Sample records for access health corp

  1. Peace corps partnered health services implementation research in global health: opportunity for impact.

    PubMed

    Dykens, Andrew; Hedrick, Chris; Ndiaye, Youssoupha; Linn, Annē

    2014-09-01

    There is abundant evidence of the affordable, life-saving interventions effective at the local primary health care level in low- and middle-income countries (LMICs). However, the understanding of how to deliver those interventions in diverse settings is limited. Primary healthcare services implementation research is needed to elucidate the contextual factors that can influence the outcomes of interventions, especially at the local level. US universities commonly collaborate with LMIC universities, communities, and health system partners for health services research but common barriers exist. Current challenges include the capacity to establish an ongoing presence in local settings in order to facilitate close collaboration and communication. The Peace Corps is an established development organization currently aligned with local health services in many LMICs and is well-positioned to facilitate research partnerships. This article explores the potential of a community-Peace Corps-academic partnership approach to conduct local primary healthcare services implementation research. The Peace Corps is well positioned to offer insights into local contextual factors because volunteers work closely with local leaders, have extensive trust within local communities, and have an ongoing, constant, well-integrated presence. However, the Peace Corps does not routinely conduct primary healthcare services implementation research. Universities, within the United States and locally, could benefit from the established resources and trust of the Peace Corps to conduct health services implementation research to advance access to local health services and further the knowledge of real world application of local health services in a diversity of settings. The proposed partnership would consist of (1) a local community advisory board and local health system leaders, (2) Peace Corps volunteers, and (3) a US-LMIC academic institutional collaboration. Within the proposed partnership approach

  2. Peace Corps Partnered Health Services Implementation Research in Global Health: Opportunity for Impact

    PubMed Central

    Hedrick, Chris; Ndiaye, Youssoupha; Linn, Annē

    2014-01-01

    Background: There is abundant evidence of the affordable, life-saving interventions effective at the local primary health care level in low- and middle-income countries (LMICs). However, the understanding of how to deliver those interventions in diverse settings is limited. Primary healthcare services implementation research is needed to elucidate the contextual factors that can influence the outcomes of interventions, especially at the local level. US universities commonly collaborate with LMIC universities, communities, and health system partners for health services research but common barriers exist. Current challenges include the capacity to establish an ongoing presence in local settings in order to facilitate close collaboration and communication. The Peace Corps is an established development organization currently aligned with local health services in many LMICs and is well-positioned to facilitate research partnerships. This article explores the potential of a community–Peace Corps–academic partnership approach to conduct local primary healthcare services implementation research. Discussion: The Peace Corps is well positioned to offer insights into local contextual factors because volunteers work closely with local leaders, have extensive trust within local communities, and have an ongoing, constant, well-integrated presence. However, the Peace Corps does not routinely conduct primary healthcare services implementation research. Universities, within the United States and locally, could benefit from the established resources and trust of the Peace Corps to conduct health services implementation research to advance access to local health services and further the knowledge of real world application of local health services in a diversity of settings. The proposed partnership would consist of (1) a local community advisory board and local health system leaders, (2) Peace Corps volunteers, and (3) a US-LMIC academic institutional collaboration. Within the

  3. Fine-Grained Access Control for Electronic Health Record Systems

    NASA Astrophysics Data System (ADS)

    Hue, Pham Thi Bach; Wohlgemuth, Sven; Echizen, Isao; Thuy, Dong Thi Bich; Thuc, Nguyen Dinh

    There needs to be a strategy for securing the privacy of patients when exchanging health records between various entities over the Internet. Despite the fact that health care providers such as Google Health and Microsoft Corp.'s Health Vault comply with the U.S Health Insurance Portability and Accountability Act (HIPAA), the privacy of patients is still at risk. Several encryption schemes and access control mechanisms have been suggested to protect the disclosure of a patient's health record especially from unauthorized entities. However, by implementing these approaches, data owners are not capable of controlling and protecting the disclosure of the individual sensitive attributes of their health records. This raises the need to adopt a secure mechanism to protect personal information against unauthorized disclosure. Therefore, we propose a new Fine-grained Access Control (FGAC) mechanism that is based on subkeys, which would allow a data owner to further control the access to his data at the column-level. We also propose a new mechanism to efficiently reduce the number of keys maintained by a data owner in cases when the users have different access privileges to different columns of the data being shared.

  4. Healthy Volunteer 2020: Comparing Peace Corps Volunteers' health metrics with Healthy People 2020 national objectives.

    PubMed

    Henderson, Susan J; Newman, Jeannette; Ferguson, Rennie W; Jung, Paul

    2016-12-01

    Healthy People 2020 (HP2020) provides a set of quantifiable objectives for improving the health and well-being of Americans. This study examines Peace Corps Volunteers' health metrics in comparison with the Leading Health Indicators (LHIs) in order to set baseline measures for Volunteers' health care and align our measurements with Healthy People 2020 standards. Health data from multiple internal Peace Corps datasets were compared with relevant LHIs and analyzed using descriptive statistics. Seventeen (65%) of the 26 LHIs were relevant to Peace Corps Volunteers. Of these, Volunteers' health measures met or were more favorable than the goals of 13 (76%) of the LHIs. There were no data available for 4 (24%) of the LHIs. The entire Volunteer population has full access to primary care, oral health, and reproductive health services. No suicides or homicides were reported among Volunteers during the analyzed time period. Utilizing the LHIs, we have identified high-priority public health issues relevant for the Peace Corps Volunteer population. We discuss the need for quality data to measure and monitor Volunteers' health progress and outcomes over time, and also to standardize our measurements with Healthy People 2020 benchmarks. This framework may foster greater collaboration to engage in health promotion and disease prevention activities driven by evidence-based information, which may, in turn, encourage healthy behavior among Volunteers.

  5. Naval Reserve Medicine: Recruitment Difficulties in the Medical Corps

    DTIC Science & Technology

    2016-03-01

    Reserve Naval Nurse Corps ..............24  4.  Evaluating the Effectiveness of Navy Medical Corps Accession Programs...the Navy EMF Expeditionary Medical Facility FTS Full Time Support GME Graduate Medical Education HPSP Health Professions Scholarship Program IDT...A. BACKGROUND The Department of the Navy (DON) provides operational support to the fleet by ensuring a sufficient number of medical professionals

  6. 76 FR 13438 - AccessTel, Inc., American Asset Management Corp., DME Interactive Holdings, Inc., DocuPort, Inc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-11

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] AccessTel, Inc., American Asset Management Corp., DME Interactive Holdings, Inc., DocuPort, Inc., and iCarbon Corp., Order of Suspension of Trading March 8, 2011. It appears to the Securities and Exchange Commission that there is a lack of current and accurate information concerning the...

  7. Strengthening the U.S. Public Health Service Commissioned Corps: A View From The Assistant Secretary for Health.

    PubMed

    Koh, Howard K

    2016-01-01

    To summarize the results of the major management review of the U.S. Public Health Service Commissioned Corps (2009-2010) and note related outcomes. Narrative from the U.S. Assistant Secretary for Health, who directed and oversaw the management review. The management review led to 46 recommendations, all of which have since been implemented. The subsequent organizational and operational changes have unified reporting structures, streamlined the administrative Corps organizational structure, and transferred support services to providers with expertise in uniformed services to create a new integrated personnel and payroll system. Related processes have also prompted a systematic billet review as well as establishment of explicit criteria for eligibility to become a Corps officer. Corps leaders report improvements in recruiting talented officers, increased selectivity from the candidate pool, and enhanced matching of incoming officers with agency assignments. Furthermore, Corps activity has grown in both traditional and innovative ways. The Corps has enjoyed heightened activity and outcomes in the era of health reform. The management review and its implementation have strengthened the Corps, helping officers to do their job and achieve their mission. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

  8. 42 CFR 23.13 - What nondiscrimination requirements apply to National Health Service Corps sites?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false What nondiscrimination requirements apply to National Health Service Corps sites? 23.13 Section 23.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL NATIONAL HEALTH SERVICE CORPS Assignment of National Health Service...

  9. 42 CFR 23.13 - What nondiscrimination requirements apply to National Health Service Corps sites?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false What nondiscrimination requirements apply to National Health Service Corps sites? 23.13 Section 23.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL NATIONAL HEALTH SERVICE CORPS Assignment of National Health Service...

  10. 42 CFR 23.13 - What nondiscrimination requirements apply to National Health Service Corps sites?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false What nondiscrimination requirements apply to National Health Service Corps sites? 23.13 Section 23.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL NATIONAL HEALTH SERVICE CORPS Assignment of National Health Service...

  11. 42 CFR 23.13 - What nondiscrimination requirements apply to National Health Service Corps sites?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What nondiscrimination requirements apply to National Health Service Corps sites? 23.13 Section 23.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL NATIONAL HEALTH SERVICE CORPS Assignment of National Health Service...

  12. 42 CFR 23.13 - What nondiscrimination requirements apply to National Health Service Corps sites?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false What nondiscrimination requirements apply to National Health Service Corps sites? 23.13 Section 23.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES PERSONNEL NATIONAL HEALTH SERVICE CORPS Assignment of National Health Service...

  13. 42 CFR 62.1 - What is the scope and purpose of the National Health Service Corps scholarship program?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Health Service Corps scholarship program? 62.1 Section 62.1 Public Health PUBLIC HEALTH SERVICE... SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS National Health Service Corps Scholarship Program § 62.1 What is the scope and purpose of the National Health Service Corps scholarship program? These regulations apply to...

  14. 42 CFR 62.1 - What is the scope and purpose of the National Health Service Corps scholarship program?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Health Service Corps scholarship program? 62.1 Section 62.1 Public Health PUBLIC HEALTH SERVICE... SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS National Health Service Corps Scholarship Program § 62.1 What is the scope and purpose of the National Health Service Corps scholarship program? These regulations apply to...

  15. 42 CFR 62.1 - What is the scope and purpose of the National Health Service Corps scholarship program?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Health Service Corps scholarship program? 62.1 Section 62.1 Public Health PUBLIC HEALTH SERVICE... SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS National Health Service Corps Scholarship Program § 62.1 What is the scope and purpose of the National Health Service Corps scholarship program? These regulations apply to...

  16. 42 CFR 62.1 - What is the scope and purpose of the National Health Service Corps scholarship program?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Health Service Corps scholarship program? 62.1 Section 62.1 Public Health PUBLIC HEALTH SERVICE... SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS National Health Service Corps Scholarship Program § 62.1 What is the scope and purpose of the National Health Service Corps scholarship program? These regulations apply to...

  17. 42 CFR 62.1 - What is the scope and purpose of the National Health Service Corps scholarship program?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Health Service Corps scholarship program? 62.1 Section 62.1 Public Health PUBLIC HEALTH SERVICE... SCHOLARSHIP AND LOAN REPAYMENT PROGRAMS National Health Service Corps Scholarship Program § 62.1 What is the scope and purpose of the National Health Service Corps scholarship program? These regulations apply to...

  18. Lessons Learned from a Data-Driven College Access Program: The National College Advising Corps

    ERIC Educational Resources Information Center

    Horng, Eileen L.; Evans, Brent J.; antonio, anthony l.; Foster, Jesse D.; Kalamkarian, Hoori S.; Hurd, Nicole F.; Bettinger, Eric P.

    2013-01-01

    This chapter discusses the collaboration between a national college access program, the National College Advising Corps (NCAC), and its research and evaluation team at Stanford University. NCAC is currently active in almost four hundred high schools and through the placement of a recent college graduate to serve as a college adviser provides…

  19. 32 CFR 22.520 - Campus access for military recruiting and Reserve Officer Training Corps (ROTC).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... of higher education that have policies or practices, as described in paragraph (c) of this section... Officer Training Corps Program Access to Institutions of Higher Education.” Part 216 establishes procedures by which the Department of Defense identifies institutions of higher education that have a policy...

  20. 75 FR 13805 - Aspen Group Resources Corp., Commercial Concepts, Inc., Desert Health Products, Inc., Equalnet...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-23

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Aspen Group Resources Corp., Commercial Concepts, Inc., Desert Health Products, Inc., Equalnet Communications Corp., Geneva Steel Holdings Corp... securities of Commercial Concepts, Inc. because it has not filed any periodic reports since the period ended...

  1. Holding up the oral health safety net: the role of National Health Service Corps alumni dentists in North Carolina.

    PubMed

    Bhatavadekar, Neel B; Rozier, R Gary; Konrad, Thomas R

    2011-06-01

    Access to oral health care among low income populations is a growing problem. The National Health Service Corps (NHSC) might increase the supply of dentists motivated to provide services for this population.   To determine if North Carolina dentists who began a service obligation with the NHSC in 1990-1999 continued to provide care for underserved populations and if they differ from non-NHSC alumni primary care dentists who started practice in the state during that same period.   All 19 NHSC alumni and 50 comparison dentists were surveyed by mail. NHSC alumni also responded to selected items in a telephone follow-up interview. The two groups were compared using difference of means tests and multivariate contingency tables.   National Health Service Corps alumni were more likely to be African-American (38%vs. 10%), work in safety net practices (84%vs. 23%), and see more publicly insured patients (60%vs. 19%) than comparison dentists. Yet their job satisfaction was comparable to non-NHSC alumni dentists. Analyses suggested that current practice in safety net settings is affected by dentists' race, altruistic motivations and previous NHSC participation. CONCLUSION AND POLICY IMPLICATION:  Targeted recruitment of African-American dentists and others wanting to work in underserved communities could amplify the effectiveness of the financial incentive of NHSC loan repayment and induce dentists to remain in 'safety net' settings. © 2011 FDI World Dental Federation.

  2. Behaviors and Knowledge of HealthCorps New York City High School Students: Nutrition, Mental Health, and Physical Activity.

    PubMed

    Heo, Moonseong; Irvin, Erica; Ostrovsky, Natania; Isasi, Carmen; Blank, Arthur E; Lounsbury, David W; Fredericks, Lynn; Yom, Tiana; Ginsberg, Mindy; Hayes, Shawn; Wylie-Rosett, Judith

    2016-02-01

    HealthCorps provides school wellness programming using curricula to promote changes in nutrition, mental health, and physical activity behaviors. The research objective was to evaluate effects of implementing its curricula on nutrition, mental health, and physical activity knowledge and behavior. Pre- and postsurvey data were collected (N = 2255) during the 2012-2013 academic year from 14 New York City public high schools. An 18-item knowledge questionnaire addressed 3 domains; 26 behavioral items were analyzed by factor analysis to identify 6 behavior domains, breakfast being a seventh 1-item domain. We examined the effects stratified by sex, applying mixed-effects models to take into account clustering effects of schools and participants adjusted for age. The HealthCorps program significantly increased all 3 knowledge domains (p < .05), and significantly changed several key behavioral domains. Boys significantly increased fruits/vegetables intake (p = .03). Girls increased acceptance of new fruits/vegetables (p = .03) and breakfast consumption (p = .04), and decreased sugar-sweetened beverages and energy dense food intake (p = .03). The associations between knowledge and behavior were stronger in boys than girls. The HealthCorps program significantly increased participants' knowledge on nutrition, mental health, and physical activity. It also improved several key behavioral domains, which are targets of the 2010 Dietary Guidelines to address obesity in youth. © 2016, American School Health Association.

  3. Behaviors and Knowledge of HealthCorps New York City High School Students: Nutrition, Mental Health and Physical Activity

    PubMed Central

    Moonseong, Heo; Erica, Irvin; Natania, Ostrovsky; Carmen, Isasi; Shawn, Hayes; Judith, Wylie-Rosett

    2015-01-01

    BACKGROUND HealthCorps provides school wellness programming using curricula to promote changes in nutrition, mental health and physical activity behaviors. The research objective was to evaluate effects of implementing its curricula on nutrition, mental health and physical activity knowledge and behavior. METHODS Pre- and post-survey data were collected (N = 2255) during the 2012-13 academic year from 14 New York City public high schools. An 18-item knowledge questionnaire addressed 3 domains; 26 behavioral items were analyzed by factor analysis to identify 6 behavior domains, breakfast being a seventh one-item domain. We examined the effects stratified by sex, applying mixed-effects models to take into account clustering effects of schools and participants adjusted for age. RESULTS The HealthCorps program significantly increased all 3 knowledge domains (p < .05), and significantly changed several key behavioral domains. Boys significantly increased fruits/vegetables intake (p = .03). Girls increased acceptance of new fruits/vegetables (p = .03) and breakfast consumption (p = .04), and decreased sugar-sweetened beverages and energy dense food intake (p = .03). The associations between knowledge and behavior were stronger in boys than girls. CONCLUSION The HealthCorps program significantly increased participants’ knowledge on nutrition, mental health and physical activity. It also improved several key behavioral domains, which are targets of the 2010 Dietary Guidelines to address obesity in youth. PMID:26762819

  4. An Analysis of the Populations of the Air Force's Medical and Professional Officer Corps.

    PubMed

    Keating, Edward G; Massey, Hugh G; Mele, Judith D; Mundell, Benjamin F

    2012-01-01

    Since the advent of the all-volunteer force, one of the foremost personnel challenges of the U.S. Air Force has been recruiting and retaining an adequate number of medical and professional officers in the Air Force's seven medical and professional officer corps: the Biomedical Sciences Corps (BSC), the Chaplain Corps, the Dental Corps, the Judge Advocate General (JAG) Corps (attorneys), the Medical Corps (physicians), the Medical Service Corps (MSC), and the Nurse Corps. For each of these corps, there are highly similar jobs in the private sector, so attracting and retaining these corps' officers is a constant challenge. This article analyzes all seven Air Force medical and professional officer corps and their relative statuses with regard to end strengths, accession levels, promotion flow, and attrition since the late 1970s. The authors find that recent accession and retention trends have been most adverse in the Air Force's Nurse Corps, while the MSC and the JAG Corps appear to have the most stable populations.

  5. Suspension of enrollment in the Federal Employees Health Benefits (FEHB) Program for Peace Corps volunteers. Final rule.

    PubMed

    2006-11-17

    The Office of Personnel Management is issuing a final regulation to allow Peace Corps volunteers who are FEHB Program enrolled annuitants, survivors, and former spouses to suspend their FEHB enrollments and then return to the FEHB Program during the Open Season, or return to FEHB coverage immediately, if they involuntarily lose health benefits coverage under the Peace Corps. The intent of this final rule is to allow these beneficiaries to avoid the expense of continuing to pay FEHB Program premiums while they have other health coverage as Peace Corps volunteers, without endangering their ability to return to the FEHB Program in the future.

  6. Effects of ParentCorps in Prekindergarten on Child Mental Health and Academic Performance

    PubMed Central

    Brotman, Laurie Miller; Dawson-McClure, Spring; Kamboukos, Dimitra; Huang, Keng-Yen; Calzada, Esther J.; Goldfeld, Keith; Petkova, Eva

    2017-01-01

    IMPORTANCE Low-income minority children living in urban neighborhoods are at high risk for mental health problems and underachievement. ParentCorps, a family-centered, school-based intervention in prekindergarten, improves parenting and school readiness (ie, self-regulation and preacademic skills) in 2 randomized clinical trials. The longer-term effect on child mental health and academic performance is not known. OBJECTIVE To examine whether ParentCorps delivered as an enhancement to prekindergarten programs in high-poverty urban schools leads to fewer mental health problems and increased academic performance in the early elementary school years. DESIGN, SETTING, AND PARTICIPANTS This is a 3-year follow-up study of a cluster randomized clinical trial of ParentCorps in public schools with prekindergarten programs in New York City. Ten elementary schools serving a primarily low-income, black student population were randomized in 2005, and 4 consecutive cohorts of prekindergarten students were enrolled from September 12, 2005, through December 31, 2008. We report follow-up for the 3 cohorts enrolled after the initial year of implementation. Data analysis was performed from September 1, 2014, to December 31, 2015. INTERVENTIONS ParentCorps included professional development for prekindergarten and kindergarten teachers and a program for parents and prekindergarten students (13 two-hour group sessions delivered after school by teachers and mental health professionals). MAIN OUTCOMES AND MEASURES Annual teacher ratings of mental health problems and academic performance and standardized tests of academic achievement in kindergarten and second grade by testers masked to the intervention or control group randomization. RESULTS A total of 1050 children (4 years old; 518 boys [49.3%] and 532 girls [50.7%]) in 99 prekindergarten classrooms participated in the trial (88.1% of the prekindergarten population), with 792 students enrolled from 2006 to 2008. Most families in the

  7. U.S. Public Health Service Commissioned Corps Pharmacists: Making a Difference in Advancing the Nation’s Health

    PubMed Central

    Flowers, Louis; Wick, Jeannette; Figg, William Douglas; McClelland, Robert H.; Shiber, Michael; Britton, James E.; Ngo, Diem-Kieu H.; Borders-Hemphill, Vicky; Mead, Christina; Zee, Jerry; Huntzinger, Paul

    2010-01-01

    Objective To describe how pharmacy officers in the Commissioned Corps are making a difference in protecting, promoting, and advancing health and safety of the Nation. Summary Pharmacists who serve in the Commissioned Corps of the United States Public Health Service fill roles that are considerably different than their counterparts in the private sector. Their work takes them out from behind the counter and into the world. Pharmacy officers advance the health and safety of the Nation by their involvement in the delivery of direct patient care to medically underserved people, national security, drug vigilance, research and policy-making endeavors. PHS pharmacists fill essential public health leadership and service roles throughout the U.S. Department of Health and Human Services (HHS) and certain non-HHS federal agencies and programs. The Federal Bureau of Prisons, Health Resources and Services Administration, Food and Drug Administration, United States Coast Guard, Indian Health Service, and National Institutes of Health are among the many federal agencies where pharmacy officers are assigned. Conclusion In each setting, pharmacists find traditional roles augmented with assignments and challenges that broaden the scope of their practice. PMID:19443327

  8. 20 CFR 1002.58 - Is service in the commissioned corps of the Public Health Service considered “service in the...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Public Health Service considered âservice in the uniformed services?â 1002.58 Section 1002.58 Employees... commissioned corps of the Public Health Service considered “service in the uniformed services?” Yes. Service in the commissioned corps of the Public Health Service (PHS) is “service in the uniformed services” under...

  9. 20 CFR 1002.58 - Is service in the commissioned corps of the Public Health Service considered “service in the...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Public Health Service considered âservice in the uniformed services?â 1002.58 Section 1002.58 Employees... commissioned corps of the Public Health Service considered “service in the uniformed services?” Yes. Service in the commissioned corps of the Public Health Service (PHS) is “service in the uniformed services” under...

  10. 20 CFR 1002.58 - Is service in the commissioned corps of the Public Health Service considered “service in the...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Public Health Service considered âservice in the uniformed services?â 1002.58 Section 1002.58 Employees... commissioned corps of the Public Health Service considered “service in the uniformed services?” Yes. Service in the commissioned corps of the Public Health Service (PHS) is “service in the uniformed services” under...

  11. 20 CFR 1002.58 - Is service in the commissioned corps of the Public Health Service considered “service in the...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Public Health Service considered âservice in the uniformed services?â 1002.58 Section 1002.58 Employees... commissioned corps of the Public Health Service considered “service in the uniformed services?” Yes. Service in the commissioned corps of the Public Health Service (PHS) is “service in the uniformed services” under...

  12. 20 CFR 1002.58 - Is service in the commissioned corps of the Public Health Service considered “service in the...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Public Health Service considered âservice in the uniformed services?â 1002.58 Section 1002.58 Employees... commissioned corps of the Public Health Service considered “service in the uniformed services?” Yes. Service in the commissioned corps of the Public Health Service (PHS) is “service in the uniformed services” under...

  13. The role of the US Army Veterinary Corps in military family pet health.

    PubMed

    Vincent-Johnson, Nancy A

    2013-01-01

    Even though privately-owned pet care is a lower priority mission than military working dog care, food inspection,and the public health mission, it is still very important,and the one that many Veterinary Corps officers, civil-ian veterinarians, and technicians enjoy the most. The vast majority of veterinarians and technicians went into veterinary medicine because of a love for animals. It is fulfilling to offer guidance to a client with a new puppy or kitten, see a sick pet improve after treatment, and interact with dozens of animals and clients in a day. The services provided by the Army Veterinary Corps in car-ing for pets has expanded over the years and the standard of care has improved as well. It is truly a privilege to serve those who dedicate themselves to the protection of our Nation. The Army Veterinary Corps is indeed proud to provide care to the pets of Warfighters of the Army,Navy, Marine Corps, Air Force, and Coast Guard; their family members; and our military retirees.

  14. 75 FR 51485 - Comment Request for Information Collection for OMB Control No. 1205-0033; Job Corps Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-20

    ... Employment and Training Administration is soliciting comments concerning the collection of data about Job... Health and Wellness Manager, Employment and Training Administration, Office of Job Corps, Room N-4507.... Background Job Corps is an intensive, residential training program for at-risk youth age 16 through 24 to...

  15. 75 FR 17799 - AB Liquidating Corp. (f/k/a Adaptive Broadband Corp.), Globalnet Corp., Greenland Corp...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-07

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] AB Liquidating Corp. (f/k/a Adaptive Broadband Corp.), Globalnet Corp., Greenland Corp., KeraVision, Inc., Lifespan, Inc., STAR Telecommunications... concerning the securities of STAR Telecommunications, Inc. because it has not filed any periodic reports...

  16. Marine Corps Private Cloud Computing Environment Strategy

    DTIC Science & Technology

    2012-05-15

    leveraging economies of scale through the MCEITS PCCE, the Marine Corps will measure consumed IT resources more effectively, increase or decrease...flexible broad network access, resource pooling, elastic provisioning and measured services. By leveraging economies of scale the Marine Corps will be able...IaaS SaaS / IaaS 1 1 LCE I ACE Dets I I I I ------------------~ GIG / CJ Internet Security Boundary MCEN I DISN r :------------------ MCEN

  17. Marketing public health through older adult volunteering: Experience Corps as a social marketing intervention.

    PubMed

    Tan, Erwin J; Tanner, Elizabeth K; Seeman, Teresa E; Xue, Qian-Li; Rebok, George W; Frick, Kevin D; Carlson, Michelle C; Wang, Tao; Piferi, Rachel L; McGill, Sylvia; Whitfield, Keith E; Fried, Linda P

    2010-04-01

    We present a social marketing conceptual framework for Experience Corps Baltimore City (EC) in which the desired health outcome is not the promoted product or behavior. We also demonstrate the feasibility of a social marketing-based recruitment campaign for the first year of the Baltimore Experience Corps Trial (BECT), a randomized, controlled trial of the health benefits of EC participation for older adults. We recruited older adults from the Baltimore, MD, area. Participants randomized to the intervention were placed in public schools in volunteer roles designed to increase healthy behaviors. We examined the effectiveness of a recruitment message that appealed to generativity (i.e., to make a difference for the next generation), rather than potential health benefits. Among the 155 participants recruited in the first year of the BECT, the average age was 69 years; 87% were women and 85% were African American. Participants reported primarily generative motives as their reason for interest in the BECT. Public health interventions embedded in civic engagement have the potential to engage older adults who might not respond to a direct appeal to improve their health.

  18. Health Professions Education/Nurse Training and National Health Service Corps, 1981. Hearing Before the Committee on Labor and Human Resources, United States Senate, Ninety-Seventh Congress, First Session on S. 799 [and] S. 801 (April 8, 1981).

    ERIC Educational Resources Information Center

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

    This congressional report contains testimony pertaining to two Senate bills (S. 99 and S. 801) dealing with health professions education and nurse training and with the National Health Service Corps. (The National Health Service Corps Bill, S. 801, provides for redefining health manpower shortage areas, using the Corps only where there is…

  19. Topography adjacent to Signal Corps Radar (S.C.R.) 296 Station 5, ...

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

    Topography adjacent to Signal Corps Radar (S.C.R.) 296 Station 5, showing conditions before construction, May 28, 1943, this drawing shows the Bonita Ridge access road retaining wall and general conditions at Bonita Ridge before the construction of Signal Corps Radar (S.C.R.) 296 Station 5 - Fort Barry, Signal Corps Radar 296, Station 5, Transmitter Building Foundation, Point Bonita, Marin Headlands, Sausalito, Marin County, CA

  20. Marketing Public Health Through Older Adult Volunteering: Experience Corps as a Social Marketing Intervention

    PubMed Central

    Tanner, Elizabeth K.; Seeman, Teresa E.; Xue, Qian-Li; Rebok, George W.; Frick, Kevin D.; Carlson, Michelle C.; Wang, Tao; Piferi, Rachel L.; McGill, Sylvia; Whitfield, Keith E.; Fried, Linda P.

    2010-01-01

    Objectives. We present a social marketing conceptual framework for Experience Corps Baltimore City (EC) in which the desired health outcome is not the promoted product or behavior. We also demonstrate the feasibility of a social marketing–based recruitment campaign for the first year of the Baltimore Experience Corps Trial (BECT), a randomized, controlled trial of the health benefits of EC participation for older adults. Methods. We recruited older adults from the Baltimore, MD, area. Participants randomized to the intervention were placed in public schools in volunteer roles designed to increase healthy behaviors. We examined the effectiveness of a recruitment message that appealed to generativity (i.e., to make a difference for the next generation), rather than potential health benefits. Results. Among the 155 participants recruited in the first year of the BECT, the average age was 69 years; 87% were women and 85% were African American. Participants reported primarily generative motives as their reason for interest in the BECT. Conclusions. Public health interventions embedded in civic engagement have the potential to engage older adults who might not respond to a direct appeal to improve their health. PMID:20167888

  1. PEACE CORPS, CONGRESSIONAL PRESENTATION, FISCAL YEAR 1967.

    ERIC Educational Resources Information Center

    Peace Corps, Washington, DC.

    THIS REPORT TO CONGRESS DISCUSSES THE HISTORY, FINANCIAL POLICY, VOLUNTEER PROGRAMS, AND RATIONALE OF THE PEACE CORPS, WITH EMPHASIS ON PLANS TO IMPROVE TRAINING AND EXPAND ITS PROGRAM. PEACE CORPS TEACHING, COMMUNITY DEVELOPMENT, AGRICULTURAL DEVELOPMENT, AND HEALTH EDUCATION IN VARIOUS DEVELOPING COUNTRIES ARE REVIEWED AND EVALUATED. A PROPOSAL…

  2. 75 FR 72841 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Job Corps...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-26

    ... for OMB Review; Comment Request; Job Corps Health Questionnaire ACTION: Notice. SUMMARY: The...) sponsored information collection request (ICR) titled, ``Job Corps Health Questionnaire,'' to the Office of... without change of a currently approved collection. Title of Collection: Job Corps Health Questionnaire...

  3. 75 FR 68368 - Recruitment of Sites for Assignment of Corps Personnel Obligated Under the National Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-05

    ... through the Private Practice Option. Eligible HPSAs and Entities To be eligible to receive assignment of...) provide primary medical care, mental health, or oral health services to a primary medical care, mental... assignment of Corps personnel must assure that (1) the position will permit the full scope of practice and...

  4. Possible rabies exposures in Peace Corps volunteers, 2011.

    PubMed

    Harvey, Kira; Jentes, Emily S; Charles, Myrna; Johnson, Katherine J; Petersen, Brett; Lamias, Mark J; Blanton, Jesse D; Sotir, Mark J; Brunette, Gary W

    2014-05-01

    We surveyed Peace Corps Medical Officers (PCMOs) to determine the frequency of and responses to possible rabies exposures of U.S. Peace Corps volunteers (PCVs). Surveys were sent to 56 PCMOs serving in countries with moderate or high rabies vaccine recommendations from the U.S. Centers for Disease Control and Prevention (CDC), of which 38 (68%) responded. Thirty-seven PCMOs reported that, of 4,982 PCVs, 140 (3%) experienced possible rabies exposures. Of these, 125 (89%) had previously received rabies vaccination, 129 (92%) presented with adequately cleansed wounds, and 106 (76%) were deemed to require and were given post-exposure prophylaxis (PEP). Of 35 respondents, 30 (86%) reported that rabies vaccine was always accessible to PCVs in their country within 24 hours. Overall, the Peace Corps is successful at preventing and treating possible rabies exposures. However, this study identified a few gaps in policy implementation. The Peace Corps should continue and strengthen efforts to provide education, preexposure vaccination, and PEP to PCVs.

  5. Possible Rabies Exposures in Peace Corps Volunteers, 2011

    PubMed Central

    Harvey, Kira; Jentes, Emily S.; Charles, Myrna; Johnson, Katherine J.; Petersen, Brett; Lamias, Mark J.; Blanton, Jesse D.; Sotir, Mark J.; Brunette, Gary W.

    2014-01-01

    We surveyed Peace Corps Medical Officers (PCMOs) to determine the frequency of and responses to possible rabies exposures of U.S. Peace Corps volunteers (PCVs). Surveys were sent to 56 PCMOs serving in countries with moderate or high rabies vaccine recommendations from the U.S. Centers for Disease Control and Prevention (CDC), of which 38 (68%) responded. Thirty-seven PCMOs reported that, of 4,982 PCVs, 140 (3%) experienced possible rabies exposures. Of these, 125 (89%) had previously received rabies vaccination, 129 (92%) presented with adequately cleansed wounds, and 106 (76%) were deemed to require and were given post-exposure prophylaxis (PEP). Of 35 respondents, 30 (86%) reported that rabies vaccine was always accessible to PCVs in their country within 24 hours. Overall, the Peace Corps is successful at preventing and treating possible rabies exposures. However, this study identified a few gaps in policy implementation. The Peace Corps should continue and strengthen efforts to provide education, preexposure vaccination, and PEP to PCVs. PMID:24639304

  6. Singapore Armed Forces Medical Corps-Ministry of Health clinical practice guidelines: management of heat injury.

    PubMed

    Lee, L; Fock, K M; Lim, C L F; Ong, E H M; Poon, B H; Pwee, K H; O'Muircheartaigh, C R; Seet, B; Tan, C L B; Teoh, C S

    2010-10-01

    The Singapore Armed Forces (SAF) Medical Corps and the Ministry of Health (MOH) have published clinical practice guidelines on Management of Heat Injury to provide doctors and patients in Singapore with evidence-based guidance on the prevention and clinical management of exertional heat injuries. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the SAF Medical Corps-MOH clinical practice guidelines on Management of Heat Injury, for the information of readers of the Singapore Medical Journal. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/mohcorp/publications.aspx?id=25178. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

  7. Navy Dental Corps: ninety years ... and forward.

    PubMed

    Woofter, Dennis D; Peters, Andrew; Kvaska, Greg; Turner, Carol I; Peters, Robert J; Shaffer, Richard G; Sobocinski, Andre B

    2003-01-01

    The Navy Dental Corps is responsible for ensuring the readiness of America's sailors and marines and optimizing their oral health. This article traces the history from the 1912 Act of Congress authorizing thirty "assistant dental surgeons" as the first Navy Dental Corps through service around the world. Navy dentists have seen service in every war and action in the past ninety years, reaching a peak of seven thousand officers and eleven thousand technicians in World War II. The Navy Dental Corps has served in the Korean and Vietnam Wars, Beirut, Somalia, Haiti, 9/11, Desert Storm, Desert Shield, and Operation Iraqi Freedom.

  8. Navy Nurse Corps manpower management model.

    PubMed

    Kinstler, Daniel P; Johnson, Raymond W; Richter, Anke; Kocher, Kathryn

    2008-01-01

    The Navy Nurse Corps is part of a team of professionals that provides high quality, economical health care to approximately 700,000 active duty Navy and Marine Corps members, as well as 2.6 million retired and family members. Navy Nurse Corps manpower management efficiency is critical to providing this care. This paper aims to focus on manpower planning in the Navy Nurse Corps. The Nurse Corps manages personnel primarily through the recruitment process, drawing on multiple hiring sources. Promotion rates at the lowest two ranks are mandated, but not at the higher ranks. Retention rates vary across pay grades. Using these promotion and attrition rates, a Markov model was constructed to model the personnel flow of junior nurse corps officers. Hiring sources were shown to have a statistically significant effect on promotion and retention rates. However, these effects were not found to be practically significant in the Markov model. Only small improvements in rank imbalances are possible given current recruiting guidelines. Allowing greater flexibility in recruiting practices, fewer recruits would generate a 25 percent reduction in rank imbalances, but result in understaffing. Recruiting different ranks at entry would generate a 65 percent reduction in rank imbalances without understaffing issues. Policies adjusting promotion and retention rates are more powerful in controlling personnel flows than adjusting hiring sources. These policies are the only means for addressing the fundamental sources of rank imbalances in the Navy Nurse Corps arising from current manpower guidelines. The paper shows that modeling to improve manpower management may enable the Navy Nurse Corps to more efficiently fulfill its mandate for high-quality healthcare.

  9. 77 FR 3319 - TapSlide, Inc., TTC Technology Corp. (f/k/a SmarTire Systems Inc.), TWL Corp., TXP Corp...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-23

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] TapSlide, Inc., TTC Technology Corp. (f/k/a SmarTire Systems Inc.), TWL Corp., TXP Corp., Valentec Systems, Inc. (f/k/a Acorn Holdings Corp... current and accurate information concerning the securities of TTC Technology Corp. (f/k/a SmarTire Systems...

  10. 42 CFR 21.28 - Age requirements, Regular Corps, senior assistant grade and below.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Age requirements, Regular Corps, senior assistant grade and below. 21.28 Section 21.28 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... active service in the Commissioned Corps of the Public Health Service shall be increased by the period of...

  11. An Evaluation of Marine Corps Educational Credentials.

    DTIC Science & Technology

    1983-12-01

    Recruits with the same 103 Table 17 Percent Attrition Among Male Nonprior Service Accessions Who Entered the Marine Corps between FY 1978-83 by aLevel of...dictor: It Works, But Why, (Anaheim, CA.: paper presented at the 91st Annual Convention of the American Psychological Association, August 1983

  12. 78 FR 9705 - National Advisory Council on the National Health Service Corps; Request for Nominations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-11

    ... (HRSA) is requesting nominations to fill five (5) vacancies on the National Advisory Council (NAC) on... electronically to Njeri Jones at [email protected] or mailed to 5600 Fishers Lane, Room 13-64, Rockville, MD 20857...: The National Advisory Council on the National Health Service Corps (hereafter referred to as NAC) was...

  13. GeoCorps America

    NASA Astrophysics Data System (ADS)

    Dawson, M.

    2011-12-01

    GeoCorps America, a program of the Geological Society of America's (GSA) Education and Outreach Department, provides short-term geoscience jobs in America's most amazing public lands. These jobs are hosted on federal lands managed by GeoCorps' three partner agencies: the National Park Service (NPS), the U.S. Forest Service (USFS), and the Bureau of Land Management (BLM). Agency staff submit to GSA position descriptions that help meet their geoscience needs. GSA advertises the positions online, recruits applicants from its 24,000+ members, and coordinates the placement of the candidates selected by agency staff. The typical GeoCorps position lasts for three months, pays a stipend of $2,750, and provides either free housing or a housing allowance. Some GeoCorps positions are classified as "Guest Scientist" positions, which generally last longer, involve larger payments, and require a higher level of expertise. Most GeoCorps positions occur during the spring/summer, but an increasing number of positions are being offered during the fall/winter. GeoCorps positions are open to geoscientists of all levels, from undergraduates through retired professionals. GeoCorps projects involve field and laboratory-based geoscience research, but some projects focus on developing educational programs and materials for staff, volunteers, and the public. The subject areas covered by GeoCorps projects include geology, hydrology, paleontology, mapping/GIS, soils, geo-hazards, cave/karst science, and more. GeoCorps positions have taken place at over 125 different locations nationwide, including Grand Canyon National Park, Sierra National Forest, and Craters of the Moon National Monument. In 2011, GeoCorps began offering GeoCorps Diversity Internships and GeoCorps American Indian Internships. The introduction of these programs doubled the level of diversity among GeoCorps participants. This increase in diversity is helping GSA and its partner agencies in meeting its mutual goal of

  14. 42 CFR 23.8 - What operational requirements apply to an entity to which National Health Service Corps personnel...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false What operational requirements apply to an entity to... Assignment of National Health Service Corps Personnel § 23.8 What operational requirements apply to an entity...; and (g) Establish basic data, cost accounting, and management information and reporting systems as...

  15. Sexual Health and Responsibility Program (SHARP): Preventing HIV, STIs, and Unplanned Pregnancies in the Navy and Marine Corps

    PubMed Central

    MacDonald, Michael R. (Bob)

    2013-01-01

    In 1999, the Navy and Marine Corps Public Health Center converted an HIV train-the-trainer program into a broader effort of preventing not just HIV, but also other sexually transmitted infections (STIs) and unplanned pregnancies. The premise for this broader approach was that a more comprehensive sexual health promotion message of STI, HIV, and unplanned pregnancy prevention is more likely to include at least one personally relevant concern for any given individual and is, therefore, more likely to be internalized and acted upon by the greatest number of individuals, and that risk reduction for any one of these consequences of sexual activity may reduce risk for all. This new effort was labeled the Sexual Health and Responsibility Program (SHARP). Within the Navy and Marine Corps, SHARP has become a focal and trusted source of sexual health promotion products, consultative services, and training, as well as a conduit for multidisciplinary collaboration and coordination. The existence of this central sexual health program normalizes integrated and comprehensive sexual health messages, enables efficiencies, promotes program and policy uniformity, and provides a forum for cross-organizational collaboration and continuous improvement. PMID:23450888

  16. Impact of Title VII Training Programs on Community Health Center Staffing and National Health Service Corps Participation

    PubMed Central

    Rittenhouse, Diane R.; Fryer, George E.; Phillips, Robert L.; Miyoshi, Thomas; Nielsen, Christine; Goodman, David C.; Grumbach, Kevin

    2008-01-01

    PURPOSE Community health centers (CHCs) are a critical component of the health care safety net. President Bush’s recent effort to expand CHC capacity coincides with difficulty recruiting primary care physicians and substantial cuts in federal grant programs designed to prepare and motivate physicians to practice in underserved settings. This article examines the association between physicians’ attendance in training programs funded by Health Resources and Services Administration (HRSA) Title VII Section 747 Primary Care Training Grants and 2 outcome variables: work in a CHC and participation in the National Health Service Corps Loan Repayment Program (NHSC LRP). METHODS We linked the 2004 American Medical Association Physician Master-file to HRSA Title VII grants files, Medicare claims data, and data from the NHSC. We then conducted retrospective analyses to compare the proportions of physicians working in CHCs among physicians who either had or had not attended Title VII–funded medical schools or residency programs and to determine the association between having attended Title VII–funded residency programs and subsequent NHSC LRP participation. RESULTS Three percent (5,934) of physicians who had attended Title VII–funded medical schools worked in CHCs in 2001–2003, compared with 1.9% of physicians who attended medical schools without Title VII funding (P<.001). We found a similar association between Title VII funding during residency and subsequent work in CHCs. These associations remained significant (P<.001) in logistic regression models controlling for NHSC participation, public vs private medical school, residency completion date, and physician sex. A strong association was also found between attending Title VII–funded residency programs and participation in the NHSC LRP, controlling for year completed training, physician sex, and private vs public medical school. CONCLUSIONS Continued federal support of Title VII training grant programs is

  17. Different Success Rates and Associated Factors at Three Levels of Career Progression Among US Marine Corps Officers

    DTIC Science & Technology

    1993-09-01

    establish a database of sufficient proportions to track Marine Corps officer career success from accession to the grade of 0-4. 12 "* To profile the...OBJECTIVES Accordingly, this study had three objectives. First, to establish a database of sufficient proportions to track Marine Corps officer career ... success from accession to the grade of 0-4. Second, to profile the successful Marine officer; that is, to determine what variables are associated with

  18. Comprehensive Employment and Training Act of 1973. Job Corps Health Program. A Working Document for Standing Orders. Part 1. Standing Orders for Health Personnel.

    ERIC Educational Resources Information Center

    Employment and Training Administration (DOL), Washington, DC.

