healthy food availability perceptions. Linear and logistic regression. Compared with residents in high food access areas, residents in low food access areas traveled farther to their primary food store (US Department of Agriculture Economic Research Service: 8.8 vs 7.1 miles, P = .03; CDC: 9.2 vs 6.1 miles, P < .001), accumulated more total shopping miles per week (CDC: 28.0 vs 15.4 miles; P < .001), and showed differences in perceived healthy food availability (P < .001) and shopping access (P < .001). These findings lend support to ongoing community and policy interventions aimed at reducing food access disparities. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Differences in Food Environment Perceptions and Spatial Attributes of Food Shopping between Residents of Low and High Food Access Areas

PubMed Central

Sohi, Inderbir; Bell, Bethany A.; Liu, Jihong; Battersby, Sarah E.; Liese, Angela D.

2014-01-01

Objective To explore potential differences in food shopping behaviors and healthy food availability perceptions between residents living in areas with low and high food access. Design A cross-sectional telephone survey to assess food shopping behaviors and perceptions. Data from an eight-county food environment field census used to define the CDC (Centers for Disease Control and Prevention) healthier food retail tract and USDA ERS (United States Department of Agriculture Economic Research Service) food desert measure. Participants 968 residents in eight South Carolina counties. Main Outcome Measures Residents’ food shopping behaviors and healthy food availability perceptions. Analysis Linear and logistic regression. Results Compared to residents in high food access areas, residents in low food access areas traveled further to their primary food store (USDA ERS: 8.8 vs. 7.1 miles, p=0.03; CDC: 9.2 vs. 6.1 miles, p<0.001), accumulated more total shopping miles per week; CDC 28.0 vs. 15.4 miles, p<0.001) and showed differences in perceived healthy food availability (p<0.001) and shopping access (p<0.001). Conclusions and Implications These findings lend support to ongoing community and policy interventions aimed at reducing food access disparities. PMID:24560861

Does walking explain associations between access to greenspace and lower mortality?

PubMed Central

Lachowycz, Kate; Jones, Andy P.

2014-01-01

Despite emerging evidence that access to greenspace is associated with longer life expectancy, little is understood about what causal mechanisms may explain this relationship. Based on social-ecological theories of health, greenspace has multifaceted potential to influence mortality but the potential alternative mediating pathways have not been empirically tested. This study evaluates relationships between access to greenspace, walking and mortality. Firstly, we test for an association between access to greenspace and self-reported levels of walking using a survey of 165,424 adults across England collected during 2007 and 2008. Negative binomial regression multilevel models were used to examine associations between greenspace access and self reported number of days walked in the last month, in total and for recreational and health purposes, after controlling for relevant confounders. Secondly we use an area level analysis of 6781 middle super output areas across England to examine if recreational walking mediates relationships between greenspace access and reduced premature mortality from circulatory disease. Results show clear evidence of better greenspace access being associated with higher reported recreational walking. There were between 13% and 18% more days of recreational walking in the greenest quintile compared with the least green after adjustment for confounders. Tests for mediation found no evidence that recreational walking explain the associations between greenspace and mortality. Futhermore, whilst the relationship between greenspace access and walking was observed for all areas, the relationship between greenspace access and reduced mortality was only apparent in the most deprived areas. These findings indicate that the association between greenspace and mortality, if causal, may be explained by mediators other than walking, such as psychosocial factors. Future research should concentrate on understanding the causal mechanisms underlying observed associations. PMID:24602966

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.

Travel by public transit to mammography facilities in 6 US urban areas

PubMed Central

Graham, S; Lewis, B; Flanagan, B; Watson, M; Peipins, L

2017-01-01

We examined lack of private vehicle access and 30 minutes or longer public transportation travel time to mammography facilities for women 40 years of age or older in the urban areas of Boston, Philadelphia, San Antonio, San Diego, Denver, and Seattle to identify transit marginalized populations - women for whom these travel characteristics may jointly present a barrier to clinic access. This ecological study used sex and race/ethnicity data from the 2010 US Census and household vehicle availability data from the American Community Survey 2008–2012, all at Census tract level. Using the public transportation option on Google Trip Planner we obtained the travel time from the centroid of each census tract to all local mammography facilities to determine the nearest mammography facility in each urban area. Median travel times by public transportation to the nearest facility for women with no household access to a private vehicle were obtained by ranking travel time by population group across all U.S. census tracts in each urban area and across the entire study area. The overall median travel times for each urban area for women without household access to a private vehicle ranged from a low of 15 minutes in Boston and Philadelphia to 27 minutes in San Diego. The numbers and percentages of transit marginalized women were then calculated for all urban areas by population group. While black women were less likely to have private vehicle access, and both Hispanic and black women were more likely to be transit marginalized, this outcome varied by urban area. White women constituted the largest number of transit marginalized. Our results indicate that mammography facilities are favorably located for the large majority of women, although there are still substantial numbers for whom travel may likely present a barrier to mammography facility access. PMID:29285434

Factors influencing householders' access to improved water in low-income urban areas of Accra, Ghana.

PubMed

Mahama, Ayisha Matuamo; Anaman, Kwabena Asomanin; Osei-Akoto, Isaac

2014-06-01

We analysed householders' access to improved water for drinking and other domestic uses in five selected low-income urban areas of Accra, Ghana using a survey of 1,500 households. Our definitions of improved water were different from those suggested by the World Health Organization (WHO). The results revealed that only 4.4% of the respondents had access to improved drinking water compared to 40.7% using the WHO definition. However, 88.7% of respondents had access to improved water for domestic uses compared to 98.3% using the WHO definition. Using logistic regression analysis, we established that the significant determinant of householders' access to improved drinking water was income. However, for access to improved water for other domestic uses, the significant factors were education, income and location of the household. Compared to migrants, indigenous people and people from mixed areas were less likely to have access to improved water for other domestic purposes. For the analysis using the WHO definitions, most of the independent variables were not statistically significant in determining householders' access, and those variables that were significant generated parameter estimates inconsistent with evidence from the literature and anecdotal evidence from officials of public health and water supply companies in Ghana.

Major metropolis rail system access to dental care for the retired and elderly: a high-resolution geographic study of Sydney, Australia.

PubMed

Zainab, Uswa-I; Kruger, Estie; Tennant, Marc

2015-12-01

This study examined the spatial accessibility of the Sydney Dental Hospital, to the people of metropolitan Sydney, using a geographic information systems approach. Sydney, Australia's largest city and the state capital of New South Wales, has 4.6 million people, with one-fifth of the Australian population (4.6 million people). Public dental services exist, but accessibility is limited to some specific population groups, who meet specific eligibility criteria. All adults (those older than 15 years) were included in the study, and two subsets of this population, retirees (older than 65 years) and elderly (older than 85 years), were also examined according to their proximity to the Sydney Dental Hospital, which is located immediately adjacent to the central train station. Census data (population data) and train station geo-coding data were integrated with high-resolution geographic information systems to analyse population spatial accessibility. Irrespective of the socioeconomic status, it was found that 43% of all the adults, 42.5% of the retirees and 41.6% of elders lived 2 km away from the nearest train station. Two-thirds of those in lower socioeconomic status lived within 2 km of a train station, whilst half of those in the higher socioeconomic status groups lived within 2 km from a train station. Metropolitan Sydney is an example of good urban planning where train stations are appropriately placed in high population density and low socioeconomic areas. The same should be investigated in other major metropolises, especially those still in growth and planning transportation systems. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Modeling spatial accessibility of immigrants to culturally diverse family physicians.

PubMed

Wanga, Lu; Roisman, Deborah

2011-01-01

This article uses accessibility as an analytical tool to examine health care access among immigrants in a multicultural urban setting. It applies and improves on two widely used accessibility models—the gravity model and the two-step floating catchment area model—in measuring spatial accessibility by Mainland Chinese immigrants in the Toronto Census Metropolitan Area. Empirical data on physician-seeking behaviors are collected through two rounds of questionnaire surveys. Attention is focused on journey to physician location and utilization of linguistically matched family physicians. Based on the survey data, a two-zone accessibility model is developed by relaxing the travel threshold and distance impedance parameters that are traditionally treated as a constant in the accessibility models. General linear models are used to identify relationships among spatial accessibility, geography, and socioeconomic characteristics of Mainland Chinese immigrants. The results suggest a spatial mismatch in the supply of and demand for culturally sensitive care, and residential location is the primary factor that determines spatial accessibility to family physicians. The article yields important policy implications.

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 services at the neighbourhood level. In particular, the results show that the low access neighbourhoods tend to be clustered in the neighbourhoods at the urban periphery and immediately surrounding the downtown area. PMID:27997577

An optimization framework for measuring spatial access over healthcare networks.

PubMed

Li, Zihao; Serban, Nicoleta; Swann, Julie L

2015-07-17

Measurement of healthcare spatial access over a network involves accounting for demand, supply, and network structure. Popular approaches are based on floating catchment areas; however the methods can overestimate demand over the network and fail to capture cascading effects across the system. Optimization is presented as a framework to measure spatial access. Questions related to when and why optimization should be used are addressed. The accuracy of the optimization models compared to the two-step floating catchment area method and its variations is analytically demonstrated, and a case study of specialty care for Cystic Fibrosis over the continental United States is used to compare these approaches. The optimization models capture a patient's experience rather than their opportunities and avoid overestimating patient demand. They can also capture system effects due to change based on congestion. Furthermore, the optimization models provide more elements of access than traditional catchment methods. Optimization models can incorporate user choice and other variations, and they can be useful towards targeting interventions to improve access. They can be easily adapted to measure access for different types of patients, over different provider types, or with capacity constraints in the network. Moreover, optimization models allow differences in access in rural and urban areas.

Individual Public Transportation Accessibility is Positively Associated with Self-Reported Active Commuting.

PubMed

Djurhuus, Sune; Hansen, Henning Sten; Aadahl, Mette; Glümer, Charlotte

2014-01-01

Active commuters have lower risk of chronic disease. Understanding which of the, to some extent, modifiable characteristics of public transportation that facilitate its use is thus important in a public health perspective. The aim of the study was to examine the association between individual public transportation accessibility and self-reported active commuting, and whether the associations varied with commute distance, age, and gender. Twenty-eight thousand nine hundred twenty-eight commuters in The Capital Region of Denmark reported self-reported time spent either walking or cycling to work or study each day and the distance to work or study. Data were obtained from the Danish National Health Survey collected in February to April 2010. Individual accessibility by public transportation was calculated using a multi-modal network in a GIS. Multilevel logistic regression was used to analyze the association between accessibility, expressed as access area, and being an active commuter. Public transport accessibility area based on all stops within walking and cycling distance was positively associated with being an active commuter. Distance to work, age, and gender modified the associations. Residing within 10 km commute distance and in areas of high accessibility was associated with being an active commuter and meeting the recommendations of physical activity. For the respondents above 29 years, individual public transportation accessibility was positively associated with being an active commuter. Women having high accessibility had significantly higher odds of being an active commuter compared to having a low accessibility. For men, the associations were insignificant. This study extends the knowledge about the driving forces of using public transportation for commuting by examining the individual public transportation accessibility. Findings suggest that transportation accessibility supports active commuting and planning of improved public transit accessibility has thus a potential of providing health benefits to commuters.

Evaluation of accessible mineral surface areas for improved prediction of mineral reaction rates in porous media

NASA Astrophysics Data System (ADS)

Beckingham, Lauren E.; Steefel, Carl I.; Swift, Alexander M.; Voltolini, Marco; Yang, Li; Anovitz, Lawrence M.; Sheets, Julia M.; Cole, David R.; Kneafsey, Timothy J.; Mitnick, Elizabeth H.; Zhang, Shuo; Landrot, Gautier; Ajo-Franklin, Jonathan B.; DePaolo, Donald J.; Mito, Saeko; Xue, Ziqiu

2017-05-01

The rates of mineral dissolution reactions in porous media are difficult to predict, in part because of a lack of understanding of mineral reactive surface area in natural porous media. Common estimates of mineral reactive surface area used in reactive transport models for porous media are typically ad hoc and often based on average grain size, increased to account for surface roughness or decreased by several orders of magnitude to account for reduced surface reactivity of field as opposed to laboratory samples. In this study, accessible mineral surface areas are determined for a sample from the reservoir formation at the Nagaoka pilot CO2 injection site (Japan) using a multi-scale image analysis based on synchrotron X-ray microCT, SEM QEMSCAN, XRD, SANS, and FIB-SEM. This analysis not only accounts for accessibility of mineral surfaces to macro-pores, but also accessibility through connected micro-pores in smectite, the most abundant clay mineral in this sample. While the imaging analysis reveals that most of the micro- and macro-pores are well connected, some pore regions are unconnected and thus inaccessible to fluid flow and diffusion. To evaluate whether mineral accessible surface area accurately reflects reactive surface area a flow-through core experiment is performed and modeled at the continuum scale. The core experiment is performed under conditions replicating the pilot site and the evolution of effluent solutes in the aqueous phase is tracked. Various reactive surface area models are evaluated for their ability to capture the observed effluent chemistry, beginning with parameter values determined as a best fit to a disaggregated sediment experiment (Beckingham et al., 2016) described previously. Simulations that assume that all mineral surfaces are accessible (as in the disaggregated sediment experiment) over-predict the observed mineral reaction rates, suggesting that a reduction of RSA by a factor of 10-20 is required to match the core flood experimental data. While the fit of the effluent chemistry (and inferred mineral dissolution rates) greatly improve when the pore-accessible mineral surface areas are used, it was also necessary to include highly reactive glass phases to match the experimental observations, in agreement with conclusions from the disaggregated sediment experiment. It is hypothesized here that the 10-20 reduction in reactive surface areas based on the limited pore accessibility of reactive phases in core flood experiment may be reasonable for poorly sorted and cemented sediments like those at the Nagaoka site, although this reflects pore rather than larger scale heterogeneity.