    Developed as the first of a two-part supplement to Technical Supplement Q for Standing Orders (TS-Q), this handbook of standing orders was designed to help health personnel at Comprehensive Employment and Training Act (CETA) Job Corps health centers meet the federal requirement that each center have a set of written standing orders on how to…

  19. U.S. Public Health Service Commissioned Corps pharmacists: making a difference in advancing the nation's health.

    PubMed

    Flowers, Louis; Wick, Jeannette; Figg, William Douglas; McClelland, Robert H; Shiber, Michael; Britton, James E; Ngo, Diem-Kieu H; Borders-Hemphill, Vicky; Mead, Christina; Zee, Jerry; Huntzinger, Paul

    2009-01-01

    To describe how U.S. Public Health Service (PHS) pharmacists serving in jobs that are normal for them, but considerably different than those found in the private sector, are making a difference in advancing the nation's health. Pharmacists who serve in the Commissioned Corps of PHS fill roles that are considerably different than their counterparts in the private sector. Their work takes them out from behind the counter and into the world. Pharmacy officers advance the health and safety of the nation by their involvement in the delivery of direct patient care to medically underserved people, national security, drug vigilance, research, and policy-making endeavors. PHS pharmacists fill essential public health leadership and service roles throughout the U.S. Department of Health and Human Services (HHS) and certain non-HHS federal agencies and programs. The Health Resources and Services Administration, National Institutes of Health, Federal Bureau of Prisons, Indian Health Service, Food and Drug Administration, and U.S. Coast Guard are among the many federal agencies in which pharmacy officers are assigned. In each setting, PHS pharmacists find traditional roles augmented with assignments and challenges that broaden the scope of their practice.

  20. Should the United States Marine Corps Refine Its System of Active Component Enlisted Recruitment in Order to Target the Needs of Select Marine Corps Reserve Units?

    DTIC Science & Technology

    2012-03-23

    1K.pdf ( accessed January 3, 2012). 6 Charts built by the author using data extracted the Marine Corps Total Force System database. Information...Washington D.C., February 2012. http://www.defense.gov/news/Fact_Sheet_Budget.pdf ( accessed February 17, 2012). 10 Department of Defense. 11...www.defense.gov/news/newsarticle.aspx?id=66698 ( accessed January 8, 2012) 12 Amos. 13 David Cloud, and Christi Parsons. "President Obama Calls for

  1. Patient-centred access to health care: conceptualising access at the interface of health systems and populations

    PubMed Central

    2013-01-01

    Background Access is central to the performance of health care systems around the world. However, access to health care remains a complex notion as exemplified in the variety of interpretations of the concept across authors. The aim of this paper is to suggest a conceptualisation of access to health care describing broad dimensions and determinants that integrate demand and supply-side-factors and enabling the operationalisation of access to health care all along the process of obtaining care and benefiting from the services. Methods A synthesis of the published literature on the conceptualisation of access has been performed. The most cited frameworks served as a basis to develop a revised conceptual framework. Results Here, we view access as the opportunity to identify healthcare needs, to seek healthcare services, to reach, to obtain or use health care services, and to actually have a need for services fulfilled. We conceptualise five dimensions of accessibility: 1) Approachability; 2) Acceptability; 3) Availability and accommodation; 4) Affordability; 5) Appropriateness. In this framework, five corresponding abilities of populations interact with the dimensions of accessibility to generate access. Five corollary dimensions of abilities include: 1) Ability to perceive; 2) Ability to seek; 3) Ability to reach; 4) Ability to pay; and 5) Ability to engage. Conclusions This paper explains the comprehensiveness and dynamic nature of this conceptualisation of access to care and identifies relevant determinants that can have an impact on access from a multilevel perspective where factors related to health systems, institutions, organisations and providers are considered with factors at the individual, household, community, and population levels. PMID:23496984

  2. Preparation for Childbirth. A Health Workers Manual. Appropriate Technologies for Development. Peace Corps Information Collection & Exchange Reprint R-55.

    ERIC Educational Resources Information Center

    Hansen, Miriam; And Others

    This manual was developed to help Peace Corps volunteers who are serving as community health workers in developing nations to teach expectant mothers about pregnancy and childbirth. The material is organized in four sections corresponding to four prenatal classes plus a section on labor and delivery information for health care workers. Some of the…

  3. Accessibility: global gateway to health literacy.

    PubMed

    Perlow, Ellen

    2010-01-01

    Health literacy, cited as essential to achieving Healthy People 2010's goals to "increase quality and years of healthy life" and to "eliminate health disparities," is defined by Healthy People as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." Accessibility, by definition, the aforementioned "capacity to obtain," thus is health literacy's primary prerequisite. Accessibility's designation as the global gateway to health literacy is predicated also on life's realities: global aging and climate change, war and terrorism, and life-extending medical and technological advances. People with diverse access needs are health professionals' raison d'être. However, accessibility, consummately cross-cultural and universal, is virtually absent as a topic of health promotion and practice research and scholarly discussion of health literacy and equity. A call to action to place accessibility in its rightful premier position on the profession's agenda is issued.

  4. Women in the Military: An Historical Perspective on the Nursing Corps.

    ERIC Educational Resources Information Center

    Steffel, Marilyn L.; Kaczmarek, Margaret G.

    1987-01-01

    Presents an overview of the role women have performed in the military nursing corps. Reviews the history of women in the military nursing corps; their struggle to gain officer rank, status, and pay; military family policies; and nurses' contribution to military health care. (Author/ABB)

  5. 78 FR 57921 - Municipal Mortgage & Equity LLC, Prolink Holdings Corp., RPM Technologies, Inc., SARS Corp...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-20

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Municipal Mortgage & Equity LLC, Prolink Holdings Corp., RPM Technologies, Inc., SARS Corp., Secured Digital Storage Corp., Siboney Corp., SiriCOMM... securities of SARS Corp. because it has not filed any periodic reports since the period ended June 30, 2008...

  6. 75 FR 21373 - ULH Corp. (n/k/a UniHolding Corp.), Unapix Entertainment, Inc., Unicomp, Inc., and Unidyne Corp...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-23

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] ULH Corp. (n/k/a UniHolding Corp.), Unapix Entertainment, Inc., Unicomp, Inc., and Unidyne Corp.; Order of Suspension of Trading April 21, 2010. It appears... Entertainment, Inc. because it has not filed any periodic reports since it filed a Form 10-Q for the period...

  7. Colonoscopy Screening in the US Astronaut Corps

    NASA Technical Reports Server (NTRS)

    Masterova, K.; Van Baalen, M.; Wear, M. L.; Murray, J.; Schaefer, C.

    2016-01-01

    Historically, colonoscopy screenings for astronauts have been conducted to ensure that astronauts are in good health for space missions. This data has been identified as being useful for determining appropriate occupational surveillance targets and requirements. Colonoscopies in the astronaut corps can be used for: (a) Assessing overall colon health, (b) A point of reference for future tests in current and former astronauts, (c) Following-up and tracking rates of colorectal cancer and polyps; and (d) Comparison to military and other terrestrial populations. In 2003, medical screening requirements for the active astronaut corps changed to require less frequent colonoscopies. Polyp removal during a colonoscopy is an intervention that prevents the polyp from potentially developing into cancer and decreases the individual's risk for colon cancer.

  8. Negotiating Access to Health Information to Promote Students' Health.

    PubMed

    Radis, Molly E; Updegrove, Stephen C; Somsel, Anne; Crowley, Angela A

    2016-04-01

    Access to student health information, such as immunizations, screenings, and care plans for chronic conditions, is essential for school nurses to fulfill their role in promoting students' health. School nurses typically encounter barriers to accessing health records and spend many hours attempting to retrieve health information. As a result, nurses' time is poorly utilized and students may suffer adverse outcomes including delayed school entry. In response to this pressing public health issue, a school medical advisor and director of school nurses in a local health department successfully negotiated access for school nurses to three health record systems: a state immunization tracking system, an electronic lead surveillance program, and an electronic health record system. This negotiation process is presented within a framework of the Theory of Diffusion of Innovation and provides a strategy for other school nurses seeking access to student health information. © The Author(s) 2015.

  9. Access to Oral Health Care: The Role of Federally Qualified Health Centers in Addressing Disparities and Expanding Access

    PubMed Central

    Shi, Leiyu; Hayashi, Arthur Seiji; Sharma, Ravi; Daly, Charles; Ngo-Metzger, Quyen

    2013-01-01

    Objectives. We examined utilization, unmet need, and satisfaction with oral health services among Federally Qualified Health Center patients. We examined correlates of unmet need to guide efforts to increase access to oral health services among underserved populations. Methods. Using the 2009 Health Center Patient Survey, we performed multivariate logistic regressions to examine factors associated with access to dental care at health centers, unmet need, and patient experience. Results. We found no racial or ethnic disparities in access to timely oral health care among health center patients; however, uninsured patients and those whose insurance does not provide dental coverage experienced restricted access and greater unmet need. Slightly more than half of health center patients had a dental visit in the past year, but 1 in 7 reported that their most recent visit was at least 5 years ago. Among health center patients who accessed dental care at their health center, satisfaction was high. Conclusions. These results underscore the critical role that health centers play in national efforts to improve oral health status and eliminate disparities in access to timely and appropriate dental services. PMID:23327254

  10. A Strategy to Enhance Student Experiences in Public Health Emergency Preparedness and Response: Medical Reserve Corps Nursing Student Summer Externship.

    PubMed

    Stein, Loren Nell Melton

    Development of the public health nursing workforce is crucial to advancing our nation's health. Many organizations, including the American Association of Colleges of Nursing, Centers for Disease Control and Prevention, and the US Department of Health and Human Services, have identified the need for strengthening academia's connection to public health and tailoring experiences to enhance workforce competency. The Oklahoma Medical Reserve Corps (OKMRC) Nursing Student Summer Externship was developed as a strategy to provide nursing students with strengthened knowledge and skills in disaster response through a structured summer volunteer experience with nurse educators within the OKMRC. The Medical Reserve Corps is a national organization with more than 200 000 volunteers dedicated to strengthening public health, improving emergency response capabilities, and building community resiliency. In the summer of 2015, the OKMRC offered a 10-week public health emergency preparedness and response externship pilot program to 8 nursing students. In the summer of 2016, the program expanded to include 3 Oklahoma baccalaureate nursing programs. Students completed trainings and participated in activities designed to provide a broad base of knowledge, an awareness of the local disaster plans, and leadership skills to assist their communities with preparedness and disaster response.

  11. Health care access among Mexican Americans with different health insurance coverage.

    PubMed

    Treviño, R P; Treviño, F M; Medina, R; Ramirez, G; Ramirez, R R

    1996-05-01

    This study describes the rates of health care access among Mexican Americans with different health insurance coverage. An interview questionnaire was used to collect information regarding sociodemographics, perceived health status, health insurance coverage, and sources of health care from a random sample of 501 Mexican Americans from San Antonio, Texas. Health care access was determined more by having health insurance coverage than by health care needs. Poor Mexican Americans with health insurance had higher health care access rates than did poor Mexican Americans without health insurance. Health care access may improve health care outcomes, but more comprehensive community-based campaigns to promote health and better use of health services in underprivileged populations should be developed.

  12. Negotiating Access to Health Information to Promote Students' Health

    ERIC Educational Resources Information Center

    Radis, Molly E.; Updegrove, Stephen C.; Somsel, Anne; Crowley, Angela A.

    2016-01-01

    Access to student health information, such as immunizations, screenings, and care plans for chronic conditions, is essential for school nurses to fulfill their role in promoting students' health. School nurses typically encounter barriers to accessing health records and spend many hours attempting to retrieve health information. As a result,…

  13. 3 CFR - Delegation of Authority To Appoint Commissioned Officers of the Ready Reserve Corps of the Public...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Officers of the Ready Reserve Corps of the Public Health Service Presidential Documents Other Presidential...Reserve Corps of the Public Health Service Memorandum for the Secretary of Health and Human Services By... under section 203 of the Public Health Service Act, as amended by Public Law 111-148, to appoint...

  14. 77 FR 10598 - BIOTECH Holdings Ltd., California Oil & Gas Corp., Central Minera Corp., Chemokine Therapeutics...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-22

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] BIOTECH Holdings Ltd., California Oil & Gas Corp., Central Minera Corp., Chemokine Therapeutics Corp., and Global Precision Medical Inc.; Order of... securities of California Oil & Gas Corp. because it has not filed any periodic reports since the period ended...

  15. Health Care Access Among Deaf People.

    PubMed

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in global health knowledge for deaf people including those with even higher risk of marginalization. Examples of approaches to improve access to health care, such as providing powerful and visually accessible communication through the use of sign language, the implementation of important communication technologies, and cultural awareness trainings for health professionals are discussed. Programs that raise health knowledge in Deaf communities and models of primary health care centers for deaf people are also presented. Published documents can empower deaf people to realize their right to enjoy the highest attainable standard of health. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

    PubMed

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

    2009-10-01

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

  17. Factors associated with health care access and outcome.

    PubMed

    Paek, Min-So; Lim, Jung-Won

    2012-01-01

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

  18. What does 'access to health care' mean?

    PubMed

    Gulliford, Martin; Figueroa-Munoz, Jose; Morgan, Myfanwy; Hughes, David; Gibson, Barry; Beech, Roger; Hudson, Meryl

    2002-07-01

    Facilitating access is concerned with helping people to command appropriate health care resources in order to preserve or improve their health. Access is a complex concept and at least four aspects require evaluation. If services are available and there is an adequate supply of services, then the opportunity to obtain health care exists, and a population may 'have access' to services. The extent to which a population 'gains access' also depends on financial, organisational and social or cultural barriers that limit the utilisation of services. Thus access measured in terms of utilisation is dependent on the affordability, physical accessibility and acceptability of services and not merely adequacy of supply. Services available must be relevant and effective if the population is to 'gain access to satisfactory health outcomes'. The availability of services, and barriers to access, have to be considered in the context of the differing perspectives, health needs and material and cultural settings of diverse groups in society. Equity of access may be measured in terms of the availability, utilisation or outcomes of services. Both horizontal and vertical dimensions of equity require consideration. Copyright The Royal Society of Medicine Press Ltd 2002.

  19. Access of primary and secondary literature by health personnel in an academic health center: implications for open access*

    PubMed Central

    Steinberg, Ryan M.; Moorhead, Laura; O'Brien, Bridget; Willinsky, John

    2013-01-01

    Purpose: The research sought to ascertain the types and quantity of research evidence accessed by health personnel through PubMed and UpToDate in a university medical center over the course of a year in order to better estimate the impact that increasing levels of open access to biomedical research can be expected to have on clinical practice in the years ahead. Methods: Web log data were gathered from the 5,042 health personnel working in the Stanford University Hospitals (SUH) during 2011. Data were analyzed for access to the primary literature (abstracts and full-text) through PubMed and UpToDate and to the secondary literature, represented by UpToDate (research summaries), to establish the frequency and nature of literature consulted. Results: In 2011, SUH health personnel accessed 81,851 primary literature articles and visited UpToDate 110,336 times. Almost a third of the articles (24,529) accessed were reviews. Twenty percent (16,187) of the articles viewed were published in 2011. Conclusion: When it is available, health personnel in a clinical care setting frequently access the primary literature. While further studies are needed, this preliminary finding speaks to the value of the National Institutes of Health public access policy and the need for medical librarians and educators to prepare health personnel for increasing public access to medical research. PMID:23930091

  20. Insurance + AccessHealth Care: Typology of Barriers to Health Care Access for Low-Income Families

    PubMed Central

    DeVoe, Jennifer E.; Baez, Alia; Angier, Heather; Krois, Lisa; Edlund, Christine; Carney, Patricia A.

    2007-01-01

    PURPOSE Public health insurance programs have expanded coverage for the poor, and family physicians provide essential services to these vulnerable populations. Despite these efforts, many Americans do not have access to basic medical care. This study was designed to identify barriers faced by low-income parents when accessing health care for their children and how insurance status affects their reporting of these barriers. METHODS A mixed methods analysis was undertaken using 722 responses to an open-ended question on a health care access survey instrument that asked low-income Oregon families, “Is there anything else you would like to tell us?” Themes were identified using immersion/crystallization techniques. Pertinent demographic attributes were used to conduct matrix coded queries. RESULTS Families reported 3 major barriers: lack of insurance coverage, poor access to services, and unaffordable costs. Disproportionate reporting of these themes was most notable based on insurance status. A higher percentage of uninsured parents (87%) reported experiencing difficulties obtaining insurance coverage compared with 40% of those with insurance. Few of the uninsured expressed concerns about access to services or health care costs (19%). Access concerns were the most common among publicly insured families, and costs were more often mentioned by families with private insurance. Families made a clear distinction between insurance and access, and having one or both elements did not assure care. Our analyses uncovered a 3-part typology of barriers to health care for low-income families. CONCLUSIONS Barriers to health care can be insurmountable for low-income families, even those with insurance coverage. Patients who do not seek care in a family medicine clinic are not necessarily getting their care elsewhere. PMID:18025488

  1. 76 FR 33115 - Delegation of Authority to Appoint Commissioned Officers of the Ready Reserve Corps of the Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-07

    ... of Authority to Appoint Commissioned Officers of the Ready Reserve Corps of the Public Health Service... of the Ready Reserve Corps of the Public Health Service Memorandum for the Secretary of Health and... functions of the President under section 203 of the Public Health Service Act, as amended by Public Law 111...

  2. Effects of ParentCorps in Prekindergarten on Child Mental Health and Academic Performance: Follow-up of a Randomized Clinical Trial Through 8 Years of Age.

    PubMed

    Brotman, Laurie Miller; Dawson-McClure, Spring; Kamboukos, Dimitra; Huang, Keng-Yen; Calzada, Esther J; Goldfeld, Keith; Petkova, Eva

    2016-12-01

    Low-income minority children living in urban neighborhoods are at high risk for mental health problems and underachievement. ParentCorps, a family-centered, school-based intervention in prekindergarten, improves parenting and school readiness (ie, self-regulation and preacademic skills) in 2 randomized clinical trials. The longer-term effect on child mental health and academic performance is not known. To examine whether ParentCorps delivered as an enhancement to prekindergarten programs in high-poverty urban schools leads to fewer mental health problems and increased academic performance in the early elementary school years. This is a 3-year follow-up study of a cluster randomized clinical trial of ParentCorps in public schools with prekindergarten programs in New York City. Ten elementary schools serving a primarily low-income, black student population were randomized in 2005, and 4 consecutive cohorts of prekindergarten students were enrolled from September 12, 2005, through December 31, 2008. We report follow-up for the 3 cohorts enrolled after the initial year of implementation. Data analysis was performed from September 1, 2014, to December 31, 2015. ParentCorps included professional development for prekindergarten and kindergarten teachers and a program for parents and prekindergarten students (13 two-hour group sessions delivered after school by teachers and mental health professionals). Annual teacher ratings of mental health problems and academic performance and standardized tests of academic achievement in kindergarten and second grade by testers masked to the intervention or control group randomization. A total of 1050 children (4 years old; 518 boys [49.3%] and 532 girls [50.7%]) in 99 prekindergarten classrooms participated in the trial (88.1% of the prekindergarten population), with 792 students enrolled from 2006 to 2008. Most families in the follow-up study (421 [69.6%]) were low income; 680 (85.9%) identified as non-Latino black, 78 (9.8%) as

  3. 42 CFR 21.28 - Age requirements, Regular Corps, senior assistant grade and below.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Age requirements, Regular Corps, senior assistant... SERVICES PERSONNEL COMMISSIONED OFFICERS Appointment § 21.28 Age requirements, Regular Corps, senior... permanent assistant grade, or (c) after age 37 to the permanent senior assistant grade: Provided, That the...

  4. First-Term Attrition among Marine Corps Women: Some Associated Factors.

    ERIC Educational Resources Information Center

    Royle, Marjorie H.

    Because the first-term attrition rate for enlisted Marine Corps women is nearly 50 percent, or about twice that for comparable men, a study was undertaken to identify factors that might be related to this high attrition rate. During the study, the following three data sets were analyzed: historical master files and recruit accession management…

  5. Health Care Access among Deaf People

    ERIC Educational Resources Information Center

    Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes

    2016-01-01

    Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in…

  6. The Viability of Hearing Protection Device Fit-Testing at Navy and Marine Corps Accession Points

    PubMed Central

    Federman, Jeremy; Duhon, Christon

    2016-01-01

    Introduction: The viability of hearing protection device (HPD) verification (i.e., fit-testing) on a large scale was investigated to address this gap in a military accession environment. Materials and Methods: Personal Attenuation Ratings (PARs) following self-fitted (SELF-Fit) HPDs were acquired from 320 US Marine Corps training recruits (87.5% male, 12.5% female) across four test protocols (1-, 3-, 5-, and 7- frequency). SELF-Fit failures received follow-up to assess potential causes. Follow-up PARs were acquired (Experimenter fit [EXP-Fit], followed by Subject re-fit [SUB Re-Fit]). EXP-Fit was intended to provide a perception (dubbed “ear canal muscle memory”) of what a correctly fitted HPD should feel like. SUB Re-Fit was completed following EXP-Fit to determine whether a training recruit could duplicate EXP-Fit on her/his own without assistance. Results: A one-way analysis of variance (ANOVA) (N=320) showed that SELF-Fit means differed significantly between protocols (P < 0.001). Post-hoc analyses showed that the 1-freq SELF-Fit mean was significantly lower than all other protocols (P < 0.03) by 5.6 dB or more. No difference was found between the multi-frequency protocols. For recruits who were followed up with EXP-Fit (n=79), across all protocols, a significant (P < 0.001) mean improvement of 25.68 dB (10.99) was found, but PARs did not differ (P = 0.99) between EXP-Fit protocols. For recruits in the 3-freq and 5-freq protocol groups who experienced all three PAR test methods (n=33), PAR methods differed (P < 0.001) but no method by protocol interaction was found (P = 0.46). Post hoc tests showed that both EXP-Fit and SUB Re-Fit had significantly better attenuation than SELF-Fit (P < 0.001), but no difference was found between EXPFit and SUB Re-Fit (P = 0.59). For SELF-Fit, the 1-freq protocol resulted in a 35% pass rate, whereas the 3-, 5-, and 7-freq protocols resulted in >60% pass rates. Results showed that once recruits experienced how HPDs should

  7. 76 FR 65768 - ADS Media Group, Inc., American Enterprise Development Corp., and Arcland Energy Corp.; Order of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-24

    ... Development Corp., and Arcland Energy Corp.; Order of Suspension of Trading October 20, 2011. It appears to... current and accurate information concerning the securities of American Enterprise Development Corp... securities of Arcland Energy Corp. because it has not filed any periodic reports since the period ended April...

  8. Relationship between health literacy, health information access, health behavior, and health status in Japanese people.

    PubMed

    Suka, Machi; Odajima, Takeshi; Okamoto, Masako; Sumitani, Masahiko; Igarashi, Ataru; Ishikawa, Hirono; Kusama, Makiko; Yamamoto, Michiko; Nakayama, Takeo; Sugimori, Hiroki

    2015-05-01

    To examine the relationship between health literacy (HL), health information access, health behavior, and health status in Japanese people. A questionnaire survey was conducted at six healthcare facilities in Japan. Eligible respondents aged 20-64 years (n=1218) were included. Path analysis with structural equation modeling was performed to test the hypothesis model linking HL to health information access, health behavior, and health status. The acceptable fitting model indicated that the pathways linking HL to health status consisted of two indirect paths; one intermediated by health information access and another intermediated by health behavior. Those with higher HL as measured by the 14-item Health Literacy Scale (HLS-14) were significantly more likely to get sufficient health information from multiple sources, less likely to have risky habits of smoking, regular drinking, and lack of exercise, and in turn, more likely to report good self-rated health. HL was significantly associated with health information access and health behavior in Japanese people. HL may play a key role in health promotion, even in highly educated countries like Japan. In order to enhance the effects of health promotion interventions, health professionals should aim at raising HL levels of their target population groups. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. 42 CFR 21.28 - Age requirements, Regular Corps, senior assistant grade and below.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... assistant grade and below. No candidate for appointment to the Regular Corps, except in the nurse category, shall be appointed (a) after age 31 to the permanent junior assistant grade, (b) after age 34 to the... 42 Public Health 1 2014-10-01 2014-10-01 false Age requirements, Regular Corps, senior assistant...

  10. 42 CFR 21.28 - Age requirements, Regular Corps, senior assistant grade and below.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... assistant grade and below. No candidate for appointment to the Regular Corps, except in the nurse category, shall be appointed (a) after age 31 to the permanent junior assistant grade, (b) after age 34 to the... 42 Public Health 1 2013-10-01 2013-10-01 false Age requirements, Regular Corps, senior assistant...

  11. 42 CFR 21.28 - Age requirements, Regular Corps, senior assistant grade and below.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... assistant grade and below. No candidate for appointment to the Regular Corps, except in the nurse category, shall be appointed (a) after age 31 to the permanent junior assistant grade, (b) after age 34 to the... 42 Public Health 1 2012-10-01 2012-10-01 false Age requirements, Regular Corps, senior assistant...

  12. 20 CFR 638.502 - Job Corps basic education program.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... education program. The Job Corps Director shall prescribe or provide for basic education curricula to be... Educational Development (GED); (d) World of work; (e) Health education; (f) Driver education; and (g) English...

  13. Corps Work Force Mobility.

    DTIC Science & Technology

    1979-08-01

    particular attention. Expressed Mobility (as stated on career program forms) was compared to actual mobility and revealed a close correla- tion. The...i 1 Introduction 1 2 How Mobile Are Corps Employees ? 2 3 Why Do Corps Employees Move? 5 4 When Do Corps Employees Move? 7 5 What Influence Does Locale...Have On Mobility? 11 6 Real Versus Stated Mobility 16 7 Conclusion 21 Figure 1 Career Mobility 3 2 Motivation for Employee Mobility 6 3 Frequency of

  14. 77 FR 60002 - In the Matter of Diomed Holdings, Inc., Dominion Minerals Corp., EnerLume Energy Management Corp...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-01

    ...., Dominion Minerals Corp., EnerLume Energy Management Corp., EPIX Pharmaceuticals, Inc., Familymeds Group, Inc., GlycoGenesys, Inc., and Greater Atlantic Financial Corp.; Order of Suspension of Trading... concerning the securities of EnerLume Energy Management Corp. because it has not filed any periodic reports...

  15. Accessing Your Health Information: How can I access my health information and medical records?

    MedlinePlus

    ... Privacy & Security How can I access my health information/medical record? Know your rights. It is your ... to see and get copies of your health information, or share it with a third party, such ...

  16. Health Care Access among Latinos: Implications for Social and Health Care Reforms

    ERIC Educational Resources Information Center

    Perez-Escamilla, Rafael

    2010-01-01

    According to the Institute of Medicine, health care access is defined as "the degree to which people are able to obtain appropriate care from the health care system in a timely manner." Two key components of health care access are medical insurance and having access to a usual source of health care. Recent national data show that 34% of Latino…

  17. 3 CFR - Delegation of Authority To Appoint Commissioned Officers of the Ready Reserve Corps of the Public...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 3 The President 1 2014-01-01 2014-01-01 false Delegation of Authority To Appoint Commissioned Officers of the Ready Reserve Corps of the Public Health Service Presidential Documents Other Presidential Documents Memorandum of March 29, 2013 Delegation of Authority To Appoint Commissioned Officers of the Ready Reserve Corps of the Public Health...

  18. 3 CFR - Delegation of Authority To Appoint Commissioned Officers of the Ready Reserve Corps of the Public...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 3 The President 1 2012-01-01 2012-01-01 false Delegation of Authority To Appoint Commissioned Officers of the Ready Reserve Corps of the Public Health Service Presidential Documents Other Presidential Documents Memorandum of May 31, 2011 Delegation of Authority To Appoint Commissioned Officers of the Ready Reserve Corps of the Public Health...

  19. History of the Air Corps Tactical School 1920-1940

    DTIC Science & Technology

    1998-01-01

    1st Lt. Air Corps SHUFELT, James V. V. Captain Cavalry STRATEMEYER, George E. Major Air Corps SZILAGYI , Nicholas Captain Infantry TYNDALL, Frank B...Air Corps WALLACE , William J. Captain U.S. Marine Corps WEDDINGTON, Harry Captain Air Corps WEIKERT, John M. 1st Lt. Air Corps WHEELER, Walter L. 1st...M. Captain Air Corps SMITH, Joseph Captain Air Corps SMITH, Wallace G. Major Air Corps STOWELL, James S. Captain Air Corps TAYLOR, Yantis H. Captain

  20. Physician assistants and nurse practitioners in the National Health Service Corps.

    PubMed

    Pathman, Donald E; Konrad, Thomas R; Hooker, Roderick S

    2014-12-01

    This study describes the experiences of physician assistants (PAs) and nurse practitioners (NPs) in the National Health Service Corps' (NHSC) loan repayment program in 2010. In 2011, a stratified random sample of NHSC clinicians was surveyed. Data from the 148 PA and 137 NP respondents were analyzed (52.4% response rate). PAs were younger than NPs (mean age 31 versus 35 years), less often female (68% versus 91%), and more often carried educational debt over $100,000 (56% versus 24%). Both groups were serving in states familiar to them and within communities where they felt accepted. The groups were generally satisfied on most measures of work, with PAs more satisfied than NPs on some measures. The NHSC's PAs and NPs are well matched to communities and satisfied with their work. Maximizing their NHSC experiences and retention requires recognizing their differences in demographics, debt, and areas of job satisfaction.

  1. Insurance + access not equal to health care: typology of barriers to health care access for low-income families.

    PubMed

    Devoe, Jennifer E; Baez, Alia; Angier, Heather; Krois, Lisa; Edlund, Christine; Carney, Patricia A

    2007-01-01

    Public health insurance programs have expanded coverage for the poor, and family physicians provide essential services to these vulnerable populations. Despite these efforts, many Americans do not have access to basic medical care. This study was designed to identify barriers faced by low-income parents when accessing health care for their children and how insurance status affects their reporting of these barriers. A mixed methods analysis was undertaken using 722 responses to an open-ended question on a health care access survey instrument that asked low-income Oregon families, "Is there anything else you would like to tell us?" Themes were identified using immersion/crystallization techniques. Pertinent demographic attributes were used to conduct matrix coded queries. Families reported 3 major barriers: lack of insurance coverage, poor access to services, and unaffordable costs. Disproportionate reporting of these themes was most notable based on insurance status. A higher percentage of uninsured parents (87%) reported experiencing difficulties obtaining insurance coverage compared with 40% of those with insurance. Few of the uninsured expressed concerns about access to services or health care costs (19%). Access concerns were the most common among publicly insured families, and costs were more often mentioned by families with private insurance. Families made a clear distinction between insurance and access, and having one or both elements did not assure care. Our analyses uncovered a 3-part typology of barriers to health care for low-income families. Barriers to health care can be insurmountable for low-income families, even those with insurance coverage. Patients who do not seek care in a family medicine clinic are not necessarily getting their care elsewhere.

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

    PubMed

    Souliotis, Kyriakos; Hasardzhiev, Stanimir; Agapidaki, Eirini

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

  3. No Exceptions: Documenting the Abortion Experiences of US Peace Corps Volunteers

    PubMed Central

    Arnott, Grady; Parniak, Simone; LaRoche, Kathryn J.; Trussell, James

    2015-01-01

    Since 1979, US federal appropriations bills have prohibited the use of federal funds from covering abortion care for Peace Corps volunteers. There are no exceptions; unlike other groups that receive health care through US federal funding streams, including Medicaid recipients, federal employees, and women in federal prisons, abortion care is not covered for volunteers even in cases of life endangerment, rape, or incest. We interviewed 433 returned Peace Corps volunteers to document opinions of, perceptions about, and experiences with obtaining abortion care. Our results regarding the abortion experiences of Peace Corps volunteers, especially those who were raped, bear witness to a profound inequity and show that the time has come to lift the “no exceptions” funding ban on abortion coverage. PMID:25494207

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

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

    Kollar, William

    2013-07-01

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

  5. The Need to Increase Marine Corps Special Operations Command

    DTIC Science & Technology

    2009-01-01

    Operations University presentation by Major Mark Raney for USSOCOM elective (lecture, MCU, Quantico VA, 17 Feb 20Q9). 5 Stew Magnuson, "Marine Special...2008 Posture Statement.doc (Accessed 23 December, 2008) 20 David Tucker and Christopher J. Lamb , United States Special Operations Forces (New York...invasion of Afghanistan encroached on the Marine Corps historical role of being "soldiers from the sea." 38 David Tucker and Christopher J. lamb , 182

  6. Child Health and Access to Medical Care

    PubMed Central

    Leininger, Lindsey; Levy, Helen

    2016-01-01

    It might seem strange to ask whether increasing access to medical care can improve children’s health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children’s health. Nonetheless, they find that, on the whole, policies to improve access indeed improve children’s health, with the caveat that context plays a big role—medical care “matters more at some times, or for some children, than others.” Focusing on studies that can plausibly show a causal effect between policies to increase access and better health for children, and starting from an economic framework, they consider both the demand for and the supply of health care. On the demand side, they examine what happens when the government expands public insurance programs (such as Medicaid), or when parents are offered financial incentives to take their children to preventive appointments. On the supply side, they look at what happens when public insurance programs increase the payments that they offer to health-care providers, or when health-care providers are placed directly in schools where children spend their days. They also examine how the Affordable Care Act is likely to affect children’s access to medical care. Leininger and Levy reach three main conclusions. First, despite tremendous progress in recent decades, not all children have insurance coverage, and immigrant children are especially vulnerable. Second, insurance coverage alone doesn’t guarantee access to care, and insured children may still face barriers to getting the care they need. Finally, as this issue of Future of Children demonstrates, access to care is only one of the factors that policy makers should consider as they seek to make the nation’s children healthier. PMID:27516723

  7. Adolescents and access to health care.

    PubMed Central

    Klein, J. D.; Slap, G. B.; Elster, A. B.; Cohn, S. E.

    1993-01-01

    The developmental characteristics and health behaviors of adolescents make the availability of certain services--including reproductive health services, diagnosis and treatment of sexually transmitted disease, mental health and substance abuse counseling and treatment--critically important. Furthermore, to serve adolescents appropriately, services must be available in a wide range of health care settings, including community-based adolescent health, family planning and public health clinics, school-based and school-linked health clinics, physicians' offices, HMOs, and hospitals. National, authoritative content standards (for example, the American Medical Association's Guidelines for Adolescent Preventive Services (GAPS), a multispecialty, interdisciplinary guideline for a package of clinical preventive services for adolescents may increase the possibility that insurers will cover adolescent preventive services, and that these services will become part of health professionals' curricula and thus part of routine practice. However, additional and specific guidelines mandating specific services that must be available to adolescents in clinical settings (whether in schools or in communities) are also needed. Although local government, parents, providers, and schools must assume responsibility for ensuring that health services are available and accessible to adolescents, federal and state financing mandates are also needed to assist communities and providers in achieving these goals. The limitations in what even comprehensive programs currently are able to provide, and the dismally low rates of preventive service delivery to adolescents, suggests that adolescents require multiple points of access to comprehensive, coordinated services, and that preventive health interventions must be actively and increasingly integrated across health care, school, and community settings. Unless access issues are dealt with in a rational, coordinated fashion, America's adolescents will

  8. Contextual view of Point Bonita Ridge, showing Bonita Ridge access ...

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

    Contextual view of Point Bonita Ridge, showing Bonita Ridge access road retaining wall and location of Signal Corps Radar (S.C.R.) 296 Station 5 Transmitter Building foundation (see stake at center left), camera facing north - Fort Barry, Signal Corps Radar 296, Station 5, Transmitter Building Foundation, Point Bonita, Marin Headlands, Sausalito, Marin County, CA

  9. Contextualizing immigrant access to health resources.

    PubMed

    Yang, Joshua S

    2010-06-01

    A vast majority of our understanding of immigrant health centers around traits of individuals and groups. While useful, current approaches to research on immigrant health decontextualize the experience of immigrants in the United States. This paper uses a historical case study of the Chinese community in San Francisco to develop a contextual framework to understand the levels of influence that impact the availability of health resources in immigrant communities. International, transnational, transcommunity, and enclave contexts have shaped health care access for Chinese immigrants in San Francisco. The conceptual framework provides a basis for future research, programmatic, and policy work that integrates individual and contextual factors in assessing and improving immigrant access to health resources.

  10. 77 FR 4389 - In the Matter of Tornado Gold International Corp., Twin Faces East Entertainment Corp., Universal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-27

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] In the Matter of Tornado Gold International Corp., Twin Faces East Entertainment Corp., Universal Ice Blast, Inc., US Farms, Inc., US Microbics... concerning the securities of Tornado Gold International Corp. because it has not filed any periodic reports...

  11. Identifying Health Consumers' eHealth Literacy to Decrease Disparities in Accessing eHealth Information.

    PubMed

    Park, Hyejin; Cormier, Eileen; Gordon, Glenna; Baeg, Jung Hoon

    2016-02-01

    The increasing amount of health information available on the Internet highlights the importance of eHealth literacy skills for health consumers. Low eHealth literacy results in disparities in health consumers' ability to access and use eHealth information. The purpose of this study was to assess the perceived eHealth literacy of a general health consumer population so that healthcare professionals can effectively address skills gaps in health consumers' ability to access and use high-quality online health information. Participants were recruited from three public library branches in a Northeast Florida community. The eHealth Literacy Scale was used. The majority of participants (n = 108) reported they knew how and where to find health information and how to use it to make health decisions; knowledge of what health resources were available and confidence in the ability to distinguish high- from low-quality information were considerably less. The findings suggest the need for eHealth education and support to health consumers from healthcare professionals, in particular, how to access and evaluate the quality of health information.

  12. Youth Corps Case Studies: The New York City Volunteer Corps Exit Report.

    ERIC Educational Resources Information Center

    Jaffe, Natalie; Freedman, Marc

    This exit report chronicles the last 20 months of the 3-year demonstration phase of the New York City Volunteer Corps (CVC), whose members worked in teams at various sites to either provide human services or do physical work. These final months were characterized by the following factors: (1) a change in Corps leadership; (2) concern about…

  13. Power Projection: The Current and Future Relevance of the M1A1Tank to Marine Corps Capabilities

    DTIC Science & Technology

    2002-01-01

    Kenneth W. Estes, Marines under Armor : The Marine Corps and the Armored Fighting Vehicle, 1916-2000 (Annapolis, MD: Naval institute Press, 2000), 183...is the M2 heavy barrel machine gun that has been in the U.S. inventory for decades. It can be fired from under armor and has a range of 1800 meters...Accessed 9 January 2002. Estes, Kenneth W. Marines under Armor : The Marine Corps and the Armored Fighting Vehicle, 1916-2000. Annapolis, MD

  14. Youth Conservation Corps Guidance.

    ERIC Educational Resources Information Center

    Fish and Wildlife Service (Dept. of Interior), Washington, DC.

    This document provides guidelines for operating Youth Conservation Corps programs under both the Fish and Wildlife Service and the National Park Service. The guide contains 11 units that cover the following topics: (1) enrollees; (2) enrollee payroll; (3) enrollee problems; (4) Youth Conservation Corps staff; (5) accounting; (6) operations; (7)…

  15. Steps Towards Determining the Right Number of Dental Recruits the Navy Should Access to Meet the Projected Targets for Navy Dental Corps Officers

    DTIC Science & Technology

    2007-03-01

    and orofacial pain . Lastly, the Naval Postgraduate Dental School offers a one-year fellowship in maxillofacial prosthetics. The Dental Corps...65 2 -15 75% 1775 Pub Hlth Dentistry 9 0 9 7 1 2 113% 1780 Oral Pathology 10 1 9 9 0 0 100% 1785 Oral Facial Pain 14 0 14 10 1 4 127...oral health may only cause discomfort and pain , in the military environment a simple toothache can incapacitate a combat soldier as effectively as a

  16. Gender dynamics affecting maternal health and health care access and use in Uganda.

    PubMed

    Morgan, Rosemary; Tetui, Moses; Muhumuza Kananura, Rornald; Ekirapa-Kiracho, Elizabeth; George, A S

    2017-12-01

    Despite its reduction over the last decade, the maternal mortality rate in Uganda remains high, due to in part a lack of access to maternal health care. In an effort to increase access to care, a quasi-experimental trial using vouchers was implemented in Eastern Uganda between 2009 and 2011. Findings from the trial reported a dramatic increase in pregnant women's access to institutional delivery. Sustainability of such interventions, however, is an important challenge. While such interventions are able to successfully address immediate access barriers, such as lack of financial resources and transportation, they are reliant on external resources to sustain them and are not designed to address the underlying causes contributing to women's lack of access, including those related to gender. In an effort to examine ways to sustain the intervention beyond external financial resources, project implementers conducted a follow-up qualitative study to explore the root causes of women's lack of maternal health care access and utilization. Based on emergent findings, a gender analysis of the data was conducted to identify key gender dynamics affecting maternal health and maternal health care. This paper reports the key gender dynamics identified during the analysis, by detailing how gender power relations affect maternal health care access and utilization in relation to: access to resources; division of labour, including women's workload during and after pregnancy and lack of male involvement at health facilities; social norms, including perceptions of women's attitudes and behaviour during pregnancy, men's attitudes towards fatherhood, attitudes towards domestic violence, and health worker attitudes and behaviour; and decision-making. It concludes by discussing the need for integrating gender into maternal health care interventions if they are to address the root causes of barriers to maternal health access and utilization and improve access to and use of maternal health

  17. Access to health care and community social capital.

    PubMed

    Hendryx, Michael S; Ahern, Melissa M; Lovrich, Nicholas P; McCurdy, Arthur H

    2002-02-01

    To test the hypothesis that variation in reported access to health care is positively related to the level of social capital present in a community. The 1996 Household Survey of the Community Tracking Study, drawn from 22 metropolitan statistical areas across the United States (n = 19,672). Additional data for the 22 communities are from a 1996 multicity broadcast media marketing database, including key social capital indicators, the 1997 National Profile of Local Health Departments survey, and Interstudy, American Hospital Association, and American Medical Association sources. The design is cross-sectional. Self-reported access to care problems is the dependent variable. Independent variables include individual sociodemographic variables, community-level health sector variables, and social capital variables. Data are merged from the various sources and weighted to be population representative and are analyzed using hierarchical categorical modeling. Persons who live in metropolitan statistical areas featuring higher levels of social capital report fewer problems accessing health care. A higher HMO penetration rate in a metropolitan statistical area was also associated with fewer access problems. Other health sector variables were not related to health care access. The results observed for 22 major U.S. cities are consistent with the hypothesis that community social capital enables better access to care, perhaps through improving community accountability mechanisms.

  18. Globalization, global health, and access to healthcare.

    PubMed

    Collins, Téa

    2003-01-01

    It is now commonly realized that the globalization of the world economy is shaping the patterns of global health, and that associated morbidity and mortality is affecting countries' ability to achieve economic growth. The globalization of public health has important implications for access to essential healthcare. The rise of inequalities among and within countries negatively affects access to healthcare. Poor people use healthcare services less frequently when sick than do the rich. The negative impact of globalization on access to healthcare is particularly well demonstrated in countries of transitional economies. No longer protected by a centralized health sector that provided free universal access to services for everyone, large segments of the populations in the transition period found themselves denied even the most basic medical services. Only countries where regulatory institutions are strong, domestic markets are competitive and social safety nets are in place, have a good chance to enjoy the health benefits of globalization.

  19. SCORE/ACE Counselor Handbook. Service Corps of Retired Executives. Active Corps of Executives.

    ERIC Educational Resources Information Center

    Landsverk, Arvel; And Others

    This counselor handbook is intended to help Service Corps of Retired Executives/Active Corps of Executives (SCORE/ACE) counselors to plan and conduct counseling services more effectively. Included in the introductory section are an overview of the SCORE/ACE counseling program, a discussion of what the counselor does, directions for completing…

  20. Poverty and access to health care in developing countries.

    PubMed

    Peters, David H; Garg, Anu; Bloom, Gerry; Walker, Damian G; Brieger, William R; Rahman, M Hafizur

    2008-01-01

    People in poor countries tend to have less access to health services than those in better-off countries, and within countries, the poor have less access to health services. This article documents disparities in access to health services in low- and middle-income countries (LMICs), using a framework incorporating quality, geographic accessibility, availability, financial accessibility, and acceptability of services. Whereas the poor in LMICs are consistently at a disadvantage in each of the dimensions of access and their determinants, this need not be the case. Many different approaches are shown to improve access to the poor, using targeted or universal approaches, engaging government, nongovernmental, or commercial organizations, and pursuing a wide variety of strategies to finance and organize services. Key ingredients of success include concerted efforts to reach the poor, engaging communities and disadvantaged people, encouraging local adaptation, and careful monitoring of effects on the poor. Yet governments in LMICs rarely focus on the poor in their policies or the implementation or monitoring of health service strategies. There are also new innovations in financing, delivery, and regulation of health services that hold promise for improving access to the poor, such as the use of health equity funds, conditional cash transfers, and coproduction and regulation of health services. The challenge remains to find ways to ensure that vulnerable populations have a say in how strategies are developed, implemented, and accounted for in ways that demonstrate improvements in access by the poor.