A discrete choice experiment studying students' preferences for scholarships to private medical schools in Japan.

PubMed

Goto, Rei; Kakihara, Hiroaki

2016-02-09

The shortage of physicians in rural areas and in some specialties is a societal problem in Japan. Expensive tuition in private medical schools limits access to them particularly for students from middle- and low-income families. One way to reduce this barrier and lessen maldistribution is to offer conditional scholarships to private medical schools. A discrete choice experiment is carried out on a total of 374 students considering application to medical schools. The willingness to receive a conditional scholarship program to private medical schools is analyzed. The probability of attending private medical schools significantly decreased because of high tuition, a postgraduate obligation to provide a service in specific specialty areas, and the length of time of this obligation. An obligation to provide a service in rural regions had no significant effect on this probability. To motivate non-applicants to private medical schools to enroll in such schools, a decrease in tuition to around 1.2 million yen (US$ 12,000) or less, which is twice that of public schools, was found to be necessary. Further, it was found that non-applicants to private medical schools choose to apply to such schools even with restrictions if they have tuition support at the public school level. Conditional scholarships for private medical schools may widen access to medical education and simultaneously provide incentives to work in insufficiently served areas.

Walking behavior on Lapangan Merdeka district in Medan city

NASA Astrophysics Data System (ADS)

Zahrah, W.; Mandai, A. J. O.; Nasution, A. D.

2018-03-01

Lapangan Merdeka district in Medan City is an area with a lot of functions and activities. Pedestrians in this area pose particular behavior for walking. Such behavior can be formed due to certain factors. This study aimed to identify the behavior and motivation of walking, as well as knowing the perception of pedestrians on pedestrian facilities and infrastructures. This research is a qualitative descriptive study. This research was conducted in five streets that have pedestrian lanes by collecting data through observation of pedestrian facilities and infrastructures, as well as the distribution of questionnaires to investigate the characteristics of pedestrians, the behavior and motivation of walking, and perceptions of pedestrian facilities and infrastructure. The research found that the behavior of pedestrians when walking are different on certain characteristics of pedestrians as well as the specific conditions of facilities and infrastructures. The most dominant motivation when walking in this area is easy transportation access. The results of the perception of pedestrians also show that pedestrian facilities and infrastructure are good in this area.

Sexual orientation disclosure to health care providers among urban and non-urban southern lesbians.

PubMed

Austin, Erika Laine

2013-01-01

Concerns regarding sexual orientation disclosure to health care providers have been suggested as a barrier to care which may account for documented differences in the health care utilization of lesbians relative to heterosexual women. This study explored the correlates of sexual orientation disclosure to health care providers among 934 lesbian women living in urban and non-urban areas of the South. Psychosocial resources, such as self-esteem, social support, and mastery, along with several lesbian-specific experiences (proportion of lesbian, gay, bisexual, or transgender friends, access to the lesbian, gay, bisexual, or transgender community, degree of being "out"), were all independently associated with greater likelihood of having disclosed to a health care provider. Internalized homophobia and lesbian-related stigma decreased the likelihood of disclosure. Lesbians living in non-urban areas were significantly less likely to have disclosed than women in urban areas, suggesting that disclosure may present a special concern for populations in non-urban areas.

Customizing a rangefinder for community-based wildlife conservation initiatives

USGS Publications Warehouse

Ransom, Jason I.

2011-01-01

Population size of many threatened and endangered species is relatively unknown because estimating animal abundance in remote parts of the world, without access to aircraft for surveying vast areas, is a scientific challenge with few proposed solutions. One option is to enlist local community members and train them in data collection for large line transect or point count surveys, but financial and sometimes technological constraints prevent access to the necessary equipment and training for accurately quantifying distance measurements. Such measurements are paramount for generating reliable estimates of animal density. This problem was overcome in a survey of Asiatic wild ass (Equus hemionus) in the Great Gobi B Strictly Protected Area, Mongolia, by converting an inexpensive optical sporting rangefinder into a species-specific rangefinder with visual-based categorical labels. Accuracy trials concluded 96.86% of 350 distance measures matched those from a laser rangefinder. This simple customized optic subsequently allowed for a large group of minimally-trained observers to simultaneously record quantitative measures of distance, despite language, education, and skill differences among the diverse group. The large community-based effort actively engaged local residents in species conservation by including them as the foundation for collecting scientific data.

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.

A Quantitative Exposure Planning Tool for Surgical Approaches to the Sacroiliac Joint.

PubMed

Phelps, Kevin D; Ming, Bryan W; Fox, Wade E; Bellamy, Nelly; Sims, Stephen H; Karunakar, Madhav A; Hsu, Joseph R

2016-06-01

To aid in surgical planning by quantifying and comparing the osseous exposure between the anterior and posterior approaches to the sacroiliac joint. Anterior and posterior approaches were performed on 12 sacroiliac joints in 6 fresh-frozen torsos. Visual and palpable access to relevant surgical landmarks was recorded. Calibrated digital photographs were taken of each approach and analyzed using Image J. The average surface areas of exposed bone were 44 and 33 cm for the anterior and posterior approaches, respectively. The anterior iliolumbar ligament footprint could be visualized in all anterior approaches, whereas the posterior aspect could be visualized in all but one posterior approach. The anterior approach provided visual and palpable access to the anterior superior edge of the sacroiliac joint in all specimens, the posterior superior edge in 75% of specimens, and the inferior margin in 25% and 50% of specimens, respectively. The inferior sacroiliac joint was easily visualized and palpated in all posterior approaches, although access to the anterior and posterior superior edges was more limited. The anterior S1 neuroforamen was not visualized with either approach and was more consistently palpated when going posterior (33% vs. 92%). Both anterior and posterior approaches can be used for open reduction of pure sacroiliac dislocations, each with specific areas for assessing reduction. In light of current plate dimensions, fractures more than 2.5 cm lateral to the anterior iliolumbar ligament footprint are amenable to anterior plate fixation, whereas those more medial may be better addressed through a posterior approach.

Networking CD-ROMs: The Decision Maker's Guide to Local Area Network Solutions.

ERIC Educational Resources Information Center

Elshami, Ahmed M.

In an era when patrons want access to CD-ROM resources but few libraries can afford to buy multiple copies, CD-ROM local area networks (LANs) are emerging as a cost-effective way to provide shared access. To help librarians make informed decisions, this manual offers information on: (1) the basics of LANs, a "local area network primer";…

Microbiology: lessons from a first attempt at Lake Ellsworth.

PubMed

Pearce, D A; Magiopoulos, I; Mowlem, M; Tranter, M; Holt, G; Woodward, J; Siegert, M J

2016-01-28

During the attempt to directly access, measure and sample Subglacial Lake Ellsworth in 2012-2013, we conducted microbiological analyses of the drilling equipment, scientific instrumentation, field camp and natural surroundings. From these studies, a number of lessons can be learned about the cleanliness of deep Antarctic subglacial lake access leading to, in particular, knowledge of the limitations of some of the most basic relevant microbiological principles. Here, we focus on five of the core challenges faced and describe how cleanliness and sterilization were implemented in the field. In the light of our field experiences, we consider how effective these actions were, and what can be learnt for future subglacial exploration missions. The five areas covered are: (i) field camp environment and activities, (ii) the engineering processes surrounding the hot water drilling, (iii) sample handling, including recovery, stability and preservation, (iv) clean access methodologies and removal of sample material, and (v) the biodiversity and distribution of bacteria around the Antarctic. Comparisons are made between the microbiology of the Lake Ellsworth field site and other Antarctic systems, including the lakes on Signy Island, and on the Antarctic Peninsula at Lake Hodgson. Ongoing research to better define and characterize the behaviour of natural and introduced microbial populations in response to deep-ice drilling is also discussed. We recommend that future access programmes: (i) assess each specific local environment in enhanced detail due to the potential for local contamination, (ii) consider the sterility of the access in more detail, specifically focusing on single cell colonization and the introduction of new species through contamination of pre-existing microbial communities, (iii) consider experimental bias in methodological approaches, (iv) undertake in situ biodiversity detection to mitigate risk of non-sample return and post-sample contamination, and (v) address the critical question of how important these microbes are in the functioning of Antarctic ecosystems. © 2015 The Author(s).

Revealed access to haemodialysis facilities in northeastern Iran: Factors that matter in rural and urban areas.

PubMed

Kiani, Behzad; Bagheri, Nasser; Tara, Ahmad; Hoseini, Benyamin; Tabesh, Hamed; Tara, Mahmood

2017-11-07

Poor access to haemodialysis facilities is associated with high mortality and morbidity rates. This study investigated factors affecting revealed access to the haemodialysis facilities considering patients living in rural and urban areas without any haemodialysis facility (Group A) and those living urban areas with haemodialysis facilities (Group B). This study is based on selfreported Actual Access Time (AAT) to referred haemodialysis facilities and other information regarding travel to haemodialysis facilities from patients. All significant variables on univariate analysis were entered into a univariate general linear model in order to identify factors associated with AAT. Both spatial (driving time and distance) and non-spatial factors (sex, income level, caregivers, transportation mode, education level, ethnicity and personal vehicle ownership) influenced the revealed access identified in Group A. The non-spatial factors for Group B patients were the same as for Group A, but no spatial factor was identified in Group B. It was found that accessibility is strongly underestimated when driving time is chosen as accessibility measure to haemodialysis facilities. Analysis of revealed access determinants provides policymakers with an appropriate decision base for making appropriate decisions and finding solutions to decrease the access time for patients under haemodialysis therapy. Driving time alone is not a good proxy for measuring access to haemodialysis facilities as there are many other potential obstacles, such as women's special travel problems, poor other transportation possibilities, ethnicity disparities, low education levels, low caregiver status and low-income.

A passive RFID-based location system for personnel and asset monitoring.

PubMed

Hsiao, Rong-Shue; Kao, Chun-Hao; Chen, Tian-Xiang; Chen, Jui-Lun

2018-01-01

Typical radio frequency identification (RFID) access control system can be ineffective if an unauthorized person tailgates an authorized person through an access area. To propose a system by using indoor locating and tracking techniques address this problem, which is to prevent unauthorized Alzheimer's and dementia patients from getting lost including by tailgating. To achieve accurate target location, passive RFID deployment strategy is studied and a fingerprinting based passive RFID localization algorithm is proposed. The proposed system was evaluated in a building environment to simulate the performance of access control. RFID reader was installed on ceiling near the access area and tags were stitched on both shoulders of the experiment subject's garments. The probability of the error distance within 0.3 m achieved 97% in the warning area; the location precision achieved 97% within 0.4 m in the monitoring area. The result showed that if an unauthorized person enters the restricted area, the system can initiate an alert signal accurately. Therefore, the proposed system is very suitable to be used in nursing home or hospital to prevent unauthorized personnel and assets entering/exiting a confined location.

Racial Disparities In Geographic Access To Primary Care In Philadelphia.

PubMed

Brown, Elizabeth J; Polsky, Daniel; Barbu, Corentin M; Seymour, Jane W; Grande, David

2016-08-01

Primary care is often thought of as the gateway to improved health outcomes and can lead to more efficient use of health care resources. Because of primary care's cardinal importance, adequate access is an important health policy priority. In densely populated urban areas, spatial access to primary care providers across neighborhoods is poorly understood. We examined spatial variation in primary care access in Philadelphia, Pennsylvania. We calculated ratios of adults per primary care provider for each census tract and included buffer zones based on prespecified drive times around each tract. We found that the average ratio was 1,073; the supply of primary care providers varied widely across census tracts, ranging from 105 to 10,321. We identified six areas of Philadelphia that have much lower spatial accessibility to primary care relative to the rest of the city. After adjustment for sociodemographic and insurance characteristics, the odds of being in a low-access area were twenty-eight times greater for census tracts with a high proportion of African Americans than in tracts with a low proportion of African Americans. Project HOPE—The People-to-People Health Foundation, Inc.

Intersection of Living in a Rural Versus Urban Area and Race/Ethnicity in Explaining Access to Health Care in the United States

PubMed Central

Ford, Chandra L.; Wallace, Steven P.; Wang, May C.; Takahashi, Lois M.

2016-01-01

Objectives. To examine whether living in a rural versus urban area differentially exposes populations to social conditions associated with disparities in access to health care. Methods. We linked Medical Expenditure Panel Survey (2005–2010) data to geographic data from the American Community Survey (2005–2009) and Area Health Resource File (2010). We categorized census tracts as rural and urban by using the Rural–Urban Commuting Area Codes. Respondent sample sizes ranged from 49 839 to 105 306. Outcomes were access to a usual source of health care, cholesterol screening, cervical screening, dental visit within recommended intervals, and health care needs met. Results. African Americans in rural areas had lower odds of cholesterol screening (odds ratio[OR] = 0.37; 95% confidence interval[CI] = 0.25, 0.57) and cervical screening (OR = 0.48; 95% CI = 0.29, 0.80) than African Americans in urban areas. Whites had fewer screenings and dental visits in rural versus urban areas. There were mixed results for which racial/ethnic group had better access. Conclusions. Rural status confers additional disadvantage for most of the health care use measures, independently of poverty and health care supply. PMID:27310341

Cost comparison of competing local distribution systems for communication satellite traffic

NASA Technical Reports Server (NTRS)

Dopfel, F. E.