  1. Army Corps of Engineers: Better Guidance Could Improve Corps’ Information on Water Resources Projects Undertaken by Nonfederal Sponsors

    DTIC Science & Technology

    2016-12-01

    Nonfederal Sponsors Why GAO Did This Study Through its Civil Works program, the Corps designs , constructs, and maintains federal water resources...Public Works United States Senate Dear Mr. Chairman: The U.S. Army Corps of Engineers (Corps) is the world’s largest public engineering, design ...its Civil Works Program, in general, the Corps plans, designs , constructs, operates, and maintains a wide range of water resources projects. Congress

  2. Marine Corps Forces South

    Science.gov Websites

    Survival Training Course U.S. Marine Corps Capt. Joseph with Security Cooperation Training Team 18, U.S . Marine Corps Forces, South, supervises a water survival training course at Soto Cano Air Base, Honduras . The course consisted of five training days dedicated to strengthening swimmers' skill sets and

  3. A spatial analysis of variations in health access: linking geography, socio-economic status and access perceptions

    PubMed Central

    2011-01-01

    Background This paper analyses the relationship between public perceptions of access to general practitioners (GPs) surgeries and hospitals against health status, car ownership and geographic distance. In so doing it explores the different dimensions associated with facility access and accessibility. Methods Data on difficulties experienced in accessing health services, respondent health status and car ownership were collected through an attitudes survey. Road distances to the nearest service were calculated for each respondent using a GIS. Difficulty was related to geographic distance, health status and car ownership using logistic generalized linear models. A Geographically Weighted Regression (GWR) was used to explore the spatial non-stationarity in the results. Results Respondent long term illness, reported bad health and non-car ownership were found to be significant predictors of difficulty in accessing GPs and hospitals. Geographic distance was not a significant predictor of difficulty in accessing hospitals but was for GPs. GWR identified the spatial (local) variation in these global relationships indicating locations where the predictive strength of the independent variables was higher or lower than the global trend. The impacts of bad health and non-car ownership on the difficulties experienced in accessing health services varied spatially across the study area, whilst the impacts of geographic distance did not. Conclusions Difficulty in accessing different health facilities was found to be significantly related to health status and car ownership, whilst the impact of geographic distance depends on the service in question. GWR showed how these relationships were varied across the study area. This study demonstrates that the notion of access is a multi-dimensional concept, whose composition varies with location, according to the facility being considered and the health and socio-economic status of the individual concerned. PMID:21787394

  4. Health Consumers eHealth Literacy to Decrease Disparities in Accessing eHealth Information.

    PubMed

    Park, Hyejin; Cormier, Eileen; Glenna, Gordon

    2016-01-01

    The purpose of this study was to assess the perceived eHealth literacy of a general health consumer population so that health care professionals can effectively address skills gaps in health consumers' ability to access and use high quality online health information. Participants were recruited from three public library branches in a Northeast Florida community. The eHealth literacy scale (eHEALS) was used. The majority of participants (n = 108) reported they knew how and where to find health information and how to use it to make health decisions; knowledge of what health resources were available and confidence in the ability to distinguish high from low quality information was considerably less. The findings suggest the need for eHealth education and support to health consumers from health care professionals, in particular, how to access and evaluate the quality of health information.

  5. Improving efficiency and access to mental health care: combining integrated care and advanced access.

    PubMed

    Pomerantz, Andrew; Cole, Brady H; Watts, Bradley V; Weeks, William B

    2008-01-01

    To provide an example of implementation of a new program that enhances access to mental health care in primary care. A general and specialized mental health service was redesigned to introduce open access to comprehensive mental health care in a primary care clinic. Key variables measured before and after implementation of the clinic included numbers of completed referrals, waiting time for appointments and clinic productivity. Workload and pre/post-implementation waiting time data were gathered through a computerized electronic monitoring system. Waiting time for new appointments was shortened from a mean of 33 days to 19 min. Clinician productivity and evaluations of new referrals more than doubled. These improvements have been sustained for 4 years. Moving mental health services into primary care, initiating open access and increasing use of technological aids led to dramatic improvements in access to mental health care and efficient use of resources. Implementation and sustainability of the program were enhanced by using a quality improvement approach.

  6. 76 FR 42154 - BioMETRX, Inc., Biopure Corp. (n/k/a PBBPC, Inc.), Distributed Energy Systems Corp., Fortified...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-18

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] BioMETRX, Inc., Biopure Corp. (n/k/a PBBPC, Inc.), Distributed Energy Systems Corp., Fortified Holdings Corp., Knobias, Inc., and One IP Voice... concerning the securities of BioMETRX, Inc. because it has not filed any periodic reports since the period...

  7. 76 FR 56244 - Dialpoint Communications Corp., Pacel Corp., Quantum Group, Inc. (The), and Tradequest...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-12

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Dialpoint Communications Corp., Pacel Corp., Quantum Group, Inc. (The), and Tradequest International, Inc.; Order of Suspension of Trading September 8... securities of Quantum Group, Inc. (The) because it has not filed any periodic reports since the period ended...

  8. Evaluation of web accessibility of consumer health information websites.

    PubMed

    Zeng, Xiaoming; Parmanto, Bambang

    2003-01-01

    The objectives of the study are to construct a comprehensive framework for web accessibility evaluation, to evaluate the current status of web accessibility of consumer health information websites and to investigate the relationship between web accessibility and property of the websites. We selected 108 consumer health information websites from the directory service of a Web search engine. We used Web accessibility specifications to construct a framework for the measurement of Web Accessibility Barriers (WAB) of website. We found that none of the websites is completely accessible to people with disabilities, but governmental and educational health information websites exhibit better performance on web accessibility than other categories of websites. We also found that the correlation between the WAB score and the popularity of a website is statistically significant.

  9. Free internet access, the digital divide, and health information.

    PubMed

    Wagner, Todd H; Bundorf, M Kate; Singer, Sara J; Baker, Laurence C

    2005-04-01

    The Internet has emerged as a valuable tool for health information. Half of the U.S. population lacked Internet access in 2001, creating concerns about those without access. Starting in 1999, a survey firm randomly invited individuals to join their research panel in return for free Internet access. This provides a unique setting to study the ways that people who had not previously obtained Internet access use the Internet when it becomes available to them. In 2001-2002, we surveyed 12,878 individuals 21 years of age and older on the research panel regarding use of the Internet for health; 8935 (69%) responded. We analyzed respondents who had no prior Internet access, and then compared this group to those who had prior Internet access. Among those newly provided free Internet access, 24% had used the Internet for health information in the past year, and users reported notable benefits, such as improved knowledge and self-care abilities. Not surprisingly, the no-prior-Internet group reported lower rates of using the Internet (24%) than the group that had obtained Internet access prior to joining the research panel (40%), but the 2 groups reported similar perceptions of the Internet and self-reported effects. Those who obtained Internet access for the first time by joining the panel used the Internet for health and appeared to benefit from it. Access helps explain the digital divide, although most people given free access do not use the Internet for health information.

  10. Child Health and Access to Medical Care

    ERIC Educational Resources Information Center

    Leininger, Lindsey; Levy, Helen

    2015-01-01

    It might seem strange to ask whether increasing access to medical care can improve children's health. Yet Lindsey Leininger and Helen Levy begin by pointing out that access to care plays a smaller role than we might think, and that many other factors, such as those discussed elsewhere in this issue, strongly influence children's health.…

  11. A Case Study of One Teach for America Corps Member's Use of Equity Pedagogy

    ERIC Educational Resources Information Center

    Hu, Lindsay Anne Kwock

    2009-01-01

    This study investigates equitable practices used by a Teach For America (TFA) corps member (CM) in her second year of teaching low income, minority students. This study's conceptual framework is based on a contemporary conceptualization of equity pedagogy that includes: (a) tools of power and access (Delpit, 1988); (b) culturally relevant…

  12. Health care access disparities among children entering kindergarten in Nevada.

    PubMed

    Fulkerson, Nadia Deashinta; Haff, Darlene R; Chino, Michelle

    2013-09-01

    The objective of this study was to advance our understanding and appreciation of the health status of young children in the state of Nevada in addition to their discrepancies in accessing health care. This study used the 2008-2009 Nevada Kindergarten Health Survey data of 11,073 children to assess both independent and combined effects of annual household income, race/ethnicity, primary language spoken in the family, rural/urban residence, and existing medical condition on access to health care. Annual household income was a significant predictor of access to health care, with middle and high income respondents having regular access to care compared to low income counterparts. Further, English proficiency was associated with access to health care, with English-speaking Hispanics over 2.5 times more likely to have regular access to care than Spanish-speaking Hispanics. Rural residents had decreased odds of access to preventive care and having a primary care provider, but unexpectedly, had increased odds of having access to dental care compared to urban residents. Finally, parents of children with no medical conditions were more likely to have access to care than those with a medical condition. The consequences for not addressing health care access issues include deteriorating health and well-being for vulnerable socio-demographic groups in the state. Altogether these findings suggest that programs and policies within the state must be sensitive to the specific needs of at risk groups, including minorities, those with low income, and regionally and linguistically isolated residents.

  13. Health Websites: Accessibility and Usability for American Sign Language Users

    PubMed Central

    Kushalnagar, Poorna; Naturale, Joan; Paludneviciene, Raylene; Smith, Scott R.; Werfel, Emily; Doolittle, Richard; Jacobs, Stephen; DeCaro, James

    2015-01-01

    To date, there have been efforts towards creating better health information access for Deaf American Sign Language (ASL) users. However, the usability of websites with access to health information in ASL has not been evaluated. Our paper focuses on the usability of four health websites that include ASL videos. We seek to obtain ASL users’ perspectives on the navigation of these ASL-accessible websites, finding the health information that they needed, and perceived ease of understanding ASL video content. ASL users (N=32) were instructed to find specific information on four ASL-accessible websites, and answered questions related to: 1) navigation to find the task, 2) website usability, and 3) ease of understanding ASL video content for each of the four websites. Participants also gave feedback on what they would like to see in an ASL health library website, including the benefit of added captioning and/or signer model to medical illustration of health videos. Participants who had lower health literacy had greater difficulty in finding information on ASL-accessible health websites. This paper also describes the participants’ preferences for an ideal ASL-accessible health website, and concludes with a discussion on the role of accessible websites in promoting health literacy in ASL users. PMID:24901350

  14. Health websites: accessibility and usability for American sign language users.

    PubMed

    Kushalnagar, Poorna; Naturale, Joan; Paludneviciene, Raylene; Smith, Scott R; Werfel, Emily; Doolittle, Richard; Jacobs, Stephen; DeCaro, James

    2015-01-01

    To date, there have been efforts toward creating better health information access for Deaf American Sign Language (ASL) users. However, the usability of websites with access to health information in ASL has not been evaluated. Our article focuses on the usability of four health websites that include ASL videos. We seek to obtain ASL users' perspectives on the navigation of these ASL-accessible websites, finding the health information that they needed, and perceived ease of understanding ASL video content. ASL users (n = 32) were instructed to find specific information on four ASL-accessible websites, and answered questions related to (a) navigation to find the task, (b) website usability, and (c) ease of understanding ASL video content for each of the four websites. Participants also gave feedback on what they would like to see in an ASL health library website, including the benefit of added captioning and/or signer model to medical illustration of health videos. Participants who had lower health literacy had greater difficulty in finding information on ASL-accessible health websites. This article also describes the participants' preferences for an ideal ASL-accessible health website, and concludes with a discussion on the role of accessible websites in promoting health literacy in ASL users.

  15. Job Corps Vocational Offerings Review. Final Report.

    ERIC Educational Resources Information Center

    Manpower Administration (DOL), Washington, DC. Job Corps.

    The relative effectiveness of current Job Corps vocational offerings was evaluated, and occupations suitable for addition to the Job Corps vocational curricula were identified. Characteristics of Job Corps enrollees and the occupations in which training was provided were identified. To assess their comparative effectiveness, training occupations…

  16. Evaluation of Web Accessibility of Consumer Health Information Websites

    PubMed Central

    Zeng, Xiaoming; Parmanto, Bambang

    2003-01-01

    The objectives of the study are to construct a comprehensive framework for web accessibility evaluation, to evaluate the current status of web accessibility of consumer health information websites and to investigate the relationship between web accessibility and property of the websites. We selected 108 consumer health information websites from the directory service of a Web search engine. We used Web accessibility specifications to construct a framework for the measurement of Web Accessibility Barriers (WAB) of website. We found that none of the websites is completely accessible to people with disabilities, but governmental and educational health information websites exhibit better performance on web accessibility than other categories of websites. We also found that the correlation between the WAB score and the popularity of a website is statistically significant. PMID:14728272

  17. Process Assessment: Minnesota Reading Corps PreK Program

    ERIC Educational Resources Information Center

    Diaconis, Athena; Estrera, Elc; Hafford, Carol; Hernandez, Marc; Markovitz, Carrie; Muyskens, Paul

    2015-01-01

    Minnesota Reading Corps is the largest AmeriCorps State program in the country. Its mission is to help every Minnesota child become a proficient reader by the end of third grade. To meet this goal, the Minnesota Reading Corps and its host organization, ServeMinnesota Action Network, engages a diverse group of AmeriCorps members to provide…

  18. [Immigrants' access to health care in Spain: a review].

    PubMed

    Llop-Gironés, Alba; Vargas Lorenzo, Ingrid; Garcia-Subirats, Irene; Aller, Marta-Beatriz; Vázquez Navarrete, María Luisa

    2014-01-01

    An important proportion of the population in Spain is immigrant and the international literature indicates their inadequate access to health services. The objective is to contribute to improving the knowledge on access to health care of the immigrant population in Spain. Review of original papers published (1998-2012) on access to health services of the immigrant population in Spain published in Medline and MEDES. Out of 319 studies, 20 were selected, applying predefined criteria. The results were analyzed using the Aday and Andersen framework. Among the publications, 13 quantitative studies analysed differences in health care use between the immigrant and the native population, and 7 studied determinants of access of immigrants. Studies showed less use of specialized care by immigrants, higher use of emergency care and no differences in the use of primary care between groups. Five quantitative articles on determinants of access focused on factors related to the immigrant population (sex, age, educational level and holding private health insurance), but without observing clear patterns. The two qualitative studies analyzed factors related to health services, describing access to healthcare barriers such as the limited provision of information or the requirements for personal health card. Access to health care in immigrants has been scarcely studied, using different approaches and the barely analysed factors related to the services. No clear patterns were observed, as differences depend on the classification of migrants according to country of origin and the level of care. However, studies showed less use of specialized care by immigrants, higher use of emergency care and the existence of determinants of access different to their needs.

  19. Timely access to mental health care among women veterans.

    PubMed

    Brunner, Julian; Schweizer, C Amanda; Canelo, Ismelda A; Leung, Lucinda B; Strauss, Jennifer L; Yano, Elizabeth M

    2018-04-05

    Using survey data on (N = 419) patients at Department of Veterans Affairs (VA) clinics we analyzed women veterans' reports of timely access to VA mental health care. We evaluated problems that patients might face in obtaining care, and examined subjective ratings of VA care as a function of timely access to mental health care. We found that 59% of participants reported "always" getting an appointment for mental health care as soon as needed. In adjusted analyses, two problems were negatively associated with timely access to mental health care: (a) medical appointments that interfere with other activities, and (b) difficulty getting questions answered between visits. Average subjective ratings of VA ranged from 8.2-8.6 out of 10, and 93% of participants would recommend VA care. Subjective ratings of VA were higher among women who reported timely access to mental health care. Findings suggest that overall experience of care is associated with timely access to mental health care, and that such access may be amenable to improvements related to clinic hours or mechanisms for answering patient questions between visits. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  20. Perceived barriers to seeking mental health care among United States Marine Corps noncommissioned officers serving as gatekeepers for suicide prevention.

    PubMed

    VanSickle, Marcus; Werbel, Aaron; Perera, Kanchana; Pak, Kyna; DeYoung, Kathryn; Ghahramanlou-Holloway, Marjan

    2016-08-01

    Reducing mental health stigma and perceived barriers to care is a necessary strategy for addressing the public health problem of suicide among the United States Armed Forces. The purpose of this study was threefold: (a) to empirically evaluate the principal component structure of the Perceived Barriers to Care (PBTC) measure; (b) to gain an understanding of the perceived barriers to seeking mental health services among Marine Corps noncommissioned officers (NCOs) selected to participate in a primary suicide prevention training program, Never Leave a Marine Behind (NLMB); and (c) to explore the relationship among sex, education, prior exposure to suicide within one's military unit, and perceived barriers to seeking mental health services. The data for the PBTC (N = 1,758) were drawn from a previously performed pretest/posttest program evaluation study of the Marine Corp's NLMB program, which took place over 6 months in 2009 (April-October). The three highest perceptions of barriers to care reported by NCOs for their Marines were related to being embarrassed, having members of one's unit have less confidence in the Marine, and concerns about being treated differently by military unit leadership. Three principal components for PBTC were identified, accounting for approximately 59% of the total variance. Higher education and prior exposure to suicide within one's military unit significantly correlated with greater perceived barriers to care; sex was not significantly correlated with greater perceived barriers to care. Implications of these findings, in relation to future research, are further discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  1. 75 FR 50010 - Atchison Casting Corp. (n/k/a Bradken-Atchison/St. Joseph, Inc.), CityFed Financial Corp., Divine...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-16

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Atchison Casting Corp. (n/k/a Bradken-Atchison/St. Joseph, Inc.), CityFed Financial Corp., Divine, Inc. (n/k/a Enivid, Inc.), Genesis Worldwide, Inc... information concerning the securities of Atchison Casting Corp. (n/k/a Bradken-Atchison/St. Joseph, Inc...

  2. 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.

  3. The Lifetime Surveillance of Astronaut Health Newsletter

    NASA Technical Reports Server (NTRS)

    Lee, Lesley

    2011-01-01

    The June 2010 LSAH newsletter introduced the change from the Longitudinal Study of Astronaut Health research study to the new Lifetime Surveillance of Astronaut Health program (An Overview of the New Occupational Surveillance Program for the Astronaut Corps). Instead of performing research-focused retrospective analyses of astronaut medical data compared to a JSC civil servant control population, the new program is focused on prevention of disease and prospective identification and mitigation of health risks in each astronaut due to individual exposure history and the unique occupational exposures experienced by the astronaut corps. The new LSAH program has 5 primary goals: (1) Provide a comprehensive medical exam for each LSAH participant; (2) Conduct occupational surveillance; (3) Improve communication, data accessibility, integrity and storage; (4) Support operational and healthcare analyses; and (5) Support NASA research objectives. This article will focus primarily on the first goal, the comprehensive medical exam. Future newsletters will outline in detail the plans and processes for addressing the remaining program goals.

  4. 78 FR 60918 - Innovation Corps Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-02

    ... NATIONAL SCIENCE FOUNDATION Innovation Corps Advisory Committee; Notice of Meeting In accordance... announces the following meeting: Name: Innovation Corps (I-Corps) for Advisory Committee, 80463. Date/Time.... Contact Person: Rathindra DasGupta, Program Director, Innovation Corps (I-Corps), Engineering Directorate...

  5. The Marine Corps University Library.

    ERIC Educational Resources Information Center

    Ramkey, Carol E.

    2001-01-01

    Describes the Marine Corps University (Virginia) Library's collections and reserves. States that the library's resources focus on military doctrine, history, arts, and sciences, and that they include Web- and CD-ROM-based specialized military databases. Describes the library's mission to serve the university community and Marine Corps patrons…

  6. 77 FR 19744 - Advanced BioPhotonics, Inc., Advanced Viral Research Corp., Brantley Capital Corp., Brilliant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-02

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Advanced BioPhotonics, Inc., Advanced Viral Research Corp., Brantley Capital Corp., Brilliant Technologies Corporation, 4C Controls, Inc., and 2-Track... Commission that there is a lack of current and accurate information concerning the securities of Advanced Bio...

  7. Young Physicians in Rural Areas: The Impact of Service in the National Health Service Corps. Volume 2, Survey of Factors Influencing the Location Decision and Practice Patterns.

    ERIC Educational Resources Information Center

    Langwell, Kathryn; And Others

    A survey of young physicians in rural areas was conducted and information was gathered from other data sources and analyzed for three main purposes: (1) to evaluate the retention of National Health Service Corps (NHSC) alumni in Health Manpower Shortage Areas (HMSAs); (2) to document the distribution of NHSC alumni, Private Practice Option (PPO)…

  8. Health Care Access and Health Behaviors Among Men Who Have Sex With Men: The Cost of Health Disparities

    ERIC Educational Resources Information Center

    McKirnan, David J.; Du Bois, Steve N.; Alvy, Lisa M.; Jones, Kyle

    2013-01-01

    Men who have sex with men (MSM) appear to experience barriers to health care compared with general population men. This report examines individual differences in health care access within a diverse sample of urban MSM ("N" = 871). The authors examined demographic differences in health care access and the relation between access and…

  9. Enhancement of Marine Corps’ Recruiting and Retention Programs

    DTIC Science & Technology

    2008-01-01

    and reputation. The Corps has good marketing techniques due to enhancements in its marketing strategy since 2004. The Corps’ understaffing of Career...year than it has in the past to grow the Corps from 186,490 to 202,000 by fiscal year 2011. An analysis of the Corps’ environment and marketing ... strategy reveals strengths and weaknesses that can be exploited or mitigated to enhance recruiting and retention. The Corps’ execution of its mission and

  10. Health Care Access and Utilization after the 2010 Pakistan Floods.

    PubMed

    Jacquet, Gabrielle A; Kirsch, Thomas; Durrani, Aqsa; Sauer, Lauren; Doocy, Shannon

    2016-10-01

    Introduction The 2010 floods submerged more than one-fifth of Pakistan's land area and affected more than 20 million people. Over 1.6 million homes were damaged or destroyed and 2,946 direct injuries and 1,985 deaths were reported. Infrastructure damage was widespread, including critical disruptions to the power and transportation networks. Hypothesis Damage and loss of critical infrastructure will affect the population's ability to seek and access adequate health care for years to come. This study sought to evaluate factors associated with access to health care in the aftermath of the 2010 Pakistan floods. A population-proportional, randomized cluster-sampling survey method with 80 clusters of 20 (1,600) households of the flood-affected population was used. Heads of households were surveyed approximately six months after flood onset. Multivariate analysis was used to determine significance. A total of 77.8% of households reported needing health services within the first month after the floods. Household characteristics, including rural residence location, large household size, and lower pre- and post-flood income, were significantly associated (P<.05) with inadequate access to health care after the disaster. Households with inadequate access to health care were more likely to have a death or injury in the household. Significantly higher odds of inadequate access to health care were observed in rural populations (adjusted OR 4.26; 95% CI, 1.89-9.61). Adequate health care access after the 2010 Pakistani floods was associated with urban residence location, suggesting that locating health care providers in rural areas may be difficult. Access to health services also was associated with post-flood income level, suggesting health resources are not readily available to households suffering great income losses. Jacquet GA , Kirsch T , Durrani A , Sauer L , Doocy S . Health care access and utilization after the 2010 Pakistan floods. Prehosp Disaster Med. 2016;31(5):485-491.

  11. 78 FR 56263 - HydroGen Corp., QueryObject Systems Corp., Security Intelligence Technologies, Inc., Skins, Inc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-12

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] HydroGen Corp., QueryObject Systems Corp., Security Intelligence Technologies, Inc., Skins, Inc., SLM Holdings, Inc., Spring Creek Healthcare Systems... securities of Security Intelligence Technologies, Inc. because it has not filed any periodic reports since...

  12. 32 CFR 728.21 - Navy and Marine Corps reservists.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Navy and Marine Corps reservists. 728.21 Section..., Reserve Officers' Training Corps, Navy and Marine Corps Officer Candidate Programs, and National Guard Personnel § 728.21 Navy and Marine Corps reservists. (a) Scope. This section applies to reservists, as those...

  13. 32 CFR 728.21 - Navy and Marine Corps reservists.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Navy and Marine Corps reservists. 728.21 Section..., Reserve Officers' Training Corps, Navy and Marine Corps Officer Candidate Programs, and National Guard Personnel § 728.21 Navy and Marine Corps reservists. (a) Scope. This section applies to reservists, as those...

  14. 32 CFR 728.21 - Navy and Marine Corps reservists.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Navy and Marine Corps reservists. 728.21 Section..., Reserve Officers' Training Corps, Navy and Marine Corps Officer Candidate Programs, and National Guard Personnel § 728.21 Navy and Marine Corps reservists. (a) Scope. This section applies to reservists, as those...

  15. 32 CFR 728.21 - Navy and Marine Corps reservists.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Navy and Marine Corps reservists. 728.21 Section..., Reserve Officers' Training Corps, Navy and Marine Corps Officer Candidate Programs, and National Guard Personnel § 728.21 Navy and Marine Corps reservists. (a) Scope. This section applies to reservists, as those...

  16. 32 CFR 728.21 - Navy and Marine Corps reservists.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Navy and Marine Corps reservists. 728.21 Section..., Reserve Officers' Training Corps, Navy and Marine Corps Officer Candidate Programs, and National Guard Personnel § 728.21 Navy and Marine Corps reservists. (a) Scope. This section applies to reservists, as those...

  17. Baseline characteristics of different strata of astronaut corps

    NASA Technical Reports Server (NTRS)

    Hamm, Peggy B.; Pepper, L. J.

    1993-01-01

    The Longitudinal Study of Astronaut Health (LSAH) is an epidemiological study designed to study the effects of the occupational exposures incurred by astronauts in health outcomes and changes in physiological variables. Between 1959 and 1991, 195 individuals were selected for the program. The medical standards for selection have remained essentially unchanged since the Mercury Program, but the range and stringency of these criteria have been modified. Demographic and physiological variables identified during the selection year are examined for various strata of the Astronaut Corps. Specifically, age, sex, race, education, usual occupation, military affiliation, medical history, family medical history, visual and hearing measurements, physical exam variables, and specific laboratory values are investigated. Differences are examined in astronauts for the following criteria: (1) were selected prior to 1970 (n = 73) versus those selected after 1970 (n = 122); (2) have flown multiple missions versus those who have flown less than two missions; (3) have walked in space versus all others; (4) have more than 500 hours of mission time versus all others; and (5) have gone to the Moon versus all others. Length of time served in the Astronaut Corps is examined for each of these strata.

  18. Health and health care access for Syrian refugees living in İstanbul.

    PubMed

    Torun, Perihan; Mücaz Karaaslan, Meltem; Sandıklı, Büşra; Acar, Ceyda; Shurtleff, Ellyn; Dhrolia, Sophia; Herek, Bülent

    2018-06-01

    The study was conducted to assess the health needs of urban refugees living in İstanbul. A mixed methods approach was adopted to interview Syrian women from households, doctors, decision makers and NGO representatives. The data were collected between June and October 2015. The main challenges were the cost of living in İstanbul, increased rent and language barrier. Almost half (49.6%) of the interviewed women did not know about free health care rights for Syrians. In the last 30 days preceding the interview, 58.6% of the participants sought health care primarily through state hospitals, primary health care centres and pharmacies. The participants had difficulty in accessing health care due to the language barrier and a lack of knowledge of the Turkish health care system. Waiting time at hospitals and negative attitudes of health care staff reduced satisfaction in these services. In relation to life in Turkey, the main issues for Syrian refugees were not directly related to health. They have been given the right to access health care, although had many difficulties in understanding and accessing services in a crowded city.

  19. Immigrant Health in Rural Maryland: A Qualitative Study of Major Barriers to Health Care Access.

    PubMed

    Sangaramoorthy, Thurka; Guevara, Emilia M

    2017-08-01

    Immigration to rural areas in new receiving communities like Maryland's Eastern Shore is growing. Despite a rapid rise in immigration and diminishing health system resources, little attention has been focused on barriers to health care access in this region for immigrants. A total of 33 in-depth key informant interviews with providers and immigrants were conducted. Qualitative analysis employing a constant comparison approach was used to explore emergent themes related to barriers to health care access for a growing immigrant population. Participants perceived limited health care resources, lack of health insurance coverage, high health expenditures, language barriers, and non-citizenship status as barriers to immigrants' access of health care. Findings imply that immigrants living and working on the rural Eastern Shore face serious barriers to health care access. Additional work on immigrant health in rural areas and the impacts of immigration to rural health systems are needed.

  20. 76 FR 11933 - 50th Anniversary of the Peace Corps

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-03

    ... address changing and complex global needs in education, health and HIV/AIDS, business and information... America sees the world and the world sees us. Today, one of President Kennedy's most enduring legacies can... on. In our increasingly interconnected world, the mission of the Peace Corps is more relevant today...

  1. 45 CFR 164.524 - Access of individuals to protected health information.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Health Information § 164.524 Access of individuals to protected health information. (a) Standard: Access to protected health information—(1) Right of access. Except as otherwise provided in paragraph (a)(2... protected health information about the individual in a designated record set, for as long as the protected...

  2. 45 CFR 164.524 - Access of individuals to protected health information.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Health Information § 164.524 Access of individuals to protected health information. (a) Standard: Access to protected health information—(1) Right of access. Except as otherwise provided in paragraph (a)(2... protected health information about the individual in a designated record set, for as long as the protected...

  3. 77 FR 19745 - Angstrom Microsystems Corp., Bedminster National Corp., Brake Headquarters U.S.A., Inc., and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-02

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Angstrom Microsystems Corp., Bedminster National Corp., Brake Headquarters U.S.A., Inc., and BrandPartners Group, Inc.; Order of Suspension of... BrandPartners Group, Inc. because it has not filed any periodic reports since the period ended September...

  4. Outcome Evaluation: Minnesota Reading Corps PreK Program. Appendices

    ERIC Educational Resources Information Center

    Markovitz, Carrie E.; Hernandez, Marc W.; Hedberg, Eric C.; Silberglitt, Benjamin

    2015-01-01

    Minnesota Reading Corps is the largest AmeriCorps State program in the country. Its mission is to help every Minnesota child become a proficient reader by the end of third grade. To meet this goal, the Minnesota Reading Corps and its host organization, ServeMinnesota Action Network, engages a diverse group of AmeriCorps members to provide…

  5. [Accessibility of health services for users].

    PubMed

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

    2000-01-01

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

  6. Enhancing access to health information in Africa: a librarian's perspective.

    PubMed

    Gathoni, Nasra

    2012-01-01

    In recent years, tremendous progress has been made toward providing health information in Africa, in part because of technological advancements. Nevertheless, ensuring that information is accessible, comprehensible, and usable remains problematic, and there remain needs in many settings to address issues such as computer skills, literacy, and the infrastructure to access information. To determine how librarians might play a more strategic role in meeting information needs of health professionals in Africa, the author reviewed key components of information systems pertinent to knowledge management for the health sector, including access to global online resources, capacity to use computer technology for information retrieval, information literacy, and the potential for professional networks to play a role in improving access to and use of information. The author concluded that, in regions that lack adequate information systems, librarians could apply their knowledge and skills to facilitate access and use by information seekers. Ensuring access to and use of health information can also be achieved by engaging organizations and associations working to enhance access to health information, such as the Association for Health Information and Libraries in Africa. These groups can provide assistance through training, dissemination, information repackaging, and other approaches known to improve information literacy.

  7. Public health assessment for USMC Marine Corps Recruit Depot (a/k/a Parris Island Marine Corps Recruit Depot), Parris Island, Beaufort County, South Carolina, Region 4. Cerclis No. SC6170022762

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

    NONE

    1996-09-12

    Marine Corps Recruit Depot, (MCRD) Parris Island was proposed for listing on U.S. Environmental Protection Agency`s National Priorities List in August 1994. We identified two areas where chemical contaminants in soil entered the surface water wetland areas and bioaccumulated in edible fish and shellfish species: (1) contaminated fish and shellfish at the Causeway Landfill (Site 3) and (2) contaminated shellfish near the Rifle Range. These exposure situations pose no apparent public health hazard due to the low levels of contaminants detected in fish and shellfish. However, because the landfill has no impermeable cap nor leachate collection system, it is notmore » known whether contaminants in fish and shellfish will increase over time. The remaining 57 contaminated areas pose no public health hazard because people are not coming in contact with contaminants.« less

  8. Finland's strategy and implementation of citizens' access to health information.

    PubMed

    Ruotsalainen, Pekka; Iivari, Anna-Kaisa; Doupi, Persephone

    2008-01-01

    The strategy for utilizing information technology in the field of social welfare and health care in Finland was published in 1996. It was redefined in the year 2006. This updated strategy defined basic principles how digitized EHRs should be stored, accessed, disclosed and archived. The strategy together with new legislation opened the right to patients and citizens to access their own EHRs, ePrescriptions and audit-logs via the Internet. A national WEB-service platform forms the base for both public and private eHealth applications. National identification and PKI-services cover health professionals, patients and entities. Citizen's consent management is provided at national level. The access to personal health information is managed using rules derived from legislation. The roll-out of the national health information infrastructure with citizen access to personal health information should by law be finalized before the end of 2011. The implementation of the NHII is demanding, but the real challenge is to clearly understand what the impacts of citizen access to personal health information are and to what direction this kind of services should be developed. At the present state, the Finnish EHR-archive contains only information created by a health professional. Citizens' eHealth services can not be limited to the use of regulated EHR data and ePrescriptions. For health promotion, proactive prevention and health prediction more comprehensive information is needed. Therefore the next step is to develop legislation and to build a trusted environment for the use and access of heterogeneous health and welfare information.

  9. 78 FR 31997 - Greatmat Technology Corp., Kentucky USA Energy, Inc., Solar Energy Ltd., and Visiphor Corp...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-28

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Greatmat Technology Corp., Kentucky USA Energy, Inc., Solar Energy Ltd., and Visiphor Corp., Order of Suspension of Trading May 23, 2013. It appears... concerning the securities of Solar Energy Ltd. because it has not filed any periodic reports since the period...

  10. 20 CFR 638.541 - Job Corps training opportunities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Job Corps training opportunities. 638.541 Section 638.541 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR JOB CORPS PROGRAM UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.541 Job Corps...

  11. 20 CFR 638.541 - Job Corps training opportunities.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Job Corps training opportunities. 638.541 Section 638.541 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR JOB CORPS PROGRAM UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.541 Job Corps...

  12. 20 CFR 638.541 - Job Corps training opportunities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Job Corps training opportunities. 638.541 Section 638.541 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR JOB CORPS PROGRAM UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.541 Job Corps...

  13. Universal access: making health systems work for women.

    PubMed

    Ravindran, T K Sundari

    2012-01-01

    Universal coverage by health services is one of the core obligations that any legitimate government should fulfil vis-à-vis its citizens. However, universal coverage may not in itself ensure universal access to health care. Among the many challenges to ensuring universal coverage as well as access to health care are structural inequalities by caste, race, ethnicity and gender. Based on a review of published literature and applying a gender-analysis framework, this paper highlights ways in which the policies aimed at promoting universal coverage may not benefit women to the same extent as men because of gender-based differentials and inequalities in societies. It also explores how 'gender-blind' organisation and delivery of health care services may deny universal access to women even when universal coverage has been nominally achieved. The paper then makes recommendations for addressing these.

  14. Improving access to primary mental health care for Australian children.

    PubMed

    Bassilios, Bridget; Nicholas, Angela; Reifels, Lennart; King, Kylie; Spittal, Matthew J; Fletcher, Justine; Pirkis, Jane

    2016-11-01

    This study examines the uptake by children aged predominantly 0-11 years of an Australian primary mental health service - the Access to Allied Psychological Services programme - which began in 2001. In particular, it considers access to, and use of, the child component of Access to Allied Psychological Services, the Child Mental Health Service, introduced in 2010. Using routinely collected programme data from a national minimum dataset and regional population data, we conducted descriptive and regression analysis to examine programme uptake, predictors of service reach and consumer- and treatment-based characteristics of service. Between 2003 and 2013, 18,631 referrals for children were made and 75,178 sessions were scheduled via Access to Allied Psychological Services, over 50% of which were via the Child Mental Health Service in its first 3 years of operation. The rate of referrals for children to the Child Mental Health Service was associated with the rate of Access to Allied Psychological Services referrals for consumers aged 12+ years. The Child Mental Health Service has increased services provided within the Access to Allied Psychological Services programme for children with emotional and behavioural issues and their families, and is potentially filling a service gap in the area of prevention and early intervention for children who have significant levels of need but are unable to access other mental health services. Our findings are policy-relevant for other developed countries with a similar primary mental health care system that are considering means of improving service access by children. © The Royal Australian and New Zealand College of Psychiatrists 2016.

  15. Health information in Italian public health websites: moving from inaccessibility to accessibility.

    PubMed

    Mancini, Cristina; Zedda, Monica; Barbaro, Annarita

    2005-12-01

    In January 2004, the Italian government passed new legislation designed to give people with disabilities access to online services. Starting from the new legislation requirements, the purpose of this study is to investigate whether Italian Local Health Authorities websites are accessible to users with different abilities. One hundred and seventy websites were analysed evaluating their compliance to the World Wide Web Consortium (W3C) Priority 1 guidelines via a combination of appropriate accessibility testing methods. This review was carried out twice: the first time it took place between the end of 2003 and May-June 2004. The same survey was repeated again in December 2004, after the issuing of the draft of the Implementation Regulations for The Stanca Law in July 2004. In this second survey, all the websites analysed before were checked again to establish if some measures to make those sites accessible were taken. Seventy-six per cent of the analysed websites fail to satisfy the most basic W3C requirements, but Italian Local Health Authorities websites are likely to present significant improvements to access for some disabled user groups: the number of accessible websites increased consistently between the first and the second review. It seems that awareness of web accessibility issues is increasing among developers of health information websites because of law enforcement. Recommendations for future research and development are offered.

  16. [How do immigrant women access health services in the Basque Country? Perceptions of health professionals].

    PubMed

    Pérez-Urdiales, Iratxe; Goicolea, Isabel

    2017-09-12

    To determine the perception of health professionals working in alternative health centres on the barriers and facilitators in the access by immigrant women to general public health services and sexual and reproductive health in the Basque Country. Basque Country. Analysis of qualitative content based on 11 individual interviews. Health professionals working in alternative health centres of Primary Care and sexual and reproductive health. Data collection was performed between September and December 2015 in four alternative health centres. After transcription, the units of meaning, codes and categories were identified. Four categories emerged from the analysis, which represented how the characteristics of immigrant women (Tell me how you are and I will tell you how to access), the attitude of the administrative and health staff ("When they are already taken care of"), the functioning of the health system (Inflexible, passive and needs-responsive health system), and health policies ("If you do not meet the requirements, you do not go in. The law is the law") influence access to health services of immigrant women. This study shows that there are a considerable number of barriers and few facilitators to the access by immigrant women to public health and sexual and reproductive health services in the Basque Country. The alternative health centres were presented as favouring the improvement of the health of the immigrant population and in their access. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  17. 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

  18. Racial/Ethnic and Gender Disparities in Health Care Use and Access.

    PubMed

    Manuel, Jennifer I

    2018-06-01

    To document racial/ethnic and gender differences in health service use and access after the Affordable Care Act went into effect. Secondary data from the 2006-2014 National Health Interview Survey. Linear probability models were used to estimate changes in health service use and access (i.e., unmet medical need) in two separate analyses using data from 2006 to 2014 and 2012 to 2014. Adult respondents aged 18 years and older (N = 257,560). Results from the 2006-2014 and 2012-2014 analyses show differential patterns in health service use and access by race/ethnicity and gender. Non-Hispanic whites had the greatest gains in health service use and access across both analyses. While there was significant progress among Hispanic respondents from 2012 to 2014, no significant changes were found pre-post-health care reform, suggesting access may have worsened before improving for this group. Asian men had the largest increase in office visits between 2006 and 2014, and although not statistically significant, the increase continued 2012-2014. Black women and men fared the worst with respect to changes in health care access. Ongoing research is needed to track patterns of health service use and access, especially among vulnerable racial/ethnic and gender groups, to determine whether existing efforts under health care reform reduce long-standing disparities. © Health Research and Educational Trust.

  19. 33 CFR 211.78 - Maintenance and conveyance of access roads.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Site Development and Use § 211.78 Maintenance and conveyance of access roads. The Government will not... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Maintenance and conveyance of access roads. 211.78 Section 211.78 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE...

  20. Marine Corps Budgetary Reprogramming Effectiveness

    DTIC Science & Technology

    2015-03-01

    infrastructure (Appropriations Act of Congress, 2008). The environmental restoration is a transfer account controlled by the DOD. Usually in the case of...at an average just over 11 percent and the Marine Corps encircle the backend of the DOD portion of reprogramming with the Marine Corps reprogramming...blue force tracker (BFT), radio systems, high mobility multipurpose wheeled vehicle (HMMWV), medium tactical vehicle replacement (MTVR), and

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

    PubMed

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

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

  2. Perceptions of people living with HIV/AIDS regarding access to health care.

    PubMed

    Vaswani, Vina; Vaswani, Ravi

    2014-04-01

    Although the health care is replete with technology in the present day, it is not freely accessible in a developing country. The situation could be even more compromised in the case of people living with HIV/AIDS, with the added dimension of stigma and discrimination. What are the factors that act as barriers to health care? This study was conducted to look into perceptions of people living with HIV/AIDS with regard to access to health care. The study looked into accessibility of general health vis-à-vis access to antiretroviral therapy. Demographic variables like age, gender, income were studied in relation to factors such as counseling, confidentiality, stigma and discrimination, which are known to influence access to health care. People living with HIV/AIDS perceive general health care as more accessible than care for HIV treatment. Discrimination by health care workers causes a barrier to accessibility.

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

    PubMed

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

    2016-09-30

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

  4. 75 FR 10808 - CIBA Vision Corp.; Withdrawal of Color Additive Petitions

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-09

    ...) CIBA Vision Corp.; Withdrawal of Color Additive Petitions AGENCY: Food and Drug Administration, HHS... Director, Office of Food Additive Safety, Center for Food Safety and Applied Nutrition. [FR Doc. 2010-4972... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket Nos. FDA-2005-C-0245...

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

    PubMed

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

    2017-08-23

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

  6. Aquatic access for the disabled.

    PubMed

    Walk, E E; Himel, H N; Batra, E K; Baruch, L; O'Connor, M B; Tanner, A E; Edlich, R F

    1992-01-01

    Innovations in rehabilitation engineering can now provide aquatic access for the disabled. In the regional burn center, the Bodi-Gard cart shower system (Hospital Therapy Products, Inc., Wood Dale, Ill.) uses three flexible hoses to provide precise hydrotherapy and debridement. Its main mixing valve controls temperature and pressure and is easily disinfected by an in-line chamber. This shower system is complemented by the foldable Bodi-Gard mobile seat shower system (Hospital Therapy Products, Inc.). This system, which is covered by a disposable liner, surrounds the patient with eight water jets that empty into any floor drain. The Bather 2001 (Silcraft Corp., Traverse City, Mich.) is a fiberglass hydrotherapy bathtub with a unique Aqua-Seal door (Silcraft Corp.) that can be raised to provide patient access. Its unique closed-loop disinfection system prevents contamination of its internal components. The Nolan Tublift (Aquatic Access, Louisville, Ky.) is a lightweight, removable lift that uses water power to gently raise and lower its seat. It can be manually swiveled to allow access from a wheelchair. Transfer benches span the tub wall to provide access to the shower and bathtub. Although they are a less expensive alternative to the Tublift, they allow water to spill outside the tub, which may create a slippery bathroom floor. The Nolan Poolift (Guardian Products, Arleta, Calif.) is a water-powered pool lift, which automatically rotates as it descends. It is capable of lifting up to 135 kg with a home water pressure of 55 psi. In contrast, the water-powered Aquatic Access Poolift is a less expensive pool lift, which rotates manually with assistance.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Redefining the Australian Army Officer Corps Allocation Process

    DTIC Science & Technology

    2010-03-01

    Allocation Numbers (Model 2) ......................................60 Table 28. 2009 Revised Corps Allocation Overage and Underage (Model 2...characteristics: age, sex , marital status, and length of service. b. organizational characteristics: size of work group, visibility of organization...with minimal alteration to the planned corps allocation numbers. A full list of the corps overages and underages is contained in Table 23. Table

  8. Michigan Business Assistance Corps. Final Report.

    ERIC Educational Resources Information Center

    Krzyzowski, Marian J.

    The Michigan Business Assistance Corps (MBA Corps) was established by the University of Michigan Business School in 1990 to assist emerging democracies in Eastern Europe in successfully negotiating the process of economic privatization, while at the same time providing Michigan Business School graduate students with a unique international…

  9. The digital divide in public e-health: barriers to accessibility and privacy in state health department websites.

    PubMed

    West, Darrell M; Miller, Edward Alan

    2006-08-01

    State health departments have placed a tremendous amount of information, data, and services online in recent years. With the significant increase in online resources at official health sites, though, have come questions concerning equity of access and the confidentiality of electronic medical materials. This paper reports on an examination of public health department websites maintained by the 50 state governments. Using a content analysis of health department sites undertaken each year from 2000 to 2005, we investigate several dimensions of accessibility and privacy: readability levels, disability access, non-English accessibility, and the presence of privacy and security statements. We argue that although progress has been made at improving the accessibility and confidentiality of health department electronic resources, there remains much work to be done to ensure quality access for all Americans in the area of public e-health.

  10. CULTURAL FRONTIERS OF THE PEACE CORPS.

    ERIC Educational Resources Information Center

    TEXTOR, ROBERT B., ED.

    THE PRESENT WORK CONTAINS ANALYSES OF PEACE CORPS PROGRAMS IN SELECTED HOST COUNTRIES (THE PHILIPPINES, MALAYA, THAILAND, PERU, BOLIVIA, AFGHANISTAN, SOMALIA, NIGERIA, TANGANYIKA, SIERRA LEONE, TUNISIA, MOROCCO, AND JAMAICA) WRITTEN BY AN AUTHORITY ON EACH COUNTRY. COVERAGE OF DOMESTIC OPERATIONS OF THE PEACE CORPS IS STRICTLY LIMITED TO WHAT IS…

  11. YMCA Earth Service Corps Club Handbook.

    ERIC Educational Resources Information Center

    Peace Corps, Washington, DC. Information Collection and Exchange Div.

    This handbook provides Young Men's Christian Association (YMCA) Earth Service Corps club leaders and advisors with ideas for structuring clubs and service-learning projects. Activities and suggestions help to plan out the year, and improve service projects and club meetings. Contents include: (1) "What is YMCA Earth Service Corps?"; (2)…

  12. 32 CFR 700.1059 - Command of a staff corps activity.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Command of a staff corps activity. 700.1059..., Authority and Command Detail to Duty § 700.1059 Command of a staff corps activity. Officers in a staff corps shall be detailed to command only such activities as are appropriate to their corps. ...

  13. 32 CFR 700.1059 - Command of a staff corps activity.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Command of a staff corps activity. 700.1059..., Authority and Command Detail to Duty § 700.1059 Command of a staff corps activity. Officers in a staff corps shall be detailed to command only such activities as are appropriate to their corps. ...

  14. 32 CFR 700.1059 - Command of a staff corps activity.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Command of a staff corps activity. 700.1059..., Authority and Command Detail to Duty § 700.1059 Command of a staff corps activity. Officers in a staff corps shall be detailed to command only such activities as are appropriate to their corps. ...

  15. 32 CFR 700.1059 - Command of a staff corps activity.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Command of a staff corps activity. 700.1059..., Authority and Command Detail to Duty § 700.1059 Command of a staff corps activity. Officers in a staff corps shall be detailed to command only such activities as are appropriate to their corps. ...

  16. Access to medicines from a health system perspective

    PubMed Central

    Bigdeli, Maryam; Jacobs, Bart; Tomson, Goran; Laing, Richard; Ghaffar, Abdul; Dujardin, Bruno; Van Damme, Wim

    2013-01-01

    Most health system strengthening interventions ignore interconnections between systems components. In particular, complex relationships between medicines and health financing, human resources, health information and service delivery are not given sufficient consideration. As a consequence, populations' access to medicines (ATM) is addressed mainly through fragmented, often vertical approaches usually focusing on supply, unrelated to the wider issue of access to health services and interventions. The objective of this article is to embed ATM in a health system perspective. For this purpose, we perform a structured literature review: we examine existing ATM frameworks, review determinants of ATM and define at which level of the health system they are likely to occur; we analyse to which extent existing ATM frameworks take into account access constraints at different levels of the health system. Our findings suggest that ATM barriers are complex and interconnected as they occur at multiple levels of the health system. Existing ATM frameworks only partially address the full range of ATM barriers. We propose three essential paradigm shifts that take into account complex and dynamic relationships between medicines and other components of the health system. A holistic view of demand-side constraints in tandem with consideration of multiple and dynamic relationships between medicines and other health system resources should be applied; it should be recognized that determinants of ATM are rooted in national, regional and international contexts. These are schematized in a new framework proposing a health system perspective on ATM. PMID:23174879

  17. 42 CFR 124.515 - Compliance alternative for community health centers, migrant health centers and certain National...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ..., migrant health centers and certain National Health Service Corps sites. 124.515 Section 124.515 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT... certain National Health Service Corps sites. (a) Period of effectiveness. For each fiscal year for which a...

  18. 42 CFR 124.515 - Compliance alternative for community health centers, migrant health centers and certain National...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., migrant health centers and certain National Health Service Corps sites. 124.515 Section 124.515 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT... certain National Health Service Corps sites. (a) Period of effectiveness. For each fiscal year for which a...

  19. 42 CFR 124.515 - Compliance alternative for community health centers, migrant health centers and certain National...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., migrant health centers and certain National Health Service Corps sites. 124.515 Section 124.515 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT... certain National Health Service Corps sites. (a) Period of effectiveness. For each fiscal year for which a...

  20. 42 CFR 124.515 - Compliance alternative for community health centers, migrant health centers and certain National...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., migrant health centers and certain National Health Service Corps sites. 124.515 Section 124.515 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES DEVELOPMENT... certain National Health Service Corps sites. (a) Period of effectiveness. For each fiscal year for which a...

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

    PubMed

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

    2018-04-05

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

  2. 20 CFR 670.110 - What is the Job Corps program?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false What is the Job Corps program? 670.110...) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Scope and Purpose § 670.110 What is the Job Corps program? Job Corps is a national program that operates in partnership with States and...

  3. 20 CFR 670.110 - What is the Job Corps program?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false What is the Job Corps program? 670.110...) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Scope and Purpose § 670.110 What is the Job Corps program? Job Corps is a national program that operates in partnership with States and...

  4. 20 CFR 670.110 - What is the Job Corps program?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false What is the Job Corps program? 670.110...) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Scope and Purpose § 670.110 What is the Job Corps program? Job Corps is a national program that operates in partnership with States and...

  5. The Marine Corps Basic Training Experience: Stresses, Leadership, and Group Cohesion as Predictors of Attitudes, Health, and Performance.

    DTIC Science & Technology

    1982-11-01

    related to better attitudes toward the Marine Corps and greater feelings of self-improvement. (c) Negative stresses... attitudes toward the Marine Corps and higher perceived self-improvement scores. (e) Group cohesion had very little relation to attitudes toward the ...Predictors of Attitudes toward the M-ri n• C-rps. The stonificant associations between leadersnip and qroup co- hesion inl aI ttitudes toward the

  6. Agents of Change; A Close Look at the Peace Corps.

    ERIC Educational Resources Information Center

    Hapgood, David; Bennett, Meridan

    A critical evaluation of the Peace Corps covers a broad range of ideas and events, including the consequences of United States intervention in the affairs of others, the theory and practice of teaching in other cultures, the difficulties of food production and nutrition, and the problems of birth control and public health. There is also a…

  7. Marine Corps Vision & Strategy 2025

    DTIC Science & Technology

    2008-01-01

    integral part of our history as a Corps. In the South Pacific after Pearl Harbor, in Korea after the communist invasion in 1950, in the jungle outposts...we have experience integrating many organizations with different levels of capability into an effective team. In the future, Marine Corps forces may...and foremost a disciplined warrior. Expeditionary Naval Force. Marines are “soldiers of the sea,” an integral part of the naval Services — lean

  8. Outcome Evaluation: Minnesota Reading Corps PreK Program. Full Report

    ERIC Educational Resources Information Center

    Markovitz, Carrie E.; Hernandez, Marc W.; Hedberg, Eric C.; Silberglitt, Benjamin

    2015-01-01

    Minnesota Reading Corps is the largest AmeriCorps State program in the country. Its mission is to help every Minnesota child become a proficient reader by the end of third grade. To meet this goal, the Minnesota Reading Corps and its host organization, ServeMinnesota Action Network, engages a diverse group of AmeriCorps members to provide…

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

    PubMed

    Khongthanachayopit, Suprawee; Laohasiriwong, Wongsa

    2017-01-01

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

  10. The digital health divide: evaluating online health information access and use among older adults.

    PubMed

    Hall, Amanda K; Bernhardt, Jay M; Dodd, Virginia; Vollrath, Morgan W

    2015-04-01

    Innovations in health information technology (HIT) provide opportunities to reduce health care spending, improve quality of care, and improve health outcomes for older adults. However, concerns relating to older adults' limited access and use of HIT, including use of the Internet for health information, fuel the digital health divide debate. This study evaluated the potential digital health divide in relation to characteristic and belief differences between older adult users and nonusers of online health information sources. A cross-sectional survey design was conducted using a random sample of older adults. A total of 225 older adults (age range = 50-92 years, M = 68.9 years, SD = 10.4) participated in the study. Seventy-six percent of all respondents had Internet access. Users and nonusers of online health information differed significantly on age (M = 66.29 vs. M = 71.13), education, and previous experience with the health care system. Users and nonusers of online health information also differed significantly on Internet and technology access, however, a large percentage of nonusers had Internet access (56.3%), desktop computers (55.9%), and laptop computers or netbooks (43.2%). Users of online health information had higher mean scores on the Computer Self-Efficacy Measure than nonusers, t(159) = -7.29, p < .0001. This study found significant differences between older adult users and nonusers of online health information. Findings suggest strategies for reducing this divide and implications for health education programs to promote HIT use among older adults. © 2014 Society for Public Health Education.

  11. 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.

  12. Job Corps. In Brief. FY-76.

    ERIC Educational Resources Information Center

    Employment and Training Administration (DOL), Washington, DC.

    The Job Corps is described as a training program for impoverished and unemployed young people between the ages of 16 and 21 which will help them become responsible adults, prepare to get and hold productive jobs, return to school or further training, or satisfy Armed Forces' entrance requirements. (Currently (1976), Job Corps provides training for…

  13. Immigrants' access to health insurance: no equality without awareness.

    PubMed

    Dzúrová, Dagmar; Winkler, Petr; Drbohlav, Dušan

    2014-07-14

    The Czech government has identified commercial health insurance as one of the major problems for migrants' access to health care. Non-EU immigrants are eligible for public health insurance only if they have employee status or permanent residency. The present study examined migrants' access to the public health insurance system in Czechia. A cross-sectional survey of 909 immigrants from Ukraine and Vietnam was conducted in March and May 2013, and binary logistic regression was applied in data analysis. Among immigrants entitled to Czech public health insurance due to permanent residency/asylum, 30% were out of the public health insurance system, and of those entitled by their employment status, 50% were out of the system. Migrants with a poor knowledge of the Czech language are more likely to remain excluded from the system of public health insurance. Instead, they either remain in the commercial health insurance system or they simultaneously pay for both commercial and public health insurance, which is highly disadvantageous. Since there are no reasonable grounds to stay outside the public health insurance, it is concluded that it is lack of awareness that keeps eligible immigrants from entering the system. It is suggested that no equal access to health care exists without sufficient awareness about health care system.

  14. [Gender inequity in the access to health care in Chile].

    PubMed

    Vega, Jeanette; Bedregal, Paula; Jadue, Liliana; Delgado, Iris

    2003-06-01

    In the last two decades, Chile has experienced advances in economical development and global health indicators. However, gender inequities persist in particular related to access to health services and financing of health insurance. To examine gender inequities in the access to health care in Chile. An analysis of data obtained from a serial national survey applied to assess social policies (CASEN) carried out by the Ministry of Planning. During the survey 45,379 and 48,107 dwellings were interviewed in 1994 and in 1998, respectively. Women use health services 1.5 times more often, their salaries are 30% lower in all socioeconomic strata. Besides, in the private health sector, women pay higher insurance premiums than men. Men of less than two years of age have 2.5 times more preventive consultations than girls. This difference, although of lesser magnitude, is also observed in people over 60 years. Women of high income quintiles and users of private health insurance have a better access to preventive consultations but not to specialized care. An improvement in equitable access of women to health care and financing is recommended. Also, monitoring systems to survey these indicators for women should improve their efficiency.

  15. Emergency access to protected health records.

    PubMed

    Künzi, Julien; Koster, Paul; Petković, Milan

    2009-01-01

    Digital Rights Management (DRM) schemes are receiving increased attention in the healthcare domain for the protection of sensitive health records as they offer security against insider attacks and advance protection features such as usage control. However, to be accepted by health care providers, a DRM solution has to fulfill specific healthcare requirements including emergency access. In this paper, we propose such DRM solution that can be deployed in highly distributed environments of electronic or personal health record infrastructures.

  16. The Digital Health Divide: Evaluating Online Health Information Access and Use Among Older Adults

    PubMed Central

    Hall, Amanda K.; Bernhardt, Jay M.; Dodd, Virginia; Vollrath, Morgan W.

    2015-01-01

    Objective Innovations in health information technology (HIT) provide opportunities to reduce health care spending, improve quality of care, and improve health outcomes for older adults. However, concerns relating to older adults’ limited access and use of HIT, including use of the Internet for health information, fuel the digital health divide debate. This study evaluated the potential digital health divide in relation to characteristic and belief differences between older adult users and nonusers of online health information sources. Methods A cross-sectional survey design was conducted using a random sample of older adults. A total of 225 older adults (age range = 50–92 years, M = 68.9 years, SD = 10.4) participated in the study. Results Seventy-six percent of all respondents had Internet access. Users and nonusers of online health information differed significantly on age (M = 66.29 vs. M = 71.13), education, and previous experience with the health care system. Users and nonusers of online health information also differed significantly on Internet and technology access, however, a large percentage of nonusers had Internet access (56.3%), desktop computers (55.9%), and laptop computers or netbooks (43.2%). Users of online health information had higher mean scores on the Computer Self-Efficacy Measure than nonusers, t(159) = −7.29, p < .0001. Conclusion This study found significant differences between older adult users and nonusers of online health information. Findings suggest strategies for reducing this divide and implications for health education programs to promote HIT use among older adults. PMID:25156311

  17. The Western New York Health Resources Project: developing access to local health information.

    PubMed

    Gray, S A; O'Shea, R; Petty, M E; Loonsk, J

    1998-07-01

    The Western New York Health Resources Project was created to fill a gap in online access to local health information resources describing the health of a defined geographic area. The project sought to identify and describe information scattered among many institutions, agencies, and individuals, and to create a database that would be widely accessible. The project proceeded in three phases with initial phases supported by grant funding. This paper describes the database development and selection of content, and concludes that a national online network of local health data representing the various geographic regions of the United States would contribute to the quality of health care in general.

  18. The Western New York Health Resources Project: developing access to local health information.

    PubMed Central

    Gray, S A; O'Shea, R; Petty, M E; Loonsk, J

    1998-01-01

    The Western New York Health Resources Project was created to fill a gap in online access to local health information resources describing the health of a defined geographic area. The project sought to identify and describe information scattered among many institutions, agencies, and individuals, and to create a database that would be widely accessible. The project proceeded in three phases with initial phases supported by grant funding. This paper describes the database development and selection of content, and concludes that a national online network of local health data representing the various geographic regions of the United States would contribute to the quality of health care in general. PMID:9681168

  19. Planetree health information services: public access to the health information people want.

    PubMed Central

    Cosgrove, T L

    1994-01-01

    In July 1981, the Planetree Health Resource Center opened on the San Francisco campus of California Pacific Medical Center (Pacific Presbyterian Medical Center). Planetree was founded on the belief that access to information can empower people and help them face health and medical challenges. The Health Resource Center was created to provide medical library and health information resources to the general public. Over the last twelve years, Planetree has tried to develop a consumer health library collection and information service that is responsive to the needs and interests of a diverse public. In an effort to increase accessibility to the medical literature, a consumer health library classification scheme was created for the organization of library materials. The scheme combines the specificity and sophistication of the National Library of Medicine classification scheme with the simplicity of common lay terminology. PMID:8136762

  20. 20 CFR 638.502 - Job Corps basic education program.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Job Corps basic education program. 638.502 Section 638.502 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR JOB CORPS PROGRAM UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.502 Job Corps basic...

  1. [Access control management in electronic health records: a systematic literature review].

    PubMed

    Carrión Señor, Inmaculada; Fernández Alemán, José Luis; Toval, Ambrosio

    2012-01-01

    This study presents the results of a systematic literature review of aspects related to access control in electronic health records systems, wireless security and privacy and security training for users. Information sources consisted of original articles found in Medline, ACM Digital Library, Wiley InterScience, IEEE Digital Library, Science@Direct, MetaPress, ERIC, CINAHL and Trip Database, published between January 2006 and January 2011. A total of 1,208 articles were extracted using a predefined search string and were reviewed by the authors. The final selection consisted of 24 articles. Of the selected articles, 21 dealt with access policies in electronic health records systems. Eleven articles discussed whether access to electronic health records should be granted by patients or by health organizations. Wireless environments were only considered in three articles. Finally, only four articles explicitly mentioned that technical training of staff and/or patients is required. Role-based access control is the preferred mechanism to deploy access policy by the designers of electronic health records. In most systems, access control is managed by users and health professionals, which promotes patients' right to control personal information. Finally, the security of wireless environments is not usually considered. However, one line of research is eHealth in mobile environments, called mHealth. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

  2. Improving access to health care for undocumented immigrants in the United States.

    PubMed

    Wallace, Steven P; Rodriguez, Michael; Padilla-Frausto, Imelda; Arredondo, Armando; Orozco, Emanuel

    2013-01-01

    To identify policies that increase access to health care for undocumented Mexican immigrants. Four focus groups (n=34 participants) were conducted with uninsured Mexican immigrants in Los Angeles, California. The feasibility and desirability of different policy proposals for increasing access were discussed by each group. Respondents raised significant problems with policies including binational health insurance, expanded employer-provided health insurance, and telemedicine. The only solution with a consensus that the change would be feasible, result in improved access, and they had confidence in was expanded access to community health centers (CHC's). Given the limited access to most specialists at CHC's and the continued barriers to hospital care for those without health insurance, the most effective way of improving the complete range of health services to undocumented immigrants is through immigration reform that will bring these workers under the other health care reform provisions.

  3. 76 FR 20992 - Sun Chemical Corp.; Filing of Color Additive Petition

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-14

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-C-0050] Sun Chemical Corp.; Filing of Color Additive Petition AGENCY: Food and Drug Administration, HHS... filed a petition proposing that the color additive regulations for D&C Red No. 6 and D&C Red No. 7 be...

  4. 33 CFR 245.50 - Removal by Corps of Engineers.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Removal by Corps of Engineers. 245.50 Section 245.50 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE REMOVAL OF WRECKS AND OTHER OBSTRUCTIONS § 245.50 Removal by Corps of Engineers. (a...

  5. 33 CFR 66.01-30 - Corps of Engineers' approval.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Corps of Engineers' approval. 66... Corps of Engineers' approval. (a) Before any private aid to navigation consisting of a fixed structure... first be obtained from the District Engineer, U.S. Army Corps of Engineers in whose district the aid...

  6. 33 CFR 245.50 - Removal by Corps of Engineers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Removal by Corps of Engineers. 245.50 Section 245.50 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE REMOVAL OF WRECKS AND OTHER OBSTRUCTIONS § 245.50 Removal by Corps of Engineers. (a...

  7. 33 CFR 245.50 - Removal by Corps of Engineers.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Removal by Corps of Engineers. 245.50 Section 245.50 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE REMOVAL OF WRECKS AND OTHER OBSTRUCTIONS § 245.50 Removal by Corps of Engineers. (a...

  8. 33 CFR 66.01-30 - Corps of Engineers' approval.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Corps of Engineers' approval. 66... Corps of Engineers' approval. (a) Before any private aid to navigation consisting of a fixed structure... first be obtained from the District Engineer, U.S. Army Corps of Engineers in whose district the aid...

  9. 33 CFR 245.50 - Removal by Corps of Engineers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Removal by Corps of Engineers. 245.50 Section 245.50 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE REMOVAL OF WRECKS AND OTHER OBSTRUCTIONS § 245.50 Removal by Corps of Engineers. (a...

  10. 33 CFR 66.01-30 - Corps of Engineers' approval.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Corps of Engineers' approval. 66... Corps of Engineers' approval. (a) Before any private aid to navigation consisting of a fixed structure... first be obtained from the District Engineer, U.S. Army Corps of Engineers in whose district the aid...

  11. 33 CFR 245.50 - Removal by Corps of Engineers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Removal by Corps of Engineers. 245.50 Section 245.50 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE REMOVAL OF WRECKS AND OTHER OBSTRUCTIONS § 245.50 Removal by Corps of Engineers. (a...

  12. 33 CFR 66.01-30 - Corps of Engineers' approval.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Corps of Engineers' approval. 66... Corps of Engineers' approval. (a) Before any private aid to navigation consisting of a fixed structure... first be obtained from the District Engineer, U.S. Army Corps of Engineers in whose district the aid...

  13. 33 CFR 66.01-30 - Corps of Engineers' approval.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Corps of Engineers' approval. 66... Corps of Engineers' approval. (a) Before any private aid to navigation consisting of a fixed structure... first be obtained from the District Engineer, U.S. Army Corps of Engineers in whose district the aid...

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

    PubMed

    Kalich, Angela; Heinemann, Lyn; Ghahari, Setareh

    2016-06-01

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

  15. Defining the Marine Corps for the Long War

    DTIC Science & Technology

    2009-03-20

    will adopt a specific regional orientation with specialized manpower and training. Foreign Area Officer (FAO), Regional Affairs Officer (RAO) and...less company grade in the Marine Corps Reserve is a natural and positive consequence of the way the Marine Corps develops its officer corps. It...Support Element • Law Enforcement Element 3rd ANGLICO 4th ANGLICO 3rd FORECON 4th FORECON supports supports supports SC MAGTF SOUTH * MFR directs each

  16. Exploring patients' perceptions of accessing electronic health records: Innovation in healthcare.

    PubMed

    Wass, Sofie; Vimarlund, Vivian; Ros, Axel

    2017-04-01

    The more widespread implementation of electronic health records has led to new ways of providing access to healthcare information, allowing patients to view their medical notes, test results, medicines and so on. In this article, we explore how patients perceive the possibility to access their electronic health record online and whether this influences patient involvement. The study includes interviews with nine patients and a survey answered by 56 patients. Our results show that patients perceive healthcare information to be more accessible and that electronic health record accessibility improves recall, understanding and patient involvement. However, to achieve the goal of involving patients as active decision-makers in their own treatment, electronic health records need to be fully available and test results, referrals and information on drug interactions need to be offered. As patient access to electronic health records spreads, it is important to gain a deeper understanding of how documentation practices can be changed to serve healthcare professionals and patients.

  17. Army Corps of Engineers: Water Resource Authorizations, Appropriations, and Activities

    DTIC Science & Technology

    2013-10-18

    Corps authorities for levee improvements and certifications (see box on “Limited Corps Role in NFIP Levee Data Certification” on page 20);19...Activities Congressional Research Service 22 Limited Corps Role in NFIP Levee Data Certification The Corps currently has a limited role in the steps...leading up to levee accreditation by the Federal Emergency Management Agency (FEMA) for FEMA’s floodmaps for the National Flood Insurance Program ( NFIP

  18. Semantically Enriched Data Access Policies in eHealth.

    PubMed

    Drozdowicz, Michał; Ganzha, Maria; Paprzycki, Marcin

    2016-11-01

    Internet of Things (IoT) requires novel solutions to facilitate autonomous, though controlled, resource access. Access policies have to facilitate interactions between heterogeneous entities (devices and humans). Here, we focus our attention on access control in eHealth. We propose an approach based on enriching policies, based on well-known and widely-used eXtensible Access Control Markup Language, with semantics. In the paper we describe an implementation of a Policy Information Point integrated with the HL7 Security and Privacy Ontology.

  19. 32 CFR 728.24 - Navy and Marine Corps Officer Candidate Programs.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Navy and Marine Corps Officer Candidate Programs... Reserve Components, Reserve Officers' Training Corps, Navy and Marine Corps Officer Candidate Programs, and National Guard Personnel § 728.24 Navy and Marine Corps Officer Candidate Programs. Members of the...

  20. 32 CFR 728.24 - Navy and Marine Corps Officer Candidate Programs.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Navy and Marine Corps Officer Candidate Programs... Reserve Components, Reserve Officers' Training Corps, Navy and Marine Corps Officer Candidate Programs, and National Guard Personnel § 728.24 Navy and Marine Corps Officer Candidate Programs. Members of the...

  1. Repository on maternal child health: health portal to improve access to information on maternal child health in India.

    PubMed

    Khanna, Rajesh; Karikalan, N; Mishra, Anil Kumar; Agarwal, Anchal; Bhattacharya, Madhulekha; Das, Jayanta K

    2013-01-02

    Quality and essential health information is considered one of the most cost-effective interventions to improve health for a developing country. Healthcare portals have revolutionalized access to health information and knowledge using the Internet and related technologies, but their usage is far from satisfactory in India. This article describes a health portal developed in India aimed at providing one-stop access to efficiently search, organize and share maternal child health information relevant from public health perspective in the country. The portal 'Repository on Maternal Child Health' was developed using an open source content management system and standardized processes were followed for collection, selection, categorization and presentation of resource materials. Its usage is evaluated using key performance indicators obtained from Google Analytics, and quality assessed using a standardized checklist of knowledge management. The results are discussed in relation to improving quality and access to health information. The portal was launched in July 2010 and provides free access to full-text of 900 resource materials categorized under specific topics and themes. During the subsequent 18 months, 52,798 visits were registered from 174 countries across the world, and more than three-fourth visits were from India alone. Nearly 44,000 unique visitors visited the website and spent an average time of 4 minutes 26 seconds. The overall bounce rate was 27.6%. An increase in the number of unique visitors was found to be significantly associated with an increase in the average time on site (p-value 0.01), increase in the web traffic through search engines (p-value 0.00), and decrease in the bounce rate (p-value 0.03). There was a high degree of agreement between the two experts regarding quality assessment carried out under the three domains of knowledge access, knowledge creation and knowledge transfer (Kappa statistic 0.72). Efficient management of health information

  2. Traveling Towards Disease: Transportation Barriers to Health Care Access

    PubMed Central

    Gerber, Ben S.; Sharp, Lisa K.

    2014-01-01

    Transportation barriers are often cited as barriers to healthcare access. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. These consequences may lead to poorer management of chronic illness and thus poorer health outcomes. However, the significance of these barriers is uncertain based on existing literature due to wide variability in both study populations and transportation barrier measures. The authors sought to synthesize the literature on the prevalence of transportation barriers to health care access. A systematic literature search of peer-reviewed studies on transportation barriers to healthcare access was performed. Inclusion criteria were as follows: (1) study addressed access barriers for ongoing primary care or chronic disease care; (2) study included assessment of transportation barriers; and (3) study was completed in the United States. In total, 61 studies were reviewed. Overall, the evidence supports that transportation barriers are an important barrier to healthcare access, particularly for those with lower incomes or the under/uninsured. Additional research needs to (1) clarify which aspects of transportation limit health care access (2) measure the impact of transportation barriers on clinically meaningful outcomes and (3) measure the impact of transportation barrier interventions and transportation policy changes. PMID:23543372

  3. Traveling towards disease: transportation barriers to health care access.

    PubMed

    Syed, Samina T; Gerber, Ben S; Sharp, Lisa K

    2013-10-01

    Transportation barriers are often cited as barriers to healthcare access. Transportation barriers lead to rescheduled or missed appointments, delayed care, and missed or delayed medication use. These consequences may lead to poorer management of chronic illness and thus poorer health outcomes. However, the significance of these barriers is uncertain based on existing literature due to wide variability in both study populations and transportation barrier measures. The authors sought to synthesize the literature on the prevalence of transportation barriers to health care access. A systematic literature search of peer-reviewed studies on transportation barriers to healthcare access was performed. Inclusion criteria were as follows: (1) study addressed access barriers for ongoing primary care or chronic disease care; (2) study included assessment of transportation barriers; and (3) study was completed in the United States. In total, 61 studies were reviewed. Overall, the evidence supports that transportation barriers are an important barrier to healthcare access, particularly for those with lower incomes or the under/uninsured. Additional research needs to (1) clarify which aspects of transportation limit health care access (2) measure the impact of transportation barriers on clinically meaningful outcomes and (3) measure the impact of transportation barrier interventions and transportation policy changes.

  4. 20 CFR 670.500 - What services must Job Corps centers provide?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false What services must Job Corps centers provide... LABOR (CONTINUED) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Program Activities and Center Operations § 670.500 What services must Job Corps centers provide? (a) Job Corps centers must...

  5. 20 CFR 670.500 - What services must Job Corps centers provide?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false What services must Job Corps centers provide... LABOR (CONTINUED) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Program Activities and Center Operations § 670.500 What services must Job Corps centers provide? (a) Job Corps centers must...

  6. 20 CFR 670.500 - What services must Job Corps centers provide?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false What services must Job Corps centers provide... LABOR (CONTINUED) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Program Activities and Center Operations § 670.500 What services must Job Corps centers provide? (a) Job Corps centers must...

  7. Foreign Language Training in the United States Peace Corps.

    ERIC Educational Resources Information Center

    Kulakow, Allan

    This document reports on the foreign language training offered in the Peace Corps. Following a brief introductory statement, a list of languages taught by the Peace Corps in the years 1961-67 is provided, as well as a brief description of Peace Corps language training methods. Guidelines for language coordinators are outlined, and the approach to…

  8. Army Corps of Engineers: Water Resource Authorizations, Appropriations, and Activities

    DTIC Science & Technology

    2017-02-27

    of Engineers: Water Resource Authorizations, Appropriations, and Activities Congressional Research Service Summary The U.S. Army Corps of......Engineers: Water Resource Authorizations, Appropriations, and Activities Congressional Research Service 1 Army Corps of Engineers The U.S. Army Corps of

  9. 78 FR 59409 - In the Matter of AcuNetx, Inc., Alliance Pharmaceutical Corp., BBV Vietnam SE.A. Acquisition Corp...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-26

    ... Pharmaceutical Corp., BBV Vietnam SE.A. Acquisition Corp., Cash Technologies, Inc., Conspiracy Entertainment... that there is a lack of current and accurate information concerning the securities of Cash Technologies... concerning the securities of Conspiracy Entertainment Holdings, Inc. because it has not filed any periodic...

  10. Limited electricity access in health facilities of sub-Saharan Africa: a systematic review of data on electricity access, sources, and reliability

    PubMed Central

    Adair-Rohani, Heather; Zukor, Karen; Bonjour, Sophie; Wilburn, Susan; Kuesel, Annette C; Hebert, Ryan; Fletcher, Elaine R

    2013-01-01

    ABSTRACT Background: Access to electricity is critical to health care delivery and to the overarching goal of universal health coverage. Data on electricity access in health care facilities are rarely collected and have never been reported systematically in a multi-country study. We conducted a systematic review of available national data on electricity access in health care facilities in sub-Saharan Africa. Methods: We identified publicly-available data from nationally representative facility surveys through a systematic review of articles in PubMed, as well as through websites of development agencies, ministries of health, and national statistics bureaus. To be included in our analysis, data sets had to be collected in or after 2000, be nationally representative of a sub-Saharan African country, cover both public and private health facilities, and include a clear definition of electricity access. Results: We identified 13 health facility surveys from 11 sub-Saharan African countries that met our inclusion criteria. On average, 26% of health facilities in the surveyed countries reported no access to electricity. Only 28% of health care facilities, on average, had reliable electricity among the 8 countries reporting data. Among 9 countries, an average of 7% of facilities relied solely on a generator. Electricity access in health care facilities increased by 1.5% annually in Kenya between 2004 and 2010, and by 4% annually in Rwanda between 2001 and 2007. Conclusions: Energy access for health care facilities in sub-Saharan African countries varies considerably. An urgent need exists to improve the geographic coverage, quality, and frequency of data collection on energy access in health care facilities. Standardized tools should be used to collect data on all sources of power and supply reliability. The United Nations Secretary-General's “Sustainable Energy for All” initiative provides an opportunity to comprehensively monitor energy access in health care

  11. Using social determinants of health to link health workforce diversity, care quality and access, and health disparities to achieve health equity in nursing.

    PubMed

    Williams, Shanita D; Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

    2014-01-01

    It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators-health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work-both within and outside the nursing field-that is necessary to answer these important but largely unanswered questions.

  12. Using Social Determinants of Health to Link Health Workforce Diversity, Care Quality and Access, and Health Disparities to Achieve Health Equity in Nursing

    PubMed Central

    Hansen, Kristen; Smithey, Marian; Burnley, Josepha; Koplitz, Michelle; Koyama, Kirk; Young, Janice; Bakos, Alexis

    2014-01-01

    It is widely accepted that diversifying the nation's health-care workforce is a necessary strategy to increase access to quality health care for all populations, reduce health disparities, and achieve health equity. In this article, we present a conceptual model that utilizes the social determinants of health framework to link nursing workforce diversity and care quality and access to two critical population health indicators—health disparities and health equity. Our proposed model suggests that a diverse nursing workforce can provide increased access to quality health care and health resources for all populations, and is a necessary precursor to reduce health disparities and achieve health equity. With this conceptual model as a foundation, we aim to stimulate the conceptual and analytical work—both within and outside the nursing field—that is necessary to answer these important but largely unanswered questions. PMID:24385662

  13. 20 CFR 670.500 - What services must Job Corps centers provide?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What services must Job Corps centers provide... LABOR THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Program Activities and Center Operations § 670.500 What services must Job Corps centers provide? (a) Job Corps centers must provide: (1...

  14. 20 CFR 670.500 - What services must Job Corps centers provide?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What services must Job Corps centers provide... LABOR THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Program Activities and Center Operations § 670.500 What services must Job Corps centers provide? (a) Job Corps centers must provide: (1...

  15. Leader development transformation in the Army Nurse Corps.

    PubMed

    Funari, Tamara S; Ford, Kathleen; Schoneboom, Bruce A

    2011-01-01

    The Army Nurse (AN) Corps is undergoing a historic transformation. Under the leadership of its Chief, MG Patricia Horoho, the Corps developed and implemented the AN Campaign Plan to insure that the Corps has the right capability and capacity to meet the current and future needs of the US Army. This article describes the work conducted by the AN Corps Leadership Imperative Action Team (Leader IAT) to develop full-spectrum leaders for the future. The mission of the Leader IAT is derived from both the AN Campaign plan as well as the operational objectives defined in the AN balanced scorecard. As a result of the analysis conducted during preparation of the AN Campaign Plan, several key gaps were identified regarding the Army Nurse Corps' ability to match leadership talents with the diverse demands of current missions, as well as its adaptability and flexibility to be prepared for unknown future missions. This article also introduces the Leadership Capability Map and other initiatives implemented to ensure the development of full-spectrum leaders who will be effective in the future military healthcare environment.

  16. Repository on maternal child health: Health portal to improve access to information on maternal child health in India

    PubMed Central

    2013-01-01

    Background Quality and essential health information is considered one of the most cost-effective interventions to improve health for a developing country. Healthcare portals have revolutionalized access to health information and knowledge using the Internet and related technologies, but their usage is far from satisfactory in India. This article describes a health portal developed in India aimed at providing one-stop access to efficiently search, organize and share maternal child health information relevant from public health perspective in the country. Methods The portal ‘Repository on Maternal Child Health’ was developed using an open source content management system and standardized processes were followed for collection, selection, categorization and presentation of resource materials. Its usage is evaluated using key performance indicators obtained from Google Analytics, and quality assessed using a standardized checklist of knowledge management. The results are discussed in relation to improving quality and access to health information. Results The portal was launched in July 2010 and provides free access to full-text of 900 resource materials categorized under specific topics and themes. During the subsequent 18 months, 52,798 visits were registered from 174 countries across the world, and more than three-fourth visits were from India alone. Nearly 44,000 unique visitors visited the website and spent an average time of 4 minutes 26 seconds. The overall bounce rate was 27.6%. An increase in the number of unique visitors was found to be significantly associated with an increase in the average time on site (p-value 0.01), increase in the web traffic through search engines (p-value 0.00), and decrease in the bounce rate (p-value 0.03). There was a high degree of agreement between the two experts regarding quality assessment carried out under the three domains of knowledge access, knowledge creation and knowledge transfer (Kappa statistic 0.72). Conclusions

  17. 20 CFR 670.540 - What is Job Corps' zero tolerance policy?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false What is Job Corps' zero tolerance policy? 670... (CONTINUED) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Program Activities and Center Operations § 670.540 What is Job Corps' zero tolerance policy? (a) Each Job Corps center must have a zero...

  18. 20 CFR 670.540 - What is Job Corps' zero tolerance policy?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What is Job Corps' zero tolerance policy? 670... THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Program Activities and Center Operations § 670.540 What is Job Corps' zero tolerance policy? (a) Each Job Corps center must have a zero tolerance...

  19. 20 CFR 670.540 - What is Job Corps' zero tolerance policy?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What is Job Corps' zero tolerance policy? 670... THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Program Activities and Center Operations § 670.540 What is Job Corps' zero tolerance policy? (a) Each Job Corps center must have a zero tolerance...

  20. 20 CFR 670.540 - What is Job Corps' zero tolerance policy?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false What is Job Corps' zero tolerance policy? 670... (CONTINUED) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Program Activities and Center Operations § 670.540 What is Job Corps' zero tolerance policy? (a) Each Job Corps center must have a zero...

  1. 20 CFR 670.540 - What is Job Corps' zero tolerance policy?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false What is Job Corps' zero tolerance policy? 670... (CONTINUED) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Program Activities and Center Operations § 670.540 What is Job Corps' zero tolerance policy? (a) Each Job Corps center must have a zero...

  2. Corps Operations

    DTIC Science & Technology

    2010-11-26

    accomplishes these actions by developing, recommending, and briefing the scheme of fires, including both lethal fires and nonlethal actions (electronic...Install and operate the corps information technology help desk. Provide voice, video teleconference, e-mail—Non-Secure Internet Protocol Router...Network (NIPRNET), SECRET Internet Protocol Router Network (SIPRNET), and other communication networks—assistance, and other help desk functions

  3. Facilitating consumer access to health information.

    PubMed

    Snowdon, Anne; Schnarr, Karin; Alessi, Charles

    2014-01-01

    The lead paper from Zelmer and Hagens details the substantive evolution occurring in health information technologies that has the potential to transform the relationship between consumers, health practitioners and health systems. In this commentary, the authors suggest that Canada is experiencing a shift in consumer behaviour toward a desire to actively manage one's health and wellness that is being facilitated through the advent of health applications on mobile and online technologies platforms. The result is that Canadians are now able to create personalized health solutions based on their individual health values and goals. However, before Canadians are able to derive a personal health benefit from these rapid changes in information technology, they require and are increasingly demanding greater real-time access to their own health information to better inform decision-making, as well as interoperability between their personal health tracking systems and those of their health practitioner team.

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

    PubMed

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

    2016-04-01

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

  5. Improving awareness, accountability, and access through health coaching

    PubMed Central

    Liddy, Clare; Johnston, Sharon; Irving, Hannah; Nash, Kate; Ward, Natalie

    2015-01-01

    Abstract Objective To assess patients’ experiences with and perceptions of health coaching as part of their ongoing care. Design A qualitative research design using semistructured interviews that were recorded and transcribed verbatim. Setting Ottawa, Ont. Participants Eleven patients (> 18 years of age) enrolled in a health coaching pilot program who were at risk of or diagnosed with type 2 diabetes. Methods Patients’ perspectives were assessed with semistructured interviews. Interviews were conducted with 11 patients at the end of the pilot program, using a stratified sampling approach to ensure maximum variation. Main findings All patients found the overall experience with the health coaching program to be positive. Patients believed the health coaching program was effective in increasing awareness of how diabetes affected their bodies and health, in building accountability for their health-related actions, and in improving access to care and other health resources. Conclusion Patients perceive one-on-one health coaching as an acceptable intervention in their ongoing care. Patients enrolled in the health coaching pilot program believed that there was an improvement in access to care, health literacy, and accountability, all factors considered to be precursors to behavioural change. PMID:25932483

  6. Facilitating access to pre-processed research evidence in public health

    PubMed Central

    2010-01-01

    Background Evidence-informed decision making is accepted in Canada and worldwide as necessary for the provision of effective health services. This process involves: 1) clearly articulating a practice-based issue; 2) searching for and accessing relevant evidence; 3) appraising methodological rigor and choosing the most synthesized evidence of the highest quality and relevance to the practice issue and setting that is available; and 4) extracting, interpreting, and translating knowledge, in light of the local context and resources, into practice, program and policy decisions. While the public health sector in Canada is working toward evidence-informed decision making, considerable barriers, including efficient access to synthesized resources, exist. Methods In this paper we map to a previously developed 6 level pyramid of pre-processed research evidence, relevant resources that include public health-related effectiveness evidence. The resources were identified through extensive searches of both the published and unpublished domains. Results Many resources with public health-related evidence were identified. While there were very few resources dedicated solely to public health evidence, many clinically focused resources include public health-related evidence, making tools such as the pyramid, that identify these resources, particularly helpful for public health decisions makers. A practical example illustrates the application of this model and highlights its potential to reduce the time and effort that would be required by public health decision makers to address their practice-based issues. Conclusions This paper describes an existing hierarchy of pre-processed evidence and its adaptation to the public health setting. A number of resources with public health-relevant content that are either freely accessible or requiring a subscription are identified. This will facilitate easier and faster access to pre-processed, public health-relevant evidence, with the intent of

  7. Spatial access to inpatient health care in northern rural India.

    PubMed

    Ranga, Vikram; Panda, Pradeep

    2014-05-01

    Access to health care in rural areas is a major concern for local populations as well as for policy makers in developing countries. This paper examines spatial access to in-patient health care in northern rural India. In order to measure spatial access, impedance-based competition using the Three-Step floating Catchment Area (3SFCA) method, a modification of the simple gravity model, was used. 3SFCA was chosen for the study of the districts of Pratapgarh and Kanpur Dehat in the Uttar Pradesh state and Vaishali in the Bihar state, two of India's poorest states. This approach is based on discrete distance decay and also considers more parameters than other available methods, hence is believed to be a robust methodology. It was found that Vaishali district has the highest spatial access to in-patient health care followed by Pratapgarh and Kanpur Dehat. There is serious lack of health care, in Pratapgarh and Kanpur Dehat with 40% and 90% of the villages having shortage of in-patient care facilities in these respective districts. The most important factor affecting spatial access was found to be the distance to the nearest major urban agglomeration.

  8. Access to Transportation and Health Care Utilization in a Rural Region

    ERIC Educational Resources Information Center

    Arcury, Thomas A.; Preisser, John S.; Gesler, Wilbert M.; Powers, James M.

    2005-01-01

    Access to transportation to transverse the large distances between residences and health services in rural settings is a necessity. However, little research has examined directly access to transportation in analyses of rural health care utilization. This analysis addresses the association of transportation and health care utilization in a rural…

  9. Informal politics and inequity of access to health care in Lebanon

    PubMed Central

    2012-01-01

    Introduction Despite the importance of political institutions in shaping the social environment, the causal impact of politics on health care access and inequalities has been understudied. Even when considered, research tends to focus on the effects of formal macro-political institutions such as the welfare state. We investigate how micro-politics and informal institutions affect access to care. Methods This study uses a mixed-methods approach, combining findings from a household survey (n = 1789) and qualitative interviews (n = 310) in Lebanon. Multivariate logistic regression was employed in the analysis of the survey to examine the effect of political activism on access to health care while controlling for age, sex, socioeconomic status, religious commitment and piety. Results We note a significantly positive association between political activism and the probability of receiving health aid (p < .001), with an OR of 4.0 when comparing individuals with the highest political activity to those least active in our sample. Interviews with key informants also reveal that, although a form of “universal coverage” exists in Lebanon whereby any citizen is eligible for coverage of hospitalization fees and treatments, in practice, access to health services is used by political parties and politicians as a deliberate strategy to gain and reward political support from individuals and their families. Conclusions Individuals with higher political activism have better access to health services than others. Informal, micro-level political institutions can have an important impact on health care access and utilization, with potentially detrimental effects on the least politically connected. A truly universal health care system that provides access based on medical need rather than political affiliation is needed to help to alleviate growing health disparities in the Lebanese population. PMID:22571591

  10. Health Care Access for Adults With Intellectual and Developmental Disabilities: A Scoping Review.

    PubMed

    Williamson, Heather J; Contreras, Graciela M; Rodriguez, Erica S; Smith, Jennifer M; Perkins, Elizabeth A

    2017-10-01

    Adults with intellectual and/or developmental disabilities (IDD) often experience health disparities. To address disparities, Healthy People 2020 includes specific disability and health goals focused on improving health care access. The study's purpose was to review the literature exploring health care access for adults with IDD to identify opportunities for occupational therapy research and practice. A scoping review was completed of articles discussing health care access among adults with IDD in the United States. Thirty-seven articles met the inclusion criteria. Results are framed using the ecology of human performance theory identifying person and environmental issues affecting health care access of adults with IDD. Opportunities exist for occupational therapy to improve participation and health of adults with IDD through engaging in research and practice efforts addressing health care access. Occupational therapy could develop interventions to establish skills and abilities and recommend changes to the health care environment.