1979-01-01

The boundaries of market areas which favor various means for distributing communications satellite traffic are considered. The distribution methods considered are: control Earth station with cable access, rooftop Earth stations, Earth station with radio access, and various combinations of these methods. The least cost system for a hypothetical region described by number of users and the average cable access mileage is discussed. The region is characterized by a function which expresses the distribution of users. The results indicate that the least cost distribution is central Earth station with cable access for medium to high density areas of a region combined with rooftop Earth stations or (for higher volumes) radio access for remote users.

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 demonstrated using a case study to hypothetically model changes in rural PHC workforce supply. What are the implications for practitioners? The Index of Access has significant potential for identifying how rural and remote primary health care access inequities can be addressed. This critically important information can assist health service planners, for example those working in primary health networks, to determine where and how much redistribution of PHC services is needed to correct existing inequities.

Cyber Operations and Cyber Terrorism

DTIC Science & Technology

2005-08-15

available from http://www.geocities.com/ Area51 /Shadowlands/6583/project395.html; Internet; accessed 14 April 2004. DCSINT Handbook 1.02, Cyber...www.geocities.com/ Area51 /Shadowlands/6583/project395.html; Internet; Accessed 14 April 2004. Raufer, Xavier. “New World Disorder, New

Large-area Overhead Manipulator for Access of Fields

USDA-ARS?s Scientific Manuscript database

Multi-axis, cable-driven manipulators have evolved over many years providing large area suspended platform access, programmability, relatively rigid and flexibly-positioned platform control and full six degree of freedom (DOF) manipulation of sensors and tools. We describe innovations for a new six...

Kenai Fjords National Park Over-the-Snow Transportation Feasibility Study.

DOT National Transportation Integrated Search

2012-01-31

Kenai Fjords National Park seeks to expand winter access to the Exit Glacier Area. Year-round access would better enable the park to accomplish its mission related to visitor experience, education, and research. The road to the area is inaccessible t...

Falling through the Coverage Cracks: How Documentation Status Minimizes Immigrants' Access to Health Care.

PubMed

Joseph, Tiffany D

2017-10-01

Recent policy debates have centered on health reform and who should benefit from such policy. Most immigrants are excluded from the 2010 Affordable Care Act (ACA) due to federal restrictions on public benefits for certain immigrants. But, some subnational jurisdictions have extended coverage options to federally ineligible immigrants. Yet, less is known about the effectiveness of such inclusive reforms for providing coverage and care to immigrants in those jurisdictions. This article examines the relationship between coverage and health care access for immigrants under comprehensive health reform in the Boston metropolitan area. The article uses data from interviews conducted with a total of 153 immigrants, health care professionals, and immigrant and health advocacy organization employees under the Massachusetts and ACA health reforms. Findings indicate that respondents across the various stakeholder groups perceive that immigrants' documentation status minimizes their ability to access health care even when they have health coverage. Specifically, respondents expressed that intersecting public policies, concerns that using health services would jeopardize future legalization proceedings, and immigrants' increased likelihood of deportation en route to medical appointments negatively influenced immigrants' health care access. Thus, restrictive federal policies and national-level anti-immigrant sentiment can undermine inclusive subnational policies in socially progressive places. Copyright © 2017 by Duke University Press.

Leaf Responses to Mild Drought Stress in Natural Variants of Arabidopsis1[OPEN

PubMed Central

Clauw, Pieter; Coppens, Frederik; De Beuf, Kristof; Dhondt, Stijn; Van Daele, Twiggy; Maleux, Katrien; Storme, Veronique; Clement, Lieven; Gonzalez, Nathalie; Inzé, Dirk

2015-01-01

Although the response of plants exposed to severe drought stress has been studied extensively, little is known about how plants adapt their growth under mild drought stress conditions. Here, we analyzed the leaf and rosette growth response of six Arabidopsis (Arabidopsis thaliana) accessions originating from different geographic regions when exposed to mild drought stress. The automated phenotyping platform WIWAM was used to impose stress early during leaf development, when the third leaf emerges from the shoot apical meristem. Analysis of growth-related phenotypes showed differences in leaf development between the accessions. In all six accessions, mild drought stress reduced both leaf pavement cell area and number without affecting the stomatal index. Genome-wide transcriptome analysis (using RNA sequencing) of early developing leaf tissue identified 354 genes differentially expressed under mild drought stress in the six accessions. Our results indicate the existence of a robust response over different genetic backgrounds to mild drought stress in developing leaves. The processes involved in the overall mild drought stress response comprised abscisic acid signaling, proline metabolism, and cell wall adjustments. In addition to these known severe drought-related responses, 87 genes were found to be specific for the response of young developing leaves to mild drought stress. PMID:25604532

Caring for women living with HIV: gaps in the evidence

PubMed Central

Loutfy, Mona R; Sherr, Lorraine; Sonnenberg-Schwan, Ulrike; Walmsley, Sharon L; Johnson, Margaret; d'Arminio Monforte, Antonella

2013-01-01

Introduction In the management of HIV, women and men generally undergo the same treatment pathway, with gender differences being given limited consideration. This is in spite of accumulating evidence that there are a number of potential differences between women and men which may affect response to treatment, pharmacokinetics, toxicities and coping. There are also notable psychological, behavioural, social and structural factors that may have a unique impact on women living with HIV (WLWH). Despite our increasing knowledge of HIV and advances in treatment, there are significant gaps in the data relating specifically to women. One of the factors contributing to this situation is the under-representation of women in all aspects of HIV clinical research. Furthermore, there are clinical issues unique to women, including gynaecologic and breast diseases, menopause-related factors, contraception and other topics related to women's and sexual health. Methods Using scoping review methodology, articles from the literature from 1980 to 2012 were identified using appropriate MeSH headings reflecting the clinical status of WLWH, particularly in the areas of clinical management, sexual health, emotional wellbeing and treatment access. Titles and abstracts were scanned to determine whether they were relevant to non-reproductive health in WLWH, and papers meeting inclusion criteria were reviewed. Results This review summarizes our current knowledge of the clinical status of WLWH, particularly in the areas of clinical management, sexual health, emotional wellbeing and treatment access. It suggests that there are a number of gender differences in disease and treatment outcomes, and distinct women-specific issues, such as menopause and co-morbidities, that pose significant challenges to the care of WLWH. Conclusions Based on a review of this evidence, outstanding questions and areas where further studies are required to determine gender differences in the efficacy and safety of treatment and other clinical and psychological issues specifically affecting WLWH have been identified. Well-controlled and adequately powered clinical studies are essential to help provide answers to these questions and to contribute to activities aimed at improving the health and wellbeing of WLWH. PMID:24088395

Hormone-dependent control of developmental timing through regulation of chromatin accessibility

PubMed Central

Uyehara, Christopher M.; Nystrom, Spencer L.; Niederhuber, Matthew J.; Leatham-Jensen, Mary; Ma, Yiqin; Buttitta, Laura A.

2017-01-01

Specification of tissue identity during development requires precise coordination of gene expression in both space and time. Spatially, master regulatory transcription factors are required to control tissue-specific gene expression programs. However, the mechanisms controlling how tissue-specific gene expression changes over time are less well understood. Here, we show that hormone-induced transcription factors control temporal gene expression by regulating the accessibility of DNA regulatory elements. Using the Drosophila wing, we demonstrate that temporal changes in gene expression are accompanied by genome-wide changes in chromatin accessibility at temporal-specific enhancers. We also uncover a temporal cascade of transcription factors following a pulse of the steroid hormone ecdysone such that different times in wing development can be defined by distinct combinations of hormone-induced transcription factors. Finally, we show that the ecdysone-induced transcription factor E93 controls temporal identity by directly regulating chromatin accessibility across the genome. Notably, we found that E93 controls enhancer activity through three different modalities, including promoting accessibility of late-acting enhancers and decreasing accessibility of early-acting enhancers. Together, this work supports a model in which an extrinsic signal triggers an intrinsic transcription factor cascade that drives development forward in time through regulation of chromatin accessibility. PMID:28536147

Geographic Accessibility of Pulmonologists for Adults With COPD: United States, 2013.

PubMed

Croft, Janet B; Lu, Hua; Zhang, Xingyou; Holt, James B

2016-09-01

Geographic clusters in prevalence and hospitalizations for COPD have been identified at national, state, and county levels. The study objective is to identify county-level geographic accessibility to pulmonologists for adults with COPD. Service locations of 12,392 practicing pulmonologists and 248,160 primary care physicians were identified from the 2013 National Provider Identifier Registry and weighted by census block-level populations within a series of circular distance buffer zones. Model-based county-level population counts of US adults ≥ 18 years of age with COPD were estimated from the 2013 Behavioral Risk Factor Surveillance System. The percentages of all estimated adults with potential access to at least one provider type and the county-level ratio of adults with COPD per pulmonologist were estimated for selected distances. Most US adults (100% in urbanized areas, 99.5% in urban clusters, and 91.7% in rural areas) had geographic access to a primary care physician within a 10-mile buffer distance; almost all (≥ 99.9%) had access to a primary care physician within 50 miles. At least one pulmonologist within 10 miles was available for 97.5% of US adults living in urbanized areas, but only for 38.3% in urban clusters and 34.5% in rural areas. When distance increased to 50 miles, at least one pulmonologist was available for 100% in urbanized areas, 93.2% in urban clusters, and 95.2% in rural areas. County-level ratios of adults with COPD per pulmonologist varied greatly across the United States, with residents in many counties in the Midwest having no pulmonologist within 50 miles. County-level geographic variations in pulmonologist access for adults with COPD suggest that those adults with limited access will have to depend on care from primary care physicians. Published by Elsevier Inc.

Community Perspectives on Access to and Availability of Healthy Food in Rural, Low-Resource, Latino Communities

PubMed Central

Ramírez, A. Susana; Estrada, Erendira; Grassi, Kathleen; Nathan, Stephanie

2016-01-01

Introduction Attention has focused on the food environment as a result of the growing concern with obesity rates among Latinos in rural areas. Researchers have observed associations between a lack of physical access to affordable produce in areas where supermarkets and grocery stores are limited and poor dietary intake and obesity; these associations are high in rural, low-resource neighborhoods with a high population of Latino residents. We aimed to engage residents of low-resource, Latino-majority neighborhoods in discussions of food access in a rural yet agricultural community setting, which is typically described as a “food desert.” Methods We used a mixed-methods approach and conducted 3 focus groups (n = 20) and in-depth interviews (n = 59) and surveys (n = 79) with residents of a rural yet agricultural community. We used thematic analysis to explore residents’ perceptions of access to healthy foods. Results Residents (n = 79; mean age, 41.6 y; 72% female; 79% Latino; 53% Spanish-speaking) reported that dollar and discount stores in this agricultural area provided access to produce; however, produce at retail stores was less affordable than produce at nonretail outlets such as fruit and vegetable stands. Gifts and trades of fruits and vegetables from neighbors and community organizations supplied no-cost or low-cost healthy foods. Residents’ suggestions to improve food access centered on lowering the cost of produce in existing retail outlets and seeking out nonretail outlets. Conclusion Our findings contribute to understanding of the food environment in low-resource, rural yet agricultural areas. Although such areas are characterized as “food deserts,” residents identified nonretail outlets as a viable source of affordable produce, while indicating that the cost of retail produce was a concern. Innovative policy solutions to increase healthy food consumption must focus on affordability as well as accessibility, and consider alternate, nonretail food outlets in agricultural areas. PMID:27978407

Community Perspectives on Access to and Availability of Healthy Food in Rural, Low-Resource, Latino Communities.

PubMed

Valdez, Zulema; Ramírez, A Susana; Estrada, Erendira; Grassi, Kathleen; Nathan, Stephanie

2016-12-15

Attention has focused on the food environment as a result of the growing concern with obesity rates among Latinos in rural areas. Researchers have observed associations between a lack of physical access to affordable produce in areas where supermarkets and grocery stores are limited and poor dietary intake and obesity; these associations are high in rural, low-resource neighborhoods with a high population of Latino residents. We aimed to engage residents of low-resource, Latino-majority neighborhoods in discussions of food access in a rural yet agricultural community setting, which is typically described as a "food desert." We used a mixed-methods approach and conducted 3 focus groups (n = 20) and in-depth interviews (n = 59) and surveys (n = 79) with residents of a rural yet agricultural community. We used thematic analysis to explore residents' perceptions of access to healthy foods. Residents (n = 79; mean age, 41.6 y; 72% female; 79% Latino; 53% Spanish-speaking) reported that dollar and discount stores in this agricultural area provided access to produce; however, produce at retail stores was less affordable than produce at nonretail outlets such as fruit and vegetable stands. Gifts and trades of fruits and vegetables from neighbors and community organizations supplied no-cost or low-cost healthy foods. Residents' suggestions to improve food access centered on lowering the cost of produce in existing retail outlets and seeking out nonretail outlets. Our findings contribute to understanding of the food environment in low-resource, rural yet agricultural areas. Although such areas are characterized as "food deserts," residents identified nonretail outlets as a viable source of affordable produce, while indicating that the cost of retail produce was a concern. Innovative policy solutions to increase healthy food consumption must focus on affordability as well as accessibility, and consider alternate, nonretail food outlets in agricultural areas.

Innovations in surgical stone disease.