  11. Do school-based health centers improve adolescents' access to health care, health status, and risk-taking behavior?

    PubMed

    Kisker, E E; Brown, R S

    1996-05-01

    The purpose of this investigation was to assess the School-Based Adolescent Health Care Program, which provided comprehensive health-related services in 24 school-based health centers. The outcomes evaluation compared a cohort of students attending 19 participating schools and a national sample of urban youths, using logit models to control for observed differences between the two groups of youths. Outcome measures included self-reports concerning health center utilization, use of other health care providers, knowledge of key health facts, substance use, sexual activity, contraceptive use, pregnancies and births, and health status. The health centers increased students' access to health care and improved their health knowledge. However, the estimated impacts on health status and risky behaviors were inconsistent, and most were small and not statistically significant. School-based health centers can increase students' health knowledge and access to health-related services, but more intensive or different services are needed if they are to significantly reduce risk-taking behaviors.

  12. 33 CFR 334.235 - Potomac River, Marine Corps Base Quantico (MCB Quantico) in vicinity of Marine Corps Air Facility...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Potomac River, Marine Corps Base... DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.235 Potomac River, Marine Corps Base Quantico... the navigable waters of the Potomac River extending approximately 500 meters from the high-water mark...

  13. 33 CFR 334.235 - Potomac River, Marine Corps Base Quantico (MCB Quantico) in vicinity of Marine Corps Air Facility...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Potomac River, Marine Corps Base... DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.235 Potomac River, Marine Corps Base Quantico... the navigable waters of the Potomac River extending approximately 500 meters from the high-water mark...

  14. 33 CFR 334.235 - Potomac River, Marine Corps Base Quantico (MCB Quantico) in vicinity of Marine Corps Air Facility...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Potomac River, Marine Corps Base... DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.235 Potomac River, Marine Corps Base Quantico... the navigable waters of the Potomac River extending approximately 500 meters from the high-water mark...

  15. 33 CFR 334.235 - Potomac River, Marine Corps Base Quantico (MCB Quantico) in vicinity of Marine Corps Air Facility...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Potomac River, Marine Corps Base... DEFENSE DANGER ZONE AND RESTRICTED AREA REGULATIONS § 334.235 Potomac River, Marine Corps Base Quantico... the navigable waters of the Potomac River extending approximately 500 meters from the high-water mark...

  16. Assessing Health Care Access and Use among Indigenous Peoples in Alberta: a Systematic Review.

    PubMed

    Nader, Forouz; Kolahdooz, Fariba; Sharma, Sangita

    2017-01-01

    Alberta's Indigenous population is growing, yet health care access may be limited. This paper presents a comprehensive review on health care access among Indigenous populations in Alberta with a focus on the health care services use and barriers to health care access. Scientific databases (PubMed, EMBASE, CINAHL, and PsycINFO) and online search engines were systematically searched for studies and grey literature published in English between 2000 and 2013 examining health care services access, use and barriers to access among Indigenous populations in Alberta. Information on health care services use and barriers to use or access was synthesized based on the MOOSE guidelines. Overall, compared to non-Indigenous populations, health care use rates for hospital/emergency room services were higher and health care services use of outpatient specialists was lower among Indigenous peoples. Inadequate numbers of Indigenous health care professionals; a lack of cross-cultural training; fear of foreign environments; and distance from family and friends were barriers to health care use and access. Inequity in social determinants of health among Indigenous peoples and inadequate "health services with prevention approaches," may contribute to present health disparities between Indigenous and non-Indigenous populations in the province.

  17. 77 FR 20331 - Department of the Army, Corps of Engineers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-04

    ... and Indian Field Creek along the York River in Yorktown, VA; Restricted Area AGENCY: U.S. Army Corps... comments. SUMMARY: The Corps of Engineers is proposing to amend an existing permanent restricted area in... Weapons Station Yorktown is requesting the Corps of Engineers modify the existing restricted area to...

  18. Adverse or acceptable: negotiating access to a post-apartheid health care contract.

    PubMed

    Harris, Bronwyn; Eyles, John; Penn-Kekana, Loveday; Thomas, Liz; Goudge, Jane

    2014-05-15

    As in many fragile and post-conflict countries, South Africa's social contract has formally changed from authoritarianism to democracy, yet access to services, including health care, remains inequitable and contested. We examine access barriers to quality health services and draw on social contract theory to explore ways in which a post-apartheid health care contract is narrated, practiced and negotiated by patients and providers. We consider implications for conceptualizing and promoting more inclusive, equitable health services in a post-conflict setting. Using in-depth interviews with 45 patients and 67 providers, and field observations from twelve health facilities in one rural and two urban sub-districts, we explore access narratives of those seeking and delivering - negotiating - maternal health, tuberculosis and antiretroviral services in South Africa. Although South Africa's right to access to health care is constitutionally guaranteed, in practice, a post-apartheid health care contract is not automatically or unconditionally inclusive. Access barriers, including poverty, an under-resourced, hierarchical health system, the nature of illness and treatment, and negative attitudes and actions, create conditions for insecure or adverse incorporation into this contract, or even exclusion (sometimes temporary) from health care services. Such barriers are exacerbated by differences in the expectations that patients and providers have of each other and the contract, leading to differing, potentially conflicting, identities of inclusion and exclusion: defaulting versus suffering patients, uncaring versus overstretched providers. Conversely, caring, respectful communication, individual acts of kindness, and institutional flexibility and leadership may mitigate key access barriers and limit threats to the contract, fostering more positive forms of inclusion and facilitating easier access to health care. Building health in fragile and post-conflict societies requires

  19. Adverse or acceptable: negotiating access to a post-apartheid health care contract

    PubMed Central

    2014-01-01

    Background As in many fragile and post-conflict countries, South Africa’s social contract has formally changed from authoritarianism to democracy, yet access to services, including health care, remains inequitable and contested. We examine access barriers to quality health services and draw on social contract theory to explore ways in which a post-apartheid health care contract is narrated, practiced and negotiated by patients and providers. We consider implications for conceptualizing and promoting more inclusive, equitable health services in a post-conflict setting. Methods Using in-depth interviews with 45 patients and 67 providers, and field observations from twelve health facilities in one rural and two urban sub-districts, we explore access narratives of those seeking and delivering – negotiating - maternal health, tuberculosis and antiretroviral services in South Africa. Results Although South Africa’s right to access to health care is constitutionally guaranteed, in practice, a post-apartheid health care contract is not automatically or unconditionally inclusive. Access barriers, including poverty, an under-resourced, hierarchical health system, the nature of illness and treatment, and negative attitudes and actions, create conditions for insecure or adverse incorporation into this contract, or even exclusion (sometimes temporary) from health care services. Such barriers are exacerbated by differences in the expectations that patients and providers have of each other and the contract, leading to differing, potentially conflicting, identities of inclusion and exclusion: defaulting versus suffering patients, uncaring versus overstretched providers. Conversely, caring, respectful communication, individual acts of kindness, and institutional flexibility and leadership may mitigate key access barriers and limit threats to the contract, fostering more positive forms of inclusion and facilitating easier access to health care. Conclusions Building health in

  20. Access to high-tech health care. Ethics.

    PubMed

    Merrill, J M

    1991-03-15

    Access to health care has always been limited by personal and social economics. Poverty remains one element that correlates with poor prognosis in all varieties of cancer. Prior to becoming standard therapy, elements of high-tech health care are often widely available as research protocols, participation in which is generally available without considerations of insurance coverage or personal wealth. Any person may still volunteer participation in research protocols and thereby partake in high-tech advances even before these become standard therapy. However, recent developments in the conduct of research now may limit participation. Medicare and third party insurance payers proscribe payment for research project care and always have. Recently, more than ever before, reimbursements to physicians and health care institutions have been more closely scrutinized to reject all payment in research settings. In situations in which cost and availability of the new technology, whether machine or drug, limit participation, research entrepreneurs have made research participation available to only those who can pay for it. These and similar developments threaten to limit access to high-tech health care and to actually impede cancer research.

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

    PubMed

    Kimerling, Rachel; Baumrind, Nikki

    2005-06-01

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

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

    PubMed

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

    2017-05-18

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

  3. 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

  4. Corps Mobilization Capabilities, Requirements, and Planning.

    DTIC Science & Technology

    1980-03-01

    Fundamental among these elements is the concept of "one-stop" service . Despite the Corps’ internal structure, external customers (such as military...stop" service concept. (2) Authorities that allow and encourage direct coordination among districts both internal and external to the division. (3...mobilization conditions, and discusses the internal actions the Corps should implement so as to meet these requirements. V DO 7 1473 EDITION OF I NOVUN5 IS

  5. America's Children: Health Insurance and Access to Care.

    ERIC Educational Resources Information Center

    Edmunds, Margaret, Ed.; Coye, Molly Joel, Ed.

    The National Academy of Sciences Committee on Children, Health Insurance, and Access to Care was assembled to address questions about health insurance for children, evaluating the strengths and limitations of insurance as a means of improving children's health from a variety of approaches and policies. Meeting between March 1997 and January 1998,…

  6. Deported Mexican migrants: health status and access to care

    PubMed Central

    Fernández-Niño, Julián Alfredo; Ramírez-Valdés, Carlos Jacobo; Cerecero-Garcia, Diego; Bojorquez-Chapela, Ietza

    2014-01-01

    OBJECTIVE To describe the health status and access to care of forced-return Mexican migrants deported through the Mexico-United States border and to compare it with the situation of voluntary-return migrants. METHODS Secondary data analysis from the Survey on Migration in Mexico’s Northern Border from 2012. This is a continuous survey, designed to describe migration flows between Mexico and the United States, with a mobile-population sampling design. We analyzed indicators of health and access to care among deported migrants, and compare them with voluntary-return migrants. Our analysis sample included 2,680 voluntary-return migrants, and 6,862 deportees. We employ an ordinal multiple logistic regression model, to compare the adjusted odds of having worst self-reported health between the studied groups. RESULTS As compared to voluntary-return migrants, deportees were less likely to have medical insurance in the United States (OR = 0.05; 95%CI 0.04;0.06). In the regression model a poorer self-perceived health was found to be associated with having been deported (OR = 1.71, 95%CI 1.52;1.92), as well as age (OR = 1.03, 95%CI 1.02;1.03) and years of education (OR = 0.94 95%CI 0.93;0.95). CONCLUSIONS According to our results, deportees had less access to care while in the United States, as compared with voluntary-return migrants. Our results also showed an independent and statistically significant association between deportation and having poorer self-perceived health. To promote the health and access to care of deported Mexican migrants coming back from the United States, new health and social policies are required. PMID:25119943

  7. Deported Mexican migrants: health status and access to care.

    PubMed

    Fernández-Niño, Julián Alfredo; Ramírez-Valdés, Carlos Jacobo; Cerecero-Garcia, Diego; Bojorquez-Chapela, Ietza

    2014-06-01

    OBJECTIVE To describe the health status and access to care of forced-return Mexican migrants deported through the Mexico-United States border and to compare it with the situation of voluntary-return migrants. METHODS Secondary data analysis from the Survey on Migration in Mexico's Northern Border from 2012. This is a continuous survey, designed to describe migration flows between Mexico and the United States, with a mobile-population sampling design. We analyzed indicators of health and access to care among deported migrants, and compare them with voluntary-return migrants. Our analysis sample included 2,680 voluntary-return migrants, and 6,862 deportees. We employ an ordinal multiple logistic regression model, to compare the adjusted odds of having worst self-reported health between the studied groups. RESULTS As compared to voluntary-return migrants, deportees were less likely to have medical insurance in the United States (OR = 0.05; 95%CI 0.04;0.06). In the regression model a poorer self-perceived health was found to be associated with having been deported (OR = 1.71, 95%CI 1.52;1.92), as well as age (OR = 1.03, 95%CI 1.02;1.03) and years of education (OR = 0.94 95%CI 0.93;0.95). CONCLUSIONS According to our results, deportees had less access to care while in the United States, as compared with voluntary-return migrants. Our results also showed an independent and statistically significant association between deportation and having poorer self-perceived health. To promote the health and access to care of deported Mexican migrants coming back from the United States, new health and social policies are required.

  8. 20 CFR 670.110 - What is the Job Corps program?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false What is the Job Corps program? 670.110 Section 670.110 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Scope and Purpose § 670.110 What is the Job Corps...

  9. 20 CFR 670.110 - What is the Job Corps program?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What is the Job Corps program? 670.110 Section 670.110 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Scope and Purpose § 670.110 What is the Job Corps...

  10. NREL Enhances Energy Resiliency at Marine Corps Air Station Miramar |

    Science.gov Websites

    Integrated Energy Solutions | NREL Enhances Energy Resiliency at Marine Corps Air Station Miramar NREL Enhances Energy Resiliency at Marine Corps Air Station Miramar Since 2008, NREL has partnered with Marine Corps Air Station (MCAS) Miramar, helping it become more renewable and more energy

  11. Access to mental health care among women Veterans: is VA meeting women's needs?

    PubMed

    Kimerling, Rachel; Pavao, Joanne; Greene, Liberty; Karpenko, Julie; Rodriguez, Allison; Saweikis, Meghan; Washington, Donna L

    2015-04-01

    Patient-centered access to mental health describes the fit between patient needs and resources of the system. To date, little data are available to guide implementation of services to women veterans, an underrepresented minority within Department of Veteran Affairs (VA) health care. The current study examines access to mental health care among women veterans, and identifies gender-related indicators of perceived access to mental health care. A population-based sample of 6287 women veterans using VA primary care services participated in a survey of past year perceived need for mental health care, mental health utilization, and gender-related mental health care experiences. Subjective rating of how well mental health care met their needs was used as an indicator of perceived access. Half of all women reported perceived mental health need; 84.3% of those women received care. Nearly all mental health users (90.9%) used VA services, although only about half (48.8%) reported that their mental health care met their needs completely or very well. Gender related experiences (availability of female providers, women-only treatment settings, women-only treatment groups, and gender-related comfort) were each associated with 2-fold increased odds of perceived access, and associations remained after adjusting for ease of getting care. Women VA users demonstrate very good objective access to mental health services. Desire for, and access to specialized mental health services for women varies across the population and are important aspects of shared decision making in referral and treatment planning for women using VA primary care.

  12. Health-Care Access during the Ebola Virus Epidemic in Liberia.

    PubMed

    McQuilkin, Patricia A; Udhayashankar, Kanagasabai; Niescierenko, Michelle; Maranda, Louise

    2017-09-01

    The Ebola virus disease (EVD) epidemic, which began in West Africa in December 2013, claimed more than 11,000 lives, with more than 4,800 of these deaths occurring in Liberia. The epidemic had an additional effect of paralyzing the health-care systems in affected countries, which led to even greater mortality and morbidity. Little is known about the impact that the epidemic had on the provision of basic health care. During the period from March to May 2015, we undertook a nationwide, community-based survey to learn more about health-care access during the EVD epidemic in Liberia. A cluster sampling strategy was used to administer a structured in-person survey to heads of households located within the catchment areas surrounding all 21 government hospitals in Liberia. A total of 543 heads of household from all 15 counties in Liberia participated in the study; more than half (67%) of urban respondents and 46% of rural respondents stated that it was very difficult or impossible to access health care during the epidemic. In urban areas, only 20-30% of patients seeking care during the epidemic received care, and in rural areas, only 70-80% of those seeking care were able to access it. Patients requiring prenatal and obstetric care and emergency services had the most difficulty accessing care. The results of this survey support the observation that basic health care was extremely difficult to access during the EVD epidemic in Liberia. Our results underscore the critical need to support essential health-care services during humanitarian crises to minimize preventable morbidity and mortality.

  13. Was access to health care easy for immigrants in Spain? The perspectives of health personnel in Catalonia and Andalusia.

    PubMed

    Vázquez, María-Luisa; Vargas, Ingrid; Jaramillo, Daniel López; Porthé, Victoria; López-Fernández, Luis Andrés; Vargas, Hernán; Bosch, Lola; Hernández, Silvia S; Azarola, Ainhoa Ruiz

    2016-04-01

    Until April 2012, all Spanish citizens were entitled to health care and policies had been developed at national and regional level to remove potential barriers of access, however, evidence suggested problems of access for immigrants. In order to identify factors affecting immigrants' access to health care, we conducted a qualitative study based on individual interviews with healthcare managers (n=27) and professionals (n=65) in Catalonia and Andalusia, before the policy change that restricted access for some groups. A thematic analysis was carried out. Health professionals considered access to health care "easy" for immigrants and similar to access for autochthons in both regions. Clear barriers were identified to enter the health system (in obtaining the health card) and in using services, indicating a mismatch between the characteristics of services and those of immigrants. Results did not differ among regions, except for in Catalonia, where access to care was considered harder for users without a health card, due to the fees charged, and in general, because of the distance to primary health care in rural areas. In conclusion, despite the universal coverage granted by the Spanish healthcare system and developed health policies, a number of barriers in access emerged that would require implementing the existing policies. However, the measures taken in the context of the economic crisis are pointing in the opposite direction, towards maintaining or increasing barriers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Development and Testing of a Conceptual Model Regarding Men's Access to Health Care.

    PubMed

    Leone, James E; Rovito, Michael J; Mullin, Elizabeth M; Mohammed, Shan D; Lee, Christina S

    2017-03-01

    Epidemiologic data suggest men often experience excessive morbidity and early mortality, possibly compromising family and community health over the lifespan. Moreover, the negative financial/economic consequences affected by poor male health outcomes also has been of great concern in the United States and abroad. Early and consistent access to preventative health care may improve health outcomes; however, men are far less likely to access these services. The purpose of this study was to understand what factors preclude men from accessing health care. We surveyed 485 participants using a 58-item online survey built from a conceptual model previously developed by the researchers using hegemonic masculinity theory, the theory of normative contentment, and the health belief model. For men, three items significantly ( ps < .05) predicted whether they had seen a health care provider in the past year: "I/Men do not access healthcare because I do not think there is anything wrong with me," "My health is only about me," and "I/Men do not access healthcare because most men in my family do not access healthcare." Other correlations of practical significance also were noted. Results suggest gender norms and masculine ideals may play a primary role in how men access preventative health care. Future programming targeting males should consider barriers and plan programs that are gender-sensitive in addition to being gender-specific. Clinical implications are discussed.

  15. 32 CFR 700.1059 - Command of a staff corps activity.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Command of a staff corps activity. 700.1059 Section 700.1059 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES..., Authority and Command Detail to Duty § 700.1059 Command of a staff corps activity. Officers in a staff corps...

  16. Gunton Corp. Information Sheet

    EPA Pesticide Factsheets

    Gunton Corp. (the Company) is located in Bedford Heights, Ohio, and Pottstown, Pennsylvania. The settlement involves renovation activities conducted at properties constructed prior to 1978, located in several cities in Pennsylvania.

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

    PubMed

    Austen, Sally; McGrath, Melissa

    2006-01-01

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

  18. Descriptive Study of AmeriCorps Literacy Programs: State and National. Final Report.

    ERIC Educational Resources Information Center

    Moss, Marc; Hiller, Jordan; Moore, Douglas

    AmeriCorps is composed of three programs, State and National; National Civilian Community Corps (NCCC); and Volunteers in Service to America (VISTA). The focus of this report is on the AmeriCorps State/National program. Education-related activities have been a priority for AmeriCorps' parent organization, the National Corporation for Public…

  19. 78 FR 20225 - Delegation of Authority To Appoint Commissioned Officers of the Ready Reserve Corps of the Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-04

    ... Authority To Appoint Commissioned Officers of the Ready Reserve Corps of the Public Health Service... States Code, I hereby assign to you the functions of the President under section 203 of the Public Health... of the Public Health Service. Commissions issued under this delegation of authority may not be for a...

  20. 32 CFR 765.12 - Navy and Marine Corps absentees; rewards.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Navy and Marine Corps absentees; rewards. 765.12... RULES RULES APPLICABLE TO THE PUBLIC § 765.12 Navy and Marine Corps absentees; rewards. The following is set forth as it applies to Navy and Marine Corps absentees. The term “absentee,” as used in this...

  1. 32 CFR 765.12 - Navy and Marine Corps absentees; rewards.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Navy and Marine Corps absentees; rewards. 765.12... RULES RULES APPLICABLE TO THE PUBLIC § 765.12 Navy and Marine Corps absentees; rewards. The following is set forth as it applies to Navy and Marine Corps absentees. The term “absentee,” as used in this...

  2. Army Corps of Engineers Water Resource Projects: Authorization and Appropriations

    DTIC Science & Technology

    2010-09-29

    Corps’ role in levee accreditation and improvements for the National Flood Insurance Program ( NFIP ). Responsibilities and Organization The Corps is...sponsors assume any rehabilitation cost for damage to an active project attributable to deficient maintenance. Corps Authorities and NFIP Levee...certification. The Corps currently has no general authority to perform NFIP -compliant data certifications using discretionary appropriations and is

  3. Criteria for Evaluating United States Marine Corps Installation Strategic Management

    DTIC Science & Technology

    2001-12-01

    STATES MARINE CORPS INSTALLATION STRATEGIC MANAGEMENT by James E. Leighty December 2001 Thesis Advisor: Joseph San Miguel Report...Marine Corps Installation Strategic Management Contract Number Grant Number Program Element Number Author(s) Leighty, James Project Number Task...TYPE AND DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE: Criteria For Evaluating United States Marine Corps Installation Strategic

  4. 77 FR 38834 - Advisory Committee for Innovation Corps; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-29

    ... NATIONAL SCIENCE FOUNDATION Advisory Committee for Innovation Corps; Notice of Meeting In... Foundation announces the following meeting: Name: Innovation Corps for Advisory Committee, 80463. Dates/Time... . Purpose of Meeting: To provide advice and recommendations concerning Innovation Corps. Agenda July 18...

  5. Geography Matters: State-Level Variation in Children's Oral Health Care Access and Oral Health Status

    PubMed Central

    Fisher-Owens, Susan A.; Soobader, Mah-J; Gansky, Stuart A.; Isong, Inyang A.; Weintraub, Jane A.; Platt, Larry J.; Newacheck, Paul W.

    2016-01-01

    Objectives To ascertain differences across states in children's oral health care access and oral health status and the factors that contribute to those differences Study Design Observational study using cross-sectional surveys Methods Using the 2007 National Survey of Children's Health, we examined state variation in parent's report of children's oral health care access (absence of a preventive dental visit) and oral health status. We assessed the unadjusted prevalences of these outcomes, then adjusted with child-, family-, and neighborhood-level variables using logistic regression; these results are presented directly and graphically. Using multilevel analysis, we then calculated the degree to which child-, family-, and community-level variables explained state variation. Finally, we quantified the influence of state-level variables on state variation. Results Unadjusted rates of no preventive dental care ranged 9.0-26.8% (mean 17.5%), with little impact of adjusting (10.3-26.7%). Almost 9% of population had fair/poor oral health; unadjusted range 4.1-14.5%. Adjusting analyses affected fair/poor oral health more than access (5.7-10.7%). Child, family and community factors explained ~¼ of the state variation in no preventive visit and ~½ of fair/poor oral health. State-level factors further contributed to explaining up to a third of residual state variation. Conclusion Geography matters: where a child lives has a large impact on his or her access to oral health care and oral health status, even after adjusting for child, family, community, and state variables. As state-level variation persists, other factors and richer data are needed to clarify the variation and drive changes for more egalitarian and overall improved oral health. PMID:26995567

  6. Internet and computer access and use for health information in an underserved community.

    PubMed

    Kind, Terry; Huang, Zhihuan J; Farr, Deeonna; Pomerantz, Karyn L

    2005-01-01

    The "digital divide" is the gap between those with access to information tools such as the Internet and those without access. The gap has been described by income, education, age, and race. Little information exists on computer and Internet access and use for health information by parents, particularly among populations of low income and low education level. To describe computer and Internet access and use, including health information retrieval, among low-income, urban, African American caregivers (parents). Cross-sectional survey administered in pediatric waiting rooms of urban community-based health centers in a low-income area. Caregivers of pediatric outpatients. Access to computers, Internet access, and use of Internet for health information. In 2003, among 260 African Americans who completed surveys, 58% had a computer and 41% had home Internet access. Fifty-two percent had used the Internet for finding health information. Ninety-three percent agreed or strongly agreed that there is useful health information on the Internet. Ninety-two percent agreed or strongly agreed that they would want to talk with a medical professional about health information on the Internet. Sixty-five percent of respondents had no additional schooling after high school. Annual household income was access were significantly higher in caregivers with higher education and income. Most pediatric patients' families have home computers and believe there is useful health information on the Internet, even among low-income and traditionally underserved populations. Most would like to discuss Internet-based health information with their providers.

  7. Internet access for delivery of health information to South Australians older than 50.

    PubMed

    Wilson, Carlene; Flight, Ingrid; Hart, Elizabeth; Turnbull, Deborah; Cole, Steve; Young, Graeme

    2008-04-01

    An exploratory study to determine the proportion of people aged 50-76 years who have Internet access, the location of this access, predictive characteristics of such access, and preparedness to receive unsolicited health information through this medium. A random sample of 1,000 South Australians was identified from the Australian Electoral Commission roll and contacted by telephone in 2006. They were invited to answer questions about their access to the Internet and attitude towards receiving unsolicited health information via the Internet. Of those contacted, 41% provided information. Of this group, 59% indicated that they had Internet access, mostly at home. Men were more likely than women to have home access (p<0.05). Higher educational achievement, higher economic status and younger age were all significantly associated with access. Of those who had access, 65% would be willing to receive health information through the Internet. More than half the population older than 50 years has access to the Internet at some location, and there is a general acceptance of the possibility of receiving health-promoting material via this medium. However, delivery via the Internet alone would disadvantage those who are less educated, less financially well off and older. It is likely that a generational change in the entire nature of public communication will influence the efficiency and effectiveness of preventive health promotion delivery via the Internet. In order to facilitate improved health outcomes, issues of disparity of access must be addressed.

  8. Exposing some important barriers to health care access in the rural USA.

    PubMed

    Douthit, N; Kiv, S; Dwolatzky, T; Biswas, S

    2015-06-01

    To review research published before and after the passage of the Patient Protection and Affordable Care Act (2010) examining barriers in seeking or accessing health care in rural populations in the USA. This literature review was based on a comprehensive search for all literature researching rural health care provision and access in the USA. Pubmed, Proquest Allied Nursing and Health Literature, National Rural Health Association (NRHA) Resource Center and Google Scholar databases were searched using the Medical Subject Headings (MeSH) 'Rural Health Services' and 'Rural Health.' MeSH subtitle headings used were 'USA,' 'utilization,' 'trends' and 'supply and distribution.' Keywords added to the search parameters were 'access,' 'rural' and 'health care.' Searches in Google Scholar employed the phrases 'health care disparities in the USA,' inequalities in 'health care in the USA,' 'health care in rural USA' and 'access to health care in rural USA.' After eliminating non-relevant articles, 34 articles were included. Significant differences in health care access between rural and urban areas exist. Reluctance to seek health care in rural areas was based on cultural and financial constraints, often compounded by a scarcity of services, a lack of trained physicians, insufficient public transport, and poor availability of broadband internet services. Rural residents were found to have poorer health, with rural areas having difficulty in attracting and retaining physicians, and maintaining health services on a par with their urban counterparts. Rural and urban health care disparities require an ongoing program of reform with the aim to improve the provision of services, promote recruitment, training and career development of rural health care professionals, increase comprehensive health insurance coverage and engage rural residents and healthcare providers in health promotion. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights

  9. Factors that influence Asian communities' access to mental health care.

    PubMed

    Wynaden, Dianne; Chapman, Rose; Orb, Angelica; McGowan, Sunita; Zeeman, Zenith; Yeak, SiewHo

    2005-06-01

    This paper presents the findings of a qualitative study to identify factors that influence Asian communities' access to mental health care and how mental health care is delivered to them. Semistructured interviews were completed with Asian community members/leaders and health-care professionals. Content analysis identified major themes. Participants also completed a demographic data sheet. The research aimed to provide health professionals with an increased understanding of the values and beliefs held by people from Asian communities regarding the cause and treatment of mental illness. Data analysis identified six main themes that influenced Asian communities' access to mental health care and how mental health care is delivered to them. They were: shame and stigma; causes of mental illness; family reputation; hiding up; seeking help; and lack of collaboration. The findings highlighted that people from Asian communities are unwilling to access help from mainstream services because of their beliefs, and that stigma and shame are key factors that influence this reluctance. The findings also highlight that the mental health needs of refugee women are significant, and that they comprise a vulnerable group within Australian society.

  10. 77 FR 62243 - Health Resources and Services Administration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-12

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps Notice of Meeting In accordance with section 10(a)(2... meeting: Name: National Advisory Council on the National Health Service Corps (NHSC). Dates and Times...

  11. Geography matters: state-level variation in children's oral health care access and oral health status.

    PubMed

    Fisher-Owens, S A; Soobader, M J; Gansky, S A; Isong, I A; Weintraub, J A; Platt, L J; Newacheck, P W

    2016-05-01

    To ascertain differences across states in children's oral health care access and oral health status and the factors that contribute to those differences. Observational study using cross-sectional surveys. Using the 2007 National Survey of Children's Health, we examined state variation in parents' report of children's oral health care access (absence of a preventive dental visit) and oral health status. We assessed the unadjusted prevalences of these outcomes, then adjusted with child-, family-, and neighbourhood-level variables using logistic regression; these results are presented directly and graphically. Using multilevel analysis, we then calculated the degree to which child-, family-, and community-level variables explained state variation. Finally, we quantified the influence of state-level variables on state variation. Unadjusted rates of no preventive dental care ranged 9.0-26.8% (mean 17.5%), with little impact of adjusting (10.3-26.7%). Almost 9% of the population had fair/poor oral health; unadjusted range 4.1-14.5%. Adjusting analyses affected fair/poor oral health more than access (5.7-10.7%). Child, family and community factors explained ∼¼ of the state variation in no preventive visit and ∼½ of fair/poor oral health. State-level factors further contributed to explaining up to a third of residual state variation. Geography matters: where a child lives has a large impact on his or her access to oral health care and oral health status, even after adjusting for child, family, community, and state variables. As state-level variation persists, other factors and richer data are needed to clarify the variation and drive changes for more egalitarian and overall improved oral health. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  12. Army Corps of Engineers: Water Resource Authorizations, Appropriations, and Activities

    DTIC Science & Technology

    2016-02-09

    favorable benefit -cost ratio. 31 Local sponsors assume any rehabilitation cost for damage to an active project attributable to deficient maintenance...infrastructure activities are not traditional Corps water resources projects, they are not subject to the Corps planning process (e.g., a benefit -cost...Army Corps of Engineers: Water Resource Authorizations, Appropriations, and Activities Nicole T. Carter Specialist in Natural Resources Policy

  13. [Health care access barriers and facilitators: a qualitative systematic review].

    PubMed

    Hirmas Adauy, Macarena; Poffald Angulo, Lucy; Jasmen Sepúlveda, Anita María; Aguilera Sanhueza, Ximena; Delgado Becerra, Iris; Vega Morales, Jeanette

    2013-03-01

    To determine whether health care access barriers and facilitators cut across different populations, countries, and pathologies, and if so, at which stages of health care access they occur most frequently. A qualitative systematic review of literature published between 2000 and 2010 was undertaken drawing on six international sources: Fuente Académica, MEDLINE (full-text), Academic Search Complete (a full-text multidisciplinary academic database), PubMed, SciELO, and LILACS. Scientific appraisal guidelines from the Critical Appraisal Skills Programme Español (CASPe) and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) were applied. Gray literature was also reviewed. From the review of scientific literature, 19 of 1 160 articles and 8 of 12 gray literature documents were selected. A total of 230 barriers and 35 facilitators were identified in countries with different contexts and degrees of development. The 230 barriers were classified according to the Tanahashi framework: 25 corresponded to availability, 67 to access, 87 to acceptability, and 51 to contact. Most of the barriers were related to acceptability and access. The facilitating elements that were identified had to do with personal factors, the provider-client relationship, social support, knowledge about diseases, and adaptation of the services to patients. The barriers and facilitators were seen mostly in people who initiated contact with the health systems, and they occurred at all stages of health care access. Only a few of the studies looked at people who did not initiate contact with the health services. The barriers and facilitators identified were socially determined and largely a reflection of existing social inequities in the countries. To reduce or eliminate them, joint action with other non-health sectors will be necessary.

  14. Smithfield Fresh Meats Corp.

    EPA Pesticide Factsheets

    The EPA is providing notice of a proposed Administrative Penalty Assessment against Smithfield Fresh Meats Corp., a business located at 2223 County Road 1, Crete, NE 68333-0007, for alleged violations at its facility.

  15. Health and Health Care Access of Rural Women Veterans: Findings From the National Survey of Women Veterans.

    PubMed

    Cordasco, Kristina M; Mengeling, Michelle A; Yano, Elizabeth M; Washington, Donna L

    2016-09-01

    Disparities in health and health care access between rural and urban Americans are well documented. There is evidence that these disparities are mirrored within the US veteran population. However, there are few studies assessing this issue among women veterans (WVs). Using the 2008-2009 National Survey of Women Veterans, a population-based cross-sectional national telephone survey, we examined rural WVs' health and health care access compared to urban WVs. We measured health using the Medical Outcomes Study Short-Form (SF-12); access using measures of regular source of care (RSOC), health care utilization, and unmet needs; and barriers to getting needed care. Rural WVs have significantly worse physical health functioning compared to urban WVs (mean physical component score of 43.6 for rural WVs versus 47.2 for urban WVs; P = .007). Rural WVs were more likely to have a VA RSOC (16.4% versus 10.6%; P = .009) and use VA health care (21.7% versus 12.9%; P < .001), and had fewer non-VA health care visits compared with urban WVs (mean 4.2 versus 5.9; P = .021). They had similar overall numbers of health care visits (mean 5.8 versus 7.1; P = .11 ). Access barriers were affordability for rural WVs and work release time for urban WVs. Rural WVs additionally reported that transportation was a major factor affecting health care decisions. Our findings demonstrate VA's crucial role in addressing disparities in health and health care access for rural WVs. As VA continues to strive to optimally meet the needs of all WVs, innovative care models need to account for their high health care needs and persistent barriers to care. © 2016 National Rural Health Association.

  16. Healthcare Access and Health Beliefs of the Indigenous Peoples in Remote Amazonian Peru

    PubMed Central

    Brierley, Charlotte K.; Suarez, Nicolas; Arora, Gitanjli; Graham, Devon

    2014-01-01

    Little is published about the health issues of traditional communities in the remote Peruvian Amazon. This study assessed healthcare access, health perceptions, and beliefs of the indigenous population along the Ampiyacu and Yaguasyacu rivers in north-eastern Peru. One hundred and seventy-nine adult inhabitants of 10 remote settlements attending health clinics were interviewed during a medical services trip in April 2012. Demographics, health status, access to healthcare, health education, sanitation, alcohol use, and smoke exposure were recorded. Our findings indicate that poverty, household overcrowding, and poor sanitation remain commonplace in this group. Furthermore, there are poor levels of health education and on-going barriers to accessing healthcare. Healthcare access and health education remain poor in the remote Peruvian Amazon. This combined with poverty and its sequelae render this population vulnerable to disease. PMID:24277789

  17. Scholarship Program: 1979-80 Report to Congress. Report of the Secretary of Health and Human Services on the Administration of the National Health Service Corps Scholarship Program as Required by Section 751(i) of Title VII of the Public Health Service Act, as Amended, December 12, 1979.

    ERIC Educational Resources Information Center

    Health Resources Administration (DHHS/PHS), Hyattsville, MD.

    The status of the National Health Service Corps Scholarship Program is examined in this third annual report with cumulative data from inception of the program. The scholarship award includes the payment of a monthly stipend, tuition and fees, and other educational expenses in a federal program of service-conditional awards for students of…

  18. Defense Health Care: Access to Civilian Providers under TRICARE Standard and Extra

    DTIC Science & Technology

    2011-06-01

    impediments to TRICARE Standard and Extra beneficiaries’ access to civilian health care and mental health care providers and TMA’s actions to address the...the main impediments that hinder TRICARE Standard and Extra beneficiaries’ access to civilian health care and mental health care providers...the level of reimbursement. Shortages of certain provider specialties, such as mental health care providers, at the national and local levels may also

  19. The Digital Health Divide: Evaluating Online Health Information Access and Use among Older Adults

    ERIC Educational Resources Information Center

    Hall, Amanda K.; Bernhardt, Jay M.; Dodd, Virginia; Vollrath, Morgan W.

    2015-01-01

    Objective: Innovations in health information technology (HIT) provide opportunities to reduce health care spending, improve quality of care, and improve health outcomes for older adults. However, concerns relating to older adults' limited access and use of HIT, including use of the Internet for health information, fuel the digital health divide…

  20. Theory of perceived access to breast health care in African American women.

    PubMed

    Garmon, Sandra C

    2012-01-01

    The theory presented in this article proposes an alternative view of access to care on the basis of an African American woman's perception of the necessity, availability, and appropriateness of breast health care. The theory of perceived access to breast health care in African American women may also be useful in framing future research studies exploring the relationship between access to care and utilization of primary, secondary, and tertiary clinical preventive services related to breast health care.

  1. Identifying Successful Practices to Overcome Access to Care Challenges in Community Health Centers

    PubMed Central

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

    2018-01-01

    Background: Despite health care access challenges among underserved populations, patients, providers, and staff at community health clinics (CHCs) have developed practices to overcome limited access. These “positive deviant” practices translate into organizational policies to improve health care access and patient experience. Objective: To identify effective practices to improve access to health care for low-income, uninsured or underinsured, and minority adults and their families. Participants: Seven CHC systems, involving over 40 clinics, distributed across one midwestern state in the United States. Methods: Ninety-two key informants, comprised of CHC patients (42%) and clinic staff (53%), participated in semi-structured interviews. Interview transcripts were subjected to thematic analysis to identify patient-centered solutions for managing access challenges to primary care for underserved populations. Transcripts were coded using qualitative analytic software. Results: Practices to improve access to care included addressing illiteracy and low health literacy, identifying cost-effective resources, expanding care offerings, enhancing the patient–provider relationship, and cultivating a culture of teamwork and customer service. Helping patients find the least expensive options for transportation, insurance, and medication was the most compelling patient-centered strategy. Appointment reminders and confirmation of patient plans for transportation to appointments reduced no-show rates. Conclusion: We identified nearly 35 practices for improving health care access. These were all patient-centric, uncovered by both clinic staff and patients who had successfully navigated the health care system to improve access. PMID:29552599

  2. Assessment of the Relative Effectiveness of Job Corps Current Training Occupations. Job Corps Vocational Offerings Review. Documentation Report No. 5.

    ERIC Educational Resources Information Center

    Manpower Administration (DOL), Washington, DC. Job Corps.

    As part of a multiphased evaluation of vocational training provided by the Job Corps in fiscal year 1982, an assessment was made of the relative effectiveness of current Job Corps training operations. To arrive at an estimate of overall effectiveness, the researchers weighed the following factors: job-placement percentage, average wage of job,…

  3. Comorbid mental and physical health and health access in Cambodian refugees in the US.

    PubMed

    Berthold, S Megan; Kong, Sengly; Mollica, Richard F; Kuoch, Theanvy; Scully, Mary; Franke, Todd

    2014-12-01

    Little research has been conducted on the prevalence of physical health problems in Cambodian refugees and the relationship between their mental and physical health. We identified the relationship between mental and physical health problems and barriers to healthcare access in Cambodian refugee adults. We used a cross-sectional survey design with a snowball sample of 136 Cambodian refugee adult residents of Connecticut and Western Massachusetts. 61% reported being diagnosed with three or more physical conditions and 73% with depression, posttraumatic stress disorder (PTSD) or both. Language and transportation problems were the primary barriers to accessing care. Participants with probable comorbid PTSD and depression had 1.850 times more physical health problems than those without either condition (p > .001; CI 1.334-2.566). Age moderated this relationship. Participants who had been diagnosed with both depression and PTSD reported a consistent number of health conditions across the age span while those who had no mental health conditions or only one of the two reported fewer health conditions when they were younger and more when they were older. These two groups were significantly different from the group reporting both. There is a significant relationship between chronic comorbid mental and physical health diseases affecting Cambodian refugees resettled in the US Having comorbid depression and PTSD puts Cambodian refugees at risk for physical health problems no matter their age. It is vital that those treating Cambodian genocide survivors identify and treat their prevalent comorbid health conditions. Language and transportation barriers must be addressed to improve access to mental and physical health care in this population.

  4. 76 FR 10524 - Restricted Area, Potomac River, Marine Corps Base Quantico, Quantico, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-25

    ... DEPARTMENT OF DEFENSE Department of the Army, Corps of Engineers 33 CFR Part 334 Restricted Area, Potomac River, Marine Corps Base Quantico, Quantico, VA AGENCY: United States Army Corps of Engineers... Facility (MCAF) at Marine Corps Base Quantico (MCB Quantico), located in Quantico, Virginia. DATES...

  5. [Influence of HIV related stigma on health care access].

    PubMed

    Bermúdez-Román, Viviana; Bran-Piedrahita, Lemy; Palacios-Moya, Lucía; Posada-Zapata, Isabel Cristina

    2015-01-01

    To notice the influence of the stigma surrounding HIV on the access to health services among the seropositive population of Medellín, Colombia, in 2012. A qualitative approach using Strauss' and Corbin's grounded theory. Data was collected through 13 interviews at two different moments.These interviews were transcribed and analyzed, and the data found in them was processed via axial and open coding. The myths surrounding HIV become a barrier preventing access to healthcare;this hinders timely treatment of the virus. Government policies must aim to reduce the effect that the historical discrimination against HIV has generated so that it can guarantee that infected individuals have early access to treatments for this condition as well as health promotion services.

  6. Army Corps of Engineers Water Resource Projects: Authorization and Appropriations

    DTIC Science & Technology

    2010-05-19

    and a description of the limits on the Corps’ role in levee accreditation and improvements for the National Flood Insurance Program ( NFIP ...attributable to deficient maintenance. Corps Authorities and NFIP Levee Accreditation The Federal Emergency Management Agency (FEMA) must accredit a...2005. Some interests have looked to the Corps to assist with levee data certification. The Corps currently has no general authority to perform NFIP

  7. Effectiveness of the United States Marine Corps Tiered Evaluation System

    DTIC Science & Technology

    2015-03-01

    RA Manpower and Reserve Affairs MCMAP Marine Corps Martial Arts Program MMPR Marine Corps Promotions Branch MOS military occupational specialty...STAP subsequent term alignment program TFDW Total Force Data Warehouse USMC United States Marine Corps xv THIS PAGE INTENTIONALLY LEFT BLANK...Furthermore, I would like to thank Mr. Tim Johnson at the Total Force Data Warehouse and Ms. Doreen Marucci at the Performance Evaluation Section for

  8. The Healthy Web--Access to Online Health Information for Individuals with Disabilities

    ERIC Educational Resources Information Center

    Geiger, Brian; Evans, R. R.; Cellitti, M. A.; Smith, K. Hogan; O'Neal, Marcia R.; Firsing, S. L., III; Chandan, P.

    2011-01-01

    Background: The Internet can be an invaluable resource for obtaining health information by people with disabilities. Although valid and reliable information is available, previous research revealed barriers to accessing health information online. Health education specialists have the responsibilities to insure that it is accessible to all users.…

  9. Promoting Ecological Health Resilience for Minority Youth: Enhancing Health Care Access through the School Health Center.

    ERIC Educational Resources Information Center

    Clauss-Ehlers, Caroline C. C.

    2003-01-01

    Discusses the demographic realities of children of color in the U.S., with a focus on health care needs and access issues that have an enormous influence on health status. An ecologic model is presented that incorporates cultural values and community structures into the school health center. (Contains 50 references.) (GCP)

  10. 78 FR 42803 - Comment Request for Information Collection for Job Corps Health Questionnaire (OMB Control No...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-17

    ... Job Corps is the nation's largest residential, educational, and career technical training program for... Educational Development (GED), and career technical training credentials, including industry-recognized... DEPARTMENT OF LABOR Employment and Training Administration Comment Request for Information...

  11. Deaf Adolescents’ Learning of Cardiovascular Health Information: Sources and Access Challenges

    PubMed Central

    Smith, Scott R.; Kushalnagar, Poorna; Hauser, Peter C.