PubMed

Antonelli, Jodi A

2016-05-01

Urinary stone disease is a condition characterized by a rich history of surgical innovation. Herein, we review the new ideas, devices and methods that are the cornerstones of contemporary surgical innovation in stone disease, specifically flexible ureteroscopy and percutaneous nephrolithotomy. The new ideas being applied to flexible ureteroscopy include extending the boundaries of surgical indications and eliminating the need for intraoperative fluoroscopy. Device advancements include disposable ureteroscopes and flexi semirigid ureteroscopes. Robotic flexible ureteroscopy, the use of magnets and mobile technology applications represent progress in methods of performing flexible ureteroscopy. Three-dimensional computed tomography and printing technology are enhancing percutaneous renal access. Novel image-guided access techniques are improving the accuracy of percutaneous surgery particularly for complex cases. New ideas, devices and methods are continuing to reshape the landscape of surgical stone treatment and in so doing not only have the potential to improve surgical outcomes but also to cultivate further scientific and technological advancements in this area.

DMG-α--a computational geometry library for multimolecular systems.

PubMed

Szczelina, Robert; Murzyn, Krzysztof

2014-11-24

The DMG-α library grants researchers in the field of computational biology, chemistry, and biophysics access to an open-sourced, easy to use, and intuitive software for performing fine-grained geometric analysis of molecular systems. The library is capable of computing power diagrams (weighted Voronoi diagrams) in three dimensions with 3D periodic boundary conditions, computing approximate projective 2D Voronoi diagrams on arbitrarily defined surfaces, performing shape properties recognition using α-shape theory and can do exact Solvent Accessible Surface Area (SASA) computation. The software is written mainly as a template-based C++ library for greater performance, but a rich Python interface (pydmga) is provided as a convenient way to manipulate the DMG-α routines. To illustrate possible applications of the DMG-α library, we present results of sample analyses which allowed to determine nontrivial geometric properties of two Escherichia coli-specific lipids as emerging from molecular dynamics simulations of relevant model bilayers.

Health and health-related indicators in slum, rural, and urban communities: a comparative analysis.

PubMed

Mberu, Blessing U; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C

2016-01-01

It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality outcomes. They bear a disproportionately much higher mortality burden than those living elsewhere. Slum communities had higher coverage of maternal health services than rural communities but it was not possible to compare maternal mortality rates across these residential domains. Compared to rural areas, slum communities had lower fertility and higher contraceptive use rates but these differences were reversed when slums were compared to other urban populations. Slum-rural differences in infant mortality were found to be larger in Bangladesh compared to Kenya. Mortality and morbidity indicators were worse in slums than elsewhere. However, indicators of access to care and health service coverage were found to be better in slums than in rural communities.

Health and health-related indicators in slum, rural, and urban communities: a comparative analysis

PubMed Central

Mberu, Blessing U.; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C.

2016-01-01

Background It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality outcomes. They bear a disproportionately much higher mortality burden than those living elsewhere. Slum communities had higher coverage of maternal health services than rural communities but it was not possible to compare maternal mortality rates across these residential domains. Compared to rural areas, slum communities had lower fertility and higher contraceptive use rates but these differences were reversed when slums were compared to other urban populations. Slum–rural differences in infant mortality were found to be larger in Bangladesh compared to Kenya. Conclusion Mortality and morbidity indicators were worse in slums than elsewhere. However, indicators of access to care and health service coverage were found to be better in slums than in rural communities. PMID:27924741

The intersection of gender and place in online health activities.

PubMed

Goldner, Melinda; Hale, Timothy M; Cotten, Shelia R; Stern, Michael J; Drentea, Patricia

2013-01-01

This study examines how rurality and gender are related to online health activities. Rural women face greater health risks and yet have access to a weaker health system infrastructure, which has resulted in a health disadvantage. New health information technologies may ameliorate some of these disparities; thus, the authors examine the relevance of gender and place in going online to search for health information, buy medicines, participate in health-related support groups, communicate with physicians, or maintain a personal health record. Analyzing data from the National Cancer Institute's 2007 Health Information National Trends Survey, the authors found that the relations between rurality and gender vary, depending on the specific type of online health activity, and that gender may be a more salient factor than rurality in determining whether individuals engage in particular types of online health activities. This study contributes to the literature by examining how gender and place are related to online health activities, a combined area neglected in past research, and advancing research on gender and technology. This research highlights the importance of expanding high-speed access in rural locations, increasing technological and health literacy, and tailoring the Internet to specific populations.

Reviewing independent access to HIV testing, counselling and treatment for adolescents in HIV-specific laws in sub-Saharan Africa: implications for the HIV response

PubMed Central

Eba, Patrick M.; Lim, HyeYoung

2017-01-01

Abstract Introduction: AIDS is a leading cause of death among adolescents in sub-Saharan Africa. Yet, legal, policy and social barriers continue to restrict their access to HIV services. In recent years, access to independent HIV testing and treatment for adolescents has gained increased attention. The 2013 WHO Guidance on HIV testing and counselling and care for adolescents living with HIV (WHO Guidance) calls for reviewing legal and regulatory frameworks to facilitate adolescents’ access to comprehensive HIV services. As of 31 March 2017, some 28 countries in sub-Saharan Africa have adopted HIV-specific legislation. But there is limited understanding of the provisions of these laws on access to HIV services for adolescents and their implication on efforts to scale up HIV prevention, testing, treatment and care among this population. Methods: A desk review of 28 HIV-specific laws in sub-Saharan Africa complemented with the review of HIV testing policies in four countries using human rights norms and key public health recommendations from the 2013 WHO Guidance. These recommendations call on countries to (i) lower the age of consent to HIV testing and counselling and allow mature adolescents who have not reached the age of consent to independently access HIV testing, (ii) ensure access to HIV counselling for adolescents, (iii) protect the confidentiality of adolescents living with HIV and (iv) facilitate access to HIV treatment for adolescents living with HIV. Results: Most HIV-specific laws fail to take into account human rights principles and public health recommendations for facilitating adolescents’ access to HIV services. None of the countries with HIV-specific laws has adopted all four recommendations for access to HIV services for adolescents. Discrepancies exist between HIV laws and national policy documents. Inadequate and conflicting provisions in HIV laws are likely to hinder access to HIV testing, counselling and treatment for adolescents. Conclusions: Efforts to end legal barriers to access to HIV services for adolescents in sub-Saharan Africa should address HIV-specific laws. Restrictive provisions in these laws should be reformed, and their protective norms effectively implemented including by translating them into national policies and ensuring sensitization and training of healthcare workers and communities. This study reiterates the need for action in all countries across Africa and beyond to review their laws and policies to create an enabling environment to accelerate access to HIV prevention, testing and treatment services for adolescents. PMID:28799324

Retail food environments, shopping experiences, First Nations and the provincial Norths