    2015-01-01

    Deaf individuals have more cardiovascular risks than the general population that are believed to be related to their cardiovascular health knowledge disparities. This phenomenological study describes where 20 deaf sign language-using adolescents from Rochester, New York, many who possess many positive characteristics to support their health literacy, learn cardiovascular health information and their lived experiences accessing health information. The goal is to ultimately use this information to improve the delivery of cardiovascular health education to this population and other deaf adolescents at a higher risk for weak health literacy. Deaf bilingual researchers interviewed deaf adolescents, transcribed and coded the data, and described the findings. Five major sources of cardiovascular health information were identified including family, health education teachers, healthcare providers, printed materials, and informal sources. Despite possessing advantageous characteristics contributing to stronger health literacy, study participants described significant challenges with accessing health information from each source. They also demonstrated inconsistencies in their cardiovascular health knowledge, especially regarding heart attack, stroke, and cholesterol. These findings suggest a great need for additional public funding to research deaf adolescents’ informal health-related learning, develop accessible and culturally appropriate health surveys and health education programming, improve interpreter education, and disseminate information through social media. PMID:26048900

  12. Health Care Coverage and Access Among Children, Adolescents, and Young Adults, 2010-2016: Implications for Future Health Reforms.

    PubMed

    Spencer, Donna L; McManus, Margaret; Call, Kathleen Thiede; Turner, Joanna; Harwood, Christopher; White, Patience; Alarcon, Giovann

    2018-06-01

    We examine changes to health insurance coverage and access to health care among children, adolescents, and young adults since the implementation of the Affordable Care Act. Using the National Health Interview Survey, bivariate and logistic regression analyses were conducted to compare coverage and access among children, young adolescents, older adolescents, and young adults between 2010 and 2016. We show significant improvements in coverage among children, adolescents, and young adults since 2010. We also find some gains in access during this time, particularly reductions in delayed care due to cost. While we observe few age-group differences in overall trends in coverage and access, our analysis reveals an age-gradient pattern, with incrementally worse coverage and access rates for young adolescents, older adolescents, and young adults. Prior analyses often group adolescents with younger children, masking important distinctions. Future reforms should consider the increased coverage and access risks of adolescents and young adults, recognizing that approximately 40% are low income, over a third live in the South, where many states have not expanded Medicaid, and over 15% have compromised health. Copyright © 2018 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  13. The digital divide: Examining socio-demographic factors associated with health literacy, access and use of internet to seek health information.

    PubMed

    Estacio, Emee Vida; Whittle, Rebecca; Protheroe, Joanne

    2017-02-01

    This article aims to examine the socio-demographic characteristics associated with access and use of Internet for health-related purposes and its relationship with health literacy. Data were drawn from a health literacy survey ( N = 1046) and analysed using logistic regression. Results show a strong association between health literacy, internet access and use. Socio-demographic characteristics particularly age, education, income, perceived health and social isolation also predict internet access. Thus, in addition to widening access, the movement towards digitisation of health information and services should also consider digital skills development to enable people to utilise digital technology more effectively, especially among traditionally hard-to-reach communities.

  14. Health care access among individuals involved in same-sex relationships.

    PubMed

    Heck, Julia E; Sell, Randall L; Gorin, Sherri Sheinfeld

    2006-06-01

    We used data from the National Health Interview Survey to compare health care access among individuals involved in same-sex versus opposite-sex relationships. We conducted descriptive and logistic regression analyses from pooled data on 614 individuals in same-sex relationships and 93418 individuals in opposite-sex relationships. Women in same-sex relationships (adjusted odds ratio [OR]=0.60; 95% confidence interval [CI]=0.39, 0.92) were significantly less likely than women in opposite-sex relationships to have health insurance coverage, to have seen a medical provider in the previous 12 months (OR=0.66; 95% CI=0.46, 0.95), and to have a usual source of health care (OR=0.50; 95% CI=0.35, 0.71); they were more likely to have unmet medical needs as a result of cost issues (OR=1.85; 95% CI=1.16, 2.96). In contrast, health care access among men in same-sex relationships was equivalent to or greater than that among men in opposite-sex relationships. In this study involving a nationwide probability sample, we found some important differences in access to health care between individuals in same-sex and opposite-sex relationships, particularly women.

  15. 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.

  16. 75 FR 42455 - Novartis Pharmaceuticals Corp. et al.; Withdrawal of Approval of 27 New Drug Applications and 58...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0318... NDA 6-008 Mesantoin (mephenytoin) Tablets Novartis Pharmaceuticals Corp., One Health Plaza, East... Endo Pharmaceuticals NDA 17-255 MPI DTPA Chelate multidose (kit for Medi-Physics, Inc., d/b/a GE...

  17. Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health

    PubMed Central

    Bryant-Lukosius, Denise; Valaitis, Ruta; Martin-Misener, Ruth; Donald, Faith; Peña, Laura Morán; Brousseau, Linda

    2017-01-01

    ABSTRACT Objective: to examine advanced practice nursing (APN) roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. Method: we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. Results: given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. Conclusions: given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries. PMID:28146177

  18. Web-Based Consumer Health Information: Public Access, Digital Division, and Remainders

    PubMed Central

    Lorence, Daniel; Park, Heeyoung

    2006-01-01

    Public access Internet portals and decreasing costs of personal computers have created a growing consensus that unequal access to information, or a “digital divide,” has largely disappeared for US consumers. A series of technology initiatives in the late 1990s were believed to have largely eliminated the divide. For healthcare patients, access to information is an essential part of the consumer-centric framework outlined in the recently proposed national health information initiative. Data from a recent study of health information-seeking behaviors on the Internet suggest that a “digitally underserved group” persists, effectively limiting the planned national health information infrastructure to wealthier Americans. PMID:16926743

  19. Right time, right place: improving access to health service through effective retention and distribution of health workers

    PubMed Central

    2013-01-01

    This editorial introduces the 'Right time, Right place: improving access to health service through effective retention and distribution of health workers’ thematic series. This series draws from studies in a range of countries and provides new insights into what can be done to improve access to health through more effective human resources policies, planning and management. The primary focus is on health workforce distribution and retention. PMID:24274820

  20. Role of Primary Health Care in Ensuring Access to Medicines

    PubMed Central

    Sambala, Evanson Z; Sapsed, Susan; Mkandawire, Mercy L

    2010-01-01

    To examine ways of ensuring access to health services within the framework of primary health care (PHC), since the goal of PHC to make universal health care available to all people has become increasingly neglected amid emerging themes of globalization, trade, and foreign policy. From a public health point of view, we argue that the premise of PHC can unlock barriers to health care services and contribute greatly to determining collective health through the promotion of universal basic health services. PHC has the most sophisticated and organized infrastructure, theories, and political principles, with which it can deal adequately with the issues of inequity, inequality, and social injustice which emerge from negative economic externalities and neo-liberal economic policies. Addressing these issues, especially the complex social and political influences that restrict access to medicines, may require the integration of different health initiatives into PHC. Based on current systems, PHC remains the only conventional health delivery service that can deal with resilient public health problems adequately. However, to strengthen its ability to do so, we propose the revitalization of PHC to incorporate scholarship that promotes human rights, partnerships, research and development, advocacy, and national drug policies. The concept of PHC can improve access; however, this will require the urgent interplay among theoretical, practical, political, and sociological influences arising from the economic, social, and political determinants of ill health in an era of globalization. PMID:20564760

  1. Improved Maternal and Child Health Care Access in a Rural Community.

    ERIC Educational Resources Information Center

    Carcillo, Joseph A.; And Others

    1995-01-01

    Describes an underserved rural community in which health care initiatives increased access to comprehensive care. Over a 3-year period, increased accessibility to maternal and child health care also increased use of preventive services, thus decreasing emergency room visits and hospitalizations as well as low birth weight, risk of congenital…

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

    PubMed

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

    2014-01-01

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

  3. Judaism, justice, and access to health care.

    PubMed

    Mackler, A L

    1991-06-01

    This paper develops the traditional Jewish understanding of justice (tzedakah) and support for the needy, especially as related to the provision of medical care. After an examination of justice in the Hebrew Bible, the values and institutions of tzedakah in Rabbinic Judaism are explored, with a focus on legal codes and enforceable obligations. A standard of societal responsibility to provide for the basic needs of all, with a special obligation to save lives, emerges. A Jewish view of justice in access to health care is developed on the basis of this general standard, as well as explicit discussion in legal sources. Society is responsible for the securing of access to all health care needed by any individual. Elucidation of this standard of need and corresponding societal obligations, and the significance of the Jewish model for the contemporary United States, are considered.

  4. Reproductive health information for young women in Kazakhstan: disparities in access by channel.

    PubMed

    Buckley, Cynthia; Barrett, Jennifer; Adkins, Kristen

    2008-01-01

    This study explores young women's reliance on reproductive and sexual health information channels, examining the relationship between information sources and reproductive health knowledge. Utilizing 1995 and 1999 Kazakhstan Demographic and Health Surveys, we investigate access to reproductive health knowledge among young women (ages 15-24) during a key period in the development of wide-scale reproductive health programs in Kazakhstan. Despite reproductive health campaigns throughout the 1990s, we find consistently high proportions of young women without family planning information access. Among young women with access to information, few received information from channels most strongly linked to knowledge and behavioral changes (family and medical professionals). Mass media sources and peer information networks remained the most often utilized channels. Urban residence, non-Kazakh ethnicity, older age (20-24), and higher education significantly increased the odds of accessing family planning information among young Kazakhstani women, and these same factors were especially important in terms of the relative odds of accessing medical and parental channels. While overall contraceptive knowledge and prevalence rose in Kazakhstan during the 1990s, we find knowledge varied by the information channel accessed. Findings also indicate that young women, regardless of marital status, possessed consistently low levels of reproductive health knowledge at the decade's end.

  5. Health Literacy and Access to Care

    PubMed Central

    Janke, Alex

    2016-01-01

    Despite well-documented links between low health literacy, low rates of health insurance coverage, and poor health outcomes, there has been almost no research on the relationship between low health literacy and self-reported access to care. This study analyzed a large, nationally representative sample of community-dwelling adults ages 50 and older to estimate the relationship between low health literacy and self-reported difficulty obtaining care. We found that individuals with low health literacy were significantly more likely than individuals with adequate health literacy to delay or forego needed care or to report difficulty finding a provider, even after controlling for other factors including health insurance coverage, employment, race/ethnicity, poverty, and general cognitive function. They were also more likely to lack a usual source of care, although this result was only marginally significant after controlling for other factors. The results show that in addition to any obstacles that low health literacy creates within the context of the clinical encounter, low health literacy also reduces the probability that people get in the door of the health care system in a timely way. PMID:27043757

  6. Specialty-care access for community health clinic patients: processes and barriers.

    PubMed

    Ezeonwu, Mabel C

    2018-01-01

    Community health clinics/centers (CHCs) comprise the US's core health-safety net and provide primary care to anyone who walks through their doors. However, access to specialty care for CHC patients is a big challenge. In this descriptive qualitative study, semistructured interviews of 37 referral coordinators of CHCs were used to describe their perspectives on processes and barriers to patients' access to specialty care. Analysis of data was done using content analysis. The process of coordinating care referrals for CHC patients is complex and begins with a provider's order for consultation and ends when the referring provider receives the specialist's note. Poverty, specialist and referral coordinator shortages, lack of insurance, insurance acceptability by providers, transport and clinic-location factors, lack of clinic-hospital affiliations, and poor communication between primary and specialty providers constitute critical barriers to specialty-care access for patients. Understanding the complexities of specialty-care coordination processes and access helps determine the need for comprehensive and uninterrupted access to quality health care for vulnerable populations. Guaranteed access to primary care at CHCs has not translated into improved access to specialty care. It is critical that effective policies be pursued to address the barriers and minimize interruptions in care, and to ensure continuity of care for all patients needing specialty care.

  7. 78 FR 32250 - CDM Smith and Dynamac Corp; Transfer of Data

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-29

    ... ENVIRONMENTAL PROTECTION AGENCY [EPA-HQ-OPP-2013-0036; FRL-9387-5] CDM Smith and Dynamac Corp... the submitter, will be transferred to CDM Smith and its subcontractor, Dynamac Corp, in accordance with 40 CFR 2.307(h)(3) and 2.308(i)(2). CDM Smith and its subcontractor, Dynamac Corp, have been...

  8. Taking action on the social determinants of health: improving health access for the urban poor in Mongolia

    PubMed Central

    2012-01-01

    Introduction In recent years, the country of Mongolia (population 2.8 million) has experienced rapid social changes associated with economic growth, persisting socio-economic inequities and internal migration. In order to improve health access for the urban poor, the Ministry of Health developed a "Reaching Every District" strategy (RED strategy) to deliver an integrated package of key health and social services. The aim of this article is to present findings of an assessment of the implementation of the RED strategy, and, on the basis of this assessment, articulate lessons learned for equitable urban health planning. Methods Principal methods for data collection and analysis included literature review, barrier analysis of health access and in-depth interviews and group discussions with health managers and providers. Findings The main barriers to health access for the urban poor relate to interacting effects of poverty, unhealthy daily living environments, social vulnerability and isolation. Implementation of the RED strategy has resulted in increased health access for the urban poor, as demonstrated by health staff having reached new clients with immunization, family planning and ante-natal care services, and increased civil registrations which enable social service provision. Organizational effects have included improved partnerships for health and increased motivation of the health workforce. Important lessons learned from the early implementation of the RED strategy include the need to form strong partnerships among stakeholders at each level of the health system and in the community, as well as the need to develop a specific financing strategy to address the needs of the very poor. The diverse social context for health in an urban poor setting calls for a decentralized planning and partnership strategy, but with central level commitment towards policy guidance and financing of pro-poor urban health strategies. Conclusions Lessons from Mongolia mirror other

  9. AmeriCorps VISTA: Getting Things Done for America

    ERIC Educational Resources Information Center

    Corporation for National and Community Service, 2017

    2017-01-01

    AmeriCorps VISTA (Volunteers in Service to America) engages more than 8,000 individuals annually to support community efforts to overcome poverty. AmeriCorps VISTA members serve full time for a year at nonprofit organizations or local government agencies to build the capacity of these organizations to carry out programs that alleviate poverty.…

  10. Access to antiretroviral treatment, issues of well-being and public health governance in Chad: what justifies the limited success of the universal access policy?

    PubMed Central

    2013-01-01

    Universal access to antiretroviral treatment (ART) in Chad was officially declared in December 2006. This presidential initiative was and is still funded 100% by the country’s budget and external donors’ financial support. Many factors have triggered the spread of AIDS. Some of these factors include the existence of norms and beliefs that create or increase exposure, the low-level education that precludes access to health information, social unrest, and population migration to areas of high economic opportunities and gender-based discrimination. Social forces that influence the distribution of dimensions of well-being and shape risks for infection also determine the persistence of access barriers to ART. The universal access policy is quite revolutionary but should be informed by the systemic barriers to access so as to promote equity. It is not enough to distribute ARVs and provide health services when health systems are poorly organized and managed. Comprehensive access to ART raises many organizational, ethical and policy problems that need to be solved to achieve equity in access. This paper argues that the persistence of access barriers is due to weak health systems and a poor public health leadership. AIDS has challenged health systems in a manner that is essentially different from other health problems. PMID:23902732

  11. 20 CFR 670.505 - What types of training must Job Corps centers provide?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false What types of training must Job Corps centers... LABOR (CONTINUED) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Program Activities and Center Operations § 670.505 What types of training must Job Corps centers provide? (a) Job Corps centers...

  12. Access to health care for uninsured Latina immigrants in South Carolina.

    PubMed

    Luque, John S; Soulen, Grace; Davila, Caroline B; Cartmell, Kathleen

    2018-05-02

    South Carolina is considered a "new destination" state for Latino immigrants. Language barriers, transportation difficulties, low socioeconomic status, inflexible work schedules, different cultural norms, and anxiety and fear related to the current anti-immigrant political climate all negatively impact Latino immigrants' frequency of contact with the health care system, and consequently they suffer poor health outcomes. The study objective was to explore uninsured Latina immigrant women's access to health care and alternative treatment strategies in coastal South Carolina. The study design was a qualitative interview design. Thirty women participated in semi-structured interviews in community sites. Thematic analysis identified salient categories of topics across interview participants. The themes were organized into four primary categories including: 1) Barriers and Facilitators to Healthcare, 2) Health Behaviors and Coping Mechanisms, 3) Disease Management Strategies, and 4) Cultural Factors. Participants demonstrated determination for accessing care but reported that their primary health care access barriers included the high cost of services, lack of health insurance, family and work responsibilities, and language barriers. Coping mechanisms included activating their social networks, visiting family and friends and assisting one another with navigating life challenges. Participants overcame obstacles to obtain healthcare for themselves and their family members despite the multiple barriers presented. Social networks were leveraged to protect against some of the negative effects of financial barriers to health care access.

  13. Access to care and medicines, burden of health care expenditures, and risk protection: results from the World Health Survey.

    PubMed

    Wagner, Anita K; Graves, Amy Johnson; Reiss, Sheila K; Lecates, Robert; Zhang, Fang; Ross-Degnan, Dennis

    2011-05-01

    We assessed the contribution of health insurance and a functioning public sector to access to care and medicines and household economic burden. We used descriptive and logistic regression analyses on 2002/3 World Health Survey data in 70 countries. Across countries, 286,803 households and 276,362 respondents contributed data. More than 90% of households had access to acute care. However, less than half of respondents with a chronic condition reported access. In 51 low and middle income countries (LMIC), health care expenditures accounted for 13-32% of total 4-week household expenditures. One in four poor households in low income countries incurred potentially catastrophic health care expenses and more than 40% used savings, borrowed money, or sold assets to pay for care. Between 41% and 56% of households in LMIC spent 100% of health care expenditures on medicines. Health insurance and a functioning public sector were both associated with better access to care and lower risk of economic burden. To improve access, policy makers should improve public sector provision of care, increase health insurance coverage, and expand medicines benefit policies in health insurance systems. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  14. Peace Corps in Special Education and Rehabilitation. Case Study CS-2. Appropriate Technologies for Development

    ERIC Educational Resources Information Center

    Dixon, Gregory L.; Davis, Katherine

    The monograph evaluates the efforts of the Peace Corps in special education and rehabilitation. Charts list levels of activity; work sectors (health, education, social service, or vocational); locale; specialty area (special education, occupational, physical, and speech therapy, vocational rehabilitation, and social work); and disabilities served…

  15. Differences in Access to Care among Students Using School-Based Health Centers

    ERIC Educational Resources Information Center

    Parasuraman, Sarika Rane; Shi, Leiyu

    2015-01-01

    Health care reform has changed the landscape for the nation's health safety net, and school-based health centers (SBHCs) remain an important part of this system. However, few large-scale studies have been conducted to assess their impact on access to care. This study investigated differences in access among a nationally representative sample of…

  16. Oral health and access to dental care: a qualitative exploration in rural Quebec.

    PubMed

    Emami, Elham; Wootton, John; Galarneau, Chantal; Bedos, Christophe

    2014-01-01

    We sought to explore how rural residents perceive their oral health and their access to dental care. We conducted a qualitative research study in rural Quebec. We used purposeful sampling to recruit study participants. A trained interviewer conducted audio-recorded, semistructured interviews until saturation was reached. We conducted thematic analysis to identify themes. This included interview debriefing, transcript coding, data display and interpretation. Saturation was reached after 15 interviews. Five main themes emerged from the interviews: rural idyll, perceived oral health, access to oral health care, cues to action and access to dental information. Most participants noted that they were satisfied with the rural lifestyle, and that rurality per se was not a threat to their oral health. However, they criticized the limited access to dental care in rural communities and voiced concerns about the impact on their oral health. Participants noted that motivation to seek dental care came mainly from family and friends rather than from dental care professionals. They highlighted the need for better education about oral health in rural communities. Residents' satisfaction with the rural lifestyle may be affected by unsatisfactory oral health care. Health care providers in rural communities should be engaged in tailoring strategies to improve access to oral health care.

  17. Access to essential drugs in Guyana: a public health challenge.

    PubMed

    Seoane-Vazquez, Enrique; Rodriguez-Monguio, Rosa

    2010-01-01

    Guyana's pharmaceutical sector faces major challenges that limit access to essential drugs. This study analyzes Guyana's drug policy and regulation, public financing, and drug procurement and delivery. The study also identifies main barriers to drug access and proposes alternatives to strengthen the country's public health functions. Data were collected from the country's regulatory agencies, public procurement agency, pharmacies, wholesalers, and pharmaceutical companies. The information was supplemented with interviews with a convenient sample of Guyanese health authorities and stakeholders. Data were also compiled from scientific databases, and web pages of the country's Ministries of Health, Commerce and Finance, the Bureau of Statistics, and international organizations. Major barriers to drug access include: (1) lack of national drug policy and regulation, and limited role of the regulatory authority; (2) inefficient drug selection and irrational drug use; (3) insufficient financial resources and lack of drug pricing policy; (4) inefficient planning and managing public supply system; (5) deficient epidemiological and information systems; and (6) inadequate infrastructures and human resources shortage. Improving drug access in Guyana requires the strengthening of the country's public health functions and the implementation of a national drug policy and pricing policy, streamlining the drug financing, procurement, and planning and managing drug supply; and adequate infrastructures and human resources. Copyright 2008 John Wiley & Sons, Ltd.

  18. Telecommunications as a means to access health information: an exploratory study of migrants in australia.

    PubMed

    Greenstock, Louise; Woodward-Kron, Robyn; Fraser, Catriona; Bingham, Amie; Naccarella, Lucio; Elliott, Kristine; Morris, Michal

    2012-12-28

    Health policies increasingly promote e-health developments (e.g., consumers' access to online health information) to engage patients in their health care. In order to make these developments available for culturally and socially diverse communities, not only do Internet accessibility, literacy and e-health literacy need to be taken into account, but consumers' preferences and information seeking behaviours for accessing health information have also to be understood. These considerations are crucial when designing major new health policy directions, especially for migration destination countries with culturally diverse populations, such as Australia. The aim of this study was to examine how people from a culturally and linguistically diverse (CALD) community use telecommunications (phone, mobile, Internet) to access health information. A case study was conducted using a questionnaire exploring the use of telecommunications to access health information among CALD people. The study was carried out at a community health centre in a socially and economically disadvantaged area of Melbourne, a city of 4 million people with a large CALD and migrant population. Questionnaires were translated into three languages and interpreters were provided. Fifty-nine questionnaires were completed by users of the community health centre. Most of the CALD participants did not have access to the Internet at home and very few reported using telecommunications to access health information. The findings of the study suggest that telecommunications are not necessarily perceived to be an important channel for accessing health information by members of the CALD community.

  19. 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

  20. The impact of health and health insurance literacy on access to care for Hispanic/Latino communities.

    PubMed

    Edward, Jean; Morris, Sarah; Mataoui, Fatma; Granberry, Phillip; Williams, Mark V; Torres, Idali

    2018-05-01

    The aim of this study was to assess the impact of health literacy (HL) and health insurance literacy (HIL) on health insurance status and access to health care services for Spanish-speaking communities living in Massachusetts. A total of 139 surveys (descriptive, knowledge-based HIL questions, and Short Assessment of Health Literacy in Spanish) and 30 semi-structured interviews were collected and analyzed using chi-square, Mann-Whitney U test, and logistic regression analysis. The majority of participants had inadequate HL (56%) and HIL (93%). There were differences in HL scores (t = 4.1; p < .0001) between the insured (M = 12.3, SD = 5.7) and uninsured (M = 7.9, SD = 6.7) and differences (t = 1.9; p = .05) between those with adequate HIL (M = 14.3, SD = 4.3) and inadequate HIL (M = 10.2, SD = 6.6). Participants who were uninsured (MW U = 37.6; p < .0001) and who had inadequate HL (MW U = 5.2; p = .02) were more likely to have never accessed health care in the U.S. Participants who had never accessed health care were 93% less likely to be insured and those with adequate HL were three times more likely to be insured. Health literacy and HIL are closely associated with insurance status and access to health care for Spanish-speaking communities, indicating the need for further research and enhanced public health efforts to improve knowledge and awareness around navigating health care systems. © 2018 Wiley Periodicals, Inc.

  1. [Health care access of Sub-Saharan African migrants living with chronic hepatitis B].

    PubMed

    Vignier, Nicolas; Spira, Rosemary Dray; Lert, France; Pannetier, Julie; Ravalihasy, Andrainolo; Gosselin, Anne; Lydié, Nathalie; Bouchaud, Olivier; Desgrées du Loû, Annabel

    2017-07-10

    Objective: The objective of this study was to analyse health care access of Sub-Saharan African migrants living with chronic hepatitis B (CHB) in France. Methods: The ANRS-Parcours survey was a life-event survey conducted in 2012-2013 among Sub-Saharan African migrants recruited by health care facilities managing CHB in the Paris region. Data were collected by face-to-face interview using a biographical grid and a standardized questionnaire. Results: 96.4% of the 619 participants basic health insurance coverage with CMU universal health insurance coverage in 18.6% of cases and AME state medical assistance in 23.4% of cases. One-third of basic health insurance beneficiaries did not have any complementary health insurance and 75.7% had long-term disease status. The median time to acquisition of health insurance cover after arrival in France was one year. 22.0% of participants reported delaying health care for financial reasons since their arrival in France and 9.7% reported being refused health care usually due to refusal of CMU or AME. Health care access was effective within one year of the diagnosis. Delayed health care access was more common among people without health insurance coverage in the year of diagnosis. Patients lost to follow-up for more than 12 months were rare. Conclusion: Sub-Saharan African migrants living with chronic hepatitis B rapidly access health insurance coverage and health care. However, barriers to health care access persist for some people, essentially due to absent or incomplete health insurance cover and refusal of care for AME or CMU beneficiaries.

  2. 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

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

    PubMed

    Gomes, Silvana Cardoso; Esperidião, Monique Azevedo

    2017-06-12

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

  4. Deaf Adolescents' Learning of Cardiovascular Health Information: Sources and Access Challenges.

    PubMed

    Smith, Scott R; Kushalnagar, Poorna; Hauser, Peter C

    2015-10-01

    Deaf individuals have more cardiovascular risks than the general population that are believed to be related to their cardiovascular health knowledge disparities. This phenomenological study describes where 20 deaf sign language-using adolescents from Rochester, New York, many who possess many positive characteristics to support their health literacy, learn cardiovascular health information and their lived experiences accessing health information. The goal is to ultimately use this information to improve the delivery of cardiovascular health education to this population and other deaf adolescents at a higher risk for weak health literacy. Deaf bilingual researchers interviewed deaf adolescents, transcribed and coded the data, and described the findings. Five major sources of cardiovascular health information were identified including family, health education teachers, healthcare providers, printed materials, and informal sources. Despite possessing advantageous characteristics contributing to stronger health literacy, study participants described significant challenges with accessing health information from each source. They also demonstrated inconsistencies in their cardiovascular health knowledge, especially regarding heart attack, stroke, and cholesterol. These findings suggest a great need for additional public funding to research deaf adolescents' informal health-related learning, develop accessible and culturally appropriate health surveys and health education programming, improve interpreter education, and disseminate information through social media. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Outpatient Mental Health Treatment Utilization and Military Career Impact in the United States Marine Corps

    PubMed Central

    Ghahramanlou-Holloway, Marjan; LaCroix, Jessica M.; Koss, Kari; Perera, Kanchana U.; VanSickle, Marcus R.; Novak, Laura A.

    2018-01-01

    Service members (SM) are at increased risk of psychiatric conditions, including suicide, yet research indicates SMs believe seeking mental health treatment may negatively impact their military careers, despite a paucity of research examining actual career impacts. This study examined the link between seeking outpatient mental health (MH) treatment and military career impacts within the United States Marine Corps. In Phase 1, a retrospective medical record review of outpatient MH treatment-seeking Marines (N = 38) was conducted. In Phase 2, a sample of outpatient MH treatment-seeking Marines (N = 40) was matched to a non-treatment-seeking sample of Marines (N = 138) to compare career-progression. In Phase 1, there were no significant links between demographic, military, and clinical characteristics and referral source or receipt of career-affecting treatment recommendations. In Phase 2, MH treatment-seeking Marines in outpatient settings were more likely than matched controls to be separated from the military (95.0% versus 63.0%, p = 0.002), but no more likely to experience involuntary separation. MH treatment-seeking Marines were more likely to have documented legal action (45.0% versus 23.9%, p = 0.008) and had a shorter time of military service following the index MH encounter than matched controls (p < 0.001). Clinical, anti-stigma, and suicide prevention policy implications are discussed. PMID:29690594

  6. Outpatient Mental Health Treatment Utilization and Military Career Impact in the United States Marine Corps.

    PubMed

    Ghahramanlou-Holloway, Marjan; LaCroix, Jessica M; Koss, Kari; Perera, Kanchana U; Rowan, Anderson; VanSickle, Marcus R; Novak, Laura A; Trieu, Theresa H

    2018-04-23

    Service members (SM) are at increased risk of psychiatric conditions, including suicide, yet research indicates SMs believe seeking mental health treatment may negatively impact their military careers, despite a paucity of research examining actual career impacts. This study examined the link between seeking outpatient mental health (MH) treatment and military career impacts within the United States Marine Corps. In Phase 1, a retrospective medical record review of outpatient MH treatment-seeking Marines ( N = 38) was conducted. In Phase 2, a sample of outpatient MH treatment-seeking Marines ( N = 40) was matched to a non-treatment-seeking sample of Marines ( N = 138) to compare career-progression. In Phase 1, there were no significant links between demographic, military, and clinical characteristics and referral source or receipt of career-affecting treatment recommendations. In Phase 2, MH treatment-seeking Marines in outpatient settings were more likely than matched controls to be separated from the military (95.0% versus 63.0%, p = 0.002), but no more likely to experience involuntary separation. MH treatment-seeking Marines were more likely to have documented legal action (45.0% versus 23.9%, p = 0.008) and had a shorter time of military service following the index MH encounter than matched controls ( p < 0.001). Clinical, anti-stigma, and suicide prevention policy implications are discussed.

  7. 20 CFR 670.130 - What is the role of the Job Corps Director?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What is the role of the Job Corps Director... LABOR THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Scope and Purpose § 670.130 What is the role of the Job Corps Director? The Job Corps Director has been delegated the authority to carry...

  8. 20 CFR 670.130 - What is the role of the Job Corps Director?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false What is the role of the Job Corps Director... LABOR (CONTINUED) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Scope and Purpose § 670.130 What is the role of the Job Corps Director? The Job Corps Director has been delegated the...

  9. 20 CFR 670.130 - What is the role of the Job Corps Director?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false What is the role of the Job Corps Director... LABOR (CONTINUED) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Scope and Purpose § 670.130 What is the role of the Job Corps Director? The Job Corps Director has been delegated the...

  10. Garcia Development Corp. Information Sheet

    EPA Pesticide Factsheets

    Garcia Development Corp. (the Company) is located in St. Louis, Missouri. The settlement involves renovation activities conducted at properties constructed prior to 1978, located in St. Louis, Missouri.

  11. Access to health-care in Canadian immigrants: a longitudinal study of the National Population Health Survey.

    PubMed

    Setia, Maninder Singh; Quesnel-Vallee, Amelie; Abrahamowicz, Michal; Tousignant, Pierre; Lynch, John

    2011-01-01

    Immigrants often lose their health advantage as they start adapting to the ways of the new society. Having access to care when it is needed is one way that individuals can maintain their health. We assessed the healthcare access in Canadian immigrants and the socioeconomic factors associated with access over a 12-year period. We compared two measures of healthcare access (having a regular doctor and reporting an unmet healthcare need in the past 12 months) among immigrants and Canadian-born men and women, aged more than 18 years. We applied a logistic random effects model to evaluate these outcomes separately, in 3081 males and 4187 females from the National Population Health Survey (1994-2006). Adjusting for all covariates, immigrant men and women (white and non-white) had similar odds of having a regular doctor than the Canadian-born individuals (white immigrants: males OR: 1.32, 95% C.I.: 0.89-1.94, females OR: 1.14, 95% C.I.: 0.78-1.66; non-white immigrants: males OR: 1.28, 95% C.I.: 0.73-2.23, females OR: 1.23, 95% C.I.: 0.64-2.36). Interestingly, non-white immigrant women had significantly fewer unmet health needs (OR: 0.32, 95% C.I.: 0.17-0.59). Among immigrants, time since immigration was associated with having access to a regular doctor (OR per year: 1.02, 95% C.I.: 1.00-1.04). Visible minority female immigrants were least likely to report an unmet healthcare need. In general, there is little evidence that immigrants have worse access to health-care than the Canadian-born population. © 2010 Blackwell Publishing Ltd.

  12. Access to Oral Health Care: A National Crisis and Call for Reform.

    PubMed

    Bersell, Catherine H

    2017-02-01

    Purpose: According to the report Healthy People 2020, oral health is integral to overall health and access to dental services is essential to promoting and maintaining good oral health. Yet, those who need dental care the most are often the least likely to receive it. The dental hygiene profession is poised to play a pivotal role in the resolution of oral health disparities. The purpose of this manuscript is to examine the critical issue of access to oral health care in the United States from various perspectives and consider potential implications for dental professionals and the oral health care system. This report focuses on major underserved and vulnerable populations and highlights several barriers that significantly affect the ability to access and navigate the oral health care system. These include low socioeconomic status; the shortage and maldistribution of dentists; a lack of professional training regarding current evidence-based oral health guidelines; deficient continuity of care due to inadequate interdisciplinary collaboration; low oral health literacy; and patient perceptions and misconceptions about preventive dental care. This report also contains an update on provider participation in Medicaid; the state of children's oral health; and emerging workforce models, state initiatives, and legislative reforms. Recommendations increasing access to care require local, state, and federal stakeholders to combine forces that take advantage of the existing dental hygiene workforce, utilize innovative delivery models, improve license reciprocity, reduce prohibitive supervision, and expand the dental hygiene scope of practice. The major focus of future research will be on the implementation of mid-level oral health care providers. Dental hygienists are an integral part of the access to care solution and have a great opportunity to lead the call to action and fulfill the American Dental Hygienists' Association's mandate that oral health care is the right of all

  13. 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

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

    PubMed

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

    2016-10-14

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

  15. Trends in Racial-Ethnic Disparities in Access to Mental Health Care, 2004-2012.

    PubMed

    Cook, Benjamin Lê; Trinh, Nhi-Ha; Li, Zhihui; Hou, Sherry Shu-Yeu; Progovac, Ana M

    2017-01-01

    This study compared trends in racial-ethnic disparities in mental health care access among whites, blacks, Hispanics, and Asians by using the Institute of Medicine definition of disparities as all differences except those due to clinical appropriateness, clinical need, and patient preferences. Racial-ethnic disparities in mental health care access were examined by using data from a nationally representative sample of 214,597 adults from the 2004-2012 Medical Expenditure Panel Surveys. The main outcome measures included three mental health care access measures (use of any mental health care, any outpatient care, and any psychotropic medication in the past year). Significant disparities were found in 2004-2005 and in 2011-2012 for all three racial-ethnic minority groups compared with whites in all three measures of access. Between 2004 and 2012, black-white disparities in any mental health care and any psychotropic medication use increased, respectively, from 8.2% to 10.8% and from 7.6% to 10.0%. Similarly, Hispanic-white disparities in any mental health care and any psychotropic medication use increased, respectively, from 8.4% to 10.9% and 7.3% to 10.3%. No reductions in racial-ethnic disparities in access to mental health care were identified between 2004 and 2012. For blacks and Hispanics, disparities were exacerbated over this period. Clinical interventions that improve identification of symptoms of mental illness, expansion of health insurance, and other policy interventions that remove financial barriers to access may help to reduce these disparities.

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

    PubMed Central

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

    2009-01-01

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

  17. Health Care Access Among Individuals Involved in Same-Sex Relationships

    PubMed Central

    Heck, Julia E.; Sell, Randall L.; Gorin, Sherri Sheinfeld

    2006-01-01

    Objectives. We used data from the National Health Interview Survey to compare health care access among individuals involved in same-sex versus opposite-sex relationships. Methods. We conducted descriptive and logistic regression analyses from pooled data on 614 individuals in same-sex relationships and 93418 individuals in opposite-sex relationships. Results. Women in same-sex relationships (adjusted odds ratio [OR]=0.60; 95% confidence interval [CI]=0.39, 0.92) were significantly less likely than women in opposite-sex relationships to have health insurance coverage, to have seen a medical provider in the previous 12 months (OR=0.66; 95% CI=0.46, 0.95), and to have a usual source of health care (OR=0.50; 95% CI=0.35, 0.71); they were more likely to have unmet medical needs as a result of cost issues (OR=1.85; 95% CI=1.16, 2.96). In contrast, health care access among men in same-sex relationships was equivalent to or greater than that among men in opposite-sex relationships. Conclusions. In this study involving a nationwide probability sample, we found some important differences in access to health care between individuals in same-sex and opposite-sex relationships, particularly women. PMID:16670230

  18. Indigence and access to health care in sub-Saharan Africa.

    PubMed

    Stierle, F; Kaddar, M; Tchicaya, A; Schmidt-Ehry, B

    1999-01-01

    Access to health care services for the poor and indigent is hampered by current policies of health care financing in sub-Saharan Africa. This paper reviews the issue as it is discussed in the international literature. No real strategies seem to exist for covering the health care of the indigent. Frequently, definitions of poverty and indigence are imprecise, the assessment of indigence is difficult for conceptual and technical reasons, and, therefore, the actual extent of indigence in Africa is not well known. Explicit policies rarely exist, and systematic evaluation of experiences is scarce. Results in terms of adequately identifying the indigent, and of mechanisms to improve indigents' access to health care, are rather deceiving. Policies to reduce poverty, and improve indigents' access to health care, seem to pursue strategies of depoliticizing the issue of social injustice and inequities. The problem is treated in a 'technical' manner, identifying and implementing 'operational' measures of social assistance. This approach, however, cannot resolve the problem of social exclusion, and, consequently, the problem of excluding large parts of African populations from modern health care. Therefore, this approach has to be integrated into a more 'political' approach which is interested in the process of impoverishment, and which addresses the macro-economic and social causes of poverty and inequity.

  19. Perceived Barriers to Health Care Access Among Rural Older Adults: A Qualitative Study

    ERIC Educational Resources Information Center

    Goins, R. Turner; Williams, Kimberly A.; Carter, Mary W.; Spencer, S. Melinda; Solovieva, Tatiana

    2005-01-01

    Context: Many rural elders experience limited access to health care. The majority of what we know about this issue has been based upon quantitative studies, yet qualitative studies might offer additional insight into individual perceptions of health care access. Purpose: To examine what barriers rural elders report when accessing needed health…

  20. Perceived Barriers to Health Care Access among Rural Older Adults: A Qualitative Study

    ERIC Educational Resources Information Center

    Goins, R. Turner; Williams, Kimberly A.; Carter, Mary W.; Spencer, S. Melinda; Solovieva, Tatiana

    2005-01-01

    Context: Many rural elders experience limited access to health care. The majority of what we know about this issue has been based upon quantitative studies, yet qualitative studies might offer additional insight into individual perceptions of health care access. Purpose: To examine what barriers rural elders report when accessing needed health…

  1. Telecommunications as a Means to Access Health Information: An Exploratory Study of Migrants in Australia

    PubMed Central

    Greenstock, Louise; Woodward-Kron, Robyn; Fraser, Catriona; Bingham, Amie; Naccarella, Lucio; Elliott, Kristine; Morris, Michal

    2012-01-01

    Background Health policies increasingly promote e-health developments (e.g., consumers’ access to online health information) to engage patients in their health care. In order to make these developments available for culturally and socially diverse communities, not only do Internet accessibility, literacy and e-health literacy need to be taken into account, but consumers’ preferences and information seeking behaviours for accessing health information have also to be understood. These considerations are crucial when designing major new health policy directions, especially for migration destination countries with culturally diverse populations, such as Australia. The aim of this study was to examine how people from a culturally and linguistically diverse (CALD) community use telecommunications (phone, mobile, Internet) to access health information. Design and Methods A case study was conducted using a questionnaire exploring the use of telecommunications to access health information among CALD people. The study was carried out at a community health centre in a socially and economically disadvantaged area of Melbourne, a city of 4 million people with a large CALD and migrant population. Questionnaires were translated into three languages and interpreters were provided. Fifty-nine questionnaires were completed by users of the community health centre. Results Most of the CALD participants did not have access to the Internet at home and very few reported using telecommunications to access health information. Conclusions The findings of the study suggest that telecommunications are not necessarily perceived to be an important channel for accessing health information by members of the CALD community. PMID:25170467

  2. Development and Testing of a Conceptual Model Regarding Men’s Access to Health Care

    PubMed Central

    Leone, James E.; Rovito, Michael J.; Mullin, Elizabeth M.; Mohammed, Shan D.; Lee, Christina S.

    2016-01-01

    Epidemiologic data suggest men often experience excessive morbidity and early mortality, possibly compromising family and community health over the lifespan. Moreover, the negative financial/economic consequences affected by poor male health outcomes also has been of great concern in the United States and abroad. Early and consistent access to preventative health care may improve health outcomes; however, men are far less likely to access these services. The purpose of this study was to understand what factors preclude men from accessing health care. We surveyed 485 participants using a 58-item online survey built from a conceptual model previously developed by the researchers using hegemonic masculinity theory, the theory of normative contentment, and the health belief model. For men, three items significantly (ps < .05) predicted whether they had seen a health care provider in the past year: “I/Men do not access healthcare because I do not think there is anything wrong with me,” “My health is only about me,” and “I/Men do not access healthcare because most men in my family do not access healthcare.” Other correlations of practical significance also were noted. Results suggest gender norms and masculine ideals may play a primary role in how men access preventative health care. Future programming targeting males should consider barriers and plan programs that are gender-sensitive in addition to being gender-specific. Clinical implications are discussed. PMID:27698256

  3. Information technologies for Marine Corps combat medicine.

    PubMed

    Carey, N B; Rattelman, C R; Nguyen, H Q

    1998-09-01

    Future Marine Corps warfighting concepts will make it more difficult to locate casualties, which will complicate casualty evacuation, lengthen casualty wait times, and require infantrymen or corpsmen to provide more extensive treatment. In these future scenarios, information flow and communications will be critical to medical functions. We asked, for Navy medical support to the Marines, what information will future combat medicine require and what technologies should supply those information needs? Based on analyses of patient data streams, focus groups of Navy medical personnel, and our estimates of the cost and feasibility of communications systems, we recommend the following: (1) increase medical training for some fraction of Marines, especially in hemorrhage control; (2) augment corpsmen's training; (3) furnish data systems for evacuation and supply that would provide in-transit visibility and simplify requests; (4) provide all ground medical personnel with access to treatment information systems and limited voice communications; and (5) exploit e-mail systems to reduce reliance on voice communications. Implementation time frames are discussed.

  4. Specialty-care access for community health clinic patients: processes and barriers

    PubMed Central

    Ezeonwu, Mabel C

    2018-01-01

    Introduction Community health clinics/centers (CHCs) comprise the US’s core health-safety net and provide primary care to anyone who walks through their doors. However, access to specialty care for CHC patients is a big challenge. Materials and methods In this descriptive qualitative study, semistructured interviews of 37 referral coordinators of CHCs were used to describe their perspectives on processes and barriers to patients’ access to specialty care. Analysis of data was done using content analysis. Results The process of coordinating care referrals for CHC patients is complex and begins with a provider’s order for consultation and ends when the referring provider receives the specialist’s note. Poverty, specialist and referral coordinator shortages, lack of insurance, insurance acceptability by providers, transport and clinic-location factors, lack of clinic–hospital affiliations, and poor communication between primary and specialty providers constitute critical barriers to specialty-care access for patients. Conclusion Understanding the complexities of specialty-care coordination processes and access helps determine the need for comprehensive and uninterrupted access to quality health care for vulnerable populations. Guaranteed access to primary care at CHCs has not translated into improved access to specialty care. It is critical that effective policies be pursued to address the barriers and minimize interruptions in care, and to ensure continuity of care for all patients needing specialty care. PMID:29503559

  5. Access to Preventive Health Care for Cancer Survivors

    PubMed Central

    Yabroff, K. Robin; Short, Pamela Farley; Machlin, Steven; Dowling, Emily; Rozjabek, Heather; Li, Chunyu; McNeel, Timothy; Ekwueme, Donatus U.; Virgo, Katherine S.

    2013-01-01

    Background Access to healthcare, particularly effective primary and secondary preventive care, is critical for cancer survivors, in order to minimize the adverse sequelae of cancer and its treatment. Purpose The goal of the study was to evaluate the association between cancer survivorship and access to primary and preventive health care. Methods Cancer survivors (n=4960) and individuals without a cancer history (n=64,431) aged ≥18 years, from the 2008–2010 Medical Expenditure Panel Survey (MEPS), were evaluated. Multiple measures of access and preventive services use were compared. The association between cancer survivorship and access and preventive services was evaluated with multivariate logistic regression models, stratified by age group (18–64 years and ≥65 years), controlling for the effects of age, gender, race/ethnicity, education, marital status, and comorbidities. Data were analyzed in 2013. Results Cancer survivors aged ≥65 years had equivalent or greater access and preventive services use than individuals without a cancer history, in adjusted analyses. However, among those aged 18–64 years with private health insurance, cancer survivors were more likely than other individuals to have a usual source of care and to use preventive services, whereas uninsured or publicly insured cancer survivors were generally less likely to have a usual source of care and to use preventive services than were uninsured or publicly insured adults without a cancer history. Conclusions Although access and preventive care use in cancer survivors is generally equivalent or greater compared to that of other individuals, disparities for uninsured and publicly insured cancer survivors aged 18–64 years suggest that improvements in survivor care are needed. PMID:23953357

  6. Patients struggle to access effective health care due to ongoing violence, distance, costs and health service performance in Afghanistan.

    PubMed

    Nic Carthaigh, Niamh; De Gryse, Benoit; Esmati, Abdul Sattar; Nizar, Barak; Van Overloop, Catherine; Fricke, Renzo; Bseiso, Jehan; Baker, Corinne; Decroo, Tom; Philips, Mit

    2015-05-01

    The Afghan population suffers from a long standing armed conflict. We investigated patients' experiences of their access to and use of the health services. Data were collected in four clinics from different provinces. Mixed methods were applied. The questions focused on access obstacles during the current health problem and health seeking behaviour during a previous illness episode of a household member. To access the health facilities 71.8% (545/759) of patients experienced obstacles. The combination of long distances, high costs and the conflict deprived people of life-saving healthcare. The closest public clinics were underused due to perceptions regarding their lack of availability or quality of staff, services or medicines. For one in five people, a lack of access to health care had resulted in death among family members or close friends within the last year. Violence continues to affect daily life and access to healthcare in Afghanistan. Moreover, healthcare provision is not adequately geared to meet medical and emergency needs. Impartial healthcare tailored to the context will be vital to increase access to basic and life-saving healthcare. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  7. Patients struggle to access effective health care due to ongoing violence, distance, costs and health service performance in Afghanistan

    PubMed Central

    Nic Carthaigh, Niamh; De Gryse, Benoit; Esmati, Abdul Sattar; Nizar, Barak; Van Overloop, Catherine; Fricke, Renzo; Bseiso, Jehan; Baker, Corinne; Decroo, Tom; Philips, Mit

    2015-01-01

    Background The Afghan population suffers from a long standing armed conflict. We investigated patients’ experiences of their access to and use of the health services. Methods Data were collected in four clinics from different provinces. Mixed methods were applied. The questions focused on access obstacles during the current health problem and health seeking behaviour during a previous illness episode of a household member. Results To access the health facilities 71.8% (545/759) of patients experienced obstacles. The combination of long distances, high costs and the conflict deprived people of life-saving healthcare. The closest public clinics were underused due to perceptions regarding their lack of availability or quality of staff, services or medicines. For one in five people, a lack of access to health care had resulted in death among family members or close friends within the last year. Conclusions Violence continues to affect daily life and access to healthcare in Afghanistan. Moreover, healthcare provision is not adequately geared to meet medical and emergency needs. Impartial healthcare tailored to the context will be vital to increase access to basic and life-saving healthcare. PMID:25492948

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

    PubMed

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

    2016-01-01

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

  9. 76 FR 19514 - In the Matter of: Sabratek Corp., SAN Holdings, Inc., SBD International, Inc. (n/k/a Solargy...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-07

    ... Sensors, Inc., Sentex Sensing Technology, Inc., Serefex Corp., SinoFresh HealthCare, Inc., Sonoma College... lack of current and accurate information concerning the securities of Senco Sensors, Inc. because it...

  10. Access to Care and Satisfaction Among Health Center Patients With Chronic Conditions.

    PubMed

    Shi, Leiyu; Lee, De-Chih; Haile, Geraldine Pierre; Liang, Hailun; Chung, Michelle; Sripipatana, Alek

    This study examined access to care and satisfaction among health center patients with chronic conditions. Data for this study were obtained from the 2009 Health Center Patient Survey. Dependent variables of interest included 5 measures of access to and satisfaction with care, whereas the main independent variable was number of chronic conditions. Results of bivariate analysis and multiple logistic regressions showed that patients with chronic conditions had significantly higher odds of reporting access barriers than those without chronic conditions. Our results suggested that additional efforts and resources are necessary to address the needs of health center patients with chronic conditions.

  11. How Well Is CHIP Addressing Health Care Access and Affordability for Children?

    PubMed

    Clemans-Cope, Lisa; Kenney, Genevieve; Waidmann, Timothy; Huntress, Michael; Anderson, Nathaniel

    2015-01-01

    We examine how access to care and care experiences under the Children's Health Insurance Program (CHIP) compared to private coverage and being uninsured in 10 states. We report on findings from a 2012 survey of CHIP enrollees in 10 states. We examined a range of health care access and use measures among CHIP enrollees. Comparisons of the experiences of established CHIP enrollees to the experiences of uninsured and privately insured children were used to estimate differences in children's health care. Children with CHIP coverage had substantially better access to care across a range of outcomes, other things being equal, particularly compared to those with no coverage. Compared to being uninsured, CHIP enrollees were more likely to have specialty and mental health visits and to receive prescription drugs; and their parents were much more likely to feel confident in meeting the child's health care needs and were less likely to have trouble finding providers. CHIP enrollees were less likely to have unmet needs, but 1 in 4 had at least 1 unmet need. Compared to being privately insured, CHIP enrollees had generally similar health care use and unmet needs. Additionally, CHIP enrollees had lower financial burden related to their health care needs. The findings were generally robust with respect to alternative specifications and subgroup analyses, and they corroborated findings of previous studies. Enrolling more of the uninsured children who are eligible for CHIP improved their access to a range of care, including specialty and mental health services, and reduced the financial burden of meeting their health care needs; however, we found room for improvement in CHIP enrollees' access to care. Copyright © 2015 Academic Pediatric Association. All rights reserved.

  12. Access to safe legal abortion in Malaysia: women's insights and health sector response.

    PubMed

    Low, Wah-Yun; Tong, Wen-Ting; Wong, Yut-Lin; Jegasothy, Ravindran; Choong, Sim-Poey

    2015-01-01

    Malaysia has an abortion law, which permits termination of pregnancy to save a woman's life and to preserve her physical and mental health (Penal Code Section 312, amended in 1989). However, lack of clear interpretation and understanding of the law results in women facing difficulties in accessing abortion information and services. Some health care providers were unaware of the legalities of abortion in Malaysia and influenced by their personal beliefs with regard to provision of abortion services. Accessibility to safer abortion techniques is also an issue. The development of the 2012 Guidelines on Termination of Pregnancy and Guidelines for Management of Sexual and Reproductive Health among Adolescents in Health Clinics by the Ministry of Health, Malaysia, is a step forward toward increasing women's accessibility to safe abortion services in Malaysia. This article provides an account of women's accessibility to abortion in Malaysia and the health sector response in addressing the barriers. © 2014 APJPH.

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

    PubMed

    Sopoaga, Faafetai; Parkin, Lianne; Gray, Andrew

    2012-10-26

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

  14. 78 FR 12799 - Advisory Committee for Innovation Corps; Notice of Meeting; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ... NATIONAL SCIENCE FOUNDATION Advisory Committee for Innovation Corps; Notice of Meeting; Correction... announcing a meeting of the Advisory Committee for Innovation Corps. The location and time of the business... meeting: Name: Innovation Corps Advisory Committee, 80463. Dates/Time: March 6, 2013, 10:00 a.m.-2:00 p.m...

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

    PubMed

    Gómez Gómez, Elsa

    2002-01-01

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

  16. The relationship between treatment access and spending in a managed behavioral health organization.

    PubMed

    Cuffel, B J; Regier, D

    2001-07-01

    This study replicated an earlier study that showed a linear relationship between level of treatment access and behavioral health spending. The study reported here examined whether this relationship varies by important characteristics of behavioral health plans. Access rates and total spending over a five- to seven-year period were computed for 30 behavioral health plans. Regression analysis was used to estimate the relationship between access and spending and to examine whether it varied with the characteristics of benefit plans. A linear relationship was found between level of treatment access and behavioral health spending. However, the relationship closely paralleled that found in the earlier study only for benefit plans with an employee assistance program linked to the managed behavioral health organization and for plans that do not allow the use of out-of-network providers. The results of this study replicate those of the earlier study in showing a linear relationship between access and spending, but they suggest that the magnitude of this relationship may vary according to key plan characteristics.

  17. Impacts of the Interim Federal Health Program reforms: A stakeholder analysis of barriers to health care access and provision for refugees.

    PubMed

    Antonipillai, Valentina; Baumann, Andrea; Hunter, Andrea; Wahoush, Olive; O'Shea, Timothy

    2017-11-09

    Changes to the Interim Federal Health Program (IFHP) in 2012 reduced health care access for refugees and refugee claimants, generating concerns among key stakeholders. In 2014, a new IFHP temporarily reinstated access to some health services; however, little is known about these changes, and more information is needed to map the IFHP's impact. This study explores barriers occurring during the time period of the IFHP reforms to health care access and provision for refugees. A stakeholder analysis, using 23 semi-structured interviews, was conducted to obtain insight into stakeholder perceptions of the 2014 reforms, as well as stakeholders' position and their influence to assess the acceptability of the IFHP changes. The majority of stakeholders expressed concerns about the 2014 IFHP changes as a result of the continuing barriers posed by the 2012 retrenchments and the emergence of new barriers to health care access and provision for refugees. Key barriers identified included lack of communication and awareness, lack of continuity and comprehensive care, negative political discourse and increased costs. A few stakeholders supported the reforms as they represented some, but limited, access to health care. Overall, the reforms to the IFHP in 2014 generated barriers to health care access and provision that contributed to confusion among stakeholders, the transfer of refugee health responsibility to provincial authorities and the likelihood of increased health outcome disparities, as refugees and refugee claimants chose to delay seeking health care. The study recommends that policy-makers engage with refugee health stakeholders to formulate a policy that improves health care provision and access for refugee populations.

  18. The Marine Corps Challenges in Creating a Diverse Force

    DTIC Science & Technology

    2013-03-22

    demographics, young adult’s perception of the Marines, etc.  The majority of Marine Corps Officer Selection Offices ( OSO ) has a majority of Caucasian...officers in senior the billets at the OSO . This makes potential candidates view of the Marine Corps unappealing because they feel as if leadership

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  1. Universal health insurance and health care access for homeless persons.

    PubMed

    Hwang, Stephen W; Ueng, Joanna J M; Chiu, Shirley; Kiss, Alex; Tolomiczenko, George; Cowan, Laura; Levinson, Wendy; Redelmeier, Donald A

    2010-08-01

    We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs in Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with unmet needs. Unmet health care needs were reported by 17% of participants. Compared with Toronto's general population, unmet needs were significantly more common among homeless individuals, particularly among homeless women with dependent children. Factors independently associated with a greater likelihood of unmet needs were younger age, having been a victim of physical assault in the past 12 months, and lower mental and physical health scores on the 12-Item Short Form Health Survey. Within a system of universal health insurance, homeless people still encounter barriers to obtaining health care. Strategies to reduce nonfinancial barriers faced by homeless women with children, younger adults, and recent victims of physical assault should be explored.

  2. Universal Health Insurance and Health Care Access for Homeless Persons

    PubMed Central

    Ueng, Joanna J. M.; Chiu, Shirley; Kiss, Alex; Tolomiczenko, George; Cowan, Laura; Levinson, Wendy; Redelmeier, Donald A.

    2010-01-01

    Objectives. We examined the extent of unmet needs and barriers to accessing health care among homeless people within a universal health insurance system. Methods. We randomly selected a representative sample of 1169 homeless individuals at shelters and meal programs in Toronto, Ontario. We determined the prevalence of self-reported unmet needs for health care in the past 12 months and used regression analyses to identify factors associated with unmet needs. Results. Unmet health care needs were reported by 17% of participants. Compared with Toronto's general population, unmet needs were significantly more common among homeless individuals, particularly among homeless women with dependent children. Factors independently associated with a greater likelihood of unmet needs were younger age, having been a victim of physical assault in the past 12 months, and lower mental and physical health scores on the 12-Item Short Form Health Survey. Conclusions. Within a system of universal health insurance, homeless people still encounter barriers to obtaining health care. Strategies to reduce nonfinancial barriers faced by homeless women with children, younger adults, and recent victims of physical assault should be explored. PMID:20558789

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

    PubMed

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

    2016-01-14

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

  4. Access to care and use of the Internet to search for health information: results from the US National Health Interview Survey.

    PubMed

    Amante, Daniel J; Hogan, Timothy P; Pagoto, Sherry L; English, Thomas M; Lapane, Kate L

    2015-04-29

    The insurance mandate of the Affordable Care Act has increased the number of people with health coverage in the United States. There is speculation that this increase in the number of insured could make accessing health care services more difficult. Those who are unable to access care in a timely manner may use the Internet to search for information needed to answer their health questions. The aim was to determine whether difficulty accessing health care services for reasons unrelated to insurance coverage is associated with increased use of the Internet to obtain health information. Survey data from 32,139 adults in the 2011 National Health Interview Study (NHIS) were used in this study. The exposure for this analysis was reporting difficulty accessing health care services or delaying getting care for a reason unrelated to insurance status. To define this exposure, we examined 8 questions that asked whether different access problems occurred during the previous 12 months. The outcome for this analysis, health information technology (HIT) use, was captured by examining 2 questions that asked survey respondents if they used an online health chat room or searched the Internet to obtain health information in the previous 12 months. Several multinomial logistic regressions estimating the odds of using HIT for each reported access difficulty were conducted to accomplish the study objective. Of a survey population of 32,139 adults, more than 15.90% (n=5109) reported experiencing at least one access to care barrier, whereas 3.63% (1168/32,139) reported using online health chat rooms and 43.55% (13,997/32,139) reported searching the Internet for health information. Adults who reported difficulty accessing health care services for reasons unrelated to their health insurance coverage had greater odds of using the Internet to obtain health information. Those who reported delaying getting care because they could not get an appointment soon enough (OR 2.2, 95% CI 1.9-2.5), were

  5. 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

  6. National Job Corps Study: Report on the Process Analysis. Research and Evaluation Report Series.

    ERIC Educational Resources Information Center

    Johnson, Terry; Gritz, Mark; Jackson, Russell; Burghardt, John; Boussy, Carol; Leonard, Jan; Orians, Carlyn

    This report presents results of a process analysis that describes and documents Job Corps services and operations. Chapter one provides overviews of Job Corps, the national Job Corps study, and the process analysis. Chapter two describes the administrative structure of Job Corps and presents data on the geographic distribution and characteristics…

  7. Equity in Access to Health Promotion and Risk Reduction Services: Implications for Elder Health.

    ERIC Educational Resources Information Center

    Smith, Nancy H.; Howze, Elizabeth Harper

    Although there is a national emphasis on health promotion and preventive practices, questions remain regarding the equity of access to these services by low income and minority groups, and the implications of inequities for elder health. Data from a systematic survey of 500 public and private providers of health promotion services in northern…

  8. Access to Health Care for Individuals with Developmental Disabilities from Minority Backgrounds

    ERIC Educational Resources Information Center

    Reichard, Amanda; Sacco,Therese Marie; Turnbull, H. Rutherford, III

    2004-01-01

    In this project we examined access to health care by individuals with developmental disabilities in Kansas from low income populations and from minority backgrounds. Four criteria for determining access were employed: availability, accessibility, affordability, and appropriateness of care. Factors that pose barriers and that facilitate access are…

  9. Russian Language Competencies for Peace Corps Volunteers in Russia.

    ERIC Educational Resources Information Center

    Strobykina, Irina; Fomenko, Nataliya

    This Peace Corps volunteer language training manual is based on the experience of two pre-service trainings and was guided by the Peace Corps language training curriculum. The learning approach is competency-based or topic-oriented to provide survival competencies. Three main sections review phonetics, topics for discussion, and practical grammar…

  10. 33 CFR 66.05-40 - Corps of Engineers' approval.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Corps of Engineers' approval. 66... AIDS TO NAVIGATION PRIVATE AIDS TO NAVIGATION State Aids to Navigation § 66.05-40 Corps of Engineers..., the State Administrator is responsible for obtaining prior permission from the District Engineer, U.S...

  11. 33 CFR 66.05-40 - Corps of Engineers' approval.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Corps of Engineers' approval. 66... AIDS TO NAVIGATION PRIVATE AIDS TO NAVIGATION State Aids to Navigation § 66.05-40 Corps of Engineers..., the State Administrator is responsible for obtaining prior permission from the District Engineer, U.S...

  12. 33 CFR 66.05-40 - Corps of Engineers' approval.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Corps of Engineers' approval. 66... AIDS TO NAVIGATION PRIVATE AIDS TO NAVIGATION State Aids to Navigation § 66.05-40 Corps of Engineers..., the State Administrator is responsible for obtaining prior permission from the District Engineer, U.S...

  13. 33 CFR 66.05-40 - Corps of Engineers' approval.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Corps of Engineers' approval. 66... AIDS TO NAVIGATION PRIVATE AIDS TO NAVIGATION State Aids to Navigation § 66.05-40 Corps of Engineers..., the State Administrator is responsible for obtaining prior permission from the District Engineer, U.S...

  14. 33 CFR 66.05-40 - Corps of Engineers' approval.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Corps of Engineers' approval. 66... AIDS TO NAVIGATION PRIVATE AIDS TO NAVIGATION State Aids to Navigation § 66.05-40 Corps of Engineers..., the State Administrator is responsible for obtaining prior permission from the District Engineer, U.S...

  15. 32 CFR 728.60 - Job Corps and Volunteers in Service to America (VISTA) beneficiaries.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Job Corps and Volunteers in Service to America... FACILITIES Beneficiaries of Other Federal Agencies § 728.60 Job Corps and Volunteers in Service to America... corpsmember's Job Corps center. (2) Job Corps applicants. Presentation of a letter from a screening agency (e...

  16. How primary health care staff working in rural and remote areas access skill development and expertise to support health promotion practice.

    PubMed

    McFarlane, Kathryn A; Judd, Jenni; Wapau, Hylda; Nichols, Nina; Watt, Kerrianne; Devine, Sue

    2018-05-01

    Health promotion is a key component of comprehensive primary health care. Health promotion approaches complement healthcare management by enabling individuals to increase control over their health. Many primary healthcare staff have a role to play in health promotion practice, but their ability to integrate health promotion into practice is influenced by their previous training and experience. For primary healthcare staff working in rural and remote locations, access to professional development can be limited by what is locally available and prohibitive in terms of cost for travel and accommodation. This study provides insight into how staff at a large north Queensland Aboriginal community controlled health service access skill development and health promotion expertise to support their work. A qualitative exploratory study was conducted. Small group and individual semi-structured interviews were conducted with staff at Apunipima Cape York Health Council (n=9). A purposive sampling method was used to recruit participants from a number of primary healthcare teams that were more likely to be involved in health promotion work. Both on-the-ground staff and managers were interviewed. All participants were asked how they access skill development and expertise in health promotion practice and what approaches they prefer for ongoing health promotion support. The interviews were transcribed verbatim and analysed thematically. All participants valued access to skill development, advice and support that would assist their health promotion practice. Skill development and expertise in health promotion was accessed from a variety of sources: conferences, workshops, mentoring or shared learning from internal and external colleagues, and access to online information and resources. With limited funds and limited access to professional development locally, participants fostered external and internal organisational relationships to seek in-kind advice and support. Irrespective of

  17. Exploring the drivers of health and healthcare access in Zambian prisons: a health systems approach

    PubMed Central

    Topp, Stephanie M.; Moonga, Clement N.; Luo, Nkandu; Kaingu, Michael; Chileshe, Chisela; Magwende, George; Heymann, S. Jody; Henostroza, German

    2016-01-01

    Background Prison populations in sub-Saharan Africa (SSA) experience a high burden of disease and poor access to health care. Although it is generally understood that environmental conditions are dire and contribute to disease spread, evidence of how environmental conditions interact with facility-level social and institutional factors is lacking. This study aimed to unpack the nature of interactions and their influence on health and healthcare access in the Zambian prison setting. Methods We conducted in-depth interviews of a clustered random sample of 79 male prisoners across four prisons, as well as 32 prison officers, policy makers and health care workers. Largely inductive thematic analysis was guided by the concepts of dynamic interaction and emergent behaviour, drawn from the theory of complex adaptive systems. Results A majority of inmates, as well as facility-based officers reported anxiety linked to overcrowding, sanitation, infectious disease transmission, nutrition and coercion. Due in part to differential wealth of inmates and their support networks on entering prison, and in part to the accumulation of authority and material wealth within prison, we found enormous inequity in the standard of living among prisoners at each site. In the context of such inequities, failure of the Zambian prison system to provide basic necessities (including adequate and appropriate forms of nutrition, or access to quality health care) contributed to high rates of inmate-led and officer-led coercion with direct implications for health and access to healthcare. Conclusions This systems-oriented analysis provides a more comprehensive picture of the way resource shortages and human interactions within Zambian prisons interact and affect inmate and officer health. While not a panacea, our findings highlight some strategic entry-points for important upstream and downstream reforms including urgent improvement in the availability of human resources for health; strengthening of

  18. DEPRESSION, ANXIETY, STRESS, AND THEIR ASSOCIATED FACTORS AMONG CORPS MEMBERS SERVING IN KEBBI STATE.

    PubMed

    Balami, Ahmed D

    2015-01-01

    Depression, anxiety and stress, are not only health problems by themselves, but also associated with other negative health consequences. The national youth service is usually characterized by a number of new challenges and experiences which may require life style adjustments by the corps member. However, no previous study on psychological factors has been conducted among corps members. This study was conducted to determine the prevalence of depression, anxiety and, stress and their associated factors among corps members serving in Kebbi state. A cross-sectional study was conducted among 264 corps members from four local government areas of the state. Selection of the local government areas and the individual participants was by simple random sampling. Data was collected from May to June 2014 using a self-administered questionnaire. Data analysis used chi-square test to identify the relationship between categorical variables and multivariate logistic regression to identify the independent factors for depression, anxiety and stress each. The response rate was 97%. Most of the respondents were males (63.6%), single (85.5%), and above 20 years of age (71.6%). The overall prevalences of depression, anxiety and stress among the respondents were 36.4%, 54.5% and 18.2% respectively. The independent factors for depression were; being from the North central (OR = 5.99; 95% CI: 2.194-16.354) or South-south; and the perception of earning enough income (OR = 2.987; 95% CI: 1.062-8.400). For anxiety, male gender (OR = 0.411; 95% CI: 0.169-0.999); and being from the North central were significant risk factors (OR = 3.731; 95% CI: 1.450-9.599). Being above 26 years of age was an independent risk factor for stress (OR = 0.083; 95% CI: 0.018-0.381). Also, those who had ever schooled outside their towns of residence were less likely to be stressed compared to those who had never (OR = 0.30; 95% CI: 0.110-0.855). All other factors did not show any significant association with any of

  19. Developing a framework for understanding doctors' health access: a qualitative study of Australian GPs.

    PubMed

    Kay, Margaret; Mitchell, Geoffrey; Clavarino, Alexandra; Frank, Erica

    2012-01-01

    Health access behaviours of doctors need to be understood if the profession is to adequately respond to concerns raised about doctors' health. There has been limited investigation of these issues and most qualitative studies have focussed on doctors who have been seriously unwell. This research project was designed to explore doctors' attitudes to health access and the barriers they experience using six independently facilitated focus groups (37 general practitioners) in Brisbane, Australia. Themes that emerged using inductive thematic analysis were grouped into three key categories. The findings challenge current representations of doctors' health within the medical literature. Doctors in this study reported positive attitudes towards their own health care. Health access, however, was difficult because of the barriers they encountered. These barriers are described in detail revealing the rationale used by doctors seeking care. A framework of patient, provider and profession barrier domains is developed to enable a comparison between the health access barriers of the doctor and those experienced by the general community. The complexity is highlighted as the socio-cultural factors woven through these barrier domains are recognised. The potential for this framework to provide a structure for future interventions to enhance doctors' health access is discussed.

  20. 'More health for the money': an analytical framework for access to health care through microfinance and savings groups.

    PubMed

    Saha, Somen

    2014-10-01

    The main contributors to inequities in health relates to widespread poverty. Health cannot be achieved without addressing the social determinants of health, and the answer does not lie in the health sector alone. One of the potential pathways to address vulnerabilities linked to poverty, social exclusion, and empowerment of women is aligning health programmes with empowerment interventions linked to access to capital through microfinance and self-help groups. This paper presents a framework to analyse combined health and financial interventions through microfinance programmes in reducing barriers to access health care. If properly designed and ethically managed such integrated programmes can provide more health for the money spent on health care.

  1. Dental Corps Structure: Past, Present, and Future

    DTIC Science & Technology

    1993-04-01

    improvement in dental care in Vietnam was the introduction of the modern dental unit with high speed air turbine handpiece . New portable X-ray...not be emW for opt pubilicalsm uati it hua beew defed by Se app•opriate mlitary MVnice ot goveeinit qlay. DENTAL CORPS STRUCTURE: PAST, PRESENT, AND... Dental Corps Structure: Past, Present, and Future Richard D. Shipley, COL, USA a,. :󈧎E CF REPORT ŗb . %:ME CZ’.E.E:,) L; ;F EPCR7 1erMonrn. Oa 5

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

    ERIC Educational Resources Information Center

    Foster, Larry W.; And Others

    1993-01-01

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

  3. Impact Evaluation: Minnesota Reading Corps K-3 Program. Appendices

    ERIC Educational Resources Information Center

    Markovitz, Carrie E.; Hernandez, Marc W.; Hedberg, Eric C.; Silberglitt, Benjamin

    2014-01-01

    Minnesota Reading Corps (MRC) is the largest AmeriCorps State program in the country. The goal of MRC is to ensure that students become successful readers and meet reading proficiency targets by the end of the third grade. Starting in 2011, the "Corporation for National and Community Service" (CNCS) sponsored a randomized controlled…

  4. AmeriCorps: Getting Things Done for America. Fact Sheet

    ERIC Educational Resources Information Center

    Corporation for National and Community Service, 2017

    2017-01-01

    AmeriCorps engages more than 80,000 men and women in intensive service each year at more than 21,000 locations including nonprofits, schools, public agencies, and community and faith-based groups across the country. AmeriCorps members help communities tackle pressing problems while mobilizing millions of volunteers for the organizations they…

  5. Detail view of southeast corner of Signal Corps Radar (S.C.R.) ...

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

    Detail view of southeast corner of Signal Corps Radar (S.C.R.) 296 Station 5 Transmitter Building foundation, showing Signal Corps Radar (S.C.R.) 296 Station 5 Tower concrete pier in background, camera facing north - Fort Barry, Signal Corps Radar 296, Station 5, Transmitter Building Foundation, Point Bonita, Marin Headlands, Sausalito, Marin County, CA

  6. Revamping Civilian Leadership Development in the Marine Corps

    DTIC Science & Technology

    2012-04-09

    Leadership Development in the Marine NIA Corps Sb. GRANT NUMBER NIA Sc. PROGRAM ELEMENT NUMBER N/A 6. AUTHOR(S) Sd. PROJECf NUMBER Major Jose E. Almazan...DISTRIBUTION I AVAILABILITY STATEMENT Unlimited 13. SUPPLEMENTARY NOTES N/A 14. ABSTRACT: The Marine Corps should be investing more in civilian leadership ...development and must make its use involuntary for career progression. This study endeavors to resolve whether revamping civilian leadership

  7. Predicting Health Care Utilization among Latinos: Health Locus of Control Beliefs or Access Factors?

    ERIC Educational Resources Information Center

    De Jesus, Maria; Xiao, Chenyang

    2014-01-01

    There are two competing research explanations to account for Latinos' underutilization of health services relative to non-Latino Whites in the United States. One hypothesis examines the impact of health locus of control (HLOC) beliefs, while the other focuses on the role of access factors on health care use. To date, the relative strength of…

  8. Ensuring Access to Quality Health Care in Vulnerable Communities.

    PubMed

    Bhatt, Jay; Bathija, Priya

    2018-04-24

    For millions of Americans living in vulnerable rural and urban communities, their hospital is an important, and often their only, source of health care. As transformation in the hospital and health care field continues, some communities may be at risk of losing access to health care services and the opportunities and resources they need to improve and maintain their health. Integrated, comprehensive strategies to reform health care delivery and payment, within which vulnerable communities can make individual choices based on their needs, support structures, and preferences, are needed.In this Invited Commentary, the authors outline characteristics and parameters of vulnerable communities as well as the essential health care services that hospitals should strive to maintain locally identified by the American Hospital Association Task Force on Ensuring Access in Vulnerable Communities. They also describe four of nine emerging strategies-recommended by the task force-to reform health care delivery and payment and allow hospitals to provide the essential health care services, along with implementation barriers and how to address them. While this Invited Commentary focuses on vulnerable communities, the four highlighted strategies (addressing the social determinants of health, adopting new and innovative virtual care strategies, designing global budgets, and using inpatient/outpatient transformation strategy), as well as the other five strategies, may have broader applicability for all communities.

  9. Cultivating Political Powerhouses: TFA Corps Members Experiences That Shape Local Political Engagement

    ERIC Educational Resources Information Center

    Jacobsen, Rebecca; White, Rachel; Reckhow, Sarah

    2016-01-01

    In recent years, Teach for America (TFA) has invested in developing corps members as leaders. Although TFA asks corps members for a two-year commitment, TFA celebrates the achievements of alumni who have gone on to careers in politics, public policy, and advocacy. Thus, many community leaders see the arrival of TFA corps members as having a…

  10. 78 FR 62931 - China Ritar Power Corp., Order of Suspension of Trading

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] China Ritar Power Corp., Order of Suspension of Trading October 4, 2013. It appears to the Securities and Exchange Commission that there is a lack of current and accurate information concerning the securities of China Ritar Power Corp. because China Ritar Power Corp. has not filed any periodic...

  11. Health Care Financing in Ethiopia: Implications on Access to Essential Medicines.

    PubMed

    Ali, Eskinder Eshetu

    2014-09-01

    The Ethiopian health care system is under tremendous reform. One of the issues high on the agenda is health care financing. In an effort to protect citizens from catastrophic effects of the clearly high share of out-of-pocket expenditure, the government is currently working to introduce health insurance. This article aims to highlight the components of the Ethiopian health care financing reform and discuss its implications on access to essential medicines. A desk review of government policy documents and proclamations was done. Moreover, a review of the scientific literature was done via PubMed and search of other local journals not indexed in PubMed. Revenue retention by health facilities, systematizing the fee waiver system, standardizing exemption services, outsourcing of nonclinical services, user fee setting and revision, initiation of compulsory health insurance (community-based health insurance and social health insurance), establishment of a private wing in public hospitals, and health facility autonomy were the main components of the health care financing reform in Ethiopia. Although limited, the evidence shows that there is increased health care utilization, access to medicines, and quality of services as a result of the reforms. Encouraging progress has been made in the implementation of health care financing reforms in Ethiopia. However, there is shortage of evidence on the effect of the health care financing reforms on access to essential medicines in the country. Thus, a clear need exists for well-organized research on the issue. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  12. From midwife to Peace Corps volunteer: a Baby Boomer's journey in Honduras.

    PubMed

    Drew, Deborah

    2006-01-01

    Knowledge can transcend borders, and midwife and Peace Corps volunteer Deborah Drew is living proof of this. Having practiced midwifery in the U.S. for 25 years, Deborah, along with her husband, is now serving in the Peace Corps as a health volunteer in Honduras. Using the expertise she garnered throughout her career in the U.S., she has been working primarily in the village's local maternity center with nurses and pregnant women, but also in the community with local midwives. Deborah, 59, of Peace Dale, Rhode Island, is working to improve the education level and working conditions for the midwives in her village. To that end, she has written a community partnership grant proposal in hopes of helping to form midwifery support groups that can be used as a vehicle for sharing experiences, disseminating materials, teaching (with the focus on self-education) and increasing self-esteem. Here is what Deborah has to say, in her own words.

  13. Health Care Coverage and Access Among Children, Adolescents, and Young Adults, 2010–2016: Implications for Future Health Reforms

    PubMed Central

    Spencer, Donna L.; McManus, Margaret; Call, Kathleen Thiede; Turner, Joanna; Harwood, Christopher; White, Patience; Alarcon, Giovann

    2018-01-01

    Purpose We examine changes to health insurance coverage and access to health care among children, adolescents, and young adults since the implementation of the Affordable Care Act. Methods Using the National Health Interview Survey, bivariate and logistic regression analyses were conducted to compare coverage and access among children, young adolescents, older adolescents, and young adults between 2010 and 2016. Results We show significant improvements in coverage among children, adolescents, and young adults since 2010. We also find some gains in access during this time, particularly reductions in delayed care due to cost. While we observe few age-group differences in overall trends in coverage and access, our analysis reveals an age-gradient pattern, with incrementally worse coverage and access rates for young adolescents, older adolescents, and young adults. Conclusions Prior analyses often group adolescents with younger children, masking important distinctions. Future reforms should consider the increased coverage and access risks of adolescents and young adults, recognizing that approximately 40% are low income, over a third live in the South, where many states have not expanded Medicaid, and over 15% have compromised health. PMID:29599046

  14. Access to health care for persons with disabilities in rural South Africa.

    PubMed

    Vergunst, R; Swartz, L; Hem, K-G; Eide, A H; Mannan, H; MacLachlan, M; Mji, G; Braathen, S H; Schneider, M

    2017-11-17

    Global research suggests that persons with disabilities face barriers when accessing health care services. Yet, information regarding the nature of these barriers, especially in low-income and middle-income countries is sparse. Rural contexts in these countries may present greater barriers than urban contexts, but little is known about access issues in such contexts. There is a paucity of research in South Africa looking at "triple vulnerability" - poverty, disability and rurality. This study explored issues of access to health care for persons with disabilities in an impoverished rural area in South Africa. The study includes a quantitative survey with interviews with 773 participants in 527 households. Comparisons in terms of access to health care between persons with disabilities and persons with no disabilities were explored. The approach to data analysis included quantitative data analysis using descriptive and inferential statistics. Frequency and cross tabulation, comparing and contrasting the frequency of different phenomena between persons with disabilities and persons with no disabilities, were used. Chi-square tests and Analysis of Variance tests were then incorporated into the analysis. Persons with disabilities have a higher rate of unmet health needs as compared to non-disabled. In rural Madwaleni in South Africa, persons with disabilities faced significantly more barriers to accessing health care compared to persons without disabilities. Barriers increased with disability severity and was reduced with increasing level of education, living in a household without disabled members and with age. This study has shown that access to health care in a rural area in South Africa for persons with disabilities is more of an issue than for persons without disabilities in that they face more barriers. Implications are that we need to look beyond the medical issues of disability and address social and inclusion issues as well.

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

    PubMed

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

    2016-07-14

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

  16. 75 FR 4107 - Comment Request for Information Collection for Job Corps Application Data

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... Information Collection for Job Corps Application Data AGENCY: Office of Job Corps. ACTION: Notice. SUMMARY... requirements on respondents can be properly assessed. Currently, the Employment and Training Administration is soliciting comments concerning the collection of Job Corps application data collection forms (OMB Control NO...

  17. Access to health care: solidarity and justice or egoism and injustice?

    PubMed

    Prudil, Lukas

    2008-09-01

    The aim of this paper is to answer the question whether there is a real demand for equal access to health care or--better--to medical care and which interest groups (patients, health care professionals, policy makers and others) are interested in equal access. The focus is on EU countries including recent case law from the European Court of Justice and the European Court of Human Rights. We discuss whether there is a need to have legislative safeguards to protect equal access to medical care and whether such norms really work. The paper concludes that some of the key players in medical care are not primarily governed by a real willingness to have equal and just access to medical care, but by rather egoistic approaches. It seems that policy makers and politicians are the only ones who, surprisingly, must at least formally call for and enforce equal access to medical care. Interests of other groups seem to be different.

  18. Internet access and attitudes toward online personal health information among detained youth.

    PubMed

    Gaskin, Gregory L; Longhurst, Christopher A; Anoshiravani, Arash

    2012-11-01

    To assess Internet access and usage patterns among high-risk youth involved in the juvenile justice system, and to determine if health information technology tools might play a useful role in more actively engaging this population in their health care. A sample of 79 youth between the ages of 13 and 18 years old underwent a structured interview while detained in a large, Northern California juvenile detention facility. After an institutional review board-approved assent/consent process, youth discussed their typical Internet use when not detained, as well as their attitudes toward online access to their personal health information (PHI). Detained youth from predominantly underserved, minority communities, reported high levels of access to the Internet while outside of the detention setting, with 97% reporting using the Internet at least once per month and 87% at least weekly. Furthermore, 90% of these youth expressed interest in accessing their PHI online and sharing it with either parents or physicians. Detained adolescents describe unexpectedly high usage of the Internet and online resources when they are outside of the juvenile hall setting. These youth show an interest in, and may benefit from, accessing their PHI online. Further studies are needed to understand the potential health benefits that may be realized by engaging this population through online tools.

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

    PubMed

    Kirby, James B; Sharma, Ravi

    2017-12-01

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

  20. The association between insured male expatriates' knowledge of health insurance benefits and lack of access to health care in Saudi Arabia.

    PubMed

    Alkhamis, Abdulwahab A

    2018-03-15

    Insufficient knowledge of health insurance benefits could be associated with lack of access to health care, particularly for minority populations. This study aims to assess the association between expatriates' knowledge of health insurance benefits and lack of access to health care. A cross-sectional study design was conducted from March 2015 to February 2016 among 3398 insured male expatriates in Riyadh, Saudi Arabia. The dependent variable was binary and expresses access or lack of access to health care. Independent variables included perceived and validated knowledge of health insurance benefits and other variables. Data were summarized by computing frequencies and percentage of all quantities of variables. To evaluate variations in knowledge, personal and job characteristics with lack of access to health care, the Chi square test was used. Odds ratio (OR) and 95% confidence interval (CI) were recorded for each independent variable. Multiple logistic regression and stepwise logistic regression were performed and adjusted ORs were extracted. Descriptive analysis showed that 15% of participants lacked access to health care. The majority of these were unskilled laborers, usually with no education (17.5%), who had been working for less than 3 years (28.1%) in Saudi Arabia. A total of 23.3% worked for companies with less than 50 employees and 16.5% earned less than 4500 Saudi Riyals monthly ($1200). Many (20.3%) were young (< 30 years old) or older (17.9% ≥ 56 years old) and had no formal education (24.7%). Nearly half had fair or poor health status (49.5%), were uncomfortable conversing in Arabic (29.7%) or English (16.7%) and lacked previous knowledge of health insurance (18%). For perceived knowledge of health insurance, 55.2% scored 1 or 0 from total of 3. For validated knowledge, 16.9% scored 1 or 0 from total score of 4. Multiple logistic regression analysis showed that only perceived knowledge of health insurance had significant associations with lack

  1. Invalid corps.

    PubMed

    Lande, R Gregory

    2008-06-01

    This article explores America's historical experience with medical disability compensation programs during the Revolutionary War and the Civil War. Contemporary newspaper reports, complemented by book and journal articles, provide an understanding of the medical disability compensation programs offered during the Revolutionary War and the Civil War. Military planners, politicians, and service members struggled to develop a fair and balanced medical disability compensation program during the Revolutionary War and the Civil War. Based on America's extensive experience with the Civil War Invalid Corps, an alternative for motivated military personnel could be developed.

  2. One-fifth of nonelderly Californians do not have access to job-based health insurance coverage.

    PubMed

    Lavarreda, Shana Alex; Cabezas, Livier

    2010-11-01

    Lack of job-based health insurance does not affect just workers, but entire families who depend on job-based coverage for their health care. This policy brief shows that in 2007 one-fifth of all Californians ages 0-64 who lived in households where at least one family member was employed did not have access to job-based coverage. Among adults with no access to job-based coverage through their own or a spouse's job, nearly two-thirds remained uninsured. In contrast, the majority of children with no access to health insurance through a parent obtained public health insurance, highlighting the importance of such programs. Low-income, Latino and small business employees were more likely to have no access to job-based insurance. Provisions enacted under national health care reform (the Patient Protection and Affordable Care Act of 2010) will aid some of these populations in accessing health insurance coverage.

  3. Community access to health information in Ireland.

    PubMed

    Macdougall, J

    1999-06-01

    This paper is based on a research project conducted on consumer health information (CHI) in the Republic of Ireland, the results of which were published in a report entitled Well Read: Developing Consumer Health Information in Ireland. The paper describes the research methodology and the Irish experience in relation to CHI followed by a discussion of access problems, illustrated with examples from the special needs and primary care sectors. The role of information providers in relation to primary healthcare and libraries is examined briefly, and finally the main research conclusions and recommendations are highlighted.

  4. 75 FR 25887 - Order of Suspension of Trading; In the Matter of Alyn Corp., American HealthChoice, Inc...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-10

    ... Holdings Corp.), American Quantum Cycles, Inc., American Stellar Energy, Inc. (n/k/a Tara Gold Resources... securities of American Quantum Cycles, Inc. because it has not filed any periodic reports since the period...

  5. Increasing access to healthful foods: a qualitative study with residents of low-income communities

    PubMed Central

    2015-01-01

    Background Inadequate access to healthful foods has been identified as a significant barrier to healthful dietary behaviors among individuals who live in low-income communities. The purpose of this study was to gather low-income community members’ opinions about their food purchasing choices and their perceptions of the most effective ways to increase access to healthful foods in their communities. Methods Spanish and English focus groups were conducted in low-income, ethnically-diverse communities. Participants were asked about their knowledge, factors influencing their food purchasing decisions, and their perceptions regarding solutions to increase access to healthful foods. Results A total of 148 people participated in 13 focus groups. The majority of participants were female and ethnically diverse (63% Hispanic, 17% African American, 16% Caucasian, and 4% “other”). More than 75% of the participants reported making less than $1999 USD per month. Participants reported high levels of knowledge and preference for healthful foods. The most important barriers influencing healthful shopping behaviors included high price of healthful food, inadequate geographical access to healthful food, poor quality of available healthful food, and lack of overall quality of the proximate retail stores. Suggested solutions to inadequate access included placement of new chain supermarkets in their communities. Strategies implemented in convenience stores were not seen as effective. Farmers’ markets, with specific stipulations, and community gardens were regarded as beneficial supplementary solutions. Conclusion The results from the focus groups provide important input from a needs assessment perspective from the community, identify gaps in access, and offer potential effective solutions to provide direction for the future. PMID:26222910

  6. Equity of access to maternal health interventions in Brazil and Colombia: a retrospective study.

    PubMed

    De La Torre, Amaila; Nikoloski, Zlatko; Mossialos, Elias

    2018-04-11

    Reducing maternal mortality is a top priority in Latin American countries. Despite the progress in maternal mortality reduction, Brazil and Colombia still lag behind countries at similar levels of development. Using data from the Demographic Health Survey, this study quantified and compared, by means of concentration indices, the socioeconomic-related inequity in access to four key maternal health interventions in Brazil and Colombia. Decomposition analysis of the concentration index was used for two indicators - skilled attendance at birth and postnatal care in Brazil. Coverage levels of the four key maternal health interventions were similar in the two countries. More specifically, we found that coverage of some of the interventions (e.g. ante-natal care and skilled birth assistance) was higher than 90% in both countries. Nevertheless, the concentration index analysis pointed to significant pro-rich inequities in access in all four key interventions in both countries. Interestingly, the analysis showed that Colombia fared slightly better than Brazil in terms of equity in access of the interventions studied. Finally, the decomposition analysis for the presence of a skilled attendant at birth and postnatal care in Brazil underlined the significance of regional disparities, wealth inequalities, inequalities in access to private hospitals, and inequalities in access to private health insurance. There are persistent pro-rich inequities in access to four maternal health interventions in both Brazil and Colombia. The decomposition analysis conducted on Brazilian data suggests the existence of disparities in system capacity and quality of care between the private and the public health services, resulting in inequities of access to maternal health services.