PubMed Central

Kristin, Burnett; Kelly, Skinner; Travis, Hay; Joseph, LeBlanc; Lori, Chambers

2017-01-01

Abstract Introduction: This paper looks at the market food environments of First Nations communities located in the provincial Norths by examining the potential retail competition faced by the North West Company (NWC) and by reporting on the grocery shopping experiences of people living in northern Canada. Methods: We employed two methodological approaches to assess northern retail food environments. First, we mapped food retailers in the North to examine the breadth of retail competition in the provincial Norths, focussing specifically on those communities without year-round road access. Second, we surveyed people living in communities in northern Canada about their retail and shopping experiences. Results: Fifty-four percent of communities in the provincial Norths and Far North without year-round road access did not have a grocery store that competed with the NWC. The provinces with the highest percentage of northern communities without retail competition were Ontario (87%), Saskatchewan (83%) and Manitoba (72%). Respondents to the survey (n = 92) expressed concern about their shopping experiences in three main areas: the cost of food, food quality and freshness, and availability of specific foods. Conclusion: There is limited retail competition in the provincial Norths. In Manitoba, Saskatchewan and Ontario, the NWC has no store competition in at least 70% of northern communities. Consumers living in northern Canada find it difficult to afford nutritious foods and would like access to a wider selection of perishable foods in good condition. PMID:29043760

South Africa's protracted struggle for equal distribution and equitable access - still not there.

PubMed

van Rensburg, Hendrik C J

2014-05-08

The purpose of this contribution is to analyse and explain the South African HRH case, its historical evolution, and post-apartheid reform initiatives aimed at addressing deficiencies and shortfalls. HRH in South Africa not only mirrors the nature and diversity of challenges globally, but also the strategies pursued by countries to address these challenges. Although South Africa has strongly developed health professions, large numbers of professional and mid-level workers, and also well-established training institutions, it is experiencing serious workforce shortages and access constraints. This results from the unequal distribution of health workers between the well-resourced private sector over the poorly-resourced public sector, as well as from distributional disparities between urban and rural areas. During colonial and apartheid times, disparities were aggravated by policies of racial segregation and exclusion, remnants of which are today still visible in health-professional backlogs, unequal provincial HRH distribution, and differential access to health services for specific race and class groups. Since 1994, South Africa's transition to democracy deeply transformed the health system, health professions and HRH establishments. The introduction of free-health policies, the district health system and the prioritisation of PHC ensured more equal distribution of the workforce, as well as greater access to services for deprived groups. However, the HIV/AIDS epidemic brought about huge demands for care and massive patient loads in the public-sector. The emigration of health professionals to developed countries and to the private sector also undermines the strength and effectiveness of the public health sector. For the poor, access to care thus remains constrained and in perpetual shortfall. The post-1994 government has introduced several HRH-specific strategies to recruit, distribute, motivate and retain health professionals to strengthen the public sector and to expand access and coverage. Of great significance among these is the NHI Plan that aims to bridge the structural divide and to redistribute material and human resources more equally. Its success largely hinges on HRH and the balanced deployment of the national workforce.Low- and middle-income countries have much to learn from South African HRH experiences. In turn, South Africa has much to learn from other countries, as this case study shows.

Differences in Human Papillomavirus Vaccination Among Adolescent Girls in Metropolitan Versus Non-metropolitan Areas: Considering the Moderating Roles of Maternal Socioeconomic Status and Health Care Access.

PubMed

Monnat, Shannon M; Rhubart, Danielle C; Wallington, Sherrie Flynt

2016-02-01

This study is among the first to examine metropolitan status differences in human papillomavirus (HPV) vaccine initiation and completion among United States adolescent girls and is unique in its focus on how maternal socioeconomic status and health care access moderate metropolitan status differences in HPV vaccination. Using cross-sectional data from 3573 girls aged 12-17 in the U.S. from the 2008-2010 Behavioral Risk Factor Surveillance System, we estimate main and interaction effects from binary logistic regression models to identify subgroups of girls for which there are metropolitan versus non-metropolitan differences in HPV vaccination. Overall 34 % of girls initiated vaccination, and 19 % completed all three shots. On average, there were no metropolitan status differences in vaccination odds. However, there were important subgroup differences. Among low-income girls and girls whose mothers did not complete high school, those in non-metropolitan areas had significantly higher probability of vaccine initiation than those in metropolitan areas. Among high-income girls and girls whose mothers completed college, those in metropolitan areas had significantly higher odds of vaccine initiation than those in non-metropolitan areas. Moreover, among girls whose mothers experienced a medical cost barrier, non-metropolitan girls were less likely to initiate vaccination compared to metropolitan girls. Mothers remain essential targets for public health efforts to increase HPV vaccination and combat cervical cancer. Public health experts who study barriers to HPV vaccination and physicians who come into contact with mothers should be aware of group-specific barriers to vaccination and employ more tailored efforts to increase vaccination.

A digital microfluidic system for serological immunoassays in remote settings.

PubMed

Ng, Alphonsus H C; Fobel, Ryan; Fobel, Christian; Lamanna, Julian; Rackus, Darius G; Summers, Aimee; Dixon, Christopher; Dryden, Michael D M; Lam, Charis; Ho, Man; Mufti, Nooman S; Lee, Victor; Asri, Mohd Afiq Mohd; Sykes, Edward A; Chamberlain, M Dean; Joseph, Rachael; Ope, Maurice; Scobie, Heather M; Knipes, Alaine; Rota, Paul A; Marano, Nina; Chege, Paul M; Njuguna, Mary; Nzunza, Rosemary; Kisangau, Ngina; Kiogora, John; Karuingi, Michael; Burton, John Wagacha; Borus, Peter; Lam, Eugene; Wheeler, Aaron R

2018-04-25

Serosurveys are useful for assessing population susceptibility to vaccine-preventable disease outbreaks. Although at-risk populations in remote areas could benefit from this type of information, they face several logistical barriers to implementation, such as lack of access to centralized laboratories, cold storage, and transport of samples. We describe a potential solution: a compact and portable, field-deployable, point-of-care system relying on digital microfluidics that can rapidly test a small volume of capillary blood for disease-specific antibodies. This system uses inexpensive, inkjet-printed digital microfluidic cartridges together with an integrated instrument to perform enzyme-linked immunosorbent assays (ELISAs). We performed a field validation of the system's analytical performance at Kakuma refugee camp, a remote setting in northwestern Kenya, where we tested children aged 9 to 59 months and caregivers for measles and rubella immunoglobulin G (IgG). The IgG assays were determined to have sensitivities of 86% [95% confidence interval (CI), 79 to 91% (measles)] and 81% [95% CI, 73 to 88% (rubella)] and specificities of 80% [95% CI, 49 to 94% (measles)] and 91% [95% CI, 76 to 97% (rubella)] (measles, n = 140; rubella, n = 135) compared with reference tests (measles IgG and rubella IgG ELISAs from Siemens Enzygnost) conducted in a centralized laboratory. These results demonstrate a potential role for this point-of-care system in global serological surveillance, particularly in remote areas with limited access to centralized laboratories. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.