  7. Irksome and Unpopular Duties: Pakistan’s Frontier Corps, Local Security Forces and Counterinsurgency

    DTIC Science & Technology

    2012-05-01

    the Karakorum mountain range in North West Frontier Province (now Khyber Pakhtunkhwa) to the Makran coast in Balochistan . I he Khan <>l Lalpura and...the corps along geographical lines, creating Frontier Corps-North West Frontier Province and Frontier Corps- Balochistan . Pakistan also created...major combat operations, including the Indo-Pakistani wars of 1948, 1965, and 1971. The Frontier Corps fought against separatists in Balochistan in the

  8. Access to medicines by patients of the primary health care in the Brazilian Unified Health System

    PubMed Central

    Álvares, Juliana; Guerra, Augusto Afonso; de Araújo, Vânia Eloisa; Almeida, Alessandra Maciel; Dias, Carolina Zampirolli; Ascef, Bruna de Oliveira; Costa, Ediná Alves; Guibu, Ione Aquemi; Soeiro, Orlando Mario; Leite, Silvana Nair; Karnikowski, Margô Gomes de Oliveira; Costa, Karen Sarmento; Acurcio, Francisco de Assis

    2017-01-01

    ABSTRACT OBJECTIVE To evaluate the access to medicines in primary health care of the Brazilian Unified Health System (SUS), from the patients’ perspective. METHODS This is a cross-sectional study that used data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Services, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), conducted by interviews with 8,591 patients in cities of the five regions of Brazil. Evaluation of access to medicines used concepts proposed by Penshansky and Thomas (1981), according to the dimensions: availability, accessibility, accommodation, acceptability, and affordability. Each dimension was evaluated by its own indicators. RESULTS For the “availability” dimension, 59.8% of patients reported having full access to medicines, without significant difference between regions. For “accessibility,” 60% of patients declared that the basic health unit (UBS) was not far from their house, 83% said it was very easy/easy to get to the UBS, and most patients reported that they go walking (64.5%). For “accommodation,” UBS was evaluated as very good/good for the items “comfort” (74.2%) and “cleanliness” (90.9%), and 70.8% of patients reported that they do not wait to receive their medicines, although the average waiting time was 32.9 minutes. For “acceptability,” 93.1% of patients reported to be served with respect and courtesy by the staff of the dispensing units and 90.5% declared that the units’ service was very good/good. For “affordability,” 13% of patients reported not being able to buy something important to cover expenses with health problems, and 41.8% of participants pointed out the expense with medicines. CONCLUSIONS Results show 70%–90% compliance, which is compatible with developed countries. However, access to medicines remains a challenge, because it is still heavily compromised by the low availability of essential

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

    PubMed

    Shaw, Dorothy; Cook, Rebecca J

    2012-10-01

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

  10. Progress and challenges: implementation and use of health information technology among critical-access hospitals.

    PubMed

    Gabriel, Meghan Hufstader; Jones, Emily B; Samy, Leila; King, Jennifer

    2014-07-01

    Despite major national investments to support the adoption of health information technology (IT), concerns persist that barriers are inhibiting that adoption and the use of advanced health IT capabilities in rural areas in particular. Using a survey of Medicare-certified critical-access hospitals, we examined electronic health record (EHR) adoption, key EHR functionalities, telehealth, and teleradiology, as well as challenges to EHR adoption. In 2013, 89 percent of critical-access hospitals had implemented a full or partial EHR. Adoption of key EHR capabilities varied. Critical-access hospitals that had certain types of technical assistance and resources available to support health IT were more likely to have adopted health IT capabilities and less likely to report significant challenges to EHR implementation and use, compared to other hospitals in the survey. It is important to ensure that the necessary resources and support are available to critical-access hospitals, especially those that operate independently, to assist them in adopting health IT and becoming able to electronically link to the broader health care system. Project HOPE—The People-to-People Health Foundation, Inc.

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

    PubMed

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

    2016-12-01

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

  12. Private health insurance and access to healthcare.

    PubMed

    Duggal, Ravi

    2011-01-01

    The health insurance business in India has seen a growth of over 25% per annum in the last few years with the expansion of the private health insurance sector. The premium incomes of health insurance have crossed the Rs 8,000 crore mark with the share of private companies increasing to over 41%. This is despite the fact that from the perspective of patients, health insurance is not a good deal, especially when they need it most. This raises a number of ethical issues regarding how the health insurance business runs and how medical practice adjusts to it for profiteering. This article uses the personal experience of the author to argue that health insurance in an unregulated environment can only lead to unethical practices, further victimising the patient. Further, publicly financed healthcare which operates in an environment regulating both public and private healthcare provisioning is the only way to assure access to ethical and equitable healthcare to people.

  13. 76 FR 30023 - Pamlico Sound and Adjacent Waters, NC; Danger Zones for Marine Corps Operations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-24

    ... DEPARTMENT OF DEFENSE Corps of Engineers, Department of the Army 33 CFR Part 334 Pamlico Sound and Adjacent Waters, NC; Danger Zones for Marine Corps Operations AGENCY: United States Army Corps of Engineers, DoD. ACTION: Final rule. SUMMARY: The U.S. Army Corps of Engineers is amending its regulations to...

  14. 76 FR 55953 - American Capital Partners Limited, Inc., American Educators Financial Corp. (n/k/a Asia Ventures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-09

    .... (n/k/a PrimEdge, Inc.), Bio-Warm Corp. (n/k/a PHI Gold Corp.), Black Rock Golf Corp. (a/k/a Aurus... concerning the securities of Bio-Warm Corp. (n/k/a PHI Gold Corp.) because it has not filed any periodic...

  15. An analysis of perceived access to health care in Europe: How universal is universal coverage?

    PubMed

    Cylus, Jonathan; Papanicolas, Irene

    2015-09-01

    The objective of this paper is to examine variations in perceptions of access to health care across and within 29 European countries. Using data from the 2008 round of the European Social Survey, we investigate the likelihood of an individual perceiving that they will experience difficulties accessing health care in the next 12 months, should they need it (N=51,835). We find that despite most European countries having mandates for universal health coverage, individuals who are low income, in poor health, lack citizenship in the country where they reside, 20-30 years old, unemployed and/or female have systematically greater odds of feeling unable to access care. Focusing on the role of income, we find that while there is a strong association between low income and perceived access barriers across countries, within many countries, perceptions of difficulties accessing care are not concentrated uniquely among low-income groups. This implies that factors that affect all income groups, such as poor quality care and long waiting times may serve as important barriers to access in these countries. Despite commitments to move towards universal health coverage in Europe, our results suggest that there is still significant heterogeneity among individuals' perceptions of access and important barriers to accessing health care. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  16. The 'price signal' for health care is loud and clear: A cross-sectional study of self-reported access to health care by disadvantaged Australians.

    PubMed

    Paul, Christine; Bonevski, Billie; Twyman, Laura; D'Este, Catherine; Siahpush, Mohammad; Guillaumier, Ashleigh; Bryant, Jamie; Fradgley, Elizabeth; Palazzi, Kerrin

    2016-04-01

    To describe self-reported inability to access health care and factors associated with lack of access among a socioeconomically disadvantaged group. A cross-sectional survey with 906 adult clients of a large community welfare agency in New South Wales. Clients attending the service for emergency assistance completed a touchscreen survey. Inability to access health care in the prior year was reported by more than one-third of the sample (38%), compared to the 5% found for the general population. Dentists (47%), specialists (43%) or GPs (29%) were the least accessible types of health care. The main reason for inability to access health care was cost, accounting for 60% of responses. Almost half (47%) the sample reported delayed or non-use of medicines due to cost. Increasing financial stress was associated with increased inability to access GP or specialist care, medicines and imaging. Higher anxiety scores were associated with inability to access health care, and with cost-related inability to access medicines and imaging. For disadvantaged groups, cost-related barriers to accessing care are prominent and are disproportionately high - particularly regarding dentistry, specialist and GP care. Improvements in health outcomes for disadvantaged groups are likely to require strategies to reduce cost-related barriers to health care. © 2015 Public Health Association of Australia.

  17. [Inequities in access to information and inequities in health].

    PubMed

    Filho, Alberto Pellegrini

    2002-01-01

    This piece presents evidence that inequities in information are an important determinant of health inequities and that eliminating these inequities in access to information, especially by using new information and communication technologies (ICTs), could represent a significant advance in terms of guaranteeing the right to health for all. The piece reviews the most important international scientific research findings on the determinants of the health of populations, emphasizing the role of socioeconomic inequities and of deteriorating social capital as factors that worsen health conditions. It is noteworthy that Latin America has both socioeconomic inequities and major sectors of the population living in poverty. Among the fundamental strategies for overcoming the inequalities and the poverty are greater participation by the poor in civic life and the strengthening of social capital. The contribution that the new ICTs could make to these strategies is analyzed, and the Virtual Health Library (VHL) is discussed. Coordinated by the Latin American and Caribbean Center on Health Sciences Information (BIREME), the VHL is a contribution by the Pan American Health Organization that takes advantage of the potential of ICTs to democratize information and knowledge and consequently promote equity in health. The "digital gap" is discussed as something that can produce inequity itself and also increase other inequities, including ones in health. Prospects are discussed for overcoming this gap, emphasizing the role that governments and international organizations should play in order to expand access to the global public good that information for social development is.

  18. Expanding federal funding to community health centers slows decline in access for low-income adults.

    PubMed

    McMorrow, Stacey; Zuckerman, Stephen

    2014-06-01

    To identify the impact of the Health Center Growth Initiative on access to care for low-income adults. Data on federal funding for health centers are from the Bureau of Primary Health Care's Uniform Data System (2000-2007), and individual-level measures of access and use are derived from the National Health Interview Survey (2001-2008). We estimate person-level models of access and use as a function of individual- and market-level characteristics. By using market-level fixed effects, we identify the effects of health center funding on access using changes within markets over time. We explore effects on low-income adults and further examine how those effects vary by insurance coverage. We calculate health center funding per poor person in a health care market and attach this information to individual observations on the National Health Interview Survey. Health care markets are defined as hospital referral regions. Low-income adults in markets with larger funding increases were more likely to have an office visit and to have a general doctor visit. These results were stronger for uninsured and publicly insured adults. Expansions in federal health center funding had some mitigating effects on the access declines that were generally experienced by low-income adults over this time period. © Health Research and Educational Trust.

  19. Navy Information Dominance Corps: Human Capital Strategy 2012-2017

    DTIC Science & Technology

    2012-01-01

    Information Dominance (ID) is the operational advantage gained from fully integrating information functions, capabilities, resources and people to...and information domains. The human component of ID is the Information Dominance Corps (IDC) and it has three core functions in this mission. First, it...processes, delivery of a Corps-wide learning continuum, and cultivation of an identifiable, inclusive Information Dominance culture and ethos. This

  20. [Accessible health information: a question of age?].

    PubMed

    Loos, E F

    2012-04-01

    Aging and digitalisation are important trends which have their impact on information accessibility. Accessible information about products and services is of crucial importance to ensure that all citizens can participate fully as active members of society. Senior citizens who have difficulties using new media run the risk of exclusion in today's information society. Not all senior citizens, however, encounter problems with new media. Not by a long shot. There is much to be said for 'aged heterogeneity', the concept that individual differences increase as people age. In two explorative qualitative case studies related to accessible health information--an important issue for senior citizens--that were conducted in the Netherlands, variables such as gender, education level and frequency of internet use were therefore included in the research design. In this paper, the most important results of these case studies will be discussed. Attention will be also paid to complementary theories (socialisation, life stages) which could explain differences in information search behaviour when using old or new media.

  1. Uninsured Migrants: Health Insurance Coverage and Access to Care Among Mexican Return Migrants.

    PubMed

    Wassink, Joshua

    2018-01-01

    Despite an expansive body of research on health and access to medical care among Mexican immigrants in the United States, research on return migrants focuses primarily on their labor market mobility and contributions to local development. Motivated by recent scholarship that documents poor mental and physical health among Mexican return migrants, this study investigates return migrants' health insurance coverage and access to medical care. I use descriptive and multivariate techniques to analyze data from the 2009 and 2014 rounds of Mexico's National Survey of Demographic Dynamics (ENADID, combined n=632,678). Analyses reveal a large and persistent gap between recent return migrants and non-migrants, despite rising overall health coverage in Mexico. Multivariate analyses suggest that unemployment among recent arrivals contributes to their lack of insurance. Relative to non-migrants, recently returned migrants rely disproportionately on private clinics, pharmacies, self-medication, or have no regular source of care. Mediation analysis suggests that returnees' high rate of uninsurance contributes to their inadequate access to care. This study reveals limited access to medical care among the growing population of Mexican return migrants, highlighting the need for targeted policies to facilitate successful reintegration and ensure access to vital resources such as health care.

  2. Implementing Patient Access to Electronic Health Records Under HIPAA: Lessons Learned

    PubMed Central

    Wang, Tiffany; Pizziferri, Lisa; Volk, Lynn A; Mikels, Debra A; Grant, Karen G; Wald, Jonathan S; Bates, David W

    2004-01-01

    In 2001, the Institute of Medicine (IOM) and the Health Insurance Portability and Accountability Act (HIPAA) emphasized the need for patients to have greater control over their health information. We describe a Boston healthcare system's approach to providing patients access to their electronic health records (EHRs) via Patient Gateway, a secure, Web-based portal. Implemented in 19 clinic sites to date, Patient Gateway allows patients to access information from their medical charts via the Internet in a secure manner. Since 2002, over 19,000 patients have enrolled in Patient Gateway, more than 125,000 patients have logged into the system, and over 37,000 messages have been sent by patients to their practices. There have been no major security concerns. By providing access to EHR data, secure systems like Patient Gateway allow patients a greater role in their healthcare process, as envisioned by the IOM and HIPAA. PMID:18066391

  3. RAMCO Remodel America Corp.Information Sheet

    EPA Pesticide Factsheets

    RAMCO Remodel America Corp. (the Company) is located in Memphis, Tennessee. The settlement involves renovation activities conducted at a property constructed prior to 1978, located in Memphis, Tennessee.

  4. Health care access for rural youth on equal terms? A mixed methods study protocol in northern Sweden.

    PubMed

    Goicolea, Isabel; Carson, Dean; San Sebastian, Miguel; Christianson, Monica; Wiklund, Maria; Hurtig, Anna-Karin

    2018-01-11

    The purpose of this paper is to propose a protocol for researching the impact of rural youth health service strategies on health care access. There has been no published comprehensive assessment of the effectiveness of youth health strategies in rural areas, and there is no clearly articulated model of how such assessments might be conducted. The protocol described here aims to gather information to; i) Assess rural youth access to health care according to their needs, ii) Identify and understand the strategies developed in rural areas to promote youth access to health care, and iii) Propose actions for further improvement. The protocol is described with particular reference to research being undertaken in the four northernmost counties of Sweden, which contain a widely dispersed and diverse youth population. The protocol proposes qualitative and quantitative methodologies sequentially in four phases. First, to map youth access to health care according to their health care needs, including assessing horizontal equity (equal use of health care for equivalent health needs,) and vertical equity (people with greater health needs should receive more health care than those with lesser needs). Second, a multiple case study design investigates strategies developed across the region (youth clinics, internet applications, public health programs) to improve youth access to health care. Third, qualitative comparative analysis of the 24 rural municipalities in the region identifies the best combination of conditions leading to high youth access to health care. Fourth, a concept mapping study involving rural stakeholders, care providers and youth provides recommended actions to improve rural youth access to health care. The implementation of this research protocol will contribute to 1) generating knowledge that could contribute to strengthening rural youth access to health care, as well as to 2) advancing the application of mixed methods to explore access to health care.

  5. Status Report on Human Corps Activities, 1989. Report 89-9.

    ERIC Educational Resources Information Center

    California State Postsecondary Education Commission, Sacramento.

    This report to the California legislature describes the steps that the university and state university are taking to implement the state-mandated Human Corps programs of volunteer community service by college students. Information is provided on University of California and California State University activities. The Human Corps organization is…

  6. Promoting Adoption and Adaptation. A Handbook for Teacher Corps Projects.

    ERIC Educational Resources Information Center

    Center for New Schools, Inc., Chicago, IL.

    This handbook was designed to assist local Teacher Corps projects to plan and implement the Teacher Corps'"Fourth Outcome:" the adoption or adaptation of the project's educational improvement activities by other educational agencies and institutions. Section I provides an overview of seven scenarios which might be applicable to local…

  7. 75 FR 54116 - Application To Export Electric Energy; Powerex Corp

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-03

    ... DEPARTMENT OF ENERGY [OE Docket No. EA-171-C] Application To Export Electric Energy; Powerex Corp.... SUMMARY: Powerex Corp. (Powerex) has applied to renew its authority to transmit electric energy from the..., 1998, the DOE issued Order No. EA-171 which authorized Powerex to transmit electric energy from the...

  8. 77 FR 67639 - Liberty Energy (Georgia) Corp.; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-13

    ... (Georgia) Corp.; Notice of Application Take notice that on October 25, Liberty Energy (Georgia) Corp..., an application pursuant to section 7(f) of the Natural Gas Act (NGA) requesting the determination of...) such further relief the Commission may deem appropriate, all as more fully set forth in the application...

  9. 20 CFR 670.200 - Who decides where Job Corps centers will be located?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Who decides where Job Corps centers will be... LABOR (CONTINUED) THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Site Selection and Protection and Maintenance of Facilities § 670.200 Who decides where Job Corps centers will be located? (a...

  10. 20 CFR 670.505 - What types of training must Job Corps centers provide?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What types of training must Job Corps centers... Operations § 670.505 What types of training must Job Corps centers provide? (a) Job Corps centers must... necessary for those jobs, and as appropriate, recommend changes in the center's vocational training program...

  11. Progressive segmented health insurance: Colombian health reform and access to health services.

    PubMed

    Ruiz, Fernando; Amaya, Liliana; Venegas, Stella

    2007-01-01

    Equal access for poor populations to health services is a comprehensive objective for any health reform. The Colombian health reform addressed this issue through a segmented progressive social health insurance approach. The strategy was to assure universal coverage expanding the population covered through payroll linked insurance, and implementing a subsidized insurance program for the poorest populations, those not affiliated through formal employment. A prospective study was performed to follow-up health service utilization and out-of-pocket expenses using a cohort design. It was representative of four Colombian cities (Cendex Health Services Use and Expenditure Study, 2001). A four part econometric model was applied. The model related medical service utilization and medication with different socioeconomic, geographic, and risk associated variables. Results showed that subsidized health insurance improves health service utilization and reduces the financial burden for the poorest, as compared to those non-insured. Other social health insurance schemes preserved high utilization with variable out-of-pocket expenditures. Family and age conditions have significant effect on medical service utilization. Geographic variables play a significant role in hospital inpatient service utilization. Both, geographic and income variables also have significant impact on out-of-pocket expenses. Projected utilization rates and a simulation favor a dual policy for two-stage income segmented insurance to progress towards the universal insurance goal. Copyright (c) 2006 John Wiley & Sons, Ltd.

  12. Access and authorisation in a Glocal e-Health Policy context.

    PubMed

    Scott, Richard E; Jennett, Penny; Yeo, Maryann

    2004-03-31

    Challenges to the development of appropriate yet adaptable policy and tools for security of the individual patient electronic health record (EHR) are proving to be significant. Compounding this is the unique capability of e-health to transgress all existing geo-political and other barriers. Initiatives to develop and advance policy, standards, and tools in relation to EHR access control and authorisation management must address this capability. Currently policy development initiatives take place largely in an isolated manner. This jeopardises the potential of e-health because decisions made in one jurisdiction might hamper, even prevent, an e-health opportunity in another. This paper places access and authorisation issues in an overall policy context through describing current Canadian initiatives. The National Initiative for Telehealth (NIFTE) Guidelines project is developing a framework of national guidelines for telehealth. The Policy and Peer Permission (PPP) project is developing a unique tool that provides persistent protection of data. The new corporate body 'Infoway' is developing a pan-Canadian electronic health record solution. Finally, the Glocal e-Health Policy initiative is developing a tool with which to identify and describe the inter-relationships of e-health issues amongst policy levels, themes, and actors.

  13. Future Retention of the Marine Corps Top Performing Aviators

    DTIC Science & Technology

    2016-06-10

    Aviation operations and pilot enabling technologies are increasingly sophisticated and expensive. The result is fewer but more capable aircraft... results and historic WTI population graphs, there is a clear storm on the horizon in regards to the future retention of aviator WTIs. The regression...balance, and Aviator Continuation Pay. 15. SUBJECT TERMS USMC Aviator Retention, USMC Aviation Manpower , Marine Corps Talent Management, Marine Corps

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

    PubMed Central

    2011-01-01

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

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

    PubMed

    Daley, Andrea E; Macdonnell, Judith A

    2011-09-29

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

  16. Internet access and utilization for health information among university students in Islamabad.

    PubMed

    Shaikh, Irshad Ali; Shaikh, Masood Ali; Kamal, Anila; Masood, Sobia

    2008-01-01

    Internet has changed the way we live and work. Advent of this technology has fundamentally transformed our lives the way invention of automobile changed how our lives and cities looked and worked before. Practically no information is available on the use of Internet for health by the people of Pakistan. The Objectives of the study were to assess the access and utilization pattern of Internet by university students in Islamabad, with emphasis on the healthcare information seeking. An anonymous, self-administered, and pre-tested questionnaire with questions on the access, and usage pattern of Internet, seeking health care information online, and belief about reliability of such information; was distributed to only those students who were enrolled in masters or higher degree programs. A total of 600 students were approached and 598 (99.7%) completed the questionnaires. The mean age of students was 23.5 years (range 19-40). The majority of students (423) were enrolled in masters program. Four hundred and sixty-eight students (78.26%) students had access to the computer either at home or at their university hostel. While 304 (50.84%) students had Internet access at home or in their university hostel. Out of 304 students who reported having access to Internet in the past three months, one hundred and thirty-nine (43.4%) students replied affirmatively to the question of having used Internet for seeking health care information. And 109 (78.4%) thought that such information was reliable. Out of 139 students who had used Internet for seeking health information, 35 (25.2%) students replied affirmatively to the question of having discussed health information obtained from Internet with their doctor/physician whom they visited for any illness/treatment. Majority of Islamabad university students in this study had access to computer and Internet. Young and healthy state of this educated age group perhaps accounts for limited use of Internet for seeking healthcare related

  17. ‘More health for the money’: an analytical framework for access to health care through microfinance and savings groups

    PubMed Central

    Saha, Somen

    2014-01-01

    The main contributors to inequities in health relates to widespread poverty. Health cannot be achieved without addressing the social determinants of health, and the answer does not lie in the health sector alone. One of the potential pathways to address vulnerabilities linked to poverty, social exclusion, and empowerment of women is aligning health programmes with empowerment interventions linked to access to capital through microfinance and self-help groups. This paper presents a framework to analyse combined health and financial interventions through microfinance programmes in reducing barriers to access health care. If properly designed and ethically managed such integrated programmes can provide more health for the money spent on health care. PMID:25364028

  18. [Adolescents' access to contraception: perceptions of health workers in Huechuraba, Chile].

    PubMed

    Ramírez, Giovanna Rojas; Bravo, Pamela Eguiguren; Vivaldi, María Isabel Matamala; Manríquez, Irma Palma; Pérez, Thelma Gálvez

    2017-06-08

    Identify difficulties in adolescents' access to contraceptive care and information, based on perceptions and experiences of health workers in Huechuraba, in the Metropolitan Region of Chile. This qualitative, descriptive study incorporated principles of participatory action research, involving health care teams in the survey and data analysis, and generating proposals for improvement. Seventeen (17) semi-structured individual interviews and one group interview were conducted with professionals and technical personnel involved in adolescent care in the commune's health centers. Health workers perceived that adolescents were having difficulties reaching the centers due to cultural factors, lack of information, lack of health activities in the community, while administrative requirements and procedures hindered access to care. Shortcomings were evident in the management and interpretation of fertility regulation standards and of current legislation, and in the absence of explanatory frameworks recognizing adolescents' gender, sexual, and reproductive rights. Adolescents and their needs have a low profile and there are conflicts between theory and practice regarding access to contraception and counseling, with a lack of definitions or agreements that take into account social and cultural contexts. It is urgent to provide health workers with training on gender and sexual and reproductive rights, together with opportunities for reflection in order to generate coordinated and effective approaches. Efforts are required to disseminate the program and organize activities in community spaces, together with other community sectors.

  19. Mental Health and Migration: Depression, Alcohol Abuse, and Access to Health Care among Migrants in Central Asia

    PubMed Central

    Ismayilova, Leyla; Lee, Hae Nim; Shaw, Stacey; El-Bassel, Nabila; Gilbert, Louisa; Terlikbayeva, Assel; Rozental, Yelena

    2014-01-01

    Background One fifth of Kazakhstan’s population is labor migrants working in poor conditions with limited legal rights. This paper examines self-rated health, mental health and access to health care among migrant workers. Methods Using geo-mapping, a random sample of internal and external migrant market workers was selected in Almaty (N=450). We used survey logistic regression adjusted for clustering of workers within stalls. Results Almost half of participants described their health as fair or poor and reported not seeing a doctor when needed, 6.2% had clinical depression and 8.7% met criteria for alcohol abuse. Female external migrants were at higher risk for poor health and underutilization of health services. High mobility was associated with depression among internal migrants and with alcohol abuse among female migrant workers. Conclusions This study demonstrates the urgent need to address health and mental health needs and improve access to health care among labor migrants in Central Asia. PMID:24186359

  20. Mental health and migration: depression, alcohol abuse, and access to health care among migrants in Central Asia.

    PubMed

    Ismayilova, Leyla; Lee, Hae Nim; Shaw, Stacey; El-Bassel, Nabila; Gilbert, Louisa; Terlikbayeva, Assel; Rozental, Yelena

    2014-12-01

    One-fifth of Kazakhstan's population is labor migrants working in poor conditions with limited legal rights. This paper examines self-rated health, mental health and access to health care among migrant workers. Using geo-mapping, a random sample of internal and external migrant market workers was selected in Almaty (N = 450). We used survey logistic regression adjusted for clustering of workers within stalls. Almost half of participants described their health as fair or poor and reported not seeing a doctor when needed, 6.2% had clinical depression and 8.7% met criteria for alcohol abuse. Female external migrants were at higher risk for poor health and underutilization of health services. High mobility was associated with depression among internal migrants and with alcohol abuse among female migrant workers. This study demonstrates the urgent need to address health and mental health needs and improve access to health care among labor migrants in Central Asia.

  1. Access control and privilege management in electronic health record: a systematic literature review.

    PubMed

    Jayabalan, Manoj; O'Daniel, Thomas

    2016-12-01

    This study presents a systematic literature review of access control for electronic health record systems to protect patient's privacy. Articles from 2006 to 2016 were extracted from the ACM Digital Library, IEEE Xplore Digital Library, Science Direct, MEDLINE, and MetaPress using broad eligibility criteria, and chosen for inclusion based on analysis of ISO22600. Cryptographic standards and methods were left outside the scope of this review. Three broad classes of models are being actively investigated and developed: access control for electronic health records, access control for interoperability, and access control for risk analysis. Traditional role-based access control models are extended with spatial, temporal, probabilistic, dynamic, and semantic aspects to capture contextual information and provide granular access control. Maintenance of audit trails and facilities for overriding normal roles to allow full access in emergency cases are common features. Access privilege frameworks utilizing ontology-based knowledge representation for defining the rules have attracted considerable interest, due to the higher level of abstraction that makes it possible to model domain knowledge and validate access requests efficiently.

  2. Understanding observed and unobserved health care access and utilization disparities among US Latino adults.

    PubMed

    Vargas Bustamante, Arturo; Fang, Hai; Rizzo, John A; Ortega, Alexander N

    2009-10-01

    This study hypothesizes that differences in health care access and utilization exist across Latino adults (>18 years), with U.S. Latino adults of Mexican ancestry demonstrating the worst patterns of access and utilization. The analyses use the National Health Interview Survey (NHIS) data from 1999 to 2007 (N = 33,908). The authors first estimate the disparities in health care access and utilization among different categories of Latinos. They also implement Blinder-Oaxaca techniques to decompose disparities into observed and unobserved components, comparing Latinos of Mexican ancestry with non-Mexican Latinos. Latinos of Mexican ancestry consistently demonstrate lower health care access and utilization patterns than non-Mexican Latinos. Health insurance and region of residence were the most important factors that explained observable differences. In contrast, language and citizenship status were relatively unimportant. Although a significant share of these disparities may be explained by observed characteristics, disparities because of unobserved heterogeneity among the different Latino cohorts are also considerable.

  3. Measurement and analysis of inequality of opportunity in access of maternal and child health care in Togo.

    PubMed

    Sanoussi, Yacobou

    2017-12-04

    Access to maternal and child health care in low- and middle-income countries such as Togo is characterized by significant inequalities. Most studies in the Togolese context have examined the total inequality of health and the determinants of individuals' health. Few empirical studies in Togo have focused on inequalities of opportunity in maternal and child health. To fill this gap, we estimated changes in inequality of opportunity in access to maternal and child health services between 1998 and 2013 using data from Togo Demographic and Health Surveys (DHS). We computed the Human Opportunity Index (HOI)-a measure of how individual, household, and geographic characteristics like sex and place of residence can affect individuals' access to services or goods that should be universal-using five indicators of access to healthcare and one composite indicator of access to adequate care for children. The five indicators of access were: birth in a public or private health facility; whether the child had received any vaccinations; access to prenatal care; prenatal care given by qualified staff; and having at least four antenatal visits. We then examined differences across the two years. Between 1998 and 2013, inequality of opportunities decreased for four out of six indicators. However, inequalities increased in access to antenatal care provided by qualified staff (5.9% to 12.5%) and access to adequate care (27.7% to 28.6%). Although inequality of opportunities reduced between 1998 and 2013 for some of the key maternal and child health indicators, the average coverage and access rates underscore the need for sustained efforts to ensure equitable access to primary health care for mothers and children.

  4. Public health assessment for El Toro Marine Corps Air Station, Santa Ana, Orange County, California, Region 9. CERCLIS No. CA6170023208. Final report

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

    Not Available

    El Toro Marine Corps Air Station is in Orange County, California, near the city of Irvine. The Marine Corps established El Toro in 1943, and it currently serves as the center for marine aviation operations on the Pacific Coast. El Toro Marine Corps Air Station was proposed for listing on EPA's National Priorities List (NPL) in 1989 because past operations and disposal practices contaminated local groundwater. Agricultural farm workers and well operators are exposed to contaminants in groundwater through unintentional ingestion of contaminated groundwater, dermal contact with contaminated groundwater, and inhalation of aerosolized groundwater contaminants. Future exposure could occur throughmore » two potable water wells that are located 10 miles downgradient of the contaminant plume. At the current rate of contaminant migration, those wells will be affected in one and a half to five years.« less

  5. U.S. Marine Corps Air Facility, Santa Ana, California hangers no. ...

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

    U.S. Marine Corps Air Facility, Santa Ana, California hangers no. 1&2-building no. 28 &29. Drawing no. PW-66-044 - Marine Corps Air Station Tustin, Northern Lighter Than Air Ship Hangar, Meffett Avenue & Maxfield Street, Tustin, Orange County, CA

  6. U.S. Marine Corps Air Facility, Santa Ana, California hangers no. ...

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

    U.S. Marine Corps Air Facility, Santa Ana, California hangers no. 1&2-building no. 28 &29. Drawing no. PW-66-044 - Marine Corps Air Station Tustin, East of Red Hill Avenue between Edinger Avenue & Barranca Parkway, Tustin, Orange County, CA

  7. Telemental health evaluations enhance access and efficiency in a critical access hospital emergency department.

    PubMed

    Southard, Erik P; Neufeld, Jonathan D; Laws, Stephanie

    2014-07-01

    Mentally ill patients in crisis presenting to critical access hospital emergency rooms often face exorbitant wait times to be evaluated by a trained mental health provider. Patients may be discharged from the hospital before receiving an evaluation or boarded in a hospital bed for observation, reducing quality and increasing costs. This study examined the effectiveness of an emergency telemental health evaluation service implemented in a rural hospital emergency room. Retrospective data collection was implemented to consider patients presenting to the emergency room for 212 days prior to telemedicine interventions and for 184 days after. The study compared measures of time to treatment, length of stay (regardless of inpatient or outpatient status), and door-to-consult time. There were 24 patients seen before telemedicine was implemented and 38 seen using telemedicine. All patients had a mental health evaluation ordered by a physician and completed by a mental health specialist. Significant reductions in all three time measures were observed. Mean and median times to consult were reduced from 16.2 h (standard deviation=13.2 h) and 14.2 h, respectively, to 5.4 h (standard deviation =6.4 h) and 2.6 h. Similar reductions in length of stay and door-to-consult times were observed. By t tests, use of telemedicine was associated with a statistically significant reduction in all three outcome measures. Telemedicine appears to be an effective intervention for mentally ill patients by providing more timely access to mental health evaluations in rural hospital emergency departments.

  8. Feasibility and acceptability of interventions to delay gun access in VA mental health settings.

    PubMed

    Walters, Heather; Kulkarni, Madhur; Forman, Jane; Roeder, Kathryn; Travis, Jamie; Valenstein, Marcia

    2012-01-01

    The majority of VA patient suicides are completed with firearms. Interventions that delay patients' gun access during high-risk periods may reduce suicide, but may not be acceptable to VA stakeholders or may be challenging to implement. Using qualitative methods, stakeholders' perceptions about gun safety and interventions to delay gun access during high-risk periods were explored. Ten focus groups and four individual interviews were conducted with key stakeholders, including VA mental health patients, mental health clinicians, family members and VA facility leaders (N=60). Transcripts were consensus-coded by two independent coders, and structured summaries were developed and reviewed using a consensus process. All stakeholder groups indicated that VA health system providers had a role in increasing patient safety and emphasized the need for providers to address gun access with their at-risk patients. However, VA mental health patients and clinicians reported limited discussion regarding gun access in VA mental health settings during routine care. Most, although not all, patients and clinicians indicated that routine screening for gun access was acceptable, with several noting that it was more acceptable for mental health patients. Most participants suggested that family and friends be involved in reducing gun access, but expressed concerns about potential family member safety. Participants generally found distribution of trigger locks acceptable, but were skeptical about its effectiveness. Involving Veteran Service Organizations or other individuals in temporarily holding guns during high-risk periods was acceptable to many participants but only with numerous caveats. Patients, clinicians and family members consider the VA health system to have a legitimate role in addressing gun safety. Several measures to delay gun access during high-risk periods for suicide were seen as acceptable and feasible if implemented thoughtfully. Published by Elsevier Inc.

  9. [Accessibility and resolution of mental health care: the matrix support experience].

    PubMed

    Quinderé, Paulo Henrique Dias; Jorge, Maria Salete Bessa; Nogueira, Maria Sônia Lima; Costa, Liduina Farias Almeida da; Vasconcelos, Mardenia Gomes Ferreira

    2013-07-01

    Psycho-social Care Centers (PCC) are also designed to coordinate actions in mental health care in Brazil, mainly at Primary Health Care (PHC) level. Matrix support is one of the pillars of the program, as it aims to ensure assistance of specialized back-up staff to the health teams. In this respect, this research seeks to understand how matrix actions in mental health contribute to the accessibility and resolution of mental health cases. This study involved qualitative research conducted in the cities of Fortaleza and Sobral in the State of Ceará, where 37 (thirty-seven) mental health workers, 14 (fourteen) primary health care users and 13 (thirteen) relatives who took part in matrix support actions were interviewed. As the results revealed, the PHC workers do not feel qualified to intervene in mental health cases. There is also excess haste in referring users to PCCs making access to mental health care more difficult. However, it was identified that discussions on mental health in primary care allow the appropriation of cases by PHC workers and promote rapprochement between the teams. In this way, they influence the resolution of mental health cases.

  10. A geographical perspective on access to sexual and reproductive health care for women in rural Africa.

    PubMed

    Yao, Jing; Murray, Alan T; Agadjanian, Victor

    2013-11-01

    Utilization of sexual and reproductive health (SRH) services can significantly impact health outcomes, such as pregnancy and birth, prenatal and neonatal mortality, maternal morbidity and mortality, and vertical transmission of infectious diseases like HIV/AIDS. It has long been recognized that access to SRH services is essential to positive health outcomes, especially in rural areas of developing countries, where long distances as well as poor transportation conditions, can be potential barriers to health care acquisition. Improving accessibility of health services for target populations is therefore critical for specialized healthcare programs. Thus, understanding and evaluation of current access to health care is crucial. Combining spatial information using geographical information system (GIS) with population survey data, this study details a gravity model-based method to measure and evaluate access to SRH services in rural Mozambique, and analyzes potential geographic access to such services, using family planning as an example. Access is found to be a significant factor in reported behavior, superior to traditional distance-based indicators. Spatial disparities in geographic access among different population groups also appear to exist, likely affecting overall program success. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. A geographical perspective on access to sexual and reproductive health care for women in rural Africa

    PubMed Central

    Yao, Jing; Murray, Alan T.; Agadjanian, Victor

    2015-01-01

    Utilization of sexual and reproductive health (SRH) services can significantly impact health outcomes, such as pregnancy and birth, prenatal and neonatal mortality, maternal morbidity and mortality, and vertical transmission of infectious diseases like HIV/AIDS. It has long been recognized that access to SRH services is essential to positive health outcomes, especially in rural areas of developing countries, where long distances as well as poor transportation conditions, can be potential barriers to health care acquisition. Improving accessibility of health services for target populations is therefore critical for specialized healthcare programs. Thus, understanding and evaluation of current access to health care is crucial. Combining spatial information using geographical information system (GIS) with population survey data, this study details a gravity model-based method to measure and evaluate access to SRH services in rural Mozambique, and analyzes potential geographic access to such services, using family planning as an example. Access is found to be a significant factor in reported behavior, superior to traditional distance-based indicators. Spatial disparities in geographic access among different population groups also appear to exist, likely affecting overall program success. PMID:24034952

  12. Job Corps Intergroup Relations Program.

    ERIC Educational Resources Information Center

    Job Corps (DOL), Washington, DC.

    The Job Corps Intergroup Relations Program provides an integrated curriculum involving orientation, residential living, education, and vocational training. These instructional materials for the program provide guidelines and materials emphasizing ethnic contributions in order to improve human relations among ethnic groups and between women and…

  13. Foregone Mental Health Care and Self-Reported Access Barriers among Adolescents

    ERIC Educational Resources Information Center

    Samargia, Luzette A.; Saewyc, Elizabeth M.; Elliott, Barbara A.

    2006-01-01

    Adolescents forego mental health care in spite of self-perceived needs for services; this presents a significant public health problem. Using data from the 2001 Adolescent Health Care Access Survey of 16-year-olds in Saint Louis County, Minnesota, we assessed barriers to mental health care among the 878 respondents who reported ever needing…

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

    PubMed Central

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

    2014-01-01

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

  15. Access to a Car and the Self-Reported Health and Mental Health of People Aged 65 and Older in Northern Ireland.

    PubMed

    Doebler, Stefanie

    2016-05-01

    This article examines relationships between access to a car and the self-reported health and mental health of older people. The analysis is based on a sample of N = 65,601 individuals aged 65 years and older from the Northern Ireland Longitudinal Study linked to 2001 and 2011 census returns. The findings from hierarchical linear and binary logistic multilevel path models indicate that having no access to a car is related to a considerable health and mental health disadvantage particularly for older people who live alone. Rural-urban health and mental health differences are mediated by access to a car. The findings support approaches that emphasize the importance of autonomy and independence for the well-being of older people and indicate that not having access to a car can be a problem for older people not only in rural but also in intermediate and urban areas, if no sufficient alternative forms of mobility are provided. © The Author(s) 2015.

  16. Assessing internet access and use in a medically underserved population: implications for providing enhanced health information services.

    PubMed

    Zach, Lisl; Dalrymple, Prudence W; Rogers, Michelle L; Williver-Farr, Heather

    2012-03-01

    The relationship between health information seeking, patient engagement and health literacy is not well understood. This is especially true in medically underserved populations, which are often viewed as having limited access to health information. To improve communication between an urban health centre and the community it serves, a team of library and information science researchers undertook an assessment of patients' level and methods of access to and use of the Internet. Data were collected in 53 face-to-face anonymous interviews with patients at the centre. Interviews were tape-recorded for referential accuracy, and data were analysed to identify patterns of access and use. Seventy-two percentage of study participants reported having access to the Internet through either computers or cell phones. Barriers to Internet access were predominantly lack of equipment or training rather than lack of interest. Only 21% of those with Internet access reported using the Internet to look for health information. The findings suggest that lack of access to the Internet in itself is not the primary barrier to seeking health information in this population and that the digital divide exists not at the level of information access but rather at the level of information use. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  17. Lack of access and continuity of adult health care: a national population-based survey

    PubMed Central

    Dilélio, Alitéia Santiago; Tomasi, Elaine; Thumé, Elaine; da Silveira, Denise Silva; Siqueira, Fernando Carlos Vinholes; Piccini, Roberto Xavier; Silva, Suele Manjourany; Nunes, Bruno Pereira; Facchini, Luiz Augusto

    2015-01-01

    OBJECTIVE To describe the lack of access and continuity of health care in adults. METHODS A cross-sectional population-based study was performed on a sample of 12,402 adults aged 20 to 59 years in urban areas of 100 municipalities of 23 states in the five Brazilian geopolitical regions. Barriers to the access and continuity of health care and were investigated based on receiving, needing and seeking health care (hospitalization and accident/emergency care in the last 12 months; care provided by a doctor, by other health professional or home care in the last three months). Based on the results obtained by the description of the sample, a projection is provided for adults living in Brazilian urban areas. RESULTS The highest prevalence of lack of access to health services and to provision of care by health professionals was for hospitalization (3.0%), whilst the lowest prevalence was for care provided by a doctor (1.1%). The lack of access to care provided by other health professionals was 2.0%; to accident and emergency services, 2.1%; and to home care, 2.9%. As for prevalences, the greatest absolute lack of access occurred in emergency care (more than 360,000 adults). The main reasons were structural and organizational problems, such as unavailability of hospital beds, of health professionals, of appointments for the type of care needed and charges made for care. CONCLUSIONS The universal right to health care in Brazil has not yet been achieved. These projections can help health care management in scaling the efforts needed to overcome this problem, such as expanding the infrastructure of health services and the workforce. PMID:26061454

  18. Expanding Federal Funding to Community Health Centers Slows Decline in Access for Low-Income Adults

    PubMed Central

    McMorrow, Stacey; Zuckerman, Stephen

    2014-01-01

    Objective To identify the impact of the Health Center Growth Initiative on access to care for low-income adults. Data Sources Data on federal funding for health centers are from the Bureau of Primary Health Care's Uniform Data System (2000–2007), and individual-level measures of access and use are derived from the National Health Interview Survey (2001–2008). Study Design We estimate person-level models of access and use as a function of individual- and market-level characteristics. By using market-level fixed effects, we identify the effects of health center funding on access using changes within markets over time. We explore effects on low-income adults and further examine how those effects vary by insurance coverage. Data Collection We calculate health center funding per poor person in a health care market and attach this information to individual observations on the National Health Interview Survey. Health care markets are defined as hospital referral regions. Principal Findings Low-income adults in markets with larger funding increases were more likely to have an office visit and to have a general doctor visit. These results were stronger for uninsured and publicly insured adults. Conclusions Expansions in federal health center funding had some mitigating effects on the access declines that were generally experienced by low-income adults over this time period. PMID:24344818

  19. Marine Corps Energy: Instilling an Ethos of Energy Efficiency

    DTIC Science & Technology

    2012-03-20

    promulgate this vision and strategy. Of course, as Kotter warns, the vision is never really in threat of being over-communicated. The Marine Corps always...the stages of creating major change John Kotter recommends in Leading Change to determine whether those actions are sufficient to bring about the...Corps against the stages of creating major change John Kotter recommends in Leading Change to determine whether those actions are sufficient to bring

  20. Development and Implementation of an Interactive Uniform Regulations Manual for the United States Marine Corps

    DTIC Science & Technology

    2006-09-01

    IMPLEMENTATION OF AN INTERACTIVE UNIFORM REGULATIONS MANUAL FOR THE UNITED STATES MARINE CORPS by Michael H. Villar Carsten Krause...SUBTITLE: Development and Implementation of an Interactive Uniform Regulations Manual for the United States Marine Corps 6. AUTHOR(S) Michael H. Villar...IMPLEMENTATION OF AN INTERACTIVE UNIFORM REGULATIONS MANUAL FOR THE UNITED STATES MARINE CORPS Michael H. Villar Major, United States Marine Corps B.